The root canal is by and large the most feared dental procedure and is often touted by popular culture as something unbearably painful. The mere mention of the possibility of a root canal to my patients makes many squirm in their seats. But here’s the reality – this public perception is based on misconceptions and on very outdated information. In fact, thanks to today’s modern technology and anesthesia, root canals are fast, effective, and pain-free.
As a dentist, root canals are one of my favorite procedures to perform because they quickly alleviate some of the worst toothaches on earth. So, let’s get to the bottom of this poorly misunderstood procedure and help you, as the patient, understand why the experience of getting a root canal is really no different than getting a routine filling.
What Is a Root Canal?
To understand what a root canal is, we first need a general understanding of the anatomy of a tooth. While you may have heard of enamel, the hard outer layer of a tooth, the inner layer consists of a softer substance called dentin, and beyond that at the center of the tooth, lies the pulp chamber. This pulp contains blood vessels and nerves – essentially, what keeps a tooth ‘alive.’ These nerves extend downward to the tips of the tooth roots and provide sensation and feeling to the tooth. It is when this pulp is damaged (by cavities or trauma), often resulting in severe pain, that a root canal is needed to remove the infected tissue.
During a root canal, the infected pulp is carefully removed, and the inside of the tooth is cleaned and disinfected. The root canals are then filled and sealed with a biocompatible material to prevent further infection.
Why Do You Need a Root Canal?
While various reasons may cause a tooth’s pulp to become inflamed or infected beyond repair, the following are the most common:
- Deep Decay: If an untreated cavity becomes large enough to reach the pulp, it can result in irreversible inflammation and subsequently, infection.
- Cracked Teeth: Cracked teeth, whether from teeth grinding or biting into hard foods (e.g. popcorn kernels or ice), can expose the pulp to oral bacteria and lead to infection.
- Trauma or Injury: A blow to the tooth, even without visible signs of cracks or damage, can irreversibly harm the pulp.
All above of the above have the potential to progress to abscess (pocket of pus) formation at the base of the tooth root. If these infections are left to fester and go untreated, they can move beyond the tooth and into the surrounding tissue and jawbone. In rare cases, this infection can even enter the blood stream, leading to a life-threatening condition called sepsis where multiple organ systems are impacted and antibiotics are needed.
Thankfully, root canals have the amazing ability to effectively clear infections and abscesses before they spread beyond the tooth to other tissues. Therefore, it’s critical that you seek advice from your dentist about a potential root canal if you experience any of the following symptoms:
- Severe, lingering tooth pain
- Prolonged tooth sensitivity to cold or hot
- Pain when chewing or biting
- Tooth discoloration or darkened tooth
- Swelling in the gums near the tooth
- A pimple-like bump on the gums (signs of an abscess)
While it may be scary for some to take the step to make this appointment, the relief from pain and infection far outweighs putting off treatment.
The Root Canal Procedure: What to Expect
Of course before the root canal begins, whether on the day of the procedure or prior, a consultation with your dentist is needed during which X-rays are taken. Once a treatment plan is formulated, the procedure can start.
1. Numbing the Area
First things first – numb, numb, numb! Local anesthesia is given to the affected tooth and surrounding area to ensure you feel no pain during the procedure.
2. Removing the Infected Pulp
Once you are fully numb, your dentist will create a small opening in the top of your tooth to access the pulp chamber and root canals. Using specialized instruments, your dentist will then carefully remove the inflamed and infected pulp tissue.
3. Cleaning the Root Canals
The empty pulp chamber and root canals are then disinfected and cleaned.
4. Filling and Sealing the Canals
A biocompatible material called gutta-percha is placed and sealed into the canals to prevent future infection.
5. Placing the Restoration
Typically, a temporary filling is placed in the tooth to protect it while it heals. Please note that in most cases you need to return to your dentist for a permanent restoration (usually a crown) on a different day. This restoration will protect the tooth.
How long does the procedure take?
Similar to how the experience of this procedure is akin to getting a filling done for patients, the timeline is no different. A typical root canal takes approximately 60 minutes, although this can vary depending on the tooth.
Post-Procedure Care: Recovery and Aftercare
Root canal recovery is generally pretty straightforward. While you may experience some mild discomfort or sensitivity over the next few days as the tooth heals, this is normal and can often be managed with over-the-counter pain relievers like acetaminophen (Tylenol) and ibuprofen.
Try to avoid hard and crunchy foods over the next few days, or until a final restoration or crown is placed. Fortunately, most people return to their normal activities the very next day.
This may go without saying, but be sure to contact your dentist in the unlikely event that pain persists or is severe, or if any new or worsening symptoms develop.
Frequently Asked Questions (FAQs)
Do they hurt?
Because you are numb during the procedure, you should not feel any pain. Although, I do always tell my patients to expect some minor vibration from the rotating instruments.
Can a root canal fail?
While root canals have a very high long-term success rate, reaching success percentages between 85%-97%, there is always a chance of failure (as is the case with any medical procedure). Your dentist will walk you through these odds during your consultation based on your particular tooth and the size of the infection.
What is the long term effectiveness?
When performed successfully AND followed up with a permanent restoration like a crown, a root canal-treated tooth can last a lifetime.
Are there alternatives to root canals?
When a tooth pulp is infected or irreversibly inflamed, the only two options are a root canal or an extraction. A root canal is the only choice if you want to save the natural tooth. If you opt for an extraction, I recommend replacing the tooth with an implant – here’s why.
How much does a root canal cost?
While the cost of a root canal varies depending on the tooth involved and who performs them (a general dentist or a specialized endodontist), here are some rough estimates based on my personal experience:
- Front teeth (incisors, canines): $600-$1,100
- Premolars: $800-$1,300
- Molars: $1,200-$2,000
Keep in mind that these costs depend greatly on your specific dental insurance as well as your location.
Final Thoughts
Root canals are an extremely common and effective procedure to save teeth that might otherwise need to be extracted. They prevent the spread of infection and relieve some of the worst toothaches known to man.
And, not unimportantly, they are safe and pain-free. In fact, believe or not, I once even had a patient exclaim to me after I finished her root canal – “that was so relaxing!” True story. And while it may not be a trip to the spa (for most people), I can almost guarantee that it won’t be as scary or bad as you think.
So, if you’ve been experiencing the symptoms that I mentioned in this article, or your dentist told you that you need a root canal – don’t hesitate. Scheduling that root canal is one of the best things you can do for your dental, and your overall physical, health.
Have you ever had a root canal? What do you wish others knew about the experience?
~Dr. Lee
Disclaimer: The information provided in this blog post is intended for general informational purposes only and is not a substitute for professional dental advice, diagnosis, or treatment. Always seek the advice of your dentist with any questions you may have regarding your dental health. Never disregard professional advice or delay seeking it because of something you have read on this blog. The content of this blog post reflects the opinions and experiences of the author and should not be used as a basis for medical or dental decisions without consulting your own dentist. Results from dental treatments may vary based on individual circumstances.