What a root canal actually involves
A root canal removes the infected nerve from inside a tooth so the tooth can stay. The pain people associate with root canals is the pain that brings them in — the treatment is what ends it. With a numbed tooth and modern instruments, most patients say it felt like a long filling.
When a tooth needs one
- Pain that lingers for more than a few seconds after something hot or cold.
- Pain on biting, or a tooth that feels raised.
- A tooth that has darkened compared with its neighbours.
- A pimple or lump on the gum near the root, which is an infection draining.
- Swelling of the face or jaw — treat this as urgent and call emergency dentistry.
- Nothing at all. Some infected nerves die quietly and are found on an X-ray.
Step by step
- Numbing. Local anaesthetic, and we wait until you genuinely cannot feel the tooth. A hot infection can be harder to numb; there are ways around that, and we use them rather than pressing on.
- Isolating the tooth. A small sheet keeps the tooth dry and clean and keeps solutions out of your mouth.
- Cleaning the canals. A small opening through the top of the tooth, then fine files and irrigation remove the infected tissue from each root canal. This is the part that takes the time.
- Sealing. The cleaned canals are filled with a rubber-like material so bacteria cannot recolonise them.
- Restoring the tooth. Almost always a crown on back teeth. A root-treated tooth is more brittle, and the crown is what stops it splitting later. Skipping it is the most common reason a root canal eventually fails.
Afterwards
Tenderness on biting for a few days is normal — the ligament around the root has been irritated. Over-the-counter pain relief usually covers it, and chewing on the other side for a few days helps. Severe pain, swelling, or the temporary filling coming out are all reasons to call us rather than wait.
Root canal or extraction?
Keeping your own tooth is almost always better, and usually cheaper than the alternative. Once a tooth comes out, the options are a gap, a bridge that requires cutting down two healthy neighbours, or an implant — and the jawbone begins shrinking at the site either way. Extraction is the right call when the tooth is cracked below the bone, when too little structure remains to restore, or when severe gum disease has already loosened it. We will tell you honestly which situation you are in. See tooth extraction.
Does it kill the tooth?
The nerve is removed, so the tooth no longer senses hot and cold. Everything else about it stays: the root, the ligament that holds it, the bone around it and your ability to bite on it. A well-restored root-treated tooth can last decades.
