The short answer
Less than most people fear. The tooth is numbed first, the inside of the tooth is cleaned out and sealed, and most root canals take one or two visits of about an hour and a half. Many people find it relieves the toothache that brought them in. Expect the tooth to be a little sore for a few days afterward, then come back to us for the crown.
Who does what
We diagnose the tooth and rebuild it afterward. The root canal itself is done by an endodontist, a dentist with extra specialty training who does root canals all day, usually under a surgical microscope. We send along what we found, your X-rays, and the plan for the crown, and the endodontist does their own exam before starting. Why we refer every root canal is explained here.
What happens during the appointment
- Numbing. The tooth and the area around it are numbed with local anesthetic.
- A small protective sheet. A thin sheet called a dental dam goes over the area to isolate the tooth and keep it clean and dry while they work.
- Cleaning out the inside. A small opening is made in the top of the tooth, and very fine instruments clean the inflamed or infected tissue out of the pulp chamber and the root canals.
- An extra cleaning step. Most of the endodontists we work with also use GentleWave or SWEEPS, technologies that activate the cleaning fluid inside the canals to clean them out further.
- Sealing it. Once the canals are cleaned and shaped, they’re filled with a rubber-like material called gutta-percha.
- A temporary filling usually closes the opening until the tooth is rebuilt.
Most root canals are done in one or two appointments, each lasting roughly 90 minutes.
Does it hurt?
The tooth is numb for the treatment, and the endodontists’ own association describes modern root canal treatment as typically painless. It’s usually the toothache before it that hurts, and the treatment is what relieves it.
Afterward
- A few sore days are normal. Most people have mild discomfort for a few days, and in most cases it improves within three to five days. Over-the-counter pain relievers such as ibuprofen or acetaminophen are often enough.
- Go easy on that tooth until it has its crown. The temporary filling is just that, and a back tooth with only a temporary on top can crack.
- Pain that’s getting worse instead of better after a few days, or any new swelling, is a reason to call the endodontist or us.
Then back to us for the crown
A back tooth that’s had a root canal almost always needs a crown, and sooner is better. In one eight-year study, back teeth crowned more than four months after the root canal were more than three times as likely to be pulled later. That’s why we plan the crown before the root canal starts, not after. How we make crowns is here.
Steps, visit length and recovery are from the American Association of Endodontists’ patient guide, “Root Canal Explained.” Crown timing: Pratt I, et al. J Endod. 2016;42(11):1598-1603 (a retrospective single-clinic study showing an association).
The full story: Signs You May Need a Root Canal and Are Root Canals Safe? What the Evidence Says
Chairside Q&A from Douglas Sandquist, DDS, Sandquist Dentistry, Las Vegas. More quick answers.