What Happens During a Root Canal?
Root canals have always had a terrible reputation. But they really shouldn't.
Fair and fine, an infected tooth hurts. For some reason, people believe that a root canal is the cause of the pain. The root canal stops the pain. And if you delay it, you're looking at tooth extraction, bone loss, and an expensive implant to replace what you could have saved.
If your dentist has recommended a root canal to you before, here's exactly what will happen and why getting it done quickly matters more than you think.
What Is a Root Canal (And Why You Need One)
Inside a tooth is a soft tissue called the pulp. It contains nerves, blood vessels, and connective tissue. When you're young, the pulp helps your tooth develop. Once your tooth is fully grown, however, it ceases to serve a major purpose, and your tooth can function without it.
But when the pulp gets infected or inflamed, from deep decay, trauma, a crack, or repeated procedures, it causes serious pain. The kind of pain that gave the root canal its bad reputation.
Here's what happens if you ignore it:
The infection won't stay in your tooth. It will spread to the bone around the root. You'll develop a dental abscess. Your face swells. You might get a fever. The infection can become systemic. At that point, extraction is the only option.
A root canal can prevent this. It removes the infected pulp, cleans out the infection, and seals the tooth. The pain and infection will stop, and you get to keep your tooth.
Why You Need Treatment Fast
An infected tooth hurts because the pulp is inflamed and puts pressure on the nerve inside. The pain can be:
- Constant and throbbing
- Sharp when you bite down
- Severe sensitivity to hot or cold
- A dull ache that radiates to your jaw or ear
Some patients hope the pain will go away on its own or that antibiotics will fix the problem. They won't. An infected pulp doesn't heal itself; it only gets worse. Over-the-counter pain medication provides temporary relief, but only removing the infected pulp stops the pain permanently.
If your dentist says you need a root canal, you need it soon, not eventually.
The Root Canal Procedure: Step by Step
Step 1: Examination and X-Rays
Your dentist takes digital X-rays to see inside the tooth. This shows:
- Exactly where the infection is
- How deep does it go
- Whether the infection has spread to the bone
This tells your dentist what they're dealing with and helps them plan the exact procedure.
Step 2: Local Anesthesia
This is the part people worry about.
Your dentist injects local anesthesia around the tooth. It's the same anesthesia used for fillings. You'll feel pressure, but not pain. Within 2-3 minutes, the entire area is numb.
Once it's numb, you might feel vibration or hear sounds, but no pain.
Step 3: Accessing the Infected Pulp
Your dentist creates a small opening in the top of the tooth. This gives access to the pulp chamber where the infected tissue lives.
The opening is small and precise. It's only as big as it needs to be to access and remove the pulp.
Step 4: Removing the Infected Pulp and Cleaning the Canals
Using specialized instruments, your dentist will carefully remove all the infected pulp tissue.
Then comes the critical part: cleaning. Your dentist uses a combination of files and irrigation solution to clean every millimeter inside the tooth. This step can take 15-20 minutes, depending on how curved or calcified the canals are. This removes all bacteria and infection.
Step 5: Filling and Sealing the Tooth
Once your tooth is completely clean, it's filled with a biocompatible material called gutta-percha. It's similar to rubber: flexible, safe, and naturally seals the space inside your tooth. The access opening is then sealed with a permanent filling.
Step 6: Restoring the Tooth With a Crown
A root canal removes the infection, but it also removes what keeps the tooth strong. A crown restores that structural integrity, so you can chew normally without the tooth fracturing.
Most dentists place this on the same day or schedule it for the following week. Either way, don't skip this step. Without a crown, your root canal-treated tooth often fractures or fails within 3-5 years.
Recovery: What to Expect
The good news is, recovery is fast.
You can return to normal activities the very same day. Some patients go back to work immediately. Others rest for a few hours; it's all up to you.
What you might feel:
For 2-3 days, the tooth and surrounding area might feel:
- Tender or sore (especially when chewing)
- Slightly sensitive to pressure
- Mild discomfort similar to a filling
Over-the-counter pain medication (ibuprofen or acetaminophen) handles this. Ice on the outside of the cheek for 15 minutes at a time also helps reduce swelling.
What to avoid:
- Don't chew on the treated tooth until the permanent crown is placed
- Avoid hard, sticky, or crunchy foods for a few days
- Don't skip your follow-up appointment for crown placement
Your dentist will schedule the crown placement typically 1-2 weeks after the root canal.
When to call your dentist:
- Severe pain that doesn't respond to pain medication
- Significant swelling or fever
- The temporary filling comes out
- Any unusual symptoms
What Happens If You Don't Get the Root Canal?
This is the part you need to understand.
Week 1-2: Your pain will get progressively worse. You might develop swelling in your face or jaw. Fever is possible. You won't sleep or eat normally.
Week 3-4: The infection by now has spread to the bone around your tooth. You'll develop a dental abscess (a pocket of infection). At this point, antibiotics might temporarily reduce symptoms, but they won't cure the infection. The tooth will continue to deteriorate.
Month 2+: Your tooth is severely damaged. The bone loss is significant. Extraction is now the only option. You're looking at:
- Extraction
- Bone grafting
- Implant
- Crown for the implant
Compare that to a root canal + crown. Even without definite figures, the math is clear. Get the root canal.
The Bottom Line
A root canal is a straightforward and predictable procedure. Modern techniques make the procedure fast and comfortable, unlike what the rumours have suggested.
If your dentist has recommended a root canal, don't delay. The sooner you treat it, the better the outcome and the faster you're back to normal.
Ready to stop the pain and save your tooth? Schedule your root canal appointment today.