What to Expect, Step-By-Step & Cost

  1. Looking for a dentist?
  2. Table of contents
  3. Why would a dentist do a root canal in three steps?
  4. About Mark Burhenne, DDS
  5. Why it’s needed
  6. Tooth structure 
  7. When root canal treatment is needed
  8. How root canal treatment is done
  9. Recovering from root canal treatment
  10. Rate your dentist
  11. Preparing for root canal treatment
  12. Removing the pulp
  13. Cleaning and filling the root canal
  14. Sealing and fixing the tooth
  15. Adding a crown
  16. How successful is root canal treatment?
  17. What happens during root canal treatment? Learn more about this quick, comfortable procedure that can relieve your pain and save your natural tooth.
  18. All About Root Canals
  19. Is a root canal painful?
  20. How do you know if you need a root canal?
  21. How long does it take to recover from a root canal?
  22. How much does a root canal cost? 
  23. Recommended Educational Videos on Root Canal Treatment
  24. Root Canal Treatment Step By Step
  25. Root Canal Safety
  26. How does endodontic treatment save the tooth?
  27. What is a root canal?
  28. Get Dr. B’s Dental Health Tips
  29. What is a root canal treatment?
  30. Why would my dentist not use a rubber dam for my root canal?
  31. What are my options for root canal sedation?
  32. Root Canal Cost
  33. Root Canal Alternatives
  34. Root Canal vs. Fillings
  35. Root Canal vs. Regenerative Endodontics
  36. What to Expect During a Root Canal Procedure
  37. Before the Procedure
  38. During the Procedure
  39. Getting a Crown or Filling
  40. Complications of Root Canal Therapy
  41. What is a root canal?
  42. How do you know if you need a root canal?
  43. Do you need a root canal if there’s no pain? 
  44. What to Ask Before Agreeing to Treatment
  45. Can I get a root canal while I’m pregnant?
  46. What root canal irrigants are used to clear the pulp chambers and kill bacteria before the tooth is filled?
  47. Antibiotics & Root Canal Therapy
  48. Are root canals safe?
  49. Root Canal Prevention
  50. What is the root canal procedure like?
  51. Will a root canal give me a blood infection (bacteremia)?
  52. Pain After a Root Canal
  53. Prognosis & Long-Term Outlook
  54. How long can I go before getting a root canal?
  55. Can I eat before a root canal?
  56. Reinforcing the treated tooth with a crown
  57. What are the signs that you need a root canal treatment?
  58. Do root canals cause cancer?
  59. Root Canal Recovery
  60. Pros & Cons of Root Canal Treatment
  61. Final thoughts

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Table of contents

A root canal is a common dental treatment for a tooth with inflamed or infected pulp, usually due to a deep cavity or trauma to the tooth.

Few dental treatments inspire fear like the root canal. But unlike what you might see in the movies, root canal treatment is associated with very little pain. 

On the other hand, root canals do carry some risks. They are often prescribed when another treatment is more appropriate or should be preferred. Biological dentists, in particular, generally avoid this procedure and recommend alternatives.

Below, we discuss exactly what a root canal is, how to know if it’s right for you, what to expect, and other common questions.


Why Would a Root Canal Be Done in Three Stages?
Why Would a Root Canal Be Done in Three Stages?

Why would a dentist do a root canal in three steps?

Kat, I’m sorry you needed a root canal. Whether it takes one visit or three, it’s not an easy thing to sit through.

There is no set schedule or regimen for how long it takes to do a root canal. Years ago, it was typical for the root canal to be done in two visits because if the tooth was filled after having cleaned it out in the same visit, sometimes the tooth would flare up.

Now, due to improved methods and better ways to clean the inside of the tooth, root canals are routinely done in one visit. This is certainly more convenient for the patient as well as for the dentist.

Typically, root canal specialists (known as endodontists) will complete a root canal in one visit. This is certainly more convenient for the patient but it’s also cost-effective. Speed and efficiency translate to lower cost in the long run.

Each tooth is different and the anatomy of each one can vary greatly from the others. This makes some root canals very difficult and makes it necessary for multiple visits to achieve a successful operation.

Some upper first molars, perhaps the most difficult teeth to perform root canals on, can take more than just two visits to completely seal. These teeth can have three to five canals where a lower first premolar will have only one canal. It depends on which tooth you have a root canal on; some are easy and some are more complex in their internal anatomy, hence, require more time. Cost is also usually commensurate with the complexity of the treatment

In regards to your mention of a third visit in order to place pins, I don’t believe that pins are a good thing to place inside of the tooth. They typically lead to a weakening in the structure of the tooth and micro-fractures, and down the road, problems that lead to the loss of the tooth. Using modern composite bonding techniques, it is usually possible to avoid the use of pins. This last step in the root canal is referred to as the “build up,” which is a process that involves restoring the original mass of the tooth so that the dentist can place a crown over the tooth.

To answer your question, this must have been a very difficult root canal to perform. Thankfully, dentists charge by the procedure and not by the hour.

Mark Burhenne DDS

What to Expect, Step-By-Step & Cost

About Mark Burhenne, DDS

I’m on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. You can read my story here. I have been a dentist in private practice for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California.

Root canal treatment (endodontics) is a dental procedure used to treat infection at the centre of a tooth.

Root canal treatment is not painful and can save a tooth that might otherwise have to be removed completely.

Why it’s needed

The infection at the centre of a tooth (the root canal) is caused by bacteria that live in the mouth and invade the tooth.

This can happen after:

  • tooth decay
  • leaky fillings
  • damage to teeth as a result of trauma, such as a fall

Tooth structure 

A tooth is made up of 2 parts. The crown is the top part of the tooth that’s visible in the mouth.

The root extends into the bone of the jaw, anchoring the tooth in position.

Teeth also consist of:

  • enamel – the hard outer coating
  • dentine – a softer material that supports the enamel and forms most of the tooth
  • cementum – a hard material that coats the root’s surface
  • dental pulp – the soft tissue at the centre of the tooth

The root canal system contains the dental pulp and extends from the crown of the tooth to the end of the root.

A single tooth can have more than 1 root canal.

When root canal treatment is needed

Root canal treatment is needed when dental X-rays show that the pulp has been damaged by a bacterial infection.

The pulp may become inflamed if it’s infected by bacteria, allowing the bacteria to multiply and spread.

The symptoms of a pulp infection include:

  • pain when eating or drinking hot or cold food and drink
  • pain when biting or chewing
  • a loose tooth

As the infection progresses, these symptoms often disappear as the pulp dies.

Your tooth then appears to have healed, but the infection has in fact spread through the root canal system.

You eventually get further symptoms such as:

  • pain when biting or chewing returning
  • swelling of the gum near the affected tooth
  • pus oozing from the affected tooth
  • a swollen cheek or jaw
  • the tooth becoming a darker colour

It’s important to see your dentist if you develop toothache. If your tooth is infected, the pulp cannot heal by itself.

Leaving the infected tooth in your mouth may make it worse.

There may also be less chance of the root canal treatment working if the infection within your tooth becomes established.

Antibiotics, a medicine to treat bacterial infections, are not effective in treating root canal infections. They can though help to treat infection that spreads beyond the root and causes swelling.

How root canal treatment is done

To treat the infection in the root canal, the bacteria need to be removed.

This can be done by either:

  • removing the bacteria from the root canal system (root canal treatment)
  • removing the tooth (extraction)

But removing the tooth is not usually recommended as it’s better to keep as many of your natural teeth as possible.

Before having root canal treatment, you’ll usually be given a local anaesthetic.

This means the procedure should be painless and no more unpleasant than having a filling.

After the bacteria have been removed, the root canal is filled and the tooth sealed with a filling or crown.

In most cases the inflamed tissue near the tooth will heal naturally.

Root canal treatment is usually successful. In about 9 out of 10 cases a tooth can survive for up to 10 years after root canal treatment.

Find out how root canal treatment is done

Recovering from root canal treatment

It’s important to look after your teeth when recovering from root canal treatment.

You should avoid biting on hard foods until your treatment is complete.

After your final treatment, your restored tooth should no longer be painful, although it may feel sore for a few days.

You can take over-the-counter painkillers, such as paracetamol or ibuprofen, to relieve any discomfort.

Return to your dentist if you still have pain or swelling after using painkillers.

In most cases it’s possible to prevent the need for further root canal treatment by:

  • keeping your teeth clean
  • not eating too much sugary food
  • giving up smoking if you smoke

Find out how to take care of your teeth and gums

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Page last reviewed: 27 January 2022
Next review due: 27 January 2025

Root canal treatment is carried out by your dentist over 2 or more appointments.

Unless you’re entitled to free NHS dental treatment, you’ll have to pay for root canal treatment.

Read about NHS dental charges and how to get help with dental costs.

If the work is particularly complex, your dentist may refer you to a specialist in root canal treatment, known as an endodontist.

All registered dental specialists in the UK are listed on the General Dental Council (GDC) website.

Preparing for root canal treatment

Before having root canal treatment, your dentist may take a series of X-rays of the affected tooth.

This allows them to build up a clear picture of the root canal and assess the extent of any damage.

Root canal treatment is usually carried out under local anaesthetic, a painkilling medicine that numbs your infected tooth and the gum around it.

In some cases where the tooth has died and is no longer sensitive, it may not be necessary to use a local anaesthetic.

Removing the pulp

Your dentist will place a rubber sheet (dam) around the tooth to ensure it’s dry during treatment.

The dam also prevents you swallowing or breathing in any chemicals the dentist uses.

Your dentist will use a drill to open your tooth through the crown, the flat part at the top, to access the soft tissue at the centre of the tooth (pulp). They’ll then remove any infected pulp that remains. 

If you have a dental abscess, which is a pus-filled swelling, your dentist will be able to drain it at the same time.

Cleaning and filling the root canal

After the pulp has been removed, your dentist will clean and enlarge the root canal.

The root canal is usually very narrow, which makes it difficult to fill.

Your dentist will use a series of small files to enlarge the canals and make them a regular shape so they can be filled.

This part of the treatment may take several hours, and may need to be carried out over a number of visits.

Your front incisor and canine teeth (biting teeth) usually have a single root containing 1 root canal.

The premolars and back molar teeth (chewing teeth) have 2 or 3 roots, each containing either 1 or 2 root canals.

The more roots a tooth has, the longer the treatment will take to complete.

If the treatment needs to be carried out over several sessions, your dentist may put a small amount of medicine in the cleaned canal in between visits to kill any remaining bacteria.

The tooth will then be sealed using a temporary filling.

If you have symptoms from the infection, such as a raised temperature or large swelling, you may be given antibiotics to help manage and prevent further infection.

Sealing and fixing the tooth

At your next visit, the temporary filling and medicine within the tooth is removed and the root canal filling will be inserted.

This, along with a filling, seals the tooth and prevents reinfection.

Root-filled teeth are more likely to break than healthy unrestored teeth, so your dentist may suggest placing a crown on the tooth to protect it.

In some cases a root-filled tooth may darken, particularly if it’s died as a result of injury like a knock to the tooth.

There are several ways your dentist can treat discolouration, such as whitening the tooth using chemicals.

Adding a crown

A crown is a cap that completely covers a real tooth. It might be necessary to use a crown after root canal treatment to prevent the tooth fracturing.

Crowns can be made from:

  • metal or porcelain (or both)
  • a ceramic material
  • powdered glass

The dentist will use a drill to reduce the size of your tooth and use the crown to replace what’s removed.

A mould of your tooth will be taken to ensure the crown is the right shape and size, and fits your tooth accurately.

When fitting the crown, cement will be used to glue the crown to the trimmed-down tooth.

If there’s only a small amount of tooth left after the root canal treatment, a post can be cemented in the root canal and used to help keep the crown in place.

Find out more about what NHS dental fillings and crowns are made of

How successful is root canal treatment?

Root canal treatment is usually successful at saving the tooth and clearing the infection.

Around 9 out of 10 root-treated teeth survive for 8 to 10 years.

Having a crown fitted to the tooth after root canal treatment is important for improving tooth survival rates.

If you keep your teeth clean, your treated tooth should survive for a long time.

The survival of your tooth depends on a number of factors, including:

  • how much of the natural tooth remains
  • how well you keep your teeth clean
  • the biting forces on the tooth

But if an infection does return, the root canal treatment can be repeated.

Or if treatment has already been carried out to a high standard and the infection remains, a small operation to remove the root tip (an apicoectomy) may be carried out to treat the infection.

Page last reviewed: 27 January 2022
Next review due: 27 January 2025

A root canal treatment is a dental procedure to remove inflamed or infected pulp on the inside of the tooth which is then carefully cleaned and disinfected, then filled and sealed. Root canal treatment is designed to eliminate bacteria from the infected root canal, prevent reinfection of the tooth and save the natural tooth.

What happens during root canal treatment? Learn more about this quick, comfortable procedure that can relieve your pain and save your natural tooth.

What to Expect, Step-By-Step & CostThere’s no need to be worried if your dentist or endodontist prescribes a root canal procedure to treat a damaged or diseased tooth. Millions of teeth are treated and saved this way each year, relieving pain and making teeth healthy again.

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Inside your tooth, beneath the white enamel and a hard layer called dentin, is a soft tissue called pulp. This tissue contains blood vessels, nerves and connective tissue, which help grow the root of your tooth during its development. A fully developed tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.

A modern root canal treatment is nothing like those old sayings! It’s very similar to a routine filling and can usually be completed in one or two appointments, depending on the condition of your tooth and your personal circumstances. Getting a root canal is relatively painless and extremely effective. You’ll be back to smiling, biting and chewing with ease in no time.

Saving the natural tooth with root canal treatment has many advantages:

  • Efficient chewing
  • Normal biting force and sensation
  • Natural appearance
  • Protects other teeth from excessive wear or strain

All About Root Canals

A root canal (also known as an endodontic treatment) is a serious procedure, but one that specialists handle every day. Before engaging in any type of dental work, it’s important to know the facts about root canals.

Is a root canal painful?

Since patients are given anesthesia, a root canal isn’t more painful than a regular dental procedure, such as a filling or getting a wisdom tooth removed. However, a root canal is generally a bit sore or numb after the procedure, and can even cause mild discomfort for a few days.

How do you know if you need a root canal?

Root canals are needed for a cracked tooth from injury or genetics, a deep cavity, or issues from a previous filling. Patients generally need a root canal when they notice their teeth are sensitive, particularly to hot and cold sensations. 

There are a few symptoms that mean you might need a root canal-

  • Severe pain while chewing or biting
  • Pimples on the gums
  • A chipped or cracked tooth
  • Lingering sensitivity to hot or cold, even after the sensation has been removed
  • Swollen or tender gums
  • Deep decay or darkening of the gums

How long does it take to recover from a root canal?

How much does a root canal cost? 

The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat; the fee is usually more. Most dental insurance policies provide some coverage for endodontic treatment.

Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with an implant or bridge to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration.

Root Canal Treatment Step By Step

Need a root canal? Don’t be anxious. This informative video will walk you step-by-step through the procedure and explain how endodontists, the root canal specialists, can save your teeth.

Root Canal Safety

Concerned about the safety of root canal treatment? Watch this informative video to learn how endodontists perform millions of root canal treatments every year, safely, effectively and comfortably.

How does endodontic treatment save the tooth?

What to Expect, Step-By-Step & CostIt’s necessary to have endodontic or root canal treatment when the inside of your tooth (the pulp) becomes inflamed or infected as a result of deep decay, repeated dental procedures, faulty crowns or a crack or chip in the tooth. Trauma to your tooth may also cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, in can cause pain or lead to an abscess.

When you undergo a root canal or other endodontic treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. Afterwards, the tooth is restored with a crown or filling for protection and will continue to function like any other tooth.

Endodontic treatment helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last a lifetime.

View endodontic treatment information in French, Japanese, Portuguese or Spanish.


What is a root canal?

Root canal therapy is a type of dental procedure used to preserve a tooth after the pulp of the tooth has become inflamed or infected. This is typically caused by a deep cavity or physical trauma to the face or teeth.

Dental pulp is the soft tissue found inside the tooth containing connective tissue, nerves, and blood vessels.

During a root canal, a dentist or endodontist will clean out the infected tissue from your pulp chamber, then disinfect, fill, and seal the tooth. In most cases, a crown will be placed on top of the tooth structure to prevent cracking or chipping.

root canal procedure, root canal illustration, what to expect during a root canal

A root canal procedure allows your dentist to preserve (not save) an infected tooth by removing infected tissue and sealing it. 

Root canal procedures may also be referred to as:

  • Root canals
  • Endodontic treatment
  • Root canal therapy
  • Root canal treatment

Root canals are an appropriate treatment for a tooth with irreversible pulpitis. 

Pulpitis, or inflammation of the tooth pulp, can be reversible or irreversible. Once the nerve tissue has died as the pulp’s infection has spread, irreversible pulpitis results.

At that point, a tooth cannot be saved as a living structure.

tooth anatomy, inside of a tooth, outside of a tooth, tooth diagram

A root canal procedure can “preserve” a tooth, but not “save” it. 

By the time you need a root canal, it’s too late to save the life of the tooth because it’s already infected and dying. 

Some people refer to this as “mummifying” a dead tooth.

Preserving tooth structure benefits your oral health because it won’t affect orthodontic growth or your bite. If your dentist extracts a diseased tooth without filling its space with an implant, your teeth may shift and cause orthodontic problems.

The most common risk of root canal treatment is tooth fracture. The inside of the tooth has been scraped out, leaving the outer shell of the tooth dry, brittle, and prone to breakage.

That’s why a root canal procedure almost always requires a second procedure shortly afterward: a dental crown. A root canaled tooth needs the protection of a crown because you’ve carved out the tissue inside it.

A dental crown is a rigid covering, formed to look like a natural tooth, that is stronger than enamel. It preserves the structural integrity of the tooth and reduces the risk that it will break as it weakens over time.

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What to Expect, Step-By-Step & Cost

What is a root canal treatment?

Root canal treatment is a dental procedure which is performed to save an infected tooth from extraction. If your dentist has recommended a root canal treatment for one of your teeth, then here’s everything that you need to know about this procedure.

Root canal treatment is usually required in cases where the nervous tissue of the teeth, the dental pulp, becomes irreversibly inflamed or infected.

Why would my dentist not use a rubber dam for my root canal?

Rubber dams during root canal are controversial for patients with TMJ pain.

With a temporomandibular joint disorder (TMD), keeping your mouth open with a dental dam for up to 90 minutes during a root canal can cause significant discomfort. Some patients have TMJ pain for 6-8 weeks after the procedure.

In these cases, dentists may forego the use of a rubber dam or divide an appointment into multiple shorter sessions. Talk to your dentist about these options if you have TMD problems.

What are my options for root canal sedation?

Root canal therapy does not require sedation. However, if you want or need to be sedated for a root canal due to dental anxiety, there are 3 options:

  1. Minimal sedation: Your dentist can use nitrous oxide to ease your fear. You may also be given a mild oral sedative about an hour before your procedure. You’ll be awake during treatment but mostly unconcerned with the sounds or sensations. The effects will wear off shortly after the procedure and you should still be able to drive home.
  2. Moderate sedation: Formerly dubbed “conscious sedation”, this kind of sedation can be achieved with higher doses of an oral sedative like Valium or through an IV. You may be groggy enough to sleep during the procedure but will be easy to wake up.
  3. Deep sedation/general anesthesia: Deep sedation puts you completely “to sleep” and you can’t be easily awakened. You will probably have no memory of the procedure or the period of time shortly after you wake up. This level of sedation requires an additional two-year certification for a dentist or the use of an in-house anesthesiologist. You’ll need someone to drive you home after undergoing deep sedation.

Root Canal Cost

Before dental insurance, a root canal procedure in the United States costs anywhere from $500-$2,250. A crown after root canal ranges from $600-$2,500, depending on the material.

When performed by a general dentist, a root canal for a front tooth will cost between $500-$1,000. Molars (back teeth) cost between $1,000-$1,500 with a general dentist. Endodontists (root canal specialists) usually charge about 50% more for a root canal procedure.

A high-quality cubic zirconia (new porcelain) crown costs around $1,300, while a gold crown — which lasts longer than any other material — runs about $2,500.

Your total cost may be as little as $1,100 and as much as $4,750 for a single root canal and crown.

The cost of your treatment will also differ depending on where you live. In general, a higher cost of living will mean a higher cost for dental treatment.

How much are root canals with insurance? Root canals are almost always covered by dental insurance but the rate of coverage differs by plan. In addition, your coverage probably applies only after you’ve met your yearly deductible. 

Many traditional plans cover root canals at 80% and crowns at 50% of the billed cost. However, check your insurance plan and talk to your insurance company before treatment to be sure.

And remember: Most dental plans cap yearly coverage amounts at $1,500 or less. You may be responsible for a higher percentage of the cost than you initially expect if your dental plan reaches its cap.

Are root canals worth the cost? Root canals are often worth the cost because they have a high success rate and cost less than high-quality alternatives. The price tag for extraction with a dental implant, for instance, is significantly higher than a root canal and crown (potentially 2-3 times more).

Root Canal Alternatives

There are risks to root canal therapy, which is one reason why many functional dentists may not frequently prescribe this dental treatment. 

Depending on what kind of specialist you talk to, their recommendation for treatment may be different. Oral surgeons often prescribe an extraction with an implant, while an endodontist is more likely to recommend a root canal.

Depending on your case, there are 3 possible alternatives to root canal treatment:

  1. Dental fillings
  2. Extraction with dental restoration (implant, bridge, or dentures)
  3. Regenerative endodontics

Root Canal vs. Fillings

For cavities that have not caused irreversible pulpitis, a large filling may be a better option than a root canal. A filling allows you to retain a living tooth, which will be more resistant to new cavities and fracture than an endodontically treated tooth. 

Fillings are not an option once the tooth pulp has become irreversibly inflamed or died.

Why would a dentist recommend a root canal instead of a filling for a tooth with reversible pulpitis? Each practitioner has preferences for treatment protocols. Many dentists turn to root canal when a filling could work for a few basic reasons:

  • Large fillings require great technique. Some providers aren’t confident in their ability to successfully complete this treatment, particularly if the top of the tooth must be made very thin to place the filling. This could potentially lead to the need for follow-up dental work.
  • Irreversible pulpitis is difficult to diagnose. As explained, determining if a patient has reversible or irreversible pulpitis is not always straightforward. If a dentist is unsure, he or she may opt for the treatment most likely to be successful in either case — a root canal.
  • Root canals cost more. The vast majority of dentists I know are excellent providers who care about their patients. However, a dental practice is a business, and it’s more profitable to bill for a root canal than a filling. Root canals are almost always covered by dental insurance, so there’s little chance that the insurance company will refuse to pay.

If you’re not confident in the prescription of a root canal and believe a filling would be better, consider getting a second opinion to be sure.

Restorations that can be done after an extraction include:

  • Dental implant
  • Dental bridge
  • Dentures

A dental implant is the preferred option if you decide against a root canal, as it is less likely to lead to bone loss or gum problems than dentures. It’s a highly effective procedure and the implant allows for natural chewing and aesthetics.

Both a root canal and extraction with a dental implant have the same probability of long-term success. Dentists make treatment decisions in these cases based on factors like cost-benefit ratio, patient preference, systemic health issues, and the probability of root canal success.

After extraction of multiple side-by-side teeth, your dentist may suggest a bridge connected by implants on either side.

If you are missing a large number of teeth and are on a limited budget, you may opt for dentures instead of multiple dental implants and/or a bridge.

Root Canal vs. Regenerative Endodontics

Regenerative endodontics is a relatively new method of endodontic treatment to restore inflamed dental pulp. 

First introduced in 2004, this practice involves irrigating and disinfecting root canals of a tooth with pulpitis but not removing the infected pulp. Then, the tooth is agitated to cause bleeding at the apex of the tooth roots.

This bleeding provides the inflamed pulp of the tooth with a large number of mesenchymal stem cells (MSCs) that may heal the root of the tooth. Other stem cells may be manually injected into the tooth root.

Regenerative endodontic therapy may be successful in 91% of cases at reversing pulpal inflammation. In some cases, treatment is effective even when the pulp has initially been diagnosed with irreversible pulpitis.

This may not be the best option for many people because:

  • The field of regenerative endodontics is relatively new and untested
  • The procedure itself requires an extensive amount of perfected technique
  • It may not be easy to find a provider near you
  • This procedure is less likely to be covered by dental insurance
  • As a more experimental procedure, regenerative endodontics may be prohibitively expensive

However, this could be the future of what we currently know as root canal therapy.

What to Expect During a Root Canal Procedure

A root canal procedure can be done in 1 or 2 visits. For retreatments (in which a tooth has already received endodontic treatment), 3 visits may be requested. Each visit should take 90 minutes or less.

How long does a root canal take? A root canal procedure takes 30-90 minutes per visit. For simple cases of teeth with one root, each visit will probably 60 minutes or less. Complex cases take closer to 90 minutes per visit.

Should your root canal be done by your dentist or a specialist? Specialists in root canal therapy are called endodontists. An endodontist should perform your root canal procedure if you have complex canals or if your general dentist refers out root canal cases. However, all dentists are trained to perform root canals during dental school.

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Before the Procedure

Before your root canal procedure, your dentist will probably take x-rays or a cone-beam CT (CBCT) and perform a physical exam to identify irreversible pulpitis.

Your dentist may prescribe antibiotics before the procedure if:

  • You are immune-compromised
  • You have an existing tooth abscess
  • You present with a fever
  • Your infection had a rapid onset
  • You have developed a system-wide infection
root canal procedure, picture during root canal

During the Procedure

This is how a root canal procedure is performed, step-by-step:

  1. X-rays and exam: The dentist or endodontist will take a new set of x-rays and perform another physical exam. Many x-rays will be taken to make sure that the instruments are in the correct location to remove the infected tissue.
  2. Numbing: You will receive full local anesthesia to numb the tooth and surrounding area. This local anesthetic is more than what’s required for a filling because your dentist must remove the nerve. Your dentist will typically not put you under sedation (to sleep) for a root canal, but you can request sedation if you’re anxious.
  3. Rubber dam: A sheet of latex, called a rubber dam, will be placed over your mouth. This prevents bacteria from the rest of your mouth from entering the tooth. The dental dam also stops medications inside the tooth from being swallowed.
  4. Opening: An opening will be drilled into the top of your tooth.
  5. Cleaning and shaping: Using very refined drills and files, your dentist will remove the inflamed or infected pulp, carefully cleaning out and shaping the inside of the tooth. 
  6. Irrigation: The main pulp chambers will be irrigated with water and, in most cases, an antibacterial agent to eliminate any remaining bacteria. These chambers must be fully dry before moving on to the next step.
  7. Filling: Next, the dentist will fill and seal the tooth so it’s closed off to infection. The tooth is filled with gutta-percha, a biocompatible filling material, combined with rubber cement. A temporary filling will be placed until you get a permanent crown.

Do root canals hurt? Root canals do not hurt at all during the procedure. If the dentist is skilled at delivering the local anesthesia, you won’t feel a thing. There may be minor pain and soreness as you recover.

root canal before and after, root canal procedure, root canal steps
Root Canal Procedure: Before and After

Sometimes, a dentist will begin the root canal and things go wrong — this can be a good thing!

If your dentist gets inside the tooth and is presented with new information that changes the chances of success of a root canal, he will stop to tell you. This gives you the choice to abort the procedure before proceeding with a root canal with lower chances of success than you both originally thought.

Reasons to stop a root canal include:

  • Separated instrument: An instrument breaks off inside the tooth.
  • Calcified root canal: If the root canal is calcified, your dentist won’t be able to negotiate it well. In these cases, endodontic surgery like an apicoectomy may be required.
  • Fracture: Once the tooth is opened, your dentist might see a fracture not visible on the x-ray. Seepage can occur at the fracture line, which can lead to bone loss. If you lose bone around the tooth, you lose the support of the tooth. In these cases, an extraction with a dental implant will offer a much better prognosis.
  • Curved root: Also called “complex canal morphology,” this kind of tooth root is hard to navigate. Complex root canal anatomy — lots of hard-to-navigate twists and turns — reduce the potential success rate.

Your dentist should only do the root canal if conditions are ideal.

You can still drive home if you’ve been given only local anesthesia.

Getting a Crown or Filling

After your root canal treatment is complete, you’ll need to go back to your dentist for a crown or a filling. Crowns or fillings should be placed within 1-4 weeks after a root canal.

Do you need a crown after a root canal? If you have a root canal done on a molar or pre-molar (your back chewing teeth), you need a crown after root canal treatment. Most incisors and canines (front teeth) do not require a crown.

Some people wait to get a crown so that they don’t max out their insurance, but this can be a dangerous risk. If the tooth fractures before a crown is placed, you lose the investment of the root canal entirely.

In some cases, your dentist will recommend only a filling to protect the tooth.

  • Better success rate: Your root canal treatment is more likely to last without repeated treatment if a crown is placed on a molar or premolar. Root canal without crown is 6 times more likely to fail, according to one study over an 11-year period. Another study found that a root canaled tooth without a crown has a 63% chance of failure within 5 years.
  • Reduced chance of fracture: Without a dental crown, your tooth may become more susceptible to fracture over time. This is because the “mummified” tooth will become brittle as it no longer receives blood flow.
  • Natural-looking tooth: You can get a crown to match the color of your remaining teeth to hide discoloration and appear just like a natural tooth.
  • Lower risk of infection: A crown covers the inside of the treated tooth to prevent most bacteria from getting in, which could otherwise cause a new infection and require retreatment.

The procedure for placing a crown is done in these steps:

  1. The tooth is filed down to remove the outer layer.
  2. Impressions are taken of the new tooth shape. For in-office crowns, your dentist will take an optical impression.
  3. The impressions are sent to a lab or used to create a crown in-office.
  4. If your dentist doesn’t have the equipment to make a same-day crown, a temporary crown will be placed and you’ll wait several days while the crown is being manufactured.
  5. The crown is placed on your tooth and secured by mechanical retention. Dental cement is used to prevent saliva or any other substance from getting under the crown.

Complications of Root Canal Therapy

Potential complications of a root canal (not including those related to anesthesia) include:

  • Reinfection: A cyst or bone infection can occur years after root canal treatment, most often from a badly done procedure. Underfilling and/or not properly disinfecting the canals, as well as the presence of a broken instrument, make this outcome more likely.
  • Partial root filling: It’s possible for a dentist not to completely fill the tooth root(s) during a root canal procedure, particularly if you have a complex canal structure. This may require retreatment and should be done by an endodontist.
  • Canal or tooth crown perforation: If a dentist perforates (creates a hole) in the root canals or in the crown of your tooth, you’ll probably need to have the tooth extracted.
  • Instrument breakage: During 2.7-3.7% of root canals, an instrument breaks during treatment. Your dental provider should inform you if this occurs and let you choose whether or not to have them remove the broken piece. Even if the piece remains, this may or may not impact the success of your root canal treatment.
  • Overfilling the canal: If the canals were overfilled and the tooth is near the sinus cavity or nerve canal, this may cause post-operative pain. The pain may subside without further treatment. However, the excess filling material may need to be removed if it causes bone inflammation or significant pain, or is near the mandibular nerve or maxillary sinus.
  • Discoloration: Darkening tooth color is usually a sign of blood or a poorly done root canal. This complication can often be avoided by the use of a rubber dam, magnification device, and clean instruments.
  • Sinus drainage: It’s possible to have drainage and sinus pain after a root canal. You may notice it tastes or smells like the antibacterial solution used to disinfect your tooth during the procedure. Most likely, this occurs if the space left behind after a large abscess allowed passage of the solution into your sinus cavity. This is probably not dangerous and should go away after a short period of time. However, if you experience sudden, severe pain or any facial swelling, contact your dentist right away.

The main concern of root canal therapy is that they are never 100% clean, meaning there is always bacteria left behind in the auxiliary canals off the main root canals. 

This is true for every single root canal procedure, but the quality of treatment has a major impact on this. As a study in the Journal of the American Dental Association puts it:

“Endodontic procedural errors are not the direct cause of treatment failure; rather, the presence of pathogens in the incompletely treated or untreated root canal system is the primary cause of periradicular pathosis.”

In other words, a badly done root canal is far more likely to fail and cause problems in the future. 

I recommend all patients get a cone-beam CT (CBCT) every 3-5 years after root canal therapy to properly check for lesions or other signs of root canal failure. CBCT is a far more reliable method to recognize failure than a traditional x-ray.

Lesions and reinfection can occur with or without pain, so don’t rely on symptoms to determine whether or not your root canal was successful.

What is a root canal?

Although our teeth are protected on the outside by a hard layer known as the enamel, their interior is hollow and filled with a soft, nervous tissue known as the dental pulp. The hollow region inside each tooth root is shaped like a canal, and is hence named as the root canal. The front teeth usually have a single root canal, while the molars and the premolars tend to have multiple root canals.

How do you know if you need a root canal?

What causes the need for root canal treatment? Irreversible pulpitis (infection and inflammation of dental pulp) is what caused the need for a root canal or similar treatment option. This is usually caused by a deep cavity or injury/trauma to the tooth.

Irreversible pulpitis cannot be healed or reversed by any natural or conventional means.

In the case of tooth decay, you may be able to catch pulpitis before it becomes irreversible. To increase your chances of catching it early, practice good dental care, don’t skip dental checkups, and talk to your dentist anytime you develop a toothache.

Signs you need a root canal may include:

  • Tooth pain: Pulpitis will cause pain that may be persistent or come and go. It may be worse when you eat or bite down. Lingering pain, or pain caused by hot or cold stimuli that remains for several minutes or hours, is a telltale sign of irreversible pulpitis and the need for a root canal. Positional pain that occurs when you stand up, lay down, or run in place, may indicate a tooth abscess and a root canal. Spontaneous pain that happens without warning may also indicate an inflamed pulp. It’s possible for pulpitis to cause referred tooth pain that manifests in other teeth or your ear, face, or jaw.
  • Bump on the gum (fistula): A fistula is a small white, yellow, or red pimple-like bump that appears on the gum. This tells your dentist that there is an infection because pus, blood, and infectious materials are trying to get out and the body is trying to “vent” them. The problem is that a fistula can mislead a dentist as to which tooth needs a root canal — it doesn’t always appear next to the infected tooth.
  • Swollen gums: As an infected tooth tries to “vent” the toxic results of infection, it may also cause gums to swell, redden, and become tender. 
  • Color change of the tooth or gums: A dead or dying tooth may turn grayish over time as its blood supply diminishes. This is more likely to be noticeable on a front tooth than a back one. The infection can also darken the gums around the tooth.
  • Loosening tooth: As infection spreads, it may soften or degrade the bone in which the tooth sits. This can cause your tooth to become more mobile, wiggling upon contact.
  • Cracked tooth: If your tooth has a crack that extends down into the tooth root, it is usually impossible to save the tooth and it must be treated with a root canal or an alternative treatment option.
  • Deep cavity: A cavity can cause many of the signs above, such as pain. Your dentist may use x-rays or a cone-beam CT (CBCT) to diagnose the extent of your tooth decay.
  • Tooth abscess: Also known as a periapical abscess, this pus-filled infectious area beneath the tooth root occurs as a result of irreversible pulpitis, often due to an untreated cavity. This is not the same thing as a periodontal (gum) abscess, which may not suggest the need for a root canal.
  • Dark blood from the pulp: When your dentist opens your toot for a root canal, he or she may be able to identify irreversible pulpitis from visibly darker blood than usual. 
  • Red-yellow pus: Not all inflamed teeth bleed. Often, a sure sign of irreversible pulpitis upon opening the tooth is oozing, reddish-yellow pus.

Diagnosing a root canal is a complex process that differs between dentists. There is no cut-and-dry way to diagnose a root canal. This process is part science, part art form, to discover the degree of infection within a tooth.

Do you need a root canal if there’s no pain? 

If your dentist identifies irreversible pulpitis, you will need a root canal regardless of whether or not pain is present. 

Your tooth nerve may die, temporarily relieving pain. Your dentist may put you on antibiotics that shrink the infection, which would also cause pain to subside. 

However, irreversible pulpitis must be treated by root canal or extraction. Otherwise, it can cause serious systemic health issues.

What to Ask Before Agreeing to Treatment

In my practice, I’ve met many patients who were prescribed root canal therapy because a practitioner was in a hurry or looking for the “simplest” option, rather than the best option.

For instance, a dentist may suggest a root canal for a large cavity even if the pulp is not irreversibly inflamed and a filling would suffice. 

Dental insurance covers it, the general dentist doesn’t have to place a filling that requires more-than-average finesse, and — I hate to say it, but it’s true — the price tag is higher.

  • Is a root canal absolutely necessary?
  • Is it possible the tooth will recover and not need the root canal?
  • How did you come to the conclusion that I have irreversible pulpitis?
  • Why did the pulp die?
  • What if I don’t do the root canal?
  • Should I skip the root canal and go right to the extraction and implant?
  • Will my infection spread to other teeth or to my bone?
  • How confident are you that a root canal will be successful?
  • Should I have this done by a specialist or can you do as good of a job as a specialist can?

In general, many root canal symptoms can often be attributed to causes other than irreversible pulpitis. Until your dentist or endodontist is fairly certain that irreversible pulpitis is to blame, root canal treatment should not be prescribed

Can I get a root canal while I’m pregnant?

Available evidence suggests that root canal treatment is safe during pregnancy, particularly between weeks 13-21 of gestation. This treatment is associated with no significant increase in serious medical issues or adverse pregnancy outcomes.

The American Pregnancy Association emphasizes that, while root canals are considered safe while pregnant, it’s important to consider the risks of sedation, antibiotics, and x-rays that may be involved.

A single x-ray should not pose a risk to you or your baby. If possible, request a lower level of local anesthesia and skip other sedation. You should only take antibiotics if your dentist feels this is the only safe option, as antibiotics can affect fetal health.

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What root canal irrigants are used to clear the pulp chambers and kill bacteria before the tooth is filled?

Root canal irrigants include:

  • Ozone 
  • Sodium hypochlorite (NaClO)
  • Chlorhexidine
  • Calcium hydroxide [Ca(OH)2]

Integrative endodontic treatment is partial to ozone treatment. More than any other bactericidal solution, ozone may effectively eliminate a significant amount of bacteria in the small canals off the main pulp chamber. 

There is also no risk of antibiotic resistance with ozone, unlike other alternatives, which could lead to stronger bacterial strains. Ozone may also be used on its own or with other antimicrobial agents.

More recently, the use of antimicrobial photodynamic therapy (aPDT) has been studied as an adjunct (add-on) to these agents. aPDT can result in a significant reduction of bacteria within the pulp chamber.

Antibiotics & Root Canal Therapy

Antibiotics have been part of the standard of care for root canals for many decades. However, more recent research shows they are frequently unneeded and may contribute to antibiotic resistance.

Dentists frequently prescribe antibiotics before and after endodontic treatment for reduced chance of systemic infection, reduced pain, increased success rates, and a variety of other reasons. 

The problem is that antibiotics actually have no significant impact on root canal outcomes in almost any case.

One review of antibiotic use for root canals found that dentists are most likely to prescribe antibiotics for root canals due to the placebo effect and a lack of education, not a clinical need.

A 2016 review by the American Dental Association (ADA) found that the only legitimate reasons for antibiotics before or after a root canal were a present systemic infection, fever, or both.

  • Systemic infection caused by a tooth abscess
  • Tooth abscess in an immune-compromised patient
  • Rapid onset infection with outward symptoms in 24 hours or fewer
  • Replantation of a tooth that has been knocked out (avulsed) due to trauma
  • Trauma to the soft tissue of the mouth that requires treatment

Are root canals safe?

Root canals are safe for most people but may cause problems over time. To watch for root canal failure, get a cone-beam CT (CBCT) every 3-5 years after endodontic treatment to check for failure.

Major organizations, like the American Dental Association (ADA) and American Association of Endodontists (AAE), speak highly of the benefits of root canals. According to both the ADA and AAE, root canals pose no major danger whatsoever.

Other groups, including the International Association of Biological Dental Medicine (IABDM), do not recommend root canal therapy. 

The Root Cause documentary and some alternative dental practitioners present root canals as extremely dangerous. Their theories often cite root canal treatment as a hidden cause of any number of systemic, chronic diseases.

However, if you are at a high risk of root canal failure due to compromised immunity or other factors, you may want to opt for an alternative treatment.

Root Canal Prevention

Preventing the need for root canal therapy involves reducing your risk of untreated tooth decay and trauma to your teeth.

To reduce your risk of tooth decay:

  • Practice good oral hygiene (flossing, brushing, oil pulling, etc.)
  • Use a remineralizing toothpaste like Boka or RiseWell
  • Eat foods that prevent cavities 
  • Limit your intake of sugary, acidic, and highly processed foods
  • Avoid antibacterial oral care products like regular mouthwash, which disrupt your oral microbiome
  • Prevent dry mouth by mouth taping and practicing nose breathing
  • See your dentist for a cleaning and exam every 6 months

To prevent tooth decay from progressing to the point of a root canal: 

  • Never ignore a toothache — always discuss new tooth pain with your dentist
  • Don’t put off dental work for tooth decay unless you’re actively reversing cavities
  • Consider regenerative endodontics, a stem cell endodontic therapy, if you have existing pulpitis

To reduce your risk of trauma to teeth:

  • Always wear a mouthguard when playing sports or during athletic activity
  • Use your teeth only for eating — no opening packages, chewing on pencils, etc.
  • Be cautious in situations where falling is likely
  • Practice safe driving — always wear a seatbelt

What is the root canal procedure like?

A root canal procedure is normally completed in 2-3 appointments. However, in case of teeth which have a single root, some dentists may complete the procedure in one sitting. Here’s what you can expect during a root canal procedure:

  • Clinical Examination: When you visit your dentist with a painful tooth, he or she will first determine the cause and location of the pain. This will be done with the help of a thorough clinical examination. Your dentist may also look at x-ray images of the affected side of the jaw to exactly pin-point the location of the infected tooth. The x-rays are also required for visualizing the shape and length of the canals, for preparing an appropriate treatment plan.
  • Administration of Local Anesthesia: Root canal treatment is a surgical procedure. Therefore, it is performed under the effect of local anesthesia. In case of highly anxious or apprehensive patients, the dentist may choose to reduce their anxiety by using conscious sedation.
  • Preparing the Access Cavity: once you are completely relaxed and pain-free, your dentist will gain access inside the affected tooth by drilling a hole. Once the pulp chamber is reached, the access cavity is broadened to allow for easy insertion and removal of endodontic instruments.
  • Removing the Infected Pulp: the infected pulp from the root canals is removed with the help of various endodontic instruments. The root canal is frequently irrigated with saline or an antibacterial solution to ensure complete pulp removal.
  • Shaping the Canal: in the next step, your dentist will use endodontic of various sizes to shape the root canals in such a way that they are constricted at the bottom, while they are broader at the upper end. This is done for placement of an inert material that fits snugly inside the canal and minimizes the chances of re-infection. After canal preparation, your dentist will fill them with a medicament to accelerate the healing. If required, you may also be prescribed with antibiotics and painkillers to subside the infection and pain.
  • Obturation and Temporary Restoration: Once complete healing has taken place, your dentist will fill the prepared canals with a rubber-like material. Afterwards, the tooth is temporarily filled and allowed to heal. In the next appointment, your dentist will make an x-ray image of the tooth to visualize the progress of healing and if it is satisfactory, a permanent filling will be placed over the tooth.

Will a root canal give me a blood infection (bacteremia)?

Bacteremia after a root canal happens in 15-20% of cases. This occurs when dental pathogens spread to the bloodstream. In a healthy individual, this lasts around 20 minutes and your body can easily fight off the bacteria. 

For context, bacteremia is very common after dental cleanings — it’s generally not something to cause great concern.

In rare cases, patients can develop infective endocarditis, inflammation of the heart lining, as a result of bacteremia. Dentists used to — and still may — prescribe antibiotics as a prophylactic measure, but it’s unclear whether or not these are effective.

Pain After a Root Canal

It’s common to have a little soreness after your procedure, but extreme pain after a root canal is abnormal. One study estimates that long-term pain happens after only 12% of root canal treatments.

If you do have pain, it usually peaks 17-24 hours after the procedure. To avoid this, keep your head elevated with a wedge pillow while sleeping for the first 1-2 nights. 

Soreness from keeping your mouth open for a long period of time should go away after 1-2 days. However, if you have persistent TMJ pain, this soreness and stiffness may remain for 6-8 weeks, particularly if a dental dam was used.

You may have pain in the gum or other soft tissue around the root-canaled tooth from inflammation or damage during your root canal treatment. This should clear up within a week or two.

You can use over-the-counter pain medications like ibuprofen (Motrin) or acetaminophen (Tylenol) to relieve any pain for the day or two after a procedure.

Persistent pain (3 months or more) after root canal usually happens when you bite down or palpate the treated tooth. It’s frequently associated with:

  • A filling that is too high
  • A severe infection before your root canal
  • Previous painful dental work
  • Existing chronic pain issues

More women than men tend to develop long-term root canal pain.

If you experience severe or sudden pain in the tooth weeks, months, or years after your root canal, it may be a sign of root canal failure. Contact your dentist immediately.

Prognosis & Long-Term Outlook

Root canal success rate and long-term prognosis are remarkably high, particularly when a crown is placed on the treated tooth.

The overall success rate for root canal procedures is between 80.1%-86%. 

The success rate decreases most significantly (below 90%) after 5 years have passed.

A patented same-day root canal treatment known as the GentleWave System boasts a success rate of 97.3% after 12 months. This is similar to the treatment outcomes of traditional root canal therapy. However, the GentleWave system does result in significantly fewer reports of postoperative pain than traditional root canals.

Factors that reduce the chance of root canal success include:

  • Treatment by a general dentist, rather than an endodontist
  • Necrotic pulp (dead tooth pulp) and/or irreversible pulpitis 
  • Periodontal (gum) disease
  • Poor procedural technique (including underfilling, overfilling, or instrument breakage)
  • Fracture to the treated tooth and/or crown
  • New bacterial infection
  • Male gender
  • Hispanic/Latinx ethnicity

How long does a root canal last? On average, root canals last 10 years or more. Some root canals last a lifetime.

How long can I go before getting a root canal?

Once your dentist has diagnosed irreversible pulpitis, you need to get a root canal (or alternative treatment) right away. Your provider may prescribe antibiotics before treatment, in which case you may need to wait to finish your round of antibiotics.

When you find out you need a root canal for irreversible pulpitis, it’s like a ticking time bomb because the infection will eventually get out of control. 

Pressure, swelling, and pain are likely to get worse. You might develop a bad taste in your mouth or experience numbness. The infection could spread to more vulnerable tissues, like your heart. 

Yes, a tooth infection can kill you.

In the 1600s, tooth infections made the list of the top 6 causes of death in England. As recently as 1908, tooth infections had a mortality rate of up to 40%. That’s worse than smallpox!

Complications of infections like these, such as those from a tooth abscess, are extremely dangerous. Don’t wait for treatment!

Can I eat before a root canal?

Yes, you can usually eat up to an hour before a root canal. However, if you are undergoing sedation, you may need to stop eating earlier. Talk to your dentist to be sure.

Reinforcing the treated tooth with a crown

When a root canal treatment procedure is performed on a tooth, it loses its blood supply. As a result, the tooth tends to become brittle. Therefore, dentists recommend that after complete healing has taken place in a root canal treated tooth, it must be immediately restored with a crown to avoid fracture.

What are the signs that you need a root canal treatment?

  • Root Canal Pain: if you are having severe, continuous, or throbbing pain in one of your teeth which does not go away even after taking a pain-killer, then it indicates towards an underlying infection. The pain can also be triggered by taking hot or cold food items.
  • Swelling: swelling around the affected tooth is a characteristic sign of underlying inflammation. In the advanced stages of an infection, plus containing a pimple or a bump can appear around the infected tooth.
  • Discoloration: dental pulp can also get inflamed in case of a direct injury or trauma to the tooth. In this case, blood accumulates inside and results in the grayish or dark appearance of the tooth. Such situations also require a root canal procedure.
  • Difficulty in Eating: another classic sign of an underlying pulp infection is pain on biting from the affected tooth. This is because of the pressure which is exerted onto the pulp during chewing.
  • Fever: long standing infection or inflammation of the dental pulp can also result in high-grade fever.

Do root canals cause cancer?

No, there is no reliable evidence that root canals cause cancer.

Scientific methodologies from the 1950s drove this theory. The science on this is correlative, not causative. Root canal methods and materials have evolved many times over since those times and have been completely different since the 1970s. 

That said, a poorly done root canal can and will have effects on the health of the rest of the body. Get a cone-beam CT (CBCT) every 3-5 years to check for root canal failure.

Root Canal Recovery

For fast root canal recovery:

  • Don’t smoke for at least 7 days after the procedure
  • Avoid chewing hard, crunchy, very hot, or very spicy foods/drinks or any foods with a sharp edge (like sourdough bread) for 1-2 days
  • Avoid drinking alcohol for 1-2 days, as this may increase bleeding
  • Don’t bite or chew on the treated tooth until a permanent crown has been placed
  • Brush, floss, and maintain good oral hygiene as normal

Can you drive after a root canal? You should be able to drive immediately after a root canal procedure unless sedation was used. Root canals usually involve local anesthetic, but sedation may be requested for patients who are anxious about the procedure.

Pros & Cons of Root Canal Treatment

Is a root canal right for you? If your dentist has identified irreversible pulpitis, a root canal is one of only a few options for treatment. 

Many dentists will recommend root canal for cases of reversible pulpitis for a number of reasons. In these situations, I would ask about getting a large filling instead.

Consider the pros and cons before deciding if a root canal is the best option for your case.

Root Canal Pros:

  • You don’t have to extract the tooth.
  • You don’t lose the bone around the tooth.
  • Your orthodontic growth, bite, and normal tooth use will remain the same.
  • You will no longer experience hot or cold sensitivity in the treated tooth.
  • The recovery pain and recovery time are mild and brief.
  • The rate of success is very high even after 10 years (over 80%).
  • It’s less expensive than extraction with an implant.

Root Canal Cons:

  • There’s no such thing as a 100% clean root canal — some bacteria will always be left behind.
  • If your root canal fails, you’ll need retreatment of some kind, which carries a significant additional cost.
  • There are anecdotal reports that root canals are associated with systemic disease months to years after treatment. If you’re a healthy person, this is likely not an issue. But if you’re on the edge of optimal health, it’s possible your body can’t handle it. If you’re immunosuppressed or in poor health, you may want to consider other options.
  • It can be hard to sit with your mouth open for a few hours during the procedure, particularly if you struggle with TMJ pain.

If possible, ask a trusted friend or family member to help with your decision if you’re already in significant pain. “Deciding under the influence,” as I call it, can lead to hasty decisions — especially if your tooth hurts a great deal.

Final thoughts

No doubt, the root canal procedure is an effective treatment option for getting rid of infections of the pulp. However, it can be avoided very easily! By simply ensuring that you brush and floss your teeth regularly and visiting your dentist frequently, you can prevent all types of dental infections. So, why spend money on your treatment when you can simply avoid dental problems by maintaining a good oral hygiene?

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