Overview

What is a root canal?

Root canal treatment is a dental procedure that relieves pain caused by an infected or abscessed tooth. During the root canal process, the inflamed pulp is removed. The surfaces inside the tooth are then cleaned and disinfected, and a filling is placed to seal the space.

When is a root canal needed?

Root canal therapy is necessary when oral bacteria invade the pulp inside of your tooth. This usually happens when a cavity is left untreated for a long time. It can also occur if your tooth becomes cracked or damaged due to trauma.

What are some symptoms that indicate you may need root canal treatment?

In some cases, you may not know you have an infected tooth. However, many people notice certain symptoms. Signs you need a root canal include:

Tooth pain that doesn’t go away: Many dental problems can cause tooth pain. If you have pain deep in your tooth, you may need root canal therapy. Discomfort may also radiate to your jaw, face or other teeth.
Sensitivity to heat and cold: If your tooth hurts when you drink hot coffee or eat ice cream, it could mean that you need root canal treatment. This is especially true if the pain lingers for more than a few seconds.
Swollen gums: When a tooth is infected, pus can collect in the area. This can lead to puffy, swollen or tender gums.
Pimple on the gums: You may develop a pimple or boil on the gums. Pus from the infected tooth may drain from the pimple, causing an unpleasant taste or smell.
Swollen jaw: Sometimes pus doesn’t drain from the site. As a result, your jaw may become visibly swollen.
Tooth discoloration: When the pulp of a tooth becomes infected, it can cause your tooth to look darker. This occurs because of poor blood supply to the tooth.
Pain when pressure is applied: If you have pain when you eat or touch your tooth, it could mean the nerves around the pulp are damaged.
A chipped or cracked tooth: If you’ve cracked a tooth in an accident, when playing sports or even by biting down on something hard, bacteria can reach all the way into the tooth pulp.
Loose tooth: An infected tooth may feel looser. This is because the pus from the infected pulp can soften the bone that supports the tooth.

How common is root canal therapy?

According to the American Association of Endodontists, over 41,000 root canals are performed in the United States every day. That means that more than 15 million root canals are completed each year.

Procedure Details

How should I prepare for root canal treatment?

Before beginning your root canal, your healthcare provider can answer any questions you have about the procedure. Here are a few things you can do to prepare for your root canal treatment:

Take all medications as prescribed: You may be given antibiotics or anti-inflammatory medications a few days before your appointment, especially if there is a lot of infection present.
Don’t smoke: Tobacco products interfere with your body’s ability to heal itself. Avoid smoking several days before your root canal appointment — and stop altogether if you’re able.
Eat a healthy meal: Since the local anesthesia used during root canal therapy will make your mouth numb for a few hours, it’s a good idea to eat before your appointment.

How long does a root canal take?

Depending on the amount of infection in your tooth, root canal therapy may require one or two appointments. On average, a root canal takes about 30 to 60 minutes to complete. If you are having treatment on a larger tooth with multiple roots, it can take up to an hour and a half.

What happens during the root canal process?

Before beginning your root canal, your healthcare provider will take dental X-rays of the affected tooth. This helps determine the extent of damage and ensures that root canal therapy is the appropriate treatment option. Here are the steps that will be completed during your root canal procedure:

Anesthesia. First, local anesthesia is given to numb the infected tooth and the surrounding gums. There are also medications used in dentistry to help you relax, such as nitrous oxide, oral sedatives or intravenous (IV) sedation. Your healthcare provider may recommend sedation if you struggle with dental anxiety.
Dental dam placement. Before beginning root canal treatment, a small rubber dam is placed over the area. This isolates the tooth and keeps it dry during the procedure.
Access hole. Next, a small opening is made in the crown of the tooth to access the pulp.
Pulp removal. Tiny dental instruments are used to remove the nerves, blood vessels and tissues inside the tooth.
Shaping the canals. Once the pulp is removed, the pulp chamber and root canals are cleaned, disinfected and shaped.
Filling the canals. The empty canals are then filled with a flexible, rubbery dental material called gutta-percha.
Sealing the tooth. Next, a temporary dental filling is placed to seal the tooth and prevent bacteria from re-entering.
Placing the final restoration. In most cases, you’ll need a dental crown to protect the treated tooth and restore your bite. Crowns are custom-made, and fabrication usually takes two to three weeks. When your crown is ready, the temporary filling is removed and the permanent crown is placed. In some instances, you may be able to receive a crown during the same appointment.

Do root canals hurt?

Many people are afraid they’ll have tooth pain after root canal therapy. However, because the source of infection is removed during the procedure, most people find immediate relief following treatment. If you are experiencing throbbing pain after a root canal, call your healthcare provider right away.

What should I expect after a root canal?

While you shouldn’t have significant pain after a root canal, you may notice sensitivity for the first few days. These symptoms are normal and can be successfully managed with prescription or over-the-counter pain relievers. In most instances, side effects lessen within one to two weeks.

Who should perform my root canal procedure?

Root canal treatment is completed by a general dentist or an endodontist (a root canal specialist). General dentists can often treat teeth near the front of the mouth since they have fewer roots. If you need root canal therapy on a tooth with multiple roots — or if your case is complex — then you may be referred to an endodontist.

Risks / Benefits

What are the advantages of having a root canal procedure?

There are several benefits to choosing root canal therapy. This treatment can:

Prevent infection from spreading to other teeth.
Ease the symptoms associated with an infected tooth.
Reduce the risk of jawbone damage.
Eliminate the need for tooth extraction.

Are root canals safe?

Root canals are considered safe and effective. This procedure boasts impressive success rates of up to 98%.

What are common failed root canal symptoms?

Root canal complications can occur in some cases. This is especially true if your tooth is too damaged for this type of treatment. Failed root canal symptoms include:

Pain.
Swollen gums.
Pus or drainage.
Tooth discoloration.
Pimple or boil on the gums.
Sinus problems.

What if my root canal fails?

If your root canal fails, your healthcare provider will explore your options with you. In some cases, root canal retreatment may be possible. Or, it may be time to discuss alternative procedures.

What are the alternatives to root canal treatment?

The only alternative to root canal therapy is tooth removal. Even though it’s best to save natural teeth whenever possible, extraction may be necessary to preserve your oral health.

If you’re not a good candidate for root canal treatment, the tooth can be extracted and replaced with a dental implant, dental bridge or partial. To learn more about root canal vs extraction, call your healthcare provider.

Recovery and Outlook

How long does root canal recovery take?

Typically, root canal recovery time lasts less than a week. Mild discomfort may be present for a few days, but this can be managed with medication. If you have severe pain or discomfort that lasts longer than a week, call your healthcare provider.

Can I eat after a root canal?

Yes. However, it’s best to wait until the numbness wears off. The effects of the anesthesia usually last a few hours.

Stick with softer foods like pastas, mashed potatoes and yogurts for the first couple of days. Introduce solid food as your comfort level improves.

You should also steer clear of biting or chewing with the treated tooth. Try to chew on the other side of your mouth until your permanent dental restoration is in place.

Can you drive after a root canal?

It depends. If you had local anesthesia or nitrous oxide during your procedure, then you can drive yourself to and from your appointment. People who choose oral sedation or IV sedation will need a friend or family member to drive them.

Can you smoke after a root canal?

It isn’t recommended. Smoking interferes with healing and increases the likelihood that you’ll need more dental work in the future.

When can I resume work, school or other activities?

Most of the time, people who have had root canal therapy can go back to work or school the next day. However, if you’ve had sedation during your dental procedure, you may need an extra day or two to fully recover.

What are some root canal aftercare tips?

After root canal treatment, it’s important to keep the area clean. Brush and floss normally, and use an antibacterial mouthwash to keep germs at bay. If you still have a temporary filling placed and haven’t received your permanent crown yet, avoid chewing on the treated tooth until the crown is in place.

How long do the results of a root canal last?

As with all dental procedures, results are not guaranteed. However, when root canal therapy is performed correctly, results can last a long time — even the rest of your life.

When to Call the Doctor

When should I see my healthcare provider?

If you notice any root canal symptoms, such as tooth pain, swelling, bad taste or other warning signs, call your healthcare provider immediately. The sooner you treat an infected tooth, the better chance you have of saving it.

Routine dental check-ups also play a large role in reducing the risk of infection. During these visits, your healthcare provider can detect problems early on, before they worsen.

A note from Cleveland Clinic

Experiencing tooth pain or swelling in the jaw can be scary. Fortunately, root canal therapy can remove infection at its source so you can feel better quickly. If you suspect that you have an infected or abscessed tooth, call your healthcare provider right away. Prompt treatment can prevent infection from spreading and relieve your pain so you can get back to normal life.

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Root Canal