Are root canals painful?

Most of the time, a root canal is a relatively simple procedure with little or no discomfort. Following treatment, your dentist may recommend an over-the-counter pain reliever for you to take. Some people don't feel any pain after undergoing root canal therapy. If you are still experiencing pain weeks after a root canal, contact your dentist right away. You may need follow-up treatment.  

Most of the horror stories you hear are because the tooth has died off and is causing extreme throbbing pain that radiates and requires a root canal. The root canal procedure itself has minimal discomfort i.e. staying in the dental chair for long time and holding your mouth open. Other than that it can be the most rewarding procedure for me to perform because I take the patient out of pain. Rarely a chronic abscess is seen in an x-ray that requires a root canal that can end up causing discomfort after the procedure. It's like kicking the sleeping tiger. But here again it is not during the procedure itself because you are anesthetized. Hope this helps.
Thankfully, in most cases, a root canal can be done with little or no pain. Better anesthesia and techniques greatly reduce the time and potential for discomfort associated with root canal.
With modern anesthetics / novacaine, they shouldn't be any more painful than a typical filling. In fact, usually the tooth pain causing one to see the dentist in the first place is the most painful part of the equation. There will often be some soreness after the procedure is finished for a day or so, but that should be fairly mild, and a simple pain reliever will suffice for most people.

Thankfully, modern anesthetics allow procedures, such as root canal treatments to be done virtually pain-free. Without lidocaine, nitrous oxide, and other anesthetics, modern dentistry would be very difficult to perform.

Binod Verma

Usually root canal treatment is not painful but it can be painful if:

  • The procedure is not done correctly.
  • The procedure is rushed to finish in presence of infection.

When the diagnosis of a tooth has been determined to need root canal treatment then, depending on the nature of the diagnosis, the tooth can be resistant to getting sufficiently anesthetized. When the tooth needing root canal treatment is adequately anesthetized then the patient is very comfortable during the procedure. However, there are times when the diagnosis is such that an already painful tooth can be resistant to the anesthetic and that is when root canal treatment may be painful. So, it is always better to get regular checkups for prevention and early detection with your dentist.

Brandon Seto, DDS
The root canal procedure is not usually painful.

In cases where the patient is experiencing severe pain prior to the root canal treatment (sometimes called "hot" teeth), the local anesthetic may not be effective even when delivered to the correct area. Studies show that only 30-50% of "hot" teeth will be properly anesthetized with a single injection. HOWEVER, with modern techniques such as intraosseus local anesthesia and periodontal ligament injections, nearly 100% of these teeth can be fully anesthetized, making the root canal treatment pain-free.

One way to confirm complete anesthesia of the tooth prior to starting the root canal treatment is to test the tooth to cold. If the tooth was initially sensitive to cold, and no longer feels the cold after the injection, then it is safe to proceed with treatment. If the tooth still feels the cold, then re-injection or supplemental local anesthesia may be necessary.

A root canal procedure is similar to having a tooth filled. With a root canal the root part of the tooth is filled, and with a filling the top part of the tooth is filled. The tooth is numbed just like a filling. The numbing allows the procedure to be done without pain.

As long as the anasthetic is working, pain should be minimal to none. Sometimes when there is a lot of infection, it can make the anasthesia not as effective (so it may take more of it or longer time to make it work).

If the tooth has a crack in it, that may also have an effect on how numb you are able to get.

Most of the time, the practitioner doing the root canal is able to get you adequately numb. If not, then antibiotics may be indicated first.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.