• Root canal treatment is a dental procedure that aims to remove contaminated material from the tooth. This also prevents the tooth from becoming infected in the future.
  • Pulsating pain, sensitivity to hot and cold foods and drinks, swelling, bleeding, or dark discoloration of the tooth may indicate a condition that you should treat with a root canal.
  • If you experience symptoms such as bleeding, swelling or pain that last longer than three days after a root canal, you should contact your local endodontist.
  • Don't let the cost of dental care stop you from smiling. Use Authority Dental to find an emergency dentistry clinics near you. It’s simple, secure and free.

Do you need a root canal? Here's everything you need to know.

When do you need a root canal?

Root canal treatment is often necessary if the tooth pulp becomes infected. The most common causes include traumatic injury resulting in a crack, neglected cavities, failed previous treatment, or disease.

Symptoms that are should concern you include:

Root canal procedure step-by-step

Root canal treatment

Picture by Authority Dental under CC 2.0 license

Root canal treatment has a bad rep in the dental world. But it doesn’t have to be as scary as you think. Being aware of what each step entails can make the procedure more bearable.

Before your appointment

There are a few things to remember about before your procedure:

  • Avoid alcohol and tobacco for at least 24 hours.

  • Eat before leaving for the office.

  • Take an OTC painkiller.

  • Make sure you are familiar with the process.

Alcohol and tobacco may have a bad effect on anesthesia your dentist will likely use to manage pain during the procedure. Taking a painkiller prior to your root canal treatment means less discomfort. This goes for both the procedure and application of the anesthetic.

Your body will take less of a hit if you have a full meal beforehand. Your anxiety will also be lower if you know what is going to happen each step of the way. Ask your dentist any questions you may have.

Preparatory procedures

Your dentist or endodontist may want you to come in for an initial dental exam to perform tests on the tooth as well as X-rays. Radiographs may show the extent of the damage. This is sometimes included in the cost.

You’ll also discuss medical history, any medication you are taking, and what type of anesthetic would be best.


Typically a local injection is enough to manage pain during a root canal procedure. Patients who are extremely sensitive to pain or have dental anxiety may have to be sedated. The options are an oral anesthetic or IV.

If you are set on a deeper kind, you may have to prepare differently for your treatment.

Cleaning out the pulp

The tooth is opened up with a small drill. The dentist will then remove bacteria and infected matter with tiny instruments. Once he or she is satisfied that all contaminated materials are out, the tooth will be sealed.

Application of the sealant

This stage is similar to a regular filling. Most often, composite is used to close off the hole and the tooth is polished.

The other option is a dental crown. That is appropriate if a lot of the tooth was destroyed by the infection or if it had to be removed for a proper cleaning. Dental crowns give great cosmetic results.

Root canal pain and recovery

Root canals can hurt. Mild pain after a successful procedure is normal during recovery. You can manage it with OTC painkillers. This, however, should not last longer than 3 days. If you experience any bleeding, swelling, or pain for longer, contact your local endodontist, as you may have to return for a checkup.

Aftercare is mostly about good oral hygiene. Brush and floss at least twice a day. You can also use non-alcoholic mouthwash or a saltwater rinse. The latter can help bring down any swelling that appears on the gums around the affected tooth.

When is root canal retreatment needed?

Root canal retreatment

Picture by Authority Dental under CC 2.0 license

If the root canal was done correctly and the patient adheres to the dentist’s instructions, there shouldn’t be any complications. In the case of failed treatment, however, retreatment might be necessary. This can significantly increase the final cost of the RCT.

Jack Lawrence

Jack Lawrence, DMD

Retreatments are usually done by endodontist. If they are redone by a regular dentist the price is most often the same or a little higher than the initial procedure.

The procedure can be deemed unsuccessful if the infection was not eliminated completely. This means the bacteria continue to spread and attack the dental pulp. Such a situation is accompanied by erratic pain and swelling around the area for longer than 3 days.

Another reason for retreatment arises if the seal is incomplete or becomes worn. The canals should be closed off very thoroughly. Patients who suffer from bruxism are at particular risk of the filling coming loose. The infection then continues to spread. You may notice pain and swelling.

And lastly, it sometimes happens that cracks in the roots are not detected before the procedure. This is extremely rare, especially now, when radiographs such as CT scans are so accurate. Continuous pain and major swelling are symptoms to look for. The tooth will have to be opened up and the root canal will have to be redone.

Contact your dentist if you notice these signs, but he or she should be able to pick up on any problems during your post-op checkup.


Who is a root canal specialist?

Endodontists are experts on dental pulp issues. They focus on treating the inner part of the tooth.

How long does a root canal take?

A root canal procedure commonly takes about 30 minutes to an hour. If the tooth is badly infected or if there is an unexpected number of canals, it can last up to 90 minutes.

Is it better to pull out a tooth or root canal?

The best solution is to do whatever possible to save a tooth. Not only is an extraction itself expensive, but the tooth should also be replaced afterwards. This can turn out to be a lot more costly and you may need to think about relines or a long recovery period.

Do they put you to sleep for a root canal?

Root canal treatment is almost always done with no more than a local anesthetic. Those with high pain sensitivity or dental anxiety can discuss sedation options with their dentists.

What happens if you wait too long to get a root canal?

First of all, that can be very painful. You are likely to experience swelling from the infection which may spread to other teeth. The longer you wait, the more costly the repair will be.

What are some alternatives to root canal treatment?

Some dental professionals, mainly holistic dentists, recommend against root canal treatment. Unfortunately, the only real alternative is extraction. If you do decide to pull your tooth, or if it is damaged beyond repair, you should always choose a restoration.

Not replacing extracted teeth leads to other dentition shifting, bone loss, loss of opposing teeth, as well as diet changes. These could all affect not only your oral but also general health. The most popular solutions are dental bridges, dentures, and implants.