Does having root canal therapy hurt?

We'd be the first to acknowledge that root canal treatment has a reputation for being painful. But we'd be the last to agree that this reputation is deserved.

Will you experience pain during your treatment?

When discussing the subject of discomfort, it's really necessary to break this topic down into a few subcategories.

That's because each one has a different potential for the patient to experience it.


There's no reason to expect that scheduled root canal appointments will hurt.

For the average person and the average case, having root canal treatment should be no different than having many other types of dental procedures performed, such as having a filling placed.

Your dentist will first "numb up" both your tooth and its surrounding gum tissue. Once that's done, the remainder of the appointment should be a non-event, even to the point of being boring.

As testament to this fact, ask your dentist, they'll tell you it's somewhat common that a patient will fall asleep while their treatment is being performed.

Anxiety management may help to improve your experience.

Different from pain management is the issue of patient management. Some people may have apprehensions about their upcoming root canal treatment.

If so, they will need to be up front about this with their dentist. Doing so will give them a chance to figure out a solution. For example, the use of some type of sedative may make their procedure more bearable. (Here's more information about this subject: Conscious Sedation.)

Root canal without anesthetic?

You might be surprised to learn that many teeth that require root canal treatment could, without the use of any anesthetic, be drilled on and the patient would feel no pain whatsoever.

And, in fact, it is conceivable that in some isolated cases the person's entire root canal procedure could be completed without any anesthetic or pain.

Why? Simply because in these cases the nerve tissue in the tooth has died. And dead nerve tissue cannot transmit pain sensations.

Will this be true for you?

Should you expect that your root canal therapy can be performed without the use of an anesthetic? No, that's not realistic. But, if you have a mind set that all root canal appointments are excruciatingly painful, well, that's not realistic either.

Your dentist will numb up your tooth prior to performing your root canal treatment.

A syringe used to give dental injections.

As insurance that things will go as smoothly and uneventfully as possible, most dentists will go ahead and numb up any tooth on which they are performing endodontic therapy.

That's because they're trying to create a result that will last you a lifetime and they need to be able to concentrate on their work, not on how you are reacting to it. By numbing up your tooth, both of you will be more at ease and relaxed.

[ Related content: Will my dental injection hurt? ]

Having root canal treatment is a "good thing."

There are many reasons why a person should be eager to begin their root canal treatment.

  • For cases that have been problematic, it's root canal therapy sets the stage for the healing process.
  • For teeth that have remained quite, this window offers the ideal time to perform their therapy. You will be relaxed and rested. The treatment process should go just that much more smoothly. And your tooth can be expected to respond to the steps of the procedure more predictably.
  • Any tooth that is in need of treatment but has not yet received it is unpredictable. Having your root canal treatment completed sooner rather than later reduces the chances that you will experience a painful tooth flare up (an acute tooth abscess).

There is some potential for post-treatment pain.

We wouldn't be telling you the whole story if we didn't mention that after a root canal appointment, after your numbness has worn off, there is some potential that your tooth might hurt a little. (It really should just be minor.) We've dedicated a page to this subject: Root canal treatment aftercare.

Don't confuse having root canal treatment with the management of those painful events that signaled its need.

It seems likely that many of the remarks you hear about how painful having "root canal" is should really be attributed to those events that initially signaled that it was needed.

Acute flare ups.

With some cases, the final, and possibly only, sign that has indicated that a tooth needs root canal treatment is a toothache.

It would be a dishonest to suggest that during this time frame (a time when the tooth and its surrounding tissues are agitated and inflamed, and the patient is ill at ease and stressed) that the steps a dentist must take (to provide lasting pain relief and to set the stage for the healing process) can always be accomplished with absolutely no discomfort.

But providing this type of emergency service is different than performing the individual steps of the root canal procedure. Once the tooth has settled down, that process can be expected to be routine and essentially pain-free.

Routine cases.

The above scenario isn't to suggest that the only signal that a tooth needs endodontic therapy is that it hurts. A tooth's need for treatment can be signaled in a number of different ways, many of which don't involve any pain at all. This is why, for most patients, their entire root canal experience (diagnosis and treatment) is a non-event.

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