Does having root canal therapy hurt?

Will you experience pain during your treatment?

We'd be the first to acknowledge that root canal treatment has a reputation for being painful, but despite the popularity of this myth, we'd be the last to agree that this reputation is deserved.

To discuss this subject, it's really necessary to break the topic down into a few subcategories, because each one has a different potential for and cause of pain.

• Pain or discomfort that signals the need for root canal treatment.
• Discomfort during scheduled appointments.
• After-treatment pain.

There is no reason to anticipate that scheduled root canal appointments will involve pain or discomfort.

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

The dentist will first "numb up" the tooth and surrounding gum tissue with a local anesthetic ("Novocain"). Having done so, the remainder of the appointment should be a non-event, even to the point of being boring. As testament of this fact, it is somewhat common that a patient will fall asleep while their root canal treatment is being performed (which can be a modest nuisance for the treating dentist).

Anxiety management can help to improve your experience.

A patient may have some apprehension about their pending endodontic treatment but that is really a different issue. That is an issue of patient management as opposed to pain management.

If you are up front with your dentist about your fears and apprehensions, they can address these issues too. Either with some type of medication that you take before your appointment (possibly Valium) or else a drug administered by the dentist in-office (such as nitrous oxide, also known as laughing gas).

You may not know this.

You might be surprised to learn that, without an anesthetic, many teeth requiring root canal treatment could be drilled upon and the patient would feel no pain whatsoever.

In fact, it is conceivable that in some isolated cases (necrotic teeth where active infection and inflammation are not a complicating factor) the entire root canal process 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're certain that all root canal treatment is an excruciatingly painful experience, well, that's not realistic either.

Will your dentist numb up your tooth prior to performing your root canal treatment?

Almost certainly your dentist will 'numb up' your tooth before performing your root canal treatment, especially if you ask them to.

Nobody likes a bad time. (Not you, not your dentist.) So, just so things go as smoothly and uneventfully as possible, most dentists will go ahead and numb up any tooth on which they are performing root canal treatment.

Remember, your dentist is trying to perform treatment that will hopefully last you a lifetime. They need to be able to concentrate on their work and not on how you are reacting to it. By numbing up your tooth, both of you will be more at ease and relaxed.

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Root canal treatment is a "good thing."

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

For one, in those cases where a person's tooth has been the source of pain or swelling, it is the root canal therapy that will initiate the process by which the painful or swollen tooth can be settled down. In some cases, just those beginning steps a dentist takes as a part of performing root canal treatment can provide instant relief.

Even in those cases where relief is not immediate and total, the treatment should at least significantly reduce the level of pain, and also set the stage where the healing process can begin (and take place at a much more rapid rate than if root canal treatment had not been initiated).

In those cases where no pain or swelling has been experienced, a person should still be eager to initiate their root canal treatment. Due to the absence of pain and extensive infection, you will likely be more 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.

Additionally, 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).

Now for the bad news. Yes, there is some potential for post-operative pain.

We wouldn't be telling you the whole story if we didn't mention that after a root canal visit, after the numbness wears off, there is some potential that the patient's tooth might be tender or hurt. We've dedicated a page to discussing root canal treatment post-operative pain.

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

It seems likely that many of the remarks you hear about how painful "having a root canal" is, should really be attributed to the painful events that the person experienced leading up to receiving their actual scheduled treatment.

Unfortunately, there can be times that the final, and possibly only, sign that has signaled that root canal treatment is needed is a toothache. And it would be a fallacy to suggest that during this period of discovery (a time when the tooth and surrounding tissues are agitated and inflamed and the patient is ill at ease and stressed) that every case can be treated with absolutely no discomfort.

Having said all that, with these types of cases where there has been some type of painful toothache, the steps that the dentist takes in preparation for performing their root canal treatment are those very same steps that make immediate pain relief possible and initiate the tooth's healing process. We will also state that, with this type of situation, a patient would find any other type of dental treatment, such as an extraction (if during this time frame one could be performed at all), similarly unpalatable.

The above isn't to suggest that the only signal that treatment is needed is a toothache or pain. The need for endodontic treatment is identified in a number of different ways, many of which are painless. And this is why for many patients their entire root canal experience (diagnosis and treatment) is a non-event.