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Understanding Root Canals: The before, during and after

When you need a root canal?

If the cause of your teeth pain is serious decay or infection in the tooth pulp, your dentist may recommend a root canal. A root canal is a multi-step dental procedure that involves removing the infected tooth pulp (and sometimes the nerve) from a tooth, and sealing it to protect against future teeth pain.  Not all types of teeth pain are indications for a root canal.

But signs of infection severe enough to require a root canal include:

• Serious teeth pain when eating or when you put pressure on the area

• Teeth pain and sensitivity to hot or cold that lingers after the hot or cold stimuli have been removed

• A small, pimple-like bump on the gums near the area of teeth pain

• Darkening of the tooth

• Tenderness or swelling in the gums near the area of teeth pain

If you have one or more of the aforementioned symptoms, it is important to see a dentist as soon as possible. While there, the dentist will be able to run a couple tests to determine whether or not a root canal is needed to treat the tooth. The first set of tests are simple tests that the dentist can perform with the tools they have on hand. These tests are done to evaluate the symptoms you are reporting. you survived the dreaded root canal procedure and were relieved that it was not the nightmare you had imagined! Judging by the reactions of many of our patients, most are pleasantly surprised at just how routine the treatment is. Some patients are so relaxed they even fall asleep! We believe that root canal therapy gets its’ bad reputation because of misinformation. It’s understandable why some people tend to remember the excruciating, pre-treatment pain more than the relief provided by the dentist. The discomfort that brought them to the dentist in the first place may have lasted for days and was probably, at times, very difficult to bear. Relief usually begins immediately after receiving dental freezing (anesthesia), and the treatment is usually very routine with the subsequent healing period often uneventful. Has your root canal dentist or Endodontist told you that you need root canal treatment? If so, you're not alone. Millions of teeth are treated and saved each year with root canal, or endodontic, treatment.

What can I expect during a root canal?

A typical visit to an endodontist or dentist begins with completing paperwork, which includes your medical history and consent forms. It is advisable to bring a list of all the medications (over-the-counter and prescription) that you regularly take or have taken within the past month. Once all forms are complete, an assistant will review and chart your chief complaint, referring dentist’s information and history of the tooth pain before taking x-rays of your teeth. Once your first set of x-rays are complete, your dentist or endodontist will review your paperwork and evaluate your symptoms prior to testing the tooth in question along with adjacent teeth. After the tests are complete, a diagnosis will be given and your endodontist will discuss your treatment options.

The endodontist will make you aware of the benefits, options and risks involved in order for you to understand how endodontic treatment can relieve your pain and save your tooth. Possible post-treatment decisions such as a crown on the treated tooth also will be addressed. If you decide to receive treatment, the procedure may start immediately. Before treatment begins, you will receive local anesthesia to numb any sensations you may feel during the procedure. If the procedure is unable to be completed within one visit, medicine may be placed inside the tooth between appointments. Once your procedure is complete, more X-rays are taken to track the success of the treatment. You will be provided with review sheets that include your post-operation instructions and what to expect over the next few days.

The four steps to root canals are:

• X-ray – if a dentist suspects you may need a root canal, he will first take X-rays or examine existing X-rays to show where the decay is located

• Anesthesia – local anesthesia is administered to the affected tooth. Contrary to popular belief, a root canal is no more painful than a filling

• Pulpectomy – an opening is made and the diseased tooth pulp is removed

• Filling – the roots that have been opened (to get rid of the disease pulp) are filled with gutta-percha material and sealed off with cement. Be sure to contact your dentist if you have any questions or concerns regarding your treatment.

What can I after a root canal?

If root canal treatment has been recommended for your tooth, it is important to discuss with your dentist what outcome you can reasonably expect and what “specific-to-you instructions” you should follow.

Healing Period

Although the infected, inside part of the tooth has been removed, there is still a period of continued healing while the body repairs the area surrounding the tooth. In the vast majority of cases, the affected area of the mouth will continue to heal and symptoms will subside. If, in a week’s time, you have not experienced gradual, steady healing call your dentist. Acute Infections – If left untreated, some infections can spread to surrounding head, neck, nasal and sinus areas that can progress to life-threatening complications. A much more guarded approach is taken during this healing period, and in some severe cases, hospitalization is required.

Eating / activity

Following your treatment, you can resume your normal daily activities after the dental anesthesia has worn off. Once the anesthesia wears off, you can eat and drink as usual. It is completely normal to still feel sensitivity after a root canal, especially when chewing. You may feel more comfortable chewing on the other side of your mouth while the tissues, nerves and ligaments surrounding the root canal tooth recovers. Sometimes, the ligaments that surround the tooth become irritated and swollen and can be sensitive to touch and pressure. Although not uncommon, this added aggravation can cause discomfort during chewing. The dentist can reduce the biting forces on the tooth to lessen the impact you feel while eating.


During the healing period, it is not uncommon to feel some discomfort, but not to the degree of pre-treatment pain. Although there is no longer any nerve within the tooth, the nerves, ligaments and other surrounding tissues may still be healing. To help you manage any post-treatment tenderness, your dentist may recommend the use of an anti-inflammatory such as Advil or another type of pain reliever if you cannot take NSAIDs. If your healing is characterized by a degree of pain that is difficult to tolerate, do not hesitate to contact your dentist for further evaluation.


Not all infected teeth require antibiotics. In an effort to reduce the routine prescribing of antibiotics which can lead to drug-resistant bacteria, your dentist will only prescribe an antibiotic if the circumstances necessitate it.

Follow Up Treatment

After the root canal is complete, a permanent post and filling will be placed. With the soft tissue now removed, the tooth will tend to dry out and become brittle over time. Brittle teeth can fracture more easily. Your dentist will likely recommend the placement of a metal crown to add protection and strength to your tooth.


Of course, there are inherent risks that are involved with any surgical treatment, but attending to symptoms immediately is still the best ways to help reduce the likelihood that your root canal tooth will be fraught with future complications and aggravations. Maintaining regular check-ups will allow your dentist to monitor the healing of your root canal treated tooth and follow-up immediately if problems arise. We cannot emphasize enough the importance of regular dental visits. Early intervention can help you avoid root canal treatment. Dentists are trained to spot suspicious activity in your mouth early so that problems do not progress to the point of pain nor cause a relatively simple procedure to become an emergency. Our team of trained professionals have helped thousands of patients smile again! Call us today! A treated and restored tooth can last a lifetime with proper care.

Root canals have an extremely high success rate. Here are a few ways to take care of your teeth after a root canal:

• Practice good oral hygiene – brush teeth twice a day, and floss at least once. Taking care of your teeth can help prevent future problems

• Visit the dentist regularly – cleanings and examinations by dentists and hygienists

• Avoid chewing on hard foods – chewing on hard foods such as ice can cause teeth to break, and can harm root canals Tips for saving your teeth for the future

• If you are given a choice between root canal treatment or tooth extraction, always choose root canal treatment. Dentistry has yet to produce a denture, bridge or implant that looks, feels and functions as well as a natural tooth

• Most endodontists offer tremendous flexibility in accommodating emergency cases including weekends in some cases so your pain can be relieved quickly

• If your dentist recommends tooth extraction, ask whether root canal treatment is an option

• If your dentist says that an endodontic procedure is not an option, ask why, and request a referral to an endodontist. Endodontists are dentists who specialize in saving teeth, and have at least two years of advanced training in root canal procedures. They are experts at diagnosing and relieving tooth pain, and use advanced equipment to treat patients quickly and comfortably. Your dentist probably has partnerships with endodontists in your area already.

Never choose an extraction because you think:

• it will be cheaper! When a natural tooth is extracted, it must be replaced with an artificial tooth to prevent other teeth from shifting, and to prevent future dental problems. The cost of a denture, bridge or implant, plus the extraction, often is higher than the cost of an endodontic procedure that would save the tooth for years to come. Most dental insurance plans cover endodontic treatment

• root canal treatment will be painful! Modern techniques and effective anesthesia make root canal treatment virtually painless. In fact, discomfort after the procedure is generally greater with a tooth extraction. Patients who have experienced root canal treatment are six times more likely to describe it as "painless" than patients who have not had a root canal

• it will be quicker! Endodontic treatments generally require one to two visits lasting less than an hour each. An extraction requires one visit, but the denture, bridge or implant will require several additional visits with your dentist.