Root canal pain and recovery: the procedure, how long it takes and the tooth afterwards

When the nerve inside a tooth needs treatment

How the tooth nerve becomes inflamed

Beneath the enamel and dentine lies the dental pulp, also known as the tooth nerve. It contains nerves and blood vessels and runs through the root canals to the root tips.

Bacteria usually reach the pulp through deep decay. A cracked tooth or an accident can also damage it. The tissue then becomes inflamed or dies. This rarely heals by itself and puts the tooth at risk over time. Our page on first aid for severe toothache explains what helps until your appointment.

Symptoms of an inflamed tooth nerve

If the nerve has already died, the tooth sometimes stays quiet. In that case, only an X-ray shows the inflammation. Common signs are:

• cold or heat hurts, and the pain lingers
• the tooth throbs, often for no reason and at night too
• biting and chewing hurt
• the gum or cheek swells
• the tooth turns darker

Does a root canal hurt?

Most people find a root canal under local anaesthetic similar to an ordinary filling. Often the treatment even relieves pain.

The pain usually comes before the treatment

Patients with an inflamed tooth often arrive after days of pain. That pain comes from the inflammation. The treatment removes the inflamed tissue, and with it the cause.

What you feel during the procedure

A local anaesthetic is usual for a tooth with a living nerve. For the local anaesthetic, we also use intraosseous anaesthesia. The anaesthetic is delivered directly into the bone next to the tooth. This numbs the tooth itself, and your lip and cheek usually do not go numb. You usually feel only pressure, plus the strain of keeping your mouth open for a long time. With a badly inflamed tooth, the anaesthetic sometimes works less well. Speak up at once if you feel more than pressure. Ask beforehand about a hand signal for breaks.

No treatment on a tooth is entirely without pain. With effective anaesthesia, though, a root canal usually involves relatively little pain. At our clinic, removing decay without an injection is possible with the laser in many cases. This applies to decay, not the root canal itself.

Where the bad reputation comes from

The bad reputation of root canals often rests on outdated information and second-hand stories. The pain of the inflammation is also easily blamed on the treatment, because both happen at the same time.

How long does a root canal take?

How many appointments you usually need

Most root canals need two appointments. The canals are not filled until the second one. Sometimes one is enough, sometimes more are needed. An appointment often lasts one to two hours.

What affects how long it takes

These points mainly decide how much work is involved:

• the number of canals: front teeth usually have one, back teeth generally two to three
• how far the inflammation reaches
• curved, narrow or branching canals
• an old root filling that must come out first

Until the tooth is fully restored

The build-up, filling or crown is a separate step. It should not be delayed long, or bacteria can get back in through any leaks.

Laser and digital X-rays at our clinic

Costs, the procedure and appointments at our clinic are covered on our page on root canal treatment in Küsnacht.

Laser to help disinfect the canals

We use the laser during the thorough cleaning of the canals. It kills bacteria there and helps to disinfect the canals. We then seal the canal tightly. Our laser page explains what the laser does in the root canal. The case study on an inflamed root canal shows one case from our clinic.

Digital X-rays at each step

We take digital X-rays, which use around 80 per cent less radiation than conventional methods. The images accompany each step of the treatment.

Restoring the tooth after a root canal

Why the tooth needs protection

Decay, old fillings and the access opening often remove much of the tooth's structure. The tooth then breaks more easily. Without a nerve, it also no longer feels cold or heat. New inflammation therefore often shows only on an X-ray. A tight, stable seal keeps new bacteria out and protects against fracture.

Tooth-coloured ceramic if a crown is needed

If a crown is needed, we make it from tooth-coloured ceramic. It is stable and hardly stands out next to the neighbouring teeth. With the CEREC system, it is made directly at the clinic, in two to three hours. Read more about a ceramic crown from the CEREC system.

How long does a root canal last?

There is no fixed figure. What matters is a tight seal, good care and regular check-ups, so that new decay is spotted early.

When the tooth cannot be saved

Reasons to keep your own tooth

Your own tooth keeps the familiar feel of chewing and preserves the bone around the root. Neighbouring teeth also do not drift into a gap. See our page on ways to save a natural tooth.

Retreatment, apicectomy or replacement

If the inflammation does not heal after treatment, the root filling can be renewed. Dentists call this retreatment. Another option is an apicectomy, a minor procedure that removes the root tip. If neither helps, the tooth is removed and replaced, for example with an implant or a bridge.