Root canals have an undeserved reputation. Most patients who have had one say it felt about the same as getting a filling. The reputation comes from a time when dental anesthesia was less effective and techniques were more involved. Modern root canal therapy is comfortable, and more importantly, it relieves the pain that sent you to the dentist in the first place.
Here is what you need to know if you are wondering whether you might need one.
What a root canal actually is
Inside every tooth, beneath the hard enamel and dentin, is a soft inner chamber called the pulp. It contains nerves, blood vessels, and connective tissue. When decay reaches the pulp, or when the tooth is cracked deeply, or when a tooth has been through repeated dental procedures, the pulp can become infected or irreversibly inflamed.
A root canal removes that infected or inflamed pulp, cleans and shapes the inner canals, and seals the tooth to prevent reinfection. The tooth stays in place. A crown is typically placed afterward to protect it, since a tooth that has had its pulp removed becomes more brittle over time.
Signs you might need a root canal
These symptoms do not automatically mean you need a root canal, but they are reasons to call us and come in for an evaluation:
Persistent, throbbing toothache. Pain that is severe and ongoing, especially pain that wakes you up or is not relieved by over-the-counter pain medication, is a red flag. A toothache that lingers after the irritant is removed (like pain that stays for more than a few seconds after eating something cold) can indicate the pulp is affected.
Prolonged sensitivity to hot or cold. Brief sensitivity is normal. Sensitivity that lingers for 30 seconds or more after the temperature source is removed suggests the nerve tissue inside the tooth may be inflamed or dying.
Darkening of the tooth. A tooth that has turned gray or dark compared to its neighbors may be dying internally. This can happen after trauma to a tooth even if there was no obvious damage at the time.
Swelling or a pimple-like bump on the gum. A small bump, sometimes called a dental abscess or "gum boil," near a tooth indicates infection. These are often painless but signal a problem that needs to be addressed.
Pain when biting or chewing. Sensitivity specifically when pressure is applied to a tooth, especially if it is not going away, can indicate infection or an inflamed pulp.
How we determine whether a root canal is needed
We cannot diagnose a root canal from symptoms alone. At Copper Sky Dental, we take X-rays to look at the root and surrounding bone. We may do a cold test, applying a small amount of cold stimulus to the tooth, and observe how it responds and for how long. We check for swelling, tenderness to percussion, and examine the gum tissue around the tooth.
Sometimes a tooth looks like it might need a root canal and turns out not to. Sometimes the opposite is true. The evaluation gives us a clear answer before any treatment begins.
What the procedure involves
We start with local anesthesia to fully numb the tooth and surrounding area. This is the most important step. Once you are numb, the procedure is no more uncomfortable than a filling. You may feel pressure, but not pain.
We place a small rubber dam around the tooth to keep the area dry and clean. Then we create a small opening in the crown of the tooth to access the pulp chamber. Using very fine instruments, we remove the pulp and clean and shape the canals. The canals are then filled with a biocompatible material and sealed.
Most root canals are completed in one to two appointments. Front teeth typically have one canal and are straightforward. Back molars can have three or four canals and may take a bit longer.
After the root canal, the tooth needs a crown. A filling alone is not sufficient protection for a tooth that has had its pulp removed, especially a back tooth that handles chewing forces. We can often place the crown at a follow-up appointment within a few weeks.
Recovery
The tooth and surrounding area are often tender for a few days after the procedure. This is normal. Over-the-counter ibuprofen or acetaminophen handles most of the discomfort. Avoid chewing on that side until the crown is placed.
The infection-related pain you had before the root canal should be gone or significantly reduced. If you had a severe abscess, there may be some residual soreness while the infection fully resolves, but the acute pain typically disappears within a day or two.
Root canal versus extraction: which is better?
The goal is always to save the natural tooth. Your own teeth are stronger than any replacement, and keeping a tooth avoids the bone loss that occurs after an extraction. Root canals have a high success rate and a treated tooth can last the rest of your life with proper care.
That said, there are situations where a tooth is too far gone to save, where the cost of a root canal and crown exceeds what the tooth is worth given its condition, or where extraction and implant placement is the better long-term option. We give you an honest assessment and let you make the decision with full information. We also offer free second opinions if you have been told you need a root canal and want a second look.
Does it have to be done now?
Dental infections do not stay contained. A tooth that needs a root canal and does not get one will typically worsen, and the infection can spread to surrounding teeth and bone. In rare cases, severe dental infections require hospitalization. Putting it off is not a safe option if the diagnosis is clear.
If cost is a concern, let us know. We work with patients to find a path forward. Our restorative dentistry team can walk you through all available options, including phased treatment, to make sure the tooth is protected even if the crown comes a few weeks later.
If you have a toothache, sensitivity that is not going away, or a swollen or darkened tooth, call us at (623) 933-8410 or schedule online. We see patients from Peoria, Sun City, Sun City West, Glendale, and Surprise. Same-day appointments are available for dental pain.