Why are root canals so painful?

By:getNewToothbrush Blog

Why are root canals so painful?

Every year the American Association of Endodontists (AAE), spends the second week of May celebrating the Root Canal Awareness Week. Endodontists are dentists specializing in root canals among other treatments and they spend that week trying to dispel the myths about root canal treatment, also known as endodontic therapy.

You probably heard yourself say at some point when faced with a very painful situation, “I’d rather have a root canal!”, just like so many people. Root canals are recognized to be the most feared dental treatment. This is true to people that have gone through the procedure, but it has spread so far and wide in the collective unconscious that even people that never had one, are terrorized too.

 So why is this the single most painful dental treatment after tooth pulling?


You might already be in pain

Root canal treatment being the most feared dental treatment, many a patient prefers to postpone the necessary treatment for as long as possible. Some patients, wrongly, assume that because there is no pain, there is no need for a root canal. This might be true, but only in very few cases of incorrect diagnosis. Once your dentist or endodontist has established after testing and x-rays that you need a root canal, you do need one. It is always best to go ahead with treatment as soon as possible as pain may start at any time; and of course, oftentimes it will… in the middle of the night, leaving even strong men crying. Other patients assume that just like with a headache or stomachache, the toothache might subside on its own. This is not only a false calculation but a costly one; in terms of health since teeth never ever “cure spontaneously” and in financial terms since the cause of the coming and going pain will only keep deteriorating your already damaged tooth, costing oftentimes more to fix.

 So, because more often than not, you are diagnosed when you are already in pain, you assume that the root canal therapy is painful when the pain you feel is really caused by the infection of the nerve of your tooth. Root canal treatment in itself is painless and is performed to actually relieve you from pain. Being stressed about having a root canal can obviously also affect how you feel during the procedure, so keeping calm and cool is a good way of feeling less pain. Another misconception is that the moment the root canal treatment starts or at least the moment it finishes, the pain will fully disappear. This is unfortunately not necessarily true. The tooth itself will not be sensitive to cold or hot anymore, but the area surrounding the tooth can stay sensitive for a few days. The pain can be prevented in most cases though with a simple medicine prescribed by your dentist or endodontist.


You might have a ”hot tooth”

The term “hot” does not refer to the temperature of your tooth and much less even to how attractive it is, but can be explained as “a pulp (nerve) that has been diagnosed with irreversible inflammation and is usually accompanied by spontaneous and moderate-to-severe pain”. The dentist or endodontist working on your tooth will of course use anesthesia, also called local anesthetic, to numb the tooth and surrounding area. Unfortunately, in some instances, when the pulp of your tooth is severely infected, it becomes challenging to numb. The dentist needs a lot of patience and different anesthetic agents and/or techniques to anesthetize your tooth; achieving usually quite good anesthesia of the surrounding tissues but less results with the pulp itself. Sometimes, all the dentist can do at that point is get you as comfortable as possible.


What can you objectively expect during a root canal treatment?

Saving teeth is the endodontist’s priority and it should be yours as well. A natural tooth must always be preferred over any other options, wherever possible. Many teeth do not need to be removed and shouldn’t be; you would certainly not consider removing an arm or part of an arm that can be saved, well your tooth is as alive and important as your arm and should be treated in the same way.

As mentioned, the root canal treatment should not be feared since in itself it is painless. Surprisingly, a lot of patients fall asleep during the procedure!!

 Your dentist will open your tooth, which could alleviate pain at that point by letting pus out, if any, and lower the pressure in the pulp chamber (or root). The roots will not be removed, they are important and be used to reconstruct your tooth after, only the pulp will be taken out. Once pulp is removed, each root is cleaned, disinfected, shaped and sealed with a material called Gutta Percha to avoid future infections.

You might need between 1 to 3 sessions to finish a root canal depending on each case and must absolutely have your tooth restored as soon as possible to avoid re-infection and possibly losing your tooth due to it cracking. Should it be re-infected, you would need a retreatment, which is more expensive as retreating a tooth is more complex.

About 98% of endodontic therapy are successful. When they do fail, it is essentially due to a late or inexistent restauration (crown or onlay) as the filling placed on your tooth after the root canal is done only protects your tooth from bacteria leakage for a very short period of time.


Make sure you do not take your tooth for granted the moment your pain is gone, or the root canal is done as this is the surest way to stop smiling at once. Have the restauration complete, brush and floss as indicated by your dentist, use a service like getNewToothbrush to always have a fresh toothbrush at your disposal and have regular dental checkups.