So You Need a Root Canal. Here’s What to Expect.

TL;DR

• Root canals aren’t nearly as bad as their reputation.

• The procedure itself is usually comfortable, thanks to modern anesthesia.

• Most people feel relief, not pain, afterward.

• Recovery is quick, but a crown is often key to long-term success.

• Ignoring a needed root canal almost always leads to more pain, more damage, and higher costs.

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If someone just told you that you need a root canal, chances are your stomach dropped a little. That reaction is incredibly common and honestly, understandable.

Root canals have been misunderstood for decades, mostly because of outdated stories and pop culture exaggeration.

The reality is that modern root canals are routine, predictable, and designed to stop pain… not create more of it.

Let’s walk through what to expect, step by step, so you can go into it informed, calm, and without assuming the worst.

What Is a Root Canal?

A root canal is a procedure that removes infection from inside your tooth, specifically from the pulp, which is the soft tissue that contains nerves and blood vessels.

When bacteria reach the pulp (usually through deep decay, a crack, or a failing filling), the infection can’t heal on its own. Left untreated, it spreads deeper into the tooth and surrounding bone.

A root canal:

• Removes the infected tissue

• Cleans and disinfects the inside of the tooth

• Seals it to prevent reinfection

• Allows you to keep your natural tooth

Despite the name, we’re not actually removing the roots of the tooth. We’re hollowing them out and cleaning them.

How Do I Know If I Need This Procedure?

Some people know right away. Others are surprised.

Common signs include:

• Tooth pain when chewing or biting

• Lingering sensitivity to hot or cold

• Swollen or tender gums

• A small pimple or boil on the gums

• Darkening of the tooth

• Facial or jaw discomfort

And sometimes there are no symptoms at all.

Teeth with infected pulp don’t always hurt right away, especially if the nerve has already died. That’s why regular dental X-rays matter. They often catch problems before they turn into emergencies.

What Happens During a Root Canal Procedure?

Here’s what the appointment actually looks like:

First, the tooth is thoroughly numbed. Most patients feel pressure and vibration, but not pain. If you’re comfortable during a filling, you’ll likely be comfortable during a root canal.

Next, we place a small rubber dam to keep the area clean and dry. Then a small opening is made to access the infected pulp. Tiny instruments are used to remove the infection and clean the canals.

Once everything is disinfected, the canals are filled with a rubber-like material called gutta-percha and sealed. A temporary filling is placed until the tooth is permanently restored.

How Many Hours Does a Root Canal Take?

Most root canals take about 60 to 90 minutes. Some are completed in one visit, while others may take two appointments depending on the tooth and level of infection.

One thing patients often say afterward: “That's it? That was easier than I expected.”

How Do I Prepare for a Root Canal?

Preparation is simple.

• Eat a normal meal beforehand

• Brush and floss like usual

• Take prescribed antibiotics if given

• Bring headphones or music if dental sounds bother you

• Let us know if you’re anxious. We can slow things down and explain as we go

No fasting or special rituals involved. Just show up!

What Happens After Root Canal Treatment?

After the procedure, your mouth will feel numb for a few hours. Once that wears off, mild soreness or tenderness is normal for a few days.

Most people:

• Return to work or daily activities the same day

• Manage discomfort with over-the-counter pain relievers

• Notice relief from the infection pain fairly quickly

This isn’t a “stay on the couch for a week” situation for most patients.

How Long Does It Take to Heal After a Root Canal?

Initial healing typically takes a few days to a week. Some mild sensitivity when chewing is normal during that time.

If pain worsens instead of improves, or if swelling develops, that’s a sign to call your dentist. Those situations are uncommon, but important to address early.

What Should You Not Do After a Root Canal?

A few key don’ts:

• Don’t chew on the treated tooth until it’s crowned

• Don’t skip your follow-up appointment

• Don’t assume “no pain” means “no problem”

Root canal–treated teeth don’t always send warning signals, which makes proper restoration even more important.

Do You Need a Crown After a Root Canal?

In most cases, yes.

A tooth that’s had a root canal is more brittle because it no longer has a blood supply. A crown protects it from cracking and restores full strength.

What if there’s decay under an existing crown?

This is a common and frustrating situation.

If decay forms under a crown, especially on a tooth that’s already had a root canal, the crown usually needs to be removed and replaced. Trying to “patch” decay without removing the crown rarely seals the problem and often allows bacteria to keep spreading.

Crowns don’t last forever, and teeth don’t become immune to decay.

What Are the Benefits of Root Canal Treatment?

Root canals:

• Eliminate infection

• Relieve pain

• Preserve your natural tooth

• Prevent bone loss and bite changes

• Can last decades with proper care

In dentistry, saving a natural tooth is almost always preferable to replacing it.

What Are the Risks or Complications?

Root canals have a high success rate, but potential complications include:

• Missed canals

• Cracks in the tooth

• Delayed crown placement

• Reinfection years later

Most issues aren’t caused by the root canal itself, but by waiting too long or skipping proper restoration.

What Are the Real Costs Associated With Root Canals?

This is where many decisions get tough.

Generally:

• Root canal + crown = moderate upfront cost

• Extraction = cheaper short term

• Implant = highest long-term cost

Removing a tooth may seem simpler, but it often leads to shifting teeth, bone loss, and additional dental work later. A root canal is usually the most conservative long-term option.

What Happens If You Don’t Take Care of a Root Canal?

Untreated infections don’t resolve on their own.

They can:

• Spread into the jawbone

• Cause abscesses and swelling

• Lead to tooth loss

• Turn into dental emergencies

Ignoring the problem almost always makes it more complicated and more expensive.

Are Root Canals Safe During Pregnancy?

Yes. When needed, root canals are considered safe during pregnancy, especially during the second trimester. Treating infection is often safer than delaying care.

Final Thoughts

Root canals aren’t something anyone looks forward to. But they’re also not something you should fear. Modern dentistry has turned them into a routine, effective way to save teeth and relieve pain.

If you’ve been told you need one, the best next step is a calm conversation with your dentist.

If you’re looking for a dentist in Amherst, NY, my team and I are always happy to walk you through your options and make sure you know exactly what to expect.