Root canal treatment has an old reputation that doesn’t match modern reality. For most people, a root canal is done to relieve pain and save a tooth, not to cause pain. The bigger issue is usually the problem that led to it, like deep decay or a crack.

This guide explains when a root canal is recommended, what it involves, and what you can expect.

Key takeaways: 

• Root canal is recommended when the nerve is irreversibly inflamed or infected.
• Modern root canal treatment is typically similar to getting a filling in comfort terms.
• Antibiotics alone don’t fix an infected tooth.
• Many root canal teeth need a protective restoration afterward.

When is a root canal needed?

A root canal is considered when the tissue inside the tooth (the nerve and blood supply) can’t recover. Common reasons include:

• Deep decay reaching the nerve
• Cracks that irritate the nerve
• Trauma that damages the nerve
• Long-standing large restorations breaking down
• Infection at the root tip

Symptoms that suggest you need an assessment

You might need a root canal assessment if you have:

• Lingering pain after hot or cold
• Spontaneous throbbing pain
• Pain waking you at night
• Swelling or a gum boil
• Tenderness when biting or tapping (sometimes)

Not all infections hurt strongly. Some are silent and only discovered on imaging.

What actually happens during a root canal?

In plain terms, root canal treatment removes the unhealthy tissue from inside the tooth, disinfects the space, then seals it to prevent reinfection. A typical process involves:

• Local anaesthetic to numb the tooth
• Isolating the tooth so it says clean and dry
• Removing infected or inflamed tissue
• Disinfecting the canals
• Sealing the canals and placing a restoration

Sometimes the tooth is treated over more than one visit depending on complexity and infection.

What does it feel like now?

Most people find modern root canal treatment manageable because the tooth is numbed properly. If a tooth is very inflamed, it can be trickier to numb, but there are ways to manage that. Your comfort is the priority.

Do antibiotics fix tooth infections?

Antibiotics can be appropriate in certain situations, especially where there is spreading infection or systemic symptoms. But antibiotics don’t remove the source of infection inside the tooth. Definitive dental treatment is still needed.

Aftercare and what to expect

It’s common to have mild tenderness for a few days. Severe pain, swelling or fever should be reviewed promptly. If a tooth is structurally weakened, we often discuss a protective restoration such as an onlay or crown to reduce fracture risk.

 

FAQ’s