Root Canal Explained
Has your dentist or endodontist told you that you need a root canal? If so, you're not alone. More than 15 million teeth are treated and saved each year with a root canal, which is also called endodontic treatment. This page explains root canal treatment in detail and answers common questions about root canals so you can relieve your tooth pain and save your natural teeth.
Root Canal Basics
“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. Root canal treatment is one type of endodontic treatment.
To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it. Learn more about exactly what a root canal is.
Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay repeated dental procedures on the tooth or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
There are a few symptoms that mean you might need a root canal—
- Severe pain while chewing or biting
- Pimples on the gums
- A chipped or cracked tooth
- Lingering sensitivity to hot or cold, even after the sensation has been removed
- Swollen or tender gums
- Deep decay or darkening of the gums
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Afterward, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.
For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.
Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.
Endodontic treatment can often be performed in one or two visits and involves the following steps:
- The endodontist examines and takes a radiograph of the tooth using x-rays, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
- The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp
chamber and root canals and to shape the space for filling. - After space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called gutta-percha. The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
- After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
What is a root canal?
A root canal is a dental procedure often performed by an Endodontist to treat infection or inflammation inside a tooth. “Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. Root canal treatment is one type of endodontic treatment.
To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue, and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it. Learn more about exactly what a root canal is.
How is a root canal done?
A root canal is performed when the endodontist removes the infected or inflamed pulp and nerves in the root of the tooth, cleans and shapes the inside of the root canal, then fills and seals the space. Afterward, your regular dentist will place a crown on the tooth to protect and restore it to its original function. Anchor link to step by step procedure FAQ
Does a root canal kill the tooth?
A root canal does not kill the tooth, and after a root canal is complete, the tooth will be able to function as it normally does.
Why are root canals considered a standard dental treatment?
Root canal treatment is considered a standard dental procedure because it is a safe, effective and predictable way to eliminate infection, relieve pain and preserve your natural tooth. Decades of clinical research and advancements in materials, imaging, and techniques have made root canal treatment highly successful. Saving your natural tooth helps maintain normal biting force and sensation, protects neighboring teeth from excessive wear or strain, and supports your overall oral health.
How to know if you need a root canal?
Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, a traumatic injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
What are the signs of needing a root canal?
There are a few symptoms that mean you might need a root canal—
- Severe pain while chewing or biting
- Pimples on the gums
- A chipped or cracked tooth
- Lingering sensitivity to hot or cold, even after the sensation has been removed
- Swollen or tender gums
- Deep decay or darkening of the tooth
What happens if you don't get a root canal?
If left untreated, the localized infection in the tooth can progress into an abscess and spread to adjacent tissues, and in some cases can even be life threatening. If you are in need of a root canal, the infected pulp in the tooth needs to be removed.
When is it too late to get a root canal?
Waiting too long to get a root canal can oftentimes result in tooth loss. Many times with severe furcation, it might be too late for a root canal and the tooth would need to be extracted.
Can all teeth be treated endodontically?
Most teeth can be treated. Occasionally, a tooth can’t be saved because the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When non-surgical endodontic treatment is not effective, endodontic surgery may be able to save the tooth.
There are a few symptoms that mean you might need a root canal—
- Severe pain while chewing or biting
- Pimples on the gums
- A chipped or cracked tooth
- Lingering sensitivity to hot or cold, even after the sensation has been removed
- Swollen or tender gums
- Deep decay or darkening of the gums
What kind of dentist does root canals?
While all general dentists have been trained in root canals, endodontists are specialists in root canal treatment. Generally speaking, a general dentist specializes in treating and restoring crown of the tooth and gum health; an endodontist specializes in the health of the inside of the tooth.
Endodontists are dentists with at least two additional years of advanced training who specialize in saving natural teeth through root canal treatment, using specialized techniques and modern technology to deliver the highest level of care. Learn more about Endodontists.
The Procedure
How does endodontic treatment save the tooth?
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Afterward, you will return to your general dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Step-by-Step Endodontic Procedure
Endodontic treatment can often be performed in one or two visits and involves the following steps:
Step 1: The endodontist examines and takes a radiograph of the tooth using x-rays, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
Step 2: The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
Step 3: After space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called gutta-percha. The gutta-percha is placed along with a cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your general dentist before the tooth is restored.
Step 4: After the final visit with your endodontist, you must return to your general dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
How many visits does a root canal take?
Most root canals can be done in one to two appointments. The first appointment is the procedure itself when the infected pulp is removed. The subsequent appointment(s) is when the root canal gets cleaned and filled with a crown or other filling to prevent infections. Each appointment lasts roughly 90 minutes each.
Can you be put to sleep for a root canal?
Generally speaking, most endodontists choose local anesthesia for a root canal, meaning they are only numbing the area that needs to be treated. However, the option for sedation varies from endodontist to endodontist, and it’s best to consult your local office about their policies.
Root Canal Pain & Recovery
Is a Root Canal Painful?
Modern root canal treatment is typically painless and actually relieves the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, the vast majority of patients report that they are comfortable during the procedure.
Will I feel pain during the root canal?
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.
Your tooth may feel slightly sore for a few days after your endodontic treatment is completed while the area heals. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.
Why do people think root canals are painful?
The idea that root canals are painful is based largely on outdated information. Before modern anesthetics and advanced techniques were widely available, dental procedures could be uncomfortable. Today, root canal treatment is designed to relieve the pain caused by infection—not cause it. In fact, most patients report that having a root canal feels similar to getting a routine filling done.
Will I feel pain after the root canal?
For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.
Is pain after a root canal normal?
Mild soreness or tenderness after a root canal is normal for a few days, especially if the tooth was infected or painful beforehand. The surrounding tissues may need time to heal. This discomfort is usually manageable with over-the-counter pain relievers and should steadily improve. If pain is severe, worsens, or lasts more than a few days, contact your endodontist for evaluation.
How long does pain last after a root canal?
Most patients experience mild discomfort for a few days following treatment. Sensitivity when biting or touching the tooth is common during the initial healing period. In the majority of cases, symptoms improve within three to five days. Prolonged or increasing pain is uncommon and should be evaluated by your endodontist.
What helps relieve pain after a root canal?
Over-the-counter medications, such as ibuprofen or acetaminophen, are often sufficient to manage post-treatment discomfort. Applying a cold compress to the outside of the cheek for short intervals can also help reduce swelling. Avoid chewing on the treated tooth until it has been fully restored with a crown or permanent filling, and follow all aftercare instructions provided by your endodontist.
What to expect after a root canal?
For the first few days after a root canal, some patients may experience some sensitivity as the area heals. A follow-up appointment with your regular dentist to restore the tooth after the root canal is completed is usually needed. Your endodontist may want to check your tooth for healing in 6-12 months after the treatment is finished.
Will the tooth need any special care or additional treatment after endodontic treatment?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your general dentist for a permanent restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.
Most endodontically treated teeth last as long as other natural teeth. Rarely, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure or performing endodontic surgery can save the tooth.
Can I brush my teeth after a root canal?
Unless told otherwise by your dentist or endodontist, brush and floss as you regularly would after a root canal treatment.
Will a tooth turn black after a root canal?
Root canal treatment does not discolor the tooth, but if the tooth is dark before treatment, and still doesn't match the adjacent teeth after the root canal treatment, then the tooth can be bleached internally.
What not to do after a root canal?
After a root canal, make sure to follow all of your endodontist’s instructions, which most often include avoiding hard or especially chewy foods, brushing twice a day, and being very cautious around the area where the root canal procedure was completed.
What can I eat after a root canal?
After a root canal, try to eat soft foods that require very little chewing, like applesauce, yogurt, eggs, and fish until the tooth is permanently restored by your general dentist. Avoid hard foods that might fracture your teeth, until the tooth is permanently restored. Some dentists may suggest to not eat for a few hours until the numbness in your mouth wears off so you don’t bite your cheek or tongue.
Can you drink alcohol after a root canal?
After a root canal procedure, you can eat and drink normally, including alcohol, once the numbness wears off.
Can you eat before a root canal?
You can eat normally before a root canal treatment.
Can I drive after a root canal?
Most root canal procedures are done using local anesthesia, meaning only the areas that are being treated will be numb during the course of the procedure. This means you are awake and aware during the process and can drive and operate machinery as you normally would immediately after the procedure is over.
Can you smoke after a root canal?
While you can smoke after a root canal, it is not recommended as quitting smoking is beneficial for your overall health. Smokers are nearly twice as likely to need root canals than non-smokers, and that number increases with more years of smoking.
Risks, Costs & Options
Can a root canal fail?
Root canals can fail for a variety of reasons, including a procedure that didn’t clean the canals to begin with, a breakdown of the crown or its inner sealant, or essentially anything that allows the tooth that previously had a root canal treatment to become infected inside the roots.
What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. This usually occurs if the tooth had a prior root canal treatment, often not performed by an endodontist. In some cases, the endodontist may discover additional very narrow or curved canals that were not treated during the initial procedure.
How long does a root canal-treated tooth last?
With proper restoration and good oral hygiene, a tooth that has had a root canal can last a lifetime. Studies show that root canal treatment has a success rate of more than 90%, and millions of teeth are successfully treated each year. The long-term outcome depends on factors such as the extent of the original infection, how quickly the tooth is restored with a crown or filling, and how well you care for your teeth afterward. Learn more about how long root canal–treated teeth last on our Longevity page and related FAQs.
What factors affect the longevity of a root canal?
Several factors influence how long a root canal–treated tooth will last, including timely placement of a permanent restoration (such as a crown), maintaining good oral hygiene, attending regular dental checkups, and avoiding habits like chewing ice or using teeth as tools. Teeth in the back of the mouth, which endure greater chewing forces, often benefit from full coverage crowns to protect against fracture. Smoking and untreated decay can also reduce long-term success.
Do you need a crown after a root canal?
Needing a crown after a root canal depends highly on the location of the tooth in the mouth—teeth towards the back of the mouth like molars and premolars are needed more for chewing, and generally require crowns, where incisors or canines which aren’t needed for chewing don’t always require crowns.
Do root canals cause cancer?
There is absolutely no evidence that a root canal can cause cancer. All claims that root canals cause cancer or other illnesses are complete myths.
Are root canals safe for long-term health?
Yes. Root canal treatment is a well-established, evidence-based procedure that has been safely performed for decades. By removing bacteria and infected tissue from inside the tooth, root canal treatment helps prevent the spread of infection and supports overall oral and systemic health. When properly restored and maintained, root canal–treated teeth function like other natural teeth.
Can root canals cause systemic disease?
There is no valid scientific evidence linking properly performed root canal treatment to systemic diseases. This misconception stems from outdated research conducted nearly a century ago before modern sterilization and imaging techniques existed. Contemporary studies show that eliminating dental infection through root canal treatment reduces overall inflammation in the body rather than causing illness.
Are root canals linked to heart disease?
No. Current scientific evidence does not support a link between root canal treatment and heart disease. Treating infection inside a tooth with a root canal can help reduce the body’s bacterial burden and support better overall health.
Where did the focal infection theory come from?
The focal infection theory originated in the early 1900s, when limited scientific methods led some researchers to incorrectly believe that root canal–treated teeth could cause systemic illness. The research supporting this theory has since been thoroughly discredited. Modern endodontic procedures are performed using advanced sterilization protocols, magnification and imaging technologies that effectively treat root canal infection and make root canal treatment safe and predictable.
How much will the root canal procedure cost?
The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat; the fee is usually more. Most dental insurance policies provide some coverage for endodontic treatment.
Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with an implant or bridge to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more and take more appointments than endodontic treatment and appropriate restoration.
Is a root canal covered by insurance?
Many dental insurance plans provide coverage for root canal treatment because it is considered a predictable procedure to eliminate infection and save a natural tooth. Coverage levels vary by plan, so it is important to review your individual benefits or contact your insurance provider. Your dental office can often help estimate out-of-pocket costs before treatment begins.
Is it better to have a root canal or extraction?
It is always better to maintain a healthy, natural tooth whenever possible, and root canals allow for just that. Extracting and then replacing a tooth results in more expensive treatments, more procedures, and could even impact neighboring teeth and supporting gums.
Is a dental implant better than a root canal?
Whenever possible, saving your natural tooth with a root canal is the preferred option. Natural teeth are designed to function in harmony with surrounding teeth and bone. While dental implants are a reliable replacement option when a tooth cannot be saved, they require surgery and additional healing time. Preserving your natural tooth with root canal treatment is typically less invasive, less expensive, and requires fewer appointments, while at the same time helping maintain your natural bite and jawbone structure.
Can you refer me to an endodontist?
You can self-refer to an endodontist. While the AAE cannot recommend a particular doctor, you can search for a member in your area through the Find My Endodontist search engine.
Can you tell me if Dr. (insert name) is Board-certified?
All AAE member endodontists are licensed by the state in which they practice. Some endodontists have chosen to become Diplomates of the American Board of Endodontics and are “Board-certified.” You can search for an endodontist who has achieved Diplomate status through the ABE website.
Are endodontists available on weekends?
Most endodontists offer tremendous flexibility in accommodating emergency cases including weekends in some cases so your pain can be relieved quickly.
How do I file a complaint?
First, try to resolve the issue with your endodontist. If that does not alleviate your concern, contact your state dental board. Most boards are composed of members of the profession as well as members of the public. They may ask for a written statement prior to investigating and/or taking any disciplinary action against those who have engaged in misconduct.
A list of all state dental boards can be found here: https://www.ada.org/resources/licensure/state-dental-boards
Can you give me the name of an endodontist who utilizes a specific type of sedation or who accepts a particular insurance/medicaid?
The AAE does not keep a record of what methodologies or practice management tools each endodontist utilizes in their practice. It is best to find a list of Endodontists in your area and contact them to see which one(s) meet your needs.
Can you provide an educational background for Dr. (insert name)?
Yes. Please contact the Headquarters office through info@aae.org, or by calling 800-872-3636 (U.S., Canada, Mexico) or 312-266-7255. You can also use the AAE’s Find My Endodontist search engine and visit Endodontists’ practice websites for more information.
Root Canal Information in Other Languages
Click here to view endodontic treatment information in French, Japanese, Portuguese or Spanish.
Content Review & Medical Accuracy
The information on this page is reviewed by members of the American Association of Endodontists who are board-certified endodontists from the American Board of Endodontics and updated regularly to reflect current clinical standards and research.
This information is for educational purposes and is not a substitute for professional advice. For specific questions about your needs, please contact an AAE Endodontist through the Find My Endodontist Directory.