Are Root Canals Painful?

We previously discussed the times and circumstances where a person might need to have root canal treatment performed, but many people are wary of having it done. You may have heard people say it’s a painful procedure, but is there any truth to that, or is it just a myth.

The best way to find out is to talk to the dentists who perform them. We asked them to help clear this up, and here’s what they had to say:

Historically, root canals have been labeled as a very painful dental procedure. Before the advent of more effective local anesthetics, many types of dental treatment, including root canals, may have caused pain.

That is not the case anymore.

At this time, there is virtually no dental treatment that should cause any pain. A well-trained dentist now has several different types of local anesthetics to use and multiple modes of delivering that anesthetic so that the treatment is pain-free.

There are some patients who have high anxiety and may react to the vibration of the sound of the dental treatment. That can be counteracted by a combination of oral sedatives, nitrous oxide or laughing gas, and headphones. So, although the preparation and sound don’t actually hurt, it can be bothersome to the anxious patient.

After the root canal is started or after it is been completed, if there is any soreness, that soreness can be quickly eliminated with ibuprofen or Tylenol or a combination of both.

James Lalonde, DDS – Prosthodontist in Lafayette, IN

Root canal therapy, performed on a tooth that is not painful at the time of the procedure, is not typically painful and tends to have very little post-operative pain.

Unfortunately, if the tooth is painful prior to the root canal treatment, it is likely that the blood supply to the pulp and surrounding tissues is compromised, which makes movement of the anesthetic into the appropriate sites difficult. Furthermore, since anesthetic medication comes in an acidic form to keep it stable, it must be neutralized by the tissue electrolytes within the body at and near the site of injection. When infection abounds, the local tissues become acidic due to the byproducts and toxins released by the bacteria, causing the infection and host response. Therefore adequate anesthesia of a painful and/or infected tooth is difficult to get adequately anesthetized, and some pain may be experienced during the procedure and, even post-operatively in these case until the diseased pulp tissue is adequately removed and the surrounding infection and swelling is effectively managed regardless of even the best endodontic techniques performed by the best endodontists.

As a general rule, the more painful a tooth is prior to root canal therapy, the more discomfort that can be expected during and after the procedure. However, this should not be justification to decline appropriate root canal therapy because the same principles apply to pain expectations with an extraction. The best method of prevention of pain is to seek regular dental preventive maintenance and to notify your dentist at the earliest sign of any dental problem.

Kevin D. Huff, DDS – Dentist in Dover, OH

Most root canals are not painful. Just like when we work on a tooth to fix a filling we get the tooth numb. Anesthetics are much more capable of numbing even an infected tooth. Much of the pain associated with a root canal is due to pressure building up inside the tooth so once the root canal is started much of that pain will subside. In a severe infection case there may be difficulty getting numb but we have better ways to deal with that as well.

Cynthia M. Sachs, DDS – Dentist in Rockford, IL

Thanks to modern dental advances, most dental procedures–including root canal therapy–should be nearly painless. As Dr. Huff points out, however, a person who is already in pain because of an infection that has gone untreated for too long is the one most likely to encounter difficulties. This is all the more reason why you should visit a dentist at the first sign of a problem, rather than putting it off until it’s causing you pain.