4 important facts about root canals

If you’ve been told that you need a root canal, you’re not alone. According to the American Association of Endodontists, more than 15 million root canal procedures are performed every year.¹

For some, the words “root canal” may cause anxiety and fear. One study found that more people are afraid of getting a root canal then other very common fears, like speaking in public.²

Here’s the better news: There’s a lot of misinformation out there about root canals, which contributes to the treatment’s reputation. Read on to learn what a root canal is and when and why you might need one — plus 4 important facts to help calm fears.

A root canal is a procedure that involves removing dying or dead nerve tissue and bacteria from the pulp, or innermost part, of the tooth. The pulp is made up of blood vessels, nerves and soft, connective tissue, explains endodontist Garry L. Myers, D.D.S., an associate professor and director of the graduate program in endodontics at the Virginia Commonwealth University School of Dentistry in Richmond.¹

“A tooth’s nerve pulp runs through the root canal system inside the root of every tooth,” he says. The problem occurs when the pulp becomes inflamed or infected. Unfortunately, an infection won’t heal on its own. And it can cause pain when the infection inside the tooth spreads out of the root into the surrounding bone.³

Root canals are done to help save your tooth. They’re done by a general dentist or an endodontist, which is a dentist who specializes in diagnosing tooth pain and performing root canals.⁴

To remove the infected pulp, the dentist numbs the area with local anesthesia and creates an opening by drilling a hole in the top of your tooth, according to the American Dental Association.⁴ Then they clean out and disinfect the affected tooth, fill it with a soft material and, typically, apply a crown.^3,4

There are many reasons for having a root canal, notes Dr. Myers. “Needing a root canal may result from a deep cavity or from trauma or injury to the tooth, such as when a tooth is fractured or when a tooth is knocked out,” he says.

“Or it may be a part of natural aging and wear and tear over the years,” he continues. This results from basic things like the many meals you’ve chewed over your lifetime. The amount of dental work you’ve had and the number of teeth cleanings that you’ve gotten also factor in, he adds. “The nerves in our teeth are simply not as resilient when we get older, compared to when we were younger,” explains Dr. Myers.

Here are some key facts that will help ease some misconceptions about the procedure.

One of people’s most common fears is that the procedure will be painful, notes Dr. Myers. But a root canal typically doesn’t hurt. “It’s very rare for a root canal to be painful during the procedure. If it is, it’s often because there’s a lack of good local anesthesia,” he says.

In fact, thanks to up-to-date dental techniques, patients who undergo a root canal are 6 times more likely to describe it as painless than patients who have a tooth extracted, per the American Association of Endodontists.⁵

Still, you may feel some discomfort a day or 2 afterward. In that case, taking an over-the-counter pain reliever is usually enough to take the edge off, explains Dr. Myers. Antibiotics may be prescribed if an infection is present.⁴

Other possible symptoms after a root canal include sensitivity, swelling and inflammation.^1,3 However, if you have pain or any uncomfortable symptoms for longer than a week after the root canal, see your dentist, recommends Dr. Myers.

Some people think that once you have a root canal, you no longer have a live tooth. On the contrary, a root canal treatment saves your natural tooth and helps you avoid having to have the tooth pulled.³

Although the damaged or dead nerves inside the tooth are removed, the tooth still has roots, Dr. Myers notes. “Nerves and a blood supply still remain outside of the roots, providing nourishment to the roots of the tooth,” he says.

Root canal procedures have a very high success rate. A 2023 study published in Clinical Oral Investigations found that the success rate of a tooth surviving after a root canal ranged from 97% after 10 years to 68% after 37 years.⁶ The American Dental Association says that with proper care, your restored tooth can last a lifetime.⁴

In the event that your tooth hasn’t properly healed, or if you experience a problem, such as a loose, cracked or broken crown, you can have a redo. That’s called a retreatment.⁷

There are some things beyond your control that may result in needing a root canal, such as a tooth breaking on a popcorn kernel. But you can take certain steps to help decrease the chances of needing a root canal, Dr. Myers says. Those include practicing good oral hygiene by brushing your teeth twice a day with fluoride toothpaste, flossing daily and keeping regular dental visits.

“The best way to avoid a root canal is to take good care of your teeth and see your dentist routinely, at least once a year,” says Dr. Myers. “Getting regular exams can allow your dentist to pick up the little things early on to prevent bigger problems from developing later.”

Remember, some hard, sticky foods can cause teeth to chip, crack or break. And sugary foods and beverages — along with poor home care of your teeth — can lead to cavities. Cavities, or dental infections, can lead to you needing a root canal.³

Above all, remember this: If you do have to get a root canal, it may not be as bad as you think. Plus, it can actually save a tooth. So, talk to your dentist if you think you might need one.