Most people associate having a root canal with a lot of pain and discomfort. However, while most people can expect some discomfort during and after a root canal procedure, excessive pain is not normal.

Modern technology and the use of anesthetics make this procedure quick, safe, typically pain-free, and an excellent way to help save the natural tooth.

However, to avoid needing root canal treatment, anyone who has a toothache should see a dentist promptly to prevent any infection from getting worse, forming an abscess, or spreading throughout the tooth root system.

How much pain is normal?

Most people report feeling a little sensitive or tender for a few days after having a root canal.

There are several reasons for this:

  • The tissue around the gums remains swollen or inflamed: Even though the dentist has removed the nerve root from the tooth, there are still small nerves in the ligaments and tissue surrounding the tooth. When this area is inflamed, such as after a dental procedure, these nerve endings can also register discomfort.
  • Instrument damage: It is possible that a dental instrument used to clean out the root canal inadvertently damaged the sensitive surrounding tissue.
  • High temporary filling: This is when the dentist put in the temporary filling and they did not smooth it down enough. If the filling is even just a little higher than the surrounding tooth, it can cause the mouth to bite harder on that spot, which would make the tooth sore.

In most cases, the sensitivity and discomfort associated with a root canal should go away within a few days.

If it does not get better, or if the pain is severe or unrelieved by home measures, it is important to call the endodontist or dentist for an evaluation.

Can a root canal fail?

Fortunately, most root canals are successful. However, some root canal treatments are unsuccessful, and a person can experience more pain. There are many reasons why this happens:

  • the restoration begins to leak
  • poor oral or dental hygiene
  • breakdown of the tooth or sealing material over time
  • presence of an extra canal in the tooth that the endodontist cannot see
  • an obstruction such as a curved root canal that prevents complete cleaning of the canal
  • vertical cracks in the tooth
  • dentist or endodontist error

If the cause of the pain is due to a missed canal, the endodontist will need to open the tooth, remove the filling and try to find the canal.

If the tooth has a vertical fracture, the dentist would likely have to remove the tooth.

If a person experiences persistent inflammation or infection after a root canal, they may require a surgical procedure called a root-end resection.

Managing root canal pain at home

Over-the-counter or prescription pain relievers should be sufficient to relieve the pain after a root canal. When using medications, make sure to follow instructions carefully and call the endodontist if the pain medication is not working. Ibuprofen is a pain reliever available for purchase online.

It is important to avoid chewing or biting down on the affected tooth until the final restoration has been completed. The temporary filling is delicate and may break as a result. Also, practicing good oral hygiene with regular brushing and flossing should continue. A range of toothbrushes, toothpaste, and dental floss is available for purchase online.

How is a root canal performed?

A root canal is usually performed by an endodontist (a specialist who cares for the inside of teeth).

The following are the steps of a root canal procedure:

  • The endodontist prepares for the procedure by examining and X-raying the tooth. Next, the dentist gives a local anesthetic to numb the tooth and places a protective covering (rubber dam) in the person’s mouth to isolate the damaged tooth and protect the rest of the mouth.
  • The endodontist makes an opening in the top of the tooth to access the delicate structures inside. The dentist then removes the pulp from the chamber and root canals using very small instruments.
  • The dentist then cleans and shapes the root canals to make space for the filling, and possibly, a post to support the tooth.
  • The endodontist fills the root canals with a rubber-like substance called gutta-percha and then places an adhesive on top of the gutta-percha to seal it within the tooth.
  • The endodontist will then put a temporary filling on top of the tooth to protect the inside of the tooth while it is healing.

A person who has undergone root canal treatment will need to revisit the dentist to have the temporary filling removed. At this stage, the dentist will either put in a permanent crown or will carry out other permanent restoration on the tooth.

Once the root canal is complete, the tooth should be back to full functioning and should not cause any more pain.


Root canal treatments are carried out millions of times each year. In most cases, endodontic treatment can successfully save a tooth that has been infected or damaged.

New technologies and anesthetics help to ensure that a root canal procedure is as comfortable as possible. People who experience severe or lasting pain should report it to the endodontist for further evaluation.


Author: Nicole Galan, RN 

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