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Does root canal hurt?

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Medically reviewed by: Dr Adeel Nazir BDS(Lond) MJDF RCS MScEndo(KCL)

root canal

A really simple question, with a very complex answer

Does a Root Canal hurt?

Like many things in dentistry, root canal’s reputation is that of a scary and painful procedure. However, there are very many variables to consider before we can categorically say that root canal’s don’t hurt (spoiler alert!… the procedure itself doesn’t hurt, but what causes you to need the root canal treatment usually does).

What causes you to need root canal treatment?

Your tooth is supplied by very small nerves, that travel from your jaw bone, up through the root canal to a small pulp chamber. It’s this blood and nerve supply that gives your teeth the ability to feel hot & cold. Damage to this nerve supply can cause your tooth to devitalise and this is when you will need a root canal treatment.

Damage to your nerve can be caused by trauma, injury and decay.


  • Toothache
  • Sensitivity to hot things
  • Darkening of the enamel
  • Tender to biting
  • Pain that wakes you in the night

Does a dead tooth hurt?

A dead or dying tooth can lead to a varying level of pain, from almost non-existent to excruciatingly painful. The dying nerve your tooth usually causes an infection which can increase the pain.

The pain is not coming from the dead or dying nerve itself but, from the sensitive nerve endings around the outside of the tooth, called the periodontal membrane.

Bacteria and bits of dead nerve or pus build up in the pulp chamber inside the tooth. Unlike anywhere else in the body, there is nowhere for the swelling to expand inside the tooth – so it puts enormous pressure on the periodontal membrane, which can cause immense pain and sensitivity to pressure.

If there is an infection, it may turn into an abscess and produce other symptoms, including:

  • bad taste
  • bad smell
  • swelling
  • a pimple on the gums

What can I expect with root canal treatment?

If an infection is present we will likely need to treat this first. The infection can sometimes cause complications with local anaesthetic as it can cause a barrier that prevents it from working. Once the infection has cleared, you can expect your tooth to be completely numb throughout your treatment.

The procedure requires your dentist to isolate your tooth as much as they possibly can to eliminate any bacteria from being trapped inside the root canal, usually, a rubber dam is used for this. The dead nerve remnants, bacteria and pus are all removed with very fine instruments and irrigated with antibacterial solutions. When all of the bacteria and nerves have been removed we pack the canals, tight, with a specialist rubber filling.

Sometimes, depending on your symptoms, what caused your tooth to die and how your tooth appears clinically; we may be required to clean your tooth at one appointment and fill it at the next – leaving a sedative dressing in place in between.

Is there pain after a root canal treatment?

Root canal treatment, by its nature, is a little invasive and the treatment can take some time so it is normal for your tooth to feel a bit bruised, sore and achy but it shouldn’t be painful.

Sometimes, because you’re numb when it’s placed, your temporary filling can be a bit high – which causes pain when biting together. If your tooth is anything but a bit sore, you should contact your dentist and have to tooth reassessed.

What should I do after a root canal?

Root canal treatment weakens a tooth. It’s also possible for bacteria to leak through margins of fillings – with root canal treated teeth, this could mean failure of the root canal filling. Therefore, it is vital that you have a proper, full restoration like a crown to cover and protect it.

If you need an emergency dental appointment, get in touch today or book online! 

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