What is a Root Canal? What to Expect and How to Avoid Them
- Dr. Panesar
- Aug 28
- 7 min read
Introduction
“Unfortunately, we’re going to have to do a root canal on your tooth.” This is a dreaded phrase which many patients hear at dental offices. And through friends and family, maybe you’ve heard horror stories of painful experiences, lost teeth, or infections. It's easy to get nervous! But let’s get to the root of the matter here - root canals are routinely done in dentistry, and the vast, vast majority are perfectly safe and can help extend the life of affected teeth!
In this post we hope to clear up questions about root canals: what are they, how effective are they, and are those nasty rumours we hear really true? Stay tuned to find out! But before we can talk about the treatment, we’ll explain what it is we’re treating in the first place.
The Inner Workings of a Tooth
A root canal is a very common procedure done in dentistry - in short, it is a procedure to save a badly damaged or infected tooth. The proper terms are “endodontic treatment (endo = inside, dont = tooth)”, or “root canal treatment”. So if “endodontic treatment” refers to treatment inside of a tooth, you may be wondering - what does the inside of a tooth look like? Here’s a handy figure that shows just that:
The figure above is a healthy tooth. The areas of focus here are the “pulp” and “root canal”. The “root canal” in the figure is just an extension of the pulp - this is where the more proper term “root canal treatment (or therapy) applies. This structure contains blood vessels and critical nerves that keep your tooth “alive”, so that you can feel hot, cold, and have a sense of bite pressure (so you don’t bite too hard!).
Now that we had a look inside a tooth, let’s talk about what happens when things go wrong. In a previous post, we talked about tooth decay, and how it’s caused by acids from pesky sugar-eating bacteria. If the decay is small, it can often be treated with a filling, or even home care (flossing, brushing). However, if tooth decay goes unchecked for a long time (ie. a few years), it can extend into the tooth’s “pulp” or “nerve”. When this happens, your tooth’s nerve suffers from inflammation, better known as pulpitis. A simple way to think of this is, if you have a cut on your skin, and it gets infected, the skin will become sore and start to swell! Something similar is going on inside your tooth, except your pulp tissue/nerve has nowhere to go - the inside of your tooth is not exactly roomy! Another way this could happen, is if your tooth has a crack, and bacteria find their way to the pulp via this crack. With either a crack or tooth decay, when this happens, sometimes a patient may feel no symptoms at all. But in most cases, one or more of these symptoms will present:
Cold and/or hot sensitivity: sometimes even drinking water or breathing cold can be painful.
Biting pain: even chewing bread or mashed potatoes can hurt.
Spontaneous pain: a throbbing ache that comes with no trigger, that may radiate around the jaw.
Swelling around the tooth, that feels tender to the touch.
One other thing to keep in mind is that sometimes these symptoms can be transient - ie. a tooth may “randomly” be sensitive one day and then return to normal soon after. However, if any of these symptoms apply to you (and they’re consistent) and it’s been a while since you’ve seen your dentist, this may be your sign to get that sore spot checked out!
So now that we know a little more about what can go wrong inside your tooth, now we can talk about how to fix it. And this is where the star of our show, “root canals”, comes into play!
Well, Now I Need a Root Canal. So What Happens Next?
Once a tooth has been diagnosed with a condition that has to be treated with root canal therapy, of course the appointment has to be booked, and the finances have to be sorted first! But let’s assume all of that is done, and you’re sitting in the dental chair with your tooth numbed up and ready for treatment. You can expect this appointment to be roughly 1-3 hours, depending how complex the treatment is.
Generally speaking, if a tooth is being treated with a root canal, the dentist has determined that there is enough healthy tooth structure for the tooth to hold up long term. That being said, the first step is to remove the decay that is present. This enables a clean working field for the operator, and makes it easier to place the filling once the root canal procedure is completed.
Overall, the goal is to remove bacteria from the tooth. Once the decay has been removed, the infected pulp/nerve has to be removed next! This is done with a combination of tools, including endodontic files, and chemical agents. Endodontic files, as shown above, mechanically remove infected tissues from the tooth. Chemical agents, including Ethylenediaminetetraacetic acid (EDTA), dissolve infected tissue and remove bacteria that may have been missed by the endodontic files. With these various tools, you can be confident that the inside of your tooth will be cleaned out properly.
In the dental world, there is a common saying courtesy of endodontic pioneer Dr. Herbert Schilder: “What you remove from the root canal is more important than what you place inside it”. While this is true, it’s not exactly wise to dismiss a patient with a hollow tooth! So the next step is to seal the root canal. This is accomplished with a material called gutta percha. This is a tough, rubber-like material that fits snugly in the nerve canal(s) of a tooth. Once the gutta percha is placed, a filling is placed above it. This ensures the tooth is sealed off and “rebuilt”.
Once this point is reached, the patient can be dismissed! But what can you expect at this stage?
I’ve Just Had Root Canal Treatment. So Now What?
The Immediate Aftermath
Once you’ve had root canal treatment, there are a few things to keep in mind. First is, the tooth will likely be sore for some time. Because it was being worked on, you can expect soreness with chewing, and some aches. These symptoms should dissipate after a few days - typically we recommend avoiding chewing with that tooth for the first day after root canal treatment. In some cases your dentist may prescribe pain medication such as Tylenol (acetaminophen) or toradol (ketorolac) to help reduce soreness after the procedure.
The Longer Term
The success rate of root canal treatment is nothing to scoff at - many studies have looked at 5-10 year survival rates, and they can range anywhere from 85 - 97% (Salehrabi & Rotstein, 2004*). There are many factors that go into the survivability of a root canal treated tooth, such as amount of remaining structure, patient habits (ie is the patient a heavy grinder?), and type of restoration after treatment (filling, or crown). This last item is important, as it factors significantly in the survival of a root canal treated tooth.
We’ll cover “crowns” in another article, but essentially they are super hard restorations that cover an entire tooth. And they do improve the longevity of a root canal treated tooth - Ng et al (2011)* found in a meta-analysis (a survey of many different studies) that teeth with full coverage restorations (e.g. crowns) were 3-6 times more likely to survive long term. So in short, while root canals are highly successful overall, often a crown placed after the root canal can provide even more long term success.
That said, root canals aren’t invincible! Once the bacteria has been banished from a tooth, it has to be kept away - good home care (brushing, flossing) and regular dental visits can help ensure the treated tooth stays healthy!
Clearing Up Some Myths About Root Canals
Myth #1: Root canals are extremely painful
Truth: root canals are generally no more uncomfortable than a filling appointment. They may take a bit longer, and there may be a bit more soreness afterwards, but modern anesthetics ensure that root canals are relatively comfortable procedures.
Myth #2: It’s better to pull the tooth
Truth: Saving your natural tooth is almost always better. Your natural teeth have spent years orienting themselves into position to maximize your chewing efficiency. Losing a natural tooth can throw your bite out of sync, and can cause jaw soreness. Loss of natural teeth can result in added bite pressure onto the remaining natural teeth, and in some cases this can speed up loss of other natural teeth (e.g. if the added bite pressure causes cracks).
Implants are quite expensive! While implants are also a highly successful treatment option, they are very costly compared to root canal treatment.
Myth #3: Root canals cause illness
Truth: Now here’s where we get technical. There was some outdated research suggesting root canal treatment leaks toxins into the body and causes systemic illness. This has been discredited by volumes of modern research. We’ll provide the links to this research below:
Iwata et al. (2020, JAMA Otolaryngology) found no link between root canals and cancer risk (Citation: Iwata S, et al. "Endodontic Treatment and Risk of Cancer." JAMA Otolaryngol Head Neck Surg. 2020.)
It pays to Stay on Top of Your Dental Health
Well, there you have it! We hope we’ve shown you that root canals aren’t that scary. They are in fact a disease-removing, tooth-saving solution that is perfectly safe for your overall health. And in the vast majority of cases, they are a painless procedure with minimal pain afterwards. That being said, root canals are avoidable! In the vast majority of cases, root canal treatment is indicated due to a tooth having a large amount of decay. This decay is something that has often taken years to develop. With regular dental visits and good dental hygiene, these spots of decay can be caught and treated early, well before root canal treatment becomes a possibility. Here’s a quick cost breakdown of 2 scenarios using the Alberta Fee Guide of 2025 as a reference (keep in mind these are out of pocket costs as various insurance plans do cover both fillings and root canal treatments):
Tooth A, with a small cavity, requiring a filling that covers 2 surfaces of the tooth: $243.13
Tooth A, 3 years later, with that cavity growing to the point of requiring a 3 surface filling, and a root canal: $284.75 + $1108.48 = $1393.23
This doesn’t include the cost of a crown either!
This shows that staying on top of your dental health literally pays! If you’re experiencing any symptoms we described earlier, or would like to keep up with your regular dental care, please give us a call at 780-440-4800 for a consultation or a check-up - we’d be happy to see you and address any concerns you may have. And as always, “be true to your teeth, or they will be false to you!”
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