If you’ve ever been told you need a root canal treatment – or if a friend or family member is expecting one – you probably have questions about the process: What is it like? Will it be painful? How long will it take? Root canal treatment is actually a very common, safe, and straightforward procedure. In fact, more than 15 million root canals are performed in the US each year.¹

Ready to learn more? In this article, we’ll explain the step-by-step process for a typical root canal procedure.

Before treatment begins

Before heading to your appointment for root canal treatment, as with any visit to your dentist or endodontist, make sure you have all of your insurance information on hand. When you arrive, expect your dentist or endodontist to:

• Step 1: Revisit any X-rays that have previously been taken to prepare for the procedure. Then, he or she will perform a visual inspection of the tooth and surrounding area.
• Step 2: Administer a local anesthetic using a small needle to numb the area. You may feel a slight pinch, but there is very little pain when the anesthetic is administered. The numbing sensation will take effect almost immediately. 
• Step 3: Place a dental dam, which is a small rubber sheet, over the affected tooth to protect and isolate the area. This will keep the tooth clean and dry during the procedure.²

During root canal treatment

The root canal treatment itself will typically take about 90 minutes. Teeth with multiple canals or with an infection present may take more than one appointment.³ Here’s what to expect during a root canal:

• Step 4: Using a specially designed drill, your dentist or endodontist will create an opening in the top of the affected tooth. This opening will fully expose the top of the tooth pulp, containing the tooth’s damaged nerve and blood vessels. This phase of root canal treatment is similar to the preparation stage for a filling.
• Step 5: Next, he or she will remove the tooth pulp from the inside of the tooth and the root. This part of the tooth is formally called the root canal – and it’s how the procedure got its name.
• Step 6: The space that the pulp occupied in the center of the tooth will be carefully cleaned and widened using small dental files, shaping the inner chamber to accommodate a filling. Your dentist or endodontist will then irrigate the area with a variety of solutions to wash away any remaining pulp. The tooth and surrounding area will be thoroughly dried before moving onto the next step. 
• Step 7: An antimicrobial medication to the root canal in order to treat or prevent infection.⁴ At this stage, the tooth may be left open to drain for one or more days if infection was severe.⁵ If this is the case, you will be required to come back for a second appointment to complete the restoration.
• Step 8: If the tooth does not need to be left open to drain (the majority of cases the tooth canals will now be filled with a biocompatible material. The material used is typically gutta-percha, a rubber-like material, that seals to the tooth with an adhesive cement and helps prevent further infection.⁶
• Step 9: Finally, a temporary filling is placed on top of the tooth to provide protection from food and debris until a permanent filling or crown can be placed. In some cases, your dentist may be able to skip this step and place a permanent filling in the same appointment.

After root canal treatment

When your root canal procedure is completed, you’ll need to pay extra attention to the treated tooth for a few days. Post-treatment, consider the following:

• Step 10: Immediately after root canal treatment, you should avoid biting or chewing with the treated tooth until the numbness wears off then start with soft foods that are easy to chew.⁷
• Step 11: You may experience sensitivity or mild discomfort in the area for a few days – if so, use over-the-counter pain relievers, such as acetaminophen, ibuprofen, or aspirin, to alleviate pain. You may also be prescribed antibiotics to clear up any remaining infection that prompted the root canal treatment. If significant pain or swelling lasts for more than a few days, call your dentist.⁸
• Step 12: In most cases, you will need to visit your dentist for a follow-up appointment to restore the tooth. During this appointment, your dentist will remove the temporary filling and place a permanent filling – or, alternatively, prepare the tooth for a crown. The choice between filling and crown will depend on the specific condition and location of the tooth.⁹ In addition, depending on the severity of damage to the tooth, a metal or plastic post might be used to add stability to the filling materials and the crown.
• Step 13: After the root canal treatment and restoration with a filling or crown has been completed, your tooth can now provide normal, healthy function. Treat it the same as the rest of your teeth, as it can still develop decay or gum disease if not given proper care. Brush twice a day with a fluoride toothpaste, floss at least once per day, and make sure to attend regular exams and cleanings as prescribed by your dentist.

It used to be common for patients to dread receiving a root canal treatment. Nowadays, however, root canal treatment is a simple, straightforward tooth-saving procedure – and, in most cases, it is minimally uncomfortable or painful. You’ll likely walk away from your appointment feeling much better than you did before the treatment. It may be worth it to save a tooth that can remain healthy for a lifetime.

Think you may need a root canal procedure? Find a dentist and schedule an appointment today.

Additional resources:

• When Do You Need a Root Canal?
• No Need to Fear, a Root Canal is Here to Save Your Tooth
• Root Canals vs. Implants: Which Treatment Is Best?
• Signs and Symptoms for Root Canal Treatment
• Root Canal Signs and Symptoms

Sources:

¹ “Quick Endodontic Facts.” American Association of Endodontists, www.aae.org/specialty/about-aae/news-room/endodontic-facts/

^{2, 3, 6} “Root Canal Explained.” American Association of Endodontists, www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/root-canal-explained/

⁷ “Root Canals: FAQs About Treatment That Can Save Your Tooth.” Mouth Healthy TM, www.mouthhealthy.org/en/az-topics/r/root-canals

^{5, 9} “Slide Show: Root Canal Treatment.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2 Jan. 2015, www.mayoclinic.org/diseases-conditions/tooth-abscess/multimedia/root-canal/sls-20076717

^{4, 8} “Root Canal Treatment.” The University of Iowa | College of Dentistry and Dental Clinics, University of Iowa, www.dentistry.uiowa.edu/patient-care-rootcanal