When Do You Need a Root Canal?

Odds are, if you’re reading this blog post you’re probably experiencing some level of tooth pain and wondering “When do you need a root canal?”. You’re probably nervous about it, but you shouldn’t be- most people during their lifetimes will need dental work such as fillings, crowns, and even root canals. Root canals get a bad rap because people will say in normal comparison to something, “I’d rather have a root canal than do that.” We’ve all heard and probably even said it. Root canals have come a long way in terms of being painless and effective. This article addresses what a root canal is and other aspects of needing one, getting one, and tips on taking care of it before it turns into a emergency dental situation.

woman asking dentist when do you need a root canal

What is a Root Canal?

A root canal treatment is a dental procedure to remove inflamed or infected pulp on the inside of the tooth, which is then carefully cleaned and disinfected. Afterwards, the space is filled and sealed. The objective of a root canal is to eliminate bacteria from the infected root canal in order to prevent reinfection of the tooth and to save the natural tooth. The root canal procedure relieves pain and makes a tooth healthy again.

How to Know If Your Tooth Needs a Root Canal

A primary sign that you need a root canal is having persistent pain. This is a good time to at least schedule a virtual consultation with a dentist. Pain that lasts during normal activities of drinking or eating indicates a serious problem with a tooth. Sensitivity to hot and cold food and drinks that causes persistent pain is another strong sign that you will need a root canal. If you are experiencing root canal symptoms, you may not know that you have an infected tooth; however, you may notice certain symptoms.

These are some common symptoms that may be signs that you need a root canal:

  • Tooth pain that doesn’t go away
  • Sensitivity to heat and cold
  • Swollen gums
  • Pimple on the gums
  • Swollen jaw
  • Tooth discoloration
  • Pain when pressure is applied
  • Chipped or cracked tooth

Persistent Tooth Pain

Many dental problems can cause tooth pain. If you have pain that is deep into the tooth, you may need root canal therapy. The discomfort may also radiate into your jaw, face, or other teeth.

Tooth Sensitivity Towards Heat and Cold

Having sensitivity in a tooth when it comes into contact with a food or drink that is either hot or cold is a sign you may need a root canal. It can begin as a dull ache and progress into a sharp, intense pain. Hot drinks such as coffee or tea can stimulate the infected root and cause pain. Cold foods and drinks can also cause a lot of pain when a tooth is infected. Consuming ice, a cold smoothie, or ice cream can cause the damaged blood vessels and nerve endings to react with extreme pain.

Swollen Gums

Swollen gums are a sign of problems beneath the surface, possibly indicating that you need a root canal. If your gums are painful and swollen or if there is a raised bump on them, your dentist will examine the gums to see if inflammation is the cause. A root canal may be needed to solve the problem of inflamed gums if they don’t improve.

Tooth Discoloration

A dark, discolored tooth can be the result of poor hygiene, exposure to food and drink that stains the tooth enamel, or due to nerve damage beneath the tooth’s surface. When nerve and blood vessel damage occurs, you will need a root canal to remove the damaged root.

Pain When Pressure is Applied

If your tooth hurts when you put pressure on it, and if the pain continues for weeks or longer without improvement, you may need a root canal. This pain can be caused by a damaged root. A damaged root doesn’t heal on its own. 

Chipped or Cracked Tooth

You can chip a tooth by eating hard foods, being involved in contact sports, or from a previous dental procedure. When a tooth gets chipped or cracked, nerves can be exposed beneath the surface of the tooth and can get infected. An infection in a tooth’s root can enter the bloodstream and spread. It is important to see a dentist for a chipped or broken tooth to address the possibility of infection. An untreated infection requires a root canal to prevent further infection and pain.

What Is Done During a Root Canal Procedure?

A root canal procedure involves cleaning out the damaged or infected root. Inside a tooth is a soft tissue called pulp. The pulp is beneath the white enamel and hard layer called dentin. This tissue contains blood vessels, nerves and connective tissue that help grow the root of your tooth during its development. A fully developed tooth can survive without the pulp because the tooth continues to be fed and nourished by the tissues that surround it. After the infected tissue is removed and the canal is cleaned and shaped, gutta-percha is placed within the canal space to seal it and prevent further microbial ingress.

What is Gutta-Percha?

Derived from the latex of certain tropical trees, gutta-percha is used for its exceptional properties such as flexibility, thermal stability, and inertness. In root canals gutta-percha serves a crucial role as a filling material. Its ability to conform to the canal’s shape while remaining resilient helps ensure a tight seal, aiding in the success of the root canal treatment. Paired with dental sealer cements, gutta-percha forms a reliable barrier, contributing to the restoration of dental health and the preservation of natural teeth.

diagram of root canal procedure. file removing pulp

A modern root canal treatment is similar to a routine filling and it can usually be completed in one or two appointments. Getting a root canal is relatively painless and is extremely effective. A root canal has several advantages:

  • Normal biting force and sensation
  • Efficient chewing
  • Natural appearance
  • Protects other teeth from excessive wear

Do Root Canals Hurt?

You will receive anesthesia when having a root canal procedure so that it isn’t more painful than a regular dental procedure such as getting a filling or crown or having an extraction. The root canal will be somewhat sore or numb after the procedure and can be mildly uncomfortable for a few days. This is temporary and is manageable with over-the-counter pain relievers and by practicing proper oral hygiene. However, if the discomfort lasts longer than three days, you should see your dentist for advice.

How Should I Prepare for Root Canal Treatment?

Here are a few things you can do to prepare for a root canal treatment:

Ask Questions

When you are undergoing any type of procedure, you can experience anxiety. One way to help alleviate tension is to ask questions of your dentist so you know what to expect. Doing research such as reading this article is also a good way to gain an understanding of what is involved in a root canal.

Discuss Antibiotics

Antibiotics can reduce some symptoms due to infection in the root as well as the risk of an infection after the root canal. Your dental professional may prescribe an antibiotic that you should take both before and after the procedure.

Avoid Alcohol and Tobacco for 24 Hours Before the Procedure

Both alcohol and tobacco can affect the way blood flows through your veins. This can lead to bleeding problems during and after your root canal. Additionally, alcohol can dry out your mouth, affect how your blood clots, cause a faster heartbeat, and depress your central nervous system.

Sleep Well

Get a full night’s sleep before your dental appointment so your body is in top form for the procedure. Because your body uses sleep to repair itself, it’s also important to get a full night’s sleep after the root canal.

Take a Pain Reliever Before the Procedure

Even though today’s root canal procedure causes less discomfort than years ago, you may still have a degree of soreness. Consult with your dentist about taking a pain reliever to help alleviate some of the discomfort you may experience immediately after the treatment.

Have Some Pain Relievers On-Hand

You may need a few doses of pain relievers after the procedure during the first few hours. So that you don’t have to make a trip to the store immediately after the procedure, check to make sure you have a couple of doses on hand before you check in for your appointment.

Eat Before the Root Canal

Depending on the time of your procedure, you may want to eat beforehand. It will take several hours for the anesthesia to wear off completely and the numbness may make it difficult to eat afterwards. In order to avoid feeling hungry just after the root canal, eat a small meal a couple of hours before the treatment.

Arrange for a Ride Home, If Necessary

Most people only require a local anesthetic for the procedure and won’t need a ride home. However, some patients need sedation medicine to relax or perhaps general anesthesia before undergoing a root canal and will benefit from having a driver. Check with your dentist prior to your appointment to determine whether you need a driver or not.

Have the Right Food at Home

When you feel you can eat again after the procedure, you will need to focus on soft, cool foods. You should avoid anything hot and crunchy for a while. Soft foods are easy to chew or maybe don’t need chewing at all. The coolness can soothe irritated tissue and reduce any swelling that you have. Here are some recommended foods you should eat immediately after a root canal procedure while you still have inflammation:

  • Smoothies
  • Yogurt
  • Milkshakes
  • Pudding
  • Jello
  • Soft cereal

After your inflammation subsides, here are foods that dentists recommend:

  • Eggs
  • Soup
  • Hummus
  • Tuna salad
  • Mashed veggies like potatoes or cauliflower
  • Oatmeal and cream of wheat
  • Pancakes
  • Pasta and noodles

Take It Easy for a Couple of Days

Your body heals best when it rests. Avoid strenuous activity like exercising or doing heavy lifting for at least 48 hours after a root canal. Exercising too soon after the procedure can lead to bleeding or make your mouth ache.

man too active during root canal recovery with tooth pain

Who Performs Root Canal Treatments?

A specialized dental professional called an endodontist performs root canal procedures. They are often called “root canal dentists.” Both general dentists and endodontists perform root canal treatment, endodontists perform this procedure much more often and sometimes that is all they do. The additional training and higher treatment volume mean that an endodontist is an expert in doing root canals.

Advantages and Disadvantages of Root Canal Therapy

Is it worth getting a root canal? While most dentists agree that the advantages far outweigh the disadvantages, here are the pros and cons of having a root canal.

Pros of Having a Root Canal

A root canal will keep the natural tooth. By saving the tooth, there is no worry about losing bone. The tooth’s root will continue to stimulate the bone after the root canal and there will be very little potential for losing that tooth in the future.

A root canal stops tooth pain. The tooth pain that comes from having an inflamed or infected pulp is significant and can be difficult to deal with long term. Once everything is healed, the pain is gone.

A root canal, chosen over a tooth extraction, prevents gaps in your mouth. Gaps can cause alignment issues that cause difficulty in eating. Root canals are more affordable options over extracting a tooth and replacing it. 

Cons of Having a Root Canal

It’s possible that a root canal can weaken a tooth. Dentists must drill through the tooth to access the pulp and additional decay may need to be removed. If the tooth is too weak to function well, there may need to be a crown added.

The time required for a root canal can be a disadvantage. In most cases, a patient will only need to go to the dentist once. However, there may be two or three appointments required in complicated cases where the infection or damage is severe. Additionally, patients may need two or three visits to get root canals on the upper first molars. Upper first molars have three to five root canals. Each canal must be treated, which takes longer to complete.

How Long Do the Results of a Root Canal Last?

According to studies reported by WebMD, over 90% of root canals are successful and the patients don’t need any additional treatments. About 86% of root canals last over 10 years. Several things can affect the success rate of root canal treatments:


Having a root canal procedure performed after the issue has been allowed to fester over a prolonged period of time can affect success. The longer you wait, you run the risk of complications or needing an extraction.

Tooth’s Location 

Typically, root canals performed on teeth that are located at the front of the mouth are less complicated than treating teeth in the back of the mouth. The teeth in the front are subjected to fewer forces and bit pressures because they are primarily used for cutting and biting. Molars at the back of the mouth present the most challenges because they have multiple root canals and deal with greater forces. Covering these teeth with crowns is essential.

Quality of Restoration

Often the tooth needs to have a crown or composite bonding after being repaired with root canal therapy. The type of restoration affects how long the treatment lasts. Composite bonding is more affordable, but doesn’t offer as much protection as a crown. Teeth covered with crowns after a root canal usually have fewer complications. Additionally, how quickly the restoration is placed after the root canal affects the longevity.

What to Do When You Need a Root Canal

Once you’ve had enough of the pain or you’ve decided you need a root canal, it’s time to get in touch with a local dentist. Make sure the one you choose has good reviews that relate to root canals or similar procedures. Equally important, make sure they accept your insurance if you plan on using it. For those without insurance, there are a growing number of dentists that have very reasonable cash rates or can help you find financing.

If you’re in the Raleigh area, reach out to our team at Mint Leaf Dentistry for a fast and friendly dental experience. We offer a special MVP Club for patients who need access to affordable dental care without the need for insurance plans. We also offer sedation dentistry for patients who prefer it. Give us a call at 919-330-1710 or schedule your appointment online.