Know Before You Go: Root Canals

Updated on
root canals

If you’ve been told you need a root canal or are scheduled for one soon, you’re in the right place. This is your guide to everything you should know before getting a root canal as well as what to expect during the procedure.

By the end of this post, you’ll know:

  • Exactly what questions to ask your dentist
  • What to expect during the procedure
  • What to expect in terms of pain
  • How to not get ripped off
  • Everything that should be discussed with your dentist before you agree to a root canal

Before You Go

What Is a Root Canal?

root canals

A root canal is a procedure to preserve (not save) a dead tooth.

I say “preserve” and not “save” because it’s like mummification. It’s taking a dead pharaoh and stuffing him — it’s not saving the pharaoh’s life.

By the time you need a root canal, it’s too late to save the life of the tooth because it’s already infected and dying.

Why mummify a dead tooth? You do this because you want to keep the tooth in your mouth. It’s a dead tooth that’s mummified.

Why not pull the dead tooth out? Well, you can, and then you would have to replace the dead tooth with an implant to fill the hole left behind in your jaw along with a new, artificial tooth—and actually, the new school of thought is that going straight to an implant is the right thing to do.

The main reason for getting a root canal instead of an implant is that it’s simpler to keep your old tooth, even though it’s dead, because you can still benefit from having the structure of the dead tooth to chew food and help you speak properly.

Ever seen a movie where someone’s leg gets infected and it has to be cut off? A root canal is like that —you have to cut out the infected tissue inside the tooth to prevent infecting the rest of your body and killing you.

But there are consequences.

Having a root canal done makes the tooth brittle and prone to fracture — think of the mummified pharaoh. The inside of the tooth has been scraped out, leaving the outer shell of the tooth dry, brittle, and prone to breakage.

That’s why a root canal procedure requires a second procedure shortly afterwards: A crown.

A root canaled tooth needs protection because you’ve carved out the tissue inside it.

Enter: the crown, which is a rigid covering that is stronger than enamel that preserves the structural integrity of the tooth and prevents it from breaking.

tooth anatomy

What Are the Pros and Cons of a Root Canal?

Root Canal Pros:

  • You don’t have to extract the tooth.
  • You can keep the tooth.
  • You don’t lose the bone around the tooth.

Root Canal Cons:

  • There’s no such thing as a 100% clean root canal.
  • It can be hard to sit with your mouth open for a few hours during the procedure.

What Is the Procedure Like?

Here’s a great visual of what a root canal is, except for just two things: I don’t recommend or do posts, as they crack the teeth. The method shown for sealing the tooth is an older method called lateral condensation. There are newer and better methods used today for sealing.

You’ll sit in the chair for a few hours with your mouth open the entire time — this part is tough for most people. Load up your phone with a great audiobook or an addicting podcast to distract yourself.

During the procedure, your dentist will remove the inflamed or infected pulp, carefully cleaning out and shaping the inside of the tooth, and then filling and sealing the space so it’s closed off to infection.

After that, you’ll need to come back to the dentist to get a crown placed on the tooth to protect it so that you can once again chew on it and use it like the rest of your teeth.

After that, your tooth will function just like any other tooth would — you’ll be able to bite on it, chew on it and use it normally.

What to Ask Before Agreeing to Treatment

  • Is a root canal absolutely necessary?
  • Is it possible the tooth will recover and not need the root canal?
  • Why did the pulp die?
  • What are my options?
  • What if I don’t do the root canal?
  • Should I skip the root canal and go right to the implant?
  • Will my infection spread to other teeth or to my bone?
  • How predictable is the treatment?
  • And perhaps most important: Should I have this done by specialist or can you do as good of a job as a specialist can?

How Does My Dentist Know I Need a Root Canal?

For other conditions, a doctor can give you a blood test and the results will come back either positive or negative. It’s not so cut and dried with root canals.

Diagnosing whether you need a root canal does have a scientific basis but it can be a bit of an art form to find out how diseased the pulp of the tooth is.

This is why you really need someone who is experienced. A practitioner who rushes this process could choose the wrong treatment of the tooth.

To diagnose whether or not you need a root canal, your dentist will need to determine if the pulp inside the tooth is dead or dying or if it’s possible that the pulp could recover.

Data Points Your Dentist Uses to Decide If You Need a Root Canal

Lingering pain: Your dentist will ask you about how your tooth responds to hot and cold. When you drink cold water, does your tooth get sensitive? How long does the pain last? This is a way of figuring out if you have “lingering” or “non-lingering” pain. “Lingering” means the pain sticks around. Non-lingering pain goes away. If the pain goes away, the pulp inside your tooth might be alive enough to recover from the hot and cold, indicating that the tissue could potentially recover. If you drink cold water and you’re sensitive for the next hour or more, that’s “lingering” pulpitis (infection of the pulp) which means your tooth isn’t recovering and the nerve is likely dead.

Positional pain: Does your pain get worse when you lie down or stand up suddenly or run in place? This can be the sign of an abscess and, likely, a dead tooth.

Spontaneous pain: If pain is brought on by a stimulus like a hot or cold drink, it’s possible that the pulpitis is reversible, but if you’re sitting there doing nothing and get a wave of pain, that’s probably a dead tooth.

Fistula on the gum: A fistula is a little white, yellow, or red pimple-looking thing that shows up your gum. What this tells your dentist is that there is an infection because there is pus, blood, and infectious materials trying to get out and the body is trying to vent it. The problem is that it doesn’t always go alongside the tooth that is infected — a fistula can mislead the dentist as to which tooth it is.

Abscess: An abscess is typically seen on an x-ray. It is essentially a hole in the jawbone that shows up as a dark spot on the x-ray because the bone doesn’t want to grow in that area. Bone won’t grow in the area around an infection and an infection typically comes from the tip of the root, which is where everything is spilling out from the dead tissue inside of the tooth.

Referred pain: I weigh this one heavily. If the pain is not only in your tooth but also referring to another part of the body, like your jaw, ear, or surrounding teeth, this could mean you have an abscess. What I try to do is ask my patients in such a way that they don’t know what I’m asking so that I get the right answer.

How Long Can I Wait Before I Get My Root Canal Done?

Once you find out you need a root canal, it’s like a ticking time bomb, because the infection will eventually blow up. You’ll get more pressure and more swelling if you wait. You might get a bad taste in your mouth or might start to go numb. The infection could spread to more vulnerable tissues, like your heart. This is why people used to die of tooth infections hundreds of years ago.

Your dentist will prescribe you antibiotics for the infection. Once you start taking antibiotics, you’ve bought yourself four or five weeks. If you get on the antibiotics before the root canal is done, you’ll have less pain during the procedure because this will make it easier to get you numb.

As soon as you find out you need a root canal, you need antibiotics right away. Don’t delay! It could turn into a life-threatening condition if you don’t. Yes, a tooth infection can kill you!

Should I Get a Root Canal Or an Implant?

A big question now in dentistry is: do you go right to the implant because it’s more predictable than a root canal?

To make this decision, you need to ask your dentist about the predictability of success of a root canal. This is something that you and your dentist have to decide together, after you consider all the options for your unique case.

If you talk to an endodontist, she will want to do the root canal.

If you talk to the oral surgeon, he will want to do the implant.

All healthcare professionals tend to recommend things that we know more about and are more skilled in or comfortable with. Always keep in mind this inherent bias, and don’t be afraid to ask for a second opinion.

Root Canals Are Never “100% Clean”

accessory canals

Essentially, the concept of a root canal is this: inside of this enclosed space inside the tooth, there’s a lot of infected tissue with bad bugs. It’s up to the dentist to go in and remove 100% of that infected tissue.

The cartoon above is simplified to show just one canal, but in real life, a root has several canals that all twist and turn, making it impossible to remove perfectly 100% of this infected tissue.

After the infected tissue is removed, your dentist has to seal it off to make sure no bacteria can get back in there. There is no way to make a perfect seal because there are so many accessory canals, which are canals running off the main canal. (Imagine a vein in a leaf, with lots of little “accessory” veins running off of the main vein.)

I’ve had very few root canals fail in my nearly thirty years of dentistry. Even though we’re trained to scrape out the infected tissue once, I do it three times, but I’m maniacal about the details and getting every last little bit of tissue.

Given these two points, they say a root canal is 95% effective, which I would say is optimistic.

People that are proponents of implants see this as a con for root canals because, with an implant, you’ve removed the source of the infection completely — there are no sealing or removal issues and you’re placing something sterile into the jawbone.

This is why, if you decide to get a root canal, it’s essential your dentist is very skilled, because the procedure is so technique-sensitive, and that your dentist has assessed there’s a good chance of success of the root canal.

You want someone who’s a perfectionist.

I have an all-or-none philosophy when it comes to root canals; either you get everything and you really clean it out, or don’t bother and go with the implant.

A Word on DUI (Deciding Under the Influence)

A lot of the time, people are in a lot of pain when they have to make the decision about whether to get a root canal.

When you’re in pain and you’re desperate, I call this making decisions under the influence of pain. You’ll do anything to get rid of that pain.

Here’s where it’s important to still be wary. Make sure your dentist has your best interest at heart and is helping you make the right decision, instead of taking advantage of the state of pain you’re in.

During the Appointment

root canal rubber dam

During the appointment, your dentist will give you deep full local anesthesia, which is a little more than required for a filling because your dentist is removing the nerve.

Many x-rays will be taken to make sure that the instruments are in the correct location to remove the infected tissue.

Your dentist may place a sheet of latex, called a rubber dam, over your mouth, so that when the tooth is opened, no bacteria from the mouth can get in and when medications are used inside of the tooth, you don’t have an opportunity to swallow them.

The rubber dam essentially isolates the tooth from the oral environment and in some cases helps the dentist do the root canal.

What to Know for the Appointment

The procedure should take longer than your standard filling. Expect to get very numb with local anesthesia.

Bring a book on tape or a long podcast you can listen to in order to pass the time.

One Appointment vs. Several

Some dentists will do a root canal all in one visit. Others will take two or three visits to do it.

Neither is better than the other — again, there are differing opinions on this. Some dentists wait and let the tooth dry and empty for a little bit and disinfect a second time then fill it.

I do all of my root canals in two visits because I think this is the best way to be as thorough as possible.

It’s more profitable to do a root canal in one visit. Doing a root canal in one visit might also be considered a service to you as the patient since it might be more convenient. But my recommendation is, be willing to take your time.

Don’t rush it or try to speed things up because it is such a technique-sensitive procedure.

What to Expect During the Appointment

You shouldn’t have any pain. If the dentist is skilled at delivering the local anesthesia, you won’t feel a thing.

Sometimes, a dentist will begin the root canal and things go wrong—this can be a good thing!

If your dentist gets inside the tooth and is presented with new information that changes the chances of success of a root canal, he will stop to tell you so you have the choice to abort the procedure before proceeding with a root canal that has lower chances of success than you both originally thought.

Reasons to Abort a Root Canal

A separated instrument: This is when an instrument breaks off inside the tooth.

A calcified canal: This is a canal that can’t be filled because you can’t get inside it. If the canal cannot be negotiated due to a calcification (this is actually the tooth trying to do its own root canal) then that means the canal cannot be properly filled, hence the prognosis of the root canaled tooth drops.

A fracture: Once the tooth is opened, your dentist might see a fracture which is not visible on the x-ray typically. A fracture makes a tooth have a poor prognosis even if your dentist does the perfect root canal because seepage can occur at the fracture line, which can lead to bone loss. If you lose bone around the tooth, you lose the support of the tooth. What I always tell patients in this situation is this: Don’t remodel the kitchen if you have dry rot in the floor! Abort the procedure in this case and go for an implant.

A curved root: Also called “complex canal morphology.” Canals bend and turn. Your dentist should only do the root canal if she knows she’ll be able to negotiate to the tip of the canal. If there is complex root canal anatomy — lots of twists and turns that are hard to navigate — then the chance of success of the root canal goes down.

Your dentist should only do the root canal if conditions are ideal.

You can drive home if you got just local anesthesia. If you got knocked out, you’ll need to be driven home.

What to Ask Afterwards

After the procedure, ask your dentist:

  • How difficult was it?
  • Was it easy to negotiate the canals?

Your dentist is required to tell you if anything went wrong during the procedure. Sometimes instruments will break off inside the canal — this is called a separated instrument (see above) — and your dentist is required to tell you about it. If your dentist doesn’t, the tooth will later become re-infected because you can’t seal past the separated instrument.

What to Expect After You Go Home

You shouldn’t bite or chew on the treated tooth until you have had it restored with a crown by your dentist. A root canaled tooth is prone to fracture, so you’ll need to get the crown as soon as possible.

Until you’re able to come in to get the crown done, practice good oral hygiene and brush and floss normally.

Avoid biting on the tooth or chewing food on it.

Pain After a Root Canal

You might expect some pain, but don’t be surprised if there is no pain. No pain can happen and is not unusual.

If you do have pain, it usually peaks 17 to 24 hours after the procedure and it’s best to keep your head elevated while sleeping for the first one or two nights. If need be, take whatever pain medication that your dentist recommends.


Feeling soreness after a root canal is unusual, but it happens often enough to discuss.

Your tooth can be sore and tender, but not necessarily painful, but sore and tender to percussion and chewing for up to six months, even after you’ve gotten the crown.

The concept or theory here is that the infection was so great inside of the tooth that it affected the surrounding areas in the jaw bone and that the body has to fix those areas and that takes time.

Getting the Crown

The sooner the better, because the tooth could cracker if you bite down on something hard.

Once the root canal is done and pain has subsided, it’s wise to cover the tooth with a crown right away because a root canaled tooth has weakened and dried out.

Covering the cored out tooth with a crown gives it virtually no chance of fracturing.

Some people wait to do the crown so that they don’t max out their insurance, but this can be a dangerous game.

If the tooth breaks, you may lose your investment of the root canal and have to go to the implant and crown.

Be delicate with your tooth until you get crown and stay off of it.



My root canal was done a month ago and I still have pain. What does that mean?

A: The sensation of hot and cold typically goes away once you do root canal because the pulp is no longer in the tooth, but sometimes the root canaled tooth can be tender to percussion or chewing and it can still sometimes have positional pain. This can mean one of two things: It’s most likely normal post-surgery pain, which takes time to go away. The pain could also mean that your dentist missed a canal and didn’t fill it. Stay in communication with your dentist about the pain to decide the right course of action.

Do root canals cause cancer?

A: Many of you may have read that root canals can cause cancer by infecting the blood. The science on this is correlative, not causative, and the mechanism used to make this connection is based on methods and technologies from the 1950s. Root canal methods and materials have evolved many times over since those times and have been completely different since the 1970s. That said, a poorly done root canal can and will have effects on the health of the rest of the body.

There is a 20% chance that the blood will be infected from bugs from the tooth during the root canal procedure, which is well-documented in the medical and dental literature. It is transient, meaning it lasts for around 20 minutes and a normal, healthy body can effectively deal with it. This can also happen when you pull a tooth or even cut your skin.

This transient, i.e. temporary, infection isn’t the thing to worry about because it happens in normal life all the time and the immune system is prepared to deal with it. It is the long-term infection of the blood from a leaky root canal that was not properly sealed that is the problem.

So, how do you know if your root canal is safe, i.e. properly sealed? My tips: Have a periapical (not bitewing) x-ray taken of the tooth every three years and have a an endodontist or dentist check it for bone loss or signs of local infection, which would indicate that the root canal is not doing well. At home, every six months, take the back end of a fork or spoon and tap on the root canaled tooth. If it’s tender and sore, compared to tapping on other healthy teeth, then that may be a sign that the root canal is failing and needs to be retreated. The good news is that they are beginning to genetically tag bacteria in the blood, so they’re able to trace specific bacteria back to the origin, the root canal. This technology will soon be available publicly in the form of a blood test.


How often do I come back for a follow-up?

A: Initially, you should get a follow-up within six months and after that every five years to make sure the root canal is doing what it’s supposed to be doing, which is preventing any reinfection inside of the tooth.

Why did my dentist not use a rubber dam for me but did use one on my husband?

A: There is currently a controversy in dentistry whether rubber dam is necessary or not. Some dentists will not use a rubber dam if you have severe TMD symptoms because you won’t be able to rest your jaw for quite a long time, which can give you severe TMD symptoms for 6-8 weeks after the procedure — this pain is sometimes worse than the root canal. In the old days, it was taught that every root canal was done with a rubber dam, but more and more, there’s less use of it. I don’t consider this to be a big factor in the success of a root canal, but in some cases, if there is likelihood of dropping an instrument inside a mouth, it’s a good idea. It’s something you can certainly request.


Pulp: Deep inside each of your teeth, underneath the white enamel exterior, is the pulp. Pulp is tissue helps the tooth grow. It also gives the tooth the ability to perceive hot and cold and vibration. Pulp and nerve is good because small cavities can recalcify and solve themselves but only if the tooth is alive and has not had a root canal. Pulp can become inflamed or infected from deep decay, repeated dental procedures on the same tooth, or a crack or chip in the tooth.

Crown: A crown is the procedure that strengthens a hollowed out tooth. A crown is necessary after you get a root canal to protect the tooth after the dead tissue has been scraped out during the root canal. You’ll need a crown after your root canal so that you can bite on your tooth and use it normally after a root canal.

Root Canal: A procedure done by a dentist that saves a dead or dying tooth by “mummifying it” — essentially, scraping out the dead issue inside so that the outer portion of the tooth (the white enamel, and the root of the tooth which lives inside your gum) can stay in your mouth, instead of having to be taken out entirely.

Irreversible and reversible pulpitis: Pulpitis is inflammation of dental pulp tissue. If the pulpitis pain is irreversible, this might indicate more serious damage than if the pulpitis pain is reversible.

Endodontist: A dentist who specializes in root canals and procedures that preserve infected or diseased teeth.

Abscess: Essentially a hole in the jawbone. Bone won’t grow in the area around an infection, so this shows up as a dark space on the x-ray.

Percussion sensitivity: Tooth sensitivity, tenderness, or pain when you tap on the tooth.

Hot and cold sensitivity: Just like what it sounds like — this refers to whether your teeth are sensitive to hot or cold drinks.

Lingering and non-lingering pain: Pain that “lingers” (stays around) or does not linger (pain that goes away) are indicators your dentist will use to help determine if you need a root canal or not. When pain is lingering, this means that the tooth isn’t able to recover. When pain is non-lingering, this is a sign that the tooth is able to recover.

Read Next: Why Would a Root Canal Be Done in Three Stages?

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Leave a Comment

  1. Carol Guariglia says:

    Dear Doctor Mark, Could you please do an article on the correlation between CRP and dental health in depth. I did find it but thought it was hidden in the last article you published. I feel working in the field at a dental office for 34 years not enough people understand or ever get the information and therefore don’t know the importance of it. I thank you so much for all you do in an effort to give us this info. Some people really want to know. Thanks CarolG

  2. McKayla Strauss says:

    It’s good to know that you shouldn’t panic if you continue to experience some pain after a root canal. Honestly, I’m not sure that I would have thought that it’d just be normal post-surgery pain that goes away on its own. I might be getting a root canal soon, so that’s something that I’ll have to keep in mind afterwards. Hopefully it won’t be too bad to deal with if the pain sticks around for too long.

    • McKayla, glad this helped. Remember to talk with your dentist when you do go in for the procedure and never be afraid to call him or her about the pain. Trust your gut. Pain can be normal, but it can also be more serious, so always consult your dentist on this one.

      • So I am 13 years old and I found out I need a root canal for my chipped tooth will I be able to go to school the next day

        • Donna Demers says:

          I had a rootcanal that had decay & calcification (I was told), done 2 days ago. She found & cleaned 2 canals–then looked for 3rd canal (for Hour & a Half More (had another dentist look twice in between–when she felt exhausted (I felt) And Did Not Find 3rd canal, so she closed-filled (did that in 10 min or less. Is this Right to close it without finding). How much chance that infection is All gone please, really worried about this,

        • Anonymous says:

          I’m 13 and i just found out that I need a root canal. Since your post was in september, was the root canal painful?

        • Yes if you want to go 😉

        • I went to my local dentist, and found out I had 5 cavities (although I was in no pain). I went ahead and got them all done, one was deep, and the other were very tiny and small. The deep one was fine, and I had no problems. The tiny one that took no time to complete ended up giving me problems. I was having some sensitivity to cold, but recently the last week or two it got more intense. I’m the last 4 days now, I’m having a lot of pain but only after I eat, or trigger it. If I don’t eat or touch it, my pain won’t appear, but if I eat or anything I’ll start having pain after some time. The pain will come in a wave, and be very VERY bad, then become better and better till it’s gone. Then come back after sometime, then go away till I eat or stimulate it again. For example I ate some spaghetti last night, had some pain, but 2 hours later I had no more pain, and was able to sleep well, and this morning I have no pain as well (unless I go ahead and eat). My dentist was very quick to say I need a root canal, but how could I possibly go from one tiny cavity, to a root canal?

  3. This is great information on root canals! Before I got mine, I had no idea what to expect except for the horror stories I’d heard from people of my parents’ generation. Then I had the procedure done, and I was amazed at how simple it was. I had no pain afterwards, so I felt much better than I had prior to the procedure. Obviously no one wishes for a root canal, but they’re really much better than most people think!

    • Jane, thanks for sharing your experience! I’m glad you had no pain afterwards — always nice 🙂 This is the kind of thing I like to hear about!

      • Dr. Mark,
        I only wish I found this site 2 root canals ago. I am scheduled for a 3rd one tomorrow
        I’m scared not to have it done and Im afraid of having it done.

      • I just had a root canal from 30 years ago drilled out and they’re trying to save the tooth now. I don’t have much pain in the tooth area but I have a sore throat that started the night after the procedure. I’m taking antibiotics for a week (on day 2 now) because there was lots of infection in the old tooth and apparently under/outside the tooth. Just wondering about the sore throat. Could it be from the spread of some infectious material during the procedure, or more likely from the procedure itself with the breathing and operating in the very back of my (reportedly smallish) mouth? I don’t have any other sinus problems going on like with a cold or something.

        • Mark Burhenne, DDS says:

          It’s hard to say without an examination in person, so If it continues, I’d call my doctor and get in to see him/her.

  4. Deanna R. Jones says:

    Thanks for posting this! I was also wondering why my tooth is feeling some pain after getting a root canal. It’s interesting how removing the pulp from the tooth can cause post-surgery pain. That explains a lot about what I’m experiencing with my tooth. It’s good to know that the pain should go away soon.

    • Deanna, you’re welcome! Thanks for letting me know this was useful for you, especially since I’m working to build out the “Know Before You Go” series for more procedures. Be sure to consult your dentist regarding your pain — I want these articles to inform but never to replace consulting with your dentist 🙂

  5. Douglas Brown says:

    This is a very thorough article, and I think will be of great help to us, as we have been worrying if a root canal is looming over us. My wife has been describing pain that sounds like the positional pain that you touch on briefly here. Sometimes when she lies down her tooth starts to hurt. I really hope that it isn’t a dead tooth, but if it is we at least have a good indicator to go off of. Thanks for the tips all around.

    • Hi Douglas, you’re welcome, and thanks for taking the time to leave a comment. Glad this was of some help. I’m sorry to hear your wife is in pain. If there’s anything else I can answer for you and your wife, feel free to email me: [email protected].

  6. i just wish that dentists weren’t so quick to Rx antibiotics. there’s so much emerging research about how disrupting the gut’s microbiome is one of the worst things you can do for your health, making you prone to autoimmune conditions and obesity, among others. Chris Kresser mentioned in one of his podcasts the depressing finding that taking probiotics doesn’t appear to actually re-colonize the gut with good bacteria. this sounds similar to what you mentioned in another article about how kissing someone doesn’t mean you “catch” their bad mouth bugs necessarily, because bacterial colonies, biofilms, etc, seem to have a complicated means of establishing/maintaining homeostasis. if it was easier to fix gut dysbiosis, that’d be another matter, but it seems like for some people, one too many instances of antibiotics exposure can push them permanently over a ledge to bad health from there on out. and we have enough times in life (strep throat, UTIs) where antibiotics are truly necessary. so i think dental use can become the straw that breaks the camel’s back. i have opted NOT to take antibiotics for anything (knee surgery, implants, extractions) unless a problem arises. they never have. i fill the Rx & keep it in the drawer in case of eventual need. but i’d like it if dentists, at least, would advise this method in the first place. even if it requires a few days of really strong pain meds while the pain chills out—they’re just not as bad for overall health, and don’t do any long term damage like antibiotics can.

    • Jamie, absolutely, I agree with everything you say. It’s heartbreaking for me sometimes to prescribe an antibiotic knowing what it does. As for filling the prescription and not taking an antibiotic unless an issue comes up, I do the same for myself. In fact, I haven’t had an antibiotic in decades. However, if a dentist does not give an antibiotic and the tooth is lost or more harm is done, then s/he can be sued for malpractice. This is partly why dentists and physicians are quick to prescribe in situations where they aren’t necessarily needed, and, in many cases, where the antibiotic isn’t effective. A lot of people think “oh, it’s just an antibiotic for a tooth infection” but in the bigger picture of health, it’s no different from an antibiotic prescribed by a physician taken for something that’s not dental-related. You still get the same systemic load and response by the body even if it’s an antibiotic taken for a dental infection. The best thing we can do is prevent having to take this compromise by preventing a tooth infection. Thanks for your fantastic, in-depth comment — I hope other readers benefit from what you’ve written as well! Best, Mark

      • Other readers did benefit! The antibiotic factor put up a red flag in my mind, too. Thanks for providing us some insight into why antibiotics are prescribed and for offering your own experience and advice.

        • Thanks for all your good info, Doctor!

          My dentist (a good man) was trying to finish up my root canal yesterday. He said there is a calcified root (which he and another dentist tried and tried to drill through already), and recommended a Specialist that I can go to for a consultation (and a 3-D x-ray. (But I’m trying to avoid these costs, if possible.) He said it was up to me to make a decision concerning whether to go to this specialist.

          Is it possible that there is no infection in the calcified root? (And would my own dentist need a 3-D x-ray to find this out?) Also, what percentage/chance is it that all would turn out well if my dentist just goes ahead and finishes the root canal, leaving this calcified root alone (and puts the crown on)?

          I’m learning from what you and at least one other dentist wrote, that it isn’t a good idea to WAIT concerning putting a crown on. But I can’t get insurance until next January (over 6 months from now). My dentist seems to think it’s possible that my temporary filling will hold until then – if I’m careful. Thanks for your advice!!

          • Mark Burhenne, DDS says:

            Hi there, Martha.
            If your dentist recommends a specialist after trying to perform the work himself, I would most certainly follow his suggestion and get a second opinion. I understand the need to save money where possible, but getting quality xryas is imperative to performing a quality dental procedure. Dr. B

    • I think if you have an infection in your tooth (with is usually the case if you need a root canal) you’d probably want to take antibiotics. Strep or a UTI can be treated naturally provided you start in the early stages and then you always have the option of going to antibiotics if that doesn’t work but it’s much harder to tell how advanced things are with a tooth infection so I wouldn’t mess about. It might be difficult to repopulate your gut microbiome but it’s impossible to regrow a tooth that you’ve lost due to infection.

      • Patrice Panis says:

        Ok, but the gut’s flora is the base of the immune system, so what is better, taking the risk to lose a tooth or the risk of destroying little by little the immune system?… gosh, decisions about health are so complicated sometimes! 😉

    • I understand your point of view and agree, but in a more broad sense – in that medication Rx’s (not just antibiotics) are given too easily in many (not all) situations. However, I don’t put blame squarely on all prescribers/specialists, nor specifically on dentists, as I see the issue’s source being further up the chain (like most things are;); it is a problem stemming from the way our society and economy have evolved. We as a society have now these inherent double-standard-expectations of treatments and services rendered. This is relative in this discussions context in that we expect to not be judged on the tangible nature of pain based on a doctor’s interpretation of our describing it – so while the docs medical expertise is valued and important in prescribing something like pain meds for any specific type of health issue, their expert opinion on YOU – how *you* are feeling, how *you* may or may not handle pain, is essentially barred from the decision process as we want the right to say “i feel (x, y or z)” and not be told; “no, you don’t.” This is a good thing, in theory. The conflict as presented though, is we also demand those same professionals do not subject us to unnecessary harm, give us undue access to potentially abusive substances, etc. If they deny our opinion, we have been discriminatd against. If they allow us access, we have been enabled and now can blame an addiction on malpractice.

      I think what’s important in all health-related situations is, firstly, to educate oneself down to the position of the authority (doctor giving Rx in this case). That means going beyond whatever opinions you may have developed, and objectively determing where the source lay, so from there and working back to the relevant matter, you will be better able to know and understand their position, their influences, what factors besides the obvious may be involved in any one decision.

      So while i agree that getting an Rx filled but not necessarily taking it *can* be a sensible thing, i’d say it’s situation dependent, and very much dependent upon how much credible knowledge you have on the most important considerations like “why is the doc advising i take x amount of medication for x number of days?” and “is it necessary”, “are there alternative ways to go about this without risk to my health”, and probably lastly, arriving at “can i choose to not take this unless (symptom x,y,z) appears, since there is more at risk by taking as instructed than by waiting it out and possibly recovering without taking any?”

      Bottom line is we really do, as individuals, need to remember that – no matter what laws are in place, no matter how heavily we can rely on those who specialize in any one thing to “make the right decision” every time – the reality is that the ONE person who is ultimately responsible in the handling of your health and well-being, your safety, your knowledge and abilities is yourself. Any number of people may be available to help, assist, educate you etc, but so long as you are able to make even the simplest of decisions, think rationally, learn etc, you are responsible for the decisions you make in your life.

      Sorry for the lengthy post, and as i said it is meant to be as broad as possible.

  7. Hi dr mark
    I had a root canal approx 2 months ago but have a lot of pain at the moment. I had a prescription for abx for it which I kept in case. On them 2 and a half days (clonamox 500mg x3 times a day) but while I thought yesterday was better it’s really painful today despite also taking pons tan forte. Should I give it another day? I’m nervous, dentist advised RC may not work and if not I need an implant which scares me, both the procedure and cost (am in ireland). What do you think?

  8. Hi im just wondering my dentist told me I need a root canal on my front tooth and I’m worry ed about getin it as I have no proable with my tooth but iv being getting a white spot on my gum above da tooth 4 bout a month now it keeps comin and goin but iv no pain r anytin esle wit it so I’m just wondering is there a way I could save my tooth r wil I av 2 get a root canal done as I don’t want it coz it’s my front tooth an iv heard once ya get a root canal done it fades colour throw time

    • I think that abcess could be affecting your brain unless you typed that comment using some speech to text feature on your phone and you have an accent

  9. Royal Herry says:

    This may not be the best place to ask this, but, I’d like to see Atlanta dentists and I don’t know how to find them… do you have any info on this Atlanta dental care? They’reIt’s located Atlanta, only 15 minutes from my appartment. I am not able to find reviews on them – Exceptional Smile LLC, 4420 Bankers Cir, Atlanta, GA 30360 – (678) 841-8800

  10. Just saw the dentist and at the end of my cleaning she noticed a tooth in the back of my mouth that had a big cavity on the side of it. The top of the tooth was fine so she almost missed it. She uttered those dreaded words: “root canal.” She had to run x-rays on this tooth again. I have a followup with this dentist later in the week, but I’m wondering if I really do need a root canal (maybe I’m in denial?). I’ve never had any pain on this molar; it has never bothered me. I don’t know if I should get a second opinion

    • Anonymous says:

      I have same exact issue….what did you decide to do?

      • Since the tooth hasn’t bothered me, I haven’t done anything about it. But I know I shouldn’t wait until I feel pain, so I’m going to go to another dentist for another opinion and also because I didn’t like the dentist I originally went to. In the mean time, I’ve been saving $$$$. Dentists are so freaking expensive.

      • So I finally went to another dentist that was recommended to me and he told me I just had a big cavity that might eventually turn into a root canal. He fixed the cavity and filled it. Tooth is feeling fine so far! (though it never did hurt before)

        Definitely have your teeth checked out now and don’t wait till the last minute to fix something. The doctor told me I didn’t need a root canal yet and that it shouldn’t have been the first option, but that I should have definitely fixed the cavity a lot sooner.

  11. Walter Steck says:

    I’ve always had this horrible stigma about root canals. When a dentist even hints at the fact that I might need one, I leave town and get a new dentist. It’s makes me feel better to finally know all the facts and that there may not even be any lingering pain involved. This is such a comprehensive post, and I thank you for it.

  12. Hey guys, just wanted to tell you of my experience. I have had root canal once and in three days I am going to have it again on a different tooth. The first time was very simple, my tooth simply broke as I study in Denmark where prices for dental care are ridiculously beyond me, I had to wait for a couple of weeks to get back home and that was enough. In fact the very next day (the day before the appointment with the dentist) I started feeling severe pain. The procedure was simply and easy to forego, no complications, I was very happy about it, 6 years later the tooth is still “performing” perfectly for me.

    Now two months ago I went to the dentist as I started feeling pain in another tooth. It became sensitive to hot and cold and it simply had a cavity. The dentist said that the cavity has not yet managed to get through the dentin though it had gotten quite far. I asked her what to do and basically how beneficial it is to preserve the nerve and she confirmed that it is worth it to try to preserve it.

    A couple of days I have started feeling such a severe pain that I have never ever felt before in my life and it wouldn’t go away at all, ever. I am unable to sleep for days (for example in the past three days I have slept around 4 hours in total). So I really regret trying to save that tooth. I had a feeling that this might happen since after fixing the cavity, not even two weeks passed and I started feeling some sensitivity towards hot and cold substances. The doctor though warned me that this is to be expected.

    So while it’s just my experience, I really regret not going for the root canal treatment and it’s not even the expenses but rather this unbelievable pain I am feeling. And trust me, I know what pain is, I have once had a surgeon cut an infected wound without anesthesia and push in antiseptic tubes to clean it. Yet this pain is on a completely new level.

    Not all is lost though. There is one natural remedy that I’d like to share with you. I went through dozens of suggestions for how to battle this pain. After trying to fight the pain for three days, today I started taking antibiotics (first time in my life). No success.

    I tried like 10+ home remedies from Listerine to Salt and all to no help.

    What helped me in the end (not completely but enough to make my pain bearable) was the following:
    I took a teabag of camomile tea (though I think that you can use any kind of tea), cut it open, removed a lot of the herbs, then I squished a couple of fresh garlic cloves and put them inside the tea bag. I mixed a tablespoon of sea salt with 200ml of water until it completely dissolved. Afterwards I kept the “improved” tea bag with garlic in this salty water for about 20 seconds. I then rinsed my mouth with the salty water and put the bag next to my aching tooth. It was so hot that it was hard to keep it going so I would remove it, drink some water and put it back again. Finally I wrapped the bag in a cotton wool (the kind we use to clean face or nails), waited until it soaked in the tea bag and that made it manageable though I would assume it is not always necessary as the garlic that I have is also extremely mean, usually they aren’t as strong. Anyway, you can sort of play with what makes it manageable for you.

    II write this because I know how much of a difference it can make. Though perhaps it won’t help you but for me it did when even the prescription pain meds failed miserably.

    • Oops, sorry for such a magnitude of mistakes. Three days without sleep under extreme pain can really take a toll on your mental performance…

  13. June Robinson says:

    This is a great article for people who are going to have a root canal! I have been a little apprehensive about mine, but after reading this I feel much better. I hope all people will be able to read this article before having a root canal and will feel better prepared to meet with their dentist. Thanks for the information.

  14. Jenkins Leroyson says:

    This is some really great information. My mom was just told she’ll need a root canal and wants to know more about them. I didn’t know that that is actually what they do when they perform that! As long as it works then that’s all that matters, I guess! Thanks for sharing this.

  15. paul barrett says:

    can my dentist stop the pain of a tooth that i think may need a root canal treatment or extraction.

    i am going away on holiday in 2 weeks for two weeks and i don’t want pain whilst im away. i don’t wish to have any procedures before i go in case it makes it worse whilst im away.when i come back i am open to anything the dentist wants to do.

    • Paul, sometimes taking an antibiotic right away for seven days will give the tooth a four to five week window of no pain and no infection. I’d see your dentist and explain your situation so s/he can make a recommendation to help you get through your trip pain and infection-free. Have a great trip!

  16. Hi Doctor Mark,

    I have a question for you. I recently had a root canal done, more precisely on Sept. 11th. After the procedure, I felt a slight pain in the area. The pain lasted for about a week, and now it’s gone. It is only a mild sensation. I did the procedure in my country and then went back to Ireland, where I went to another dentist, who told me that everything is OK, and if the pain comes back I should take some antibiotics.
    However, after researching on the Internet, I found in some articles that the root canal can fail even if I do not feel pain anymore, and that the bone can become infected without me being aware.
    I am really scared, I don’t know if I should wait for a few months to get back home and do a consultation, or if I should buy the plane tickets and go back to my doctor.

    • Hi Andrea, I took a look at your x-ray, thanks for sending, that’s always helpful. I do think your root canal is incomplete on the front root – and that can cause pain and another abscess in the future. I would go see an endodontist and see if it can be repaired – that’s a specialist in root canals. If you look at the x-ray, you’ll see some filling material on the back root that extends almost to the tip of the root – which is good. On the front root, you’ll see that same material, but that material is short of the root. That tells me that area has not be instrumented and cleaned out and there could be some infected tissue in there. Let me know if that helps!

  17. Hi,

    Your article is very informative, thank you so much for writing this. I came across it while reading about root canal post op pain on the internet. I had root canal done 48 hours ago on my lower back molar, all in one go, using the rubber dam. But I have pain now that radiates 5 teeth away, being the worst at the root canal tooth in the back and the 5th tooth away from it. I cant bite down on any food with any of the 5 teeth and I am taking ibuprofen 400 mg, which reduces the pain somewhat only. If I sleep on that side, I get terrible pain. There was some swelling, but it reduced with the Ibuprofen. I have curved root canals but the doctor was confident in working with such conditions. The x-ray showed the beginnings of infection, even though the tooth was still vital according to the test, so I went with the doctors suggestion to do a root canal. Im quite worried about this.. Could I get your opinion of my situation?

    • Boy, that’s a tough one, Nele, sorry you’re going through this. If the pain is as bad as it was to begin with, then obviously, the root canal has not been effective. Here’s the problem with molar root canals: some of them have very complex anatomy – beyond curved canals – and it’s likely that there is still some of that half living tissue inside of the tooth in an accessory canal. It’s possible that the root canal is not complete. However, it’s also possible that this is just pain after the root canal and that can go on for up to six months, although it’s not usually this intense. When you said it refers five teeth down, that indicates to me that the abscess is still active and the root canal may need some re-treatment.

      • Hello Doctor,
        I went in for a cleaning with a new coupon dentist and he found $6000 worth of work. He said I needed a root canal on #10 and no others–#29 maybe, but it could just be tissue. I didn’t believe I needed all that work so went back to my regular dentist who said I did not need a root canal in #10 but needed one in 29. He said there was a lot of decay and said if I could not do all the crowns at this time to just get the core build-ups, which now include pins. Besides the several, fillings, he began to do core build-ups on 10, 11, 12. Before this, I had no pain in any tooth. I had fillings in 8 but the fillings are sensitive, but tooth tested not needing a root canal–he said a nice crown could take care of that. He got into 12 and said, “this needs a root canal”…so I had to have a root canal in 12 on the spot, which had no pain prior, nor did it show on the x-ray. I went back for the lingering new pain on 10 and his girl took x-rays of 13 & 14 (not 10) and I was given the news that 13 and 14 need root canals, too. He showed me on the x-ray haw 13 hod blown out in the three months between x-ray. I had 13 root canal done and want to stop due to no money and too much to deal with. I have 14 & 29 root canals left to do and something wrong with 10 after the core build up. I need a crown on 3, one dentist said a crown on 4, but my dentist said a filling. One dentist said a crown on 19,, the other says no…so, I walked in for a cleaning and walked out with my life ruined–5 root canals, a half dozen or more crowns, fillings, etc. I don’t know who to believe any more or what to do. I have to just stop everything and get a clear perspective of what to do next. Looks like every time I say something hurts, it’s $4000. My social security was $11,000 and my dentist doesn’t take the advertised discount plans. With 12-15K on the line, I should go to who can help me the most, even if it requires a trip somewhere. Can a root canal in 12 cause a blow out in 13 and 14?

  18. Dear Dr. Burhenne,
    I would like to know if it is possible for the pulp of a tooth to be damaged during a crowning procedure by the extreme pushing up of the pulp after the Dentist has removed the outer tooth and before placing a temporary crown? Can this cause the pulp to become inflamed and or infected resulting in a required Root Canal procedure?

  19. Jonathan Pound says:

    Thanks for your extremely informative article. Most people don’t know about the anatomy of the tooth and why they need a root canal. As you mentioned, the cavity has progressed to the point where it has invaded the pulp of the tooth and this is why it hurts so much. This is why early prevention is can help diminish costs as well as time needed to treat conditions.

  20. Chris White says:

    Recently figured out that I need to go in for a root canal here soon and I am really hoping that it is not that bad. I know that I have heard from plenty of people it is not bad, but I am not the biggest fan of even going to the dentist. I really just hope that I can get over that and go get it done with no issues. Glad to know how it is done, but like I said before, I really hope that I do not have a hard time going in and getting things done.

    • Hey Chris White i know that is a really popular name but im taking a shot in the dark to ask you if youre the one who used to live across the street from me , and you have a brother Andrew. Email me and let me know carrie.ward at roadrunner dot com

  21. Thank you for your article. I had a root canal about fifteen hours ago and I am awake because I accidentally bit down in my sleep. Is there a night guard I can get to stop this while I’m waiting for my permanent filling appointment?

  22. Breck Lewis says:

    I was really interested to learn that a root canal is not to save the tooth but just to mummified it. I always thought that the dentist was actually saving the tooth. I recently went into the dentist and told me that I needed a root canal. I just went and got a second opinion and he told me to get an implant. What procedure would ensure me the best results?

  23. Thanks for the great article. Not all dentists have true interest in their hearts for their patience and it’s all about making money. If you have great insurance even a good dentist will try to mug you. I went to my dentist and he told me that I will need to get fillings replaced on tooth 1 and 2. I know something is not right but I trusted my Dr. He blew it up and without even starting the procedure went ahead and said that I need a root canal and a crown. He started the procedure and replaced the filing. Since then I have been having pain and my teeth are so sensitive to hot and cold. I rush back to him and he said that I will have to go with a root canal and he said that your insurance is good so you don’t worry, I will take care of it. Wow! I am not going again to him for sure.

  24. Omar Khalid says:

    why does the pain of pulpitis increased by lying down or sleeping?


  25. Angelo Pinelli says:

    Hi Doctor Mark,

    I wonder if there is any test to find out if there is an infection in a tooth that has had a root canal many years a go. I hade 3 infected tooth which had root canal about 10 to 15 years ago and only discovered the infection because I broke a front tooth, I went to a clinic inquiring about tooth implant and had a CT scan. Any other x ray I had did not show any sign of infection, I did not felt pain at all except feeling very tired for most of the time and some time had a bit of gum blending. I am asking this on behalf of my brother as his dentist seems to be unaware of any possible problem that a root canal may give.

  26. Hi .I need some quick help. Thanks in advance.

    I went to the dentist today about a deep cavity. X-ray showed that it is close to the nerve but the nerve is still alive and there is no infection. I have had some pain but nothing major and there is no lingering pain. He did a number of tests and said it looks like the tooth is alive but he still recommended a root canal. I said I don’t want one if the nerve is alive and uninfected. I asked for a pulp cap instead. He was shocked that I knew what was but he agreed to it. I am scheduled for one on Wednesday morning. I was told by the receptionist that if things go ‘sideways’ I might have to get a root canal. I understand if they find the tooth is actually dead or there is a bad enough infection. Though I am sort of afraid of the dentist just deciding to do one willy nilly even though it’s not absolutely necessary. I don’t exactly have the extra cash laying around.

    Can a dentist do something I didn’t agree to?

    Thanks again.

    • No. But be careful with paperwork and in signing anything . Read it carefully and make sure youre not under the influence of anesthesia or whatever they do if they work on you and then try to make you sign

  27. I emailed you this comment already but here goes again. In mid September I had a crown install done. Soon after I experienced pain from the gum area of that crown as i tend to clean my clean with a soft pick alot while driving. Last week I experienced alot of pain and my dentist called me in 2x to see what could be the source of it. A Tap test revealed the eye tooth was hypersensitive so he did a root canal on it last Saturday (Oct17) He remarked there was no blood in the canal as he was doing the root canal indicating (I think) the tooth was already dead. He prescribed Amoxillillin 500g 3x day for the infection. Now the pain is as severe if not more so than before. He wants to see me back October the 30th. How long should I give this antibiotic and why is the pain increasing after a root canal? Your thoughts are appreciated.

    • Probably because amoxicillan doesnt work. Lol it never did for me. Nor did penicillan

  28. I had a root canal done in my second trimester. my dentist has recommended that I get a temporary filling now and a permanent one once my baby is born (6 months away).
    What should I be mindful of during these 6 months to ensure the temporary filling and my tooth(!) is kept safe?

  29. Dental Care of Chino Hills says:

    Informative post! You have well explained the pros and cons of root canal therapy. Thanks for sharing with us.

  30. Dr. M. Shoaib Khan says:

    People should learn about root canals before they go for treatment. Your post provides effective information that may help them a lot. I appreciate your article.

  31. Olivia Sherwin says:

    This is some great information, and I appreciate your point that getting a root canal means you don’t have to put in an implant. I’m scheduled to have a root canal in a few weeks, so I wanted to learn more about what that means. I’ll definitely keep in mind that by doing this procedure, I’m preventing having to get an implant. Thanks for the great post!

  32. Mary Reddington says:

    I had a crown fall out and cementing it back in did not hod it. So my dentist placed a post in the tooth’s deeply calcified root to hold a new crown. I’m worried that the post is not in a firm enough support in the calcified area. Is it likely that this crown will come off?

    • I had 4 crowns 3 of which had root canals too. 3 are still on and the one that came loose had a post but thank goodness it did or i might have swallowed the crown had it popped all the way off

  33. If I remove a root canal tooth should I replace with a removable or fixed bridge?

    • Fixed is better than removable but both of those now are not considered the standard of care—it’s the implant you should be looking to do.

      • I inherited bad teeth and have many crowns. the most recent root canal/crown is really causing me grief but I do not think I can do implants as I am sensitive to all metals. I also have the front bottom 4 teeth wired into place due to braces moving my teeth too quickly as a youth has caused the roots to die off. they are barely hanging in my mouth. my dentist is encouraging implants. I cannot afford all these implants and don’t think my bones will take it as well as the metal will cause me issues. I personally think the braces and metal fillings over the years are why I am in such despair now. I am 46. what other options do I have. I am very tiny with little gum tissue as the braces caused gingivitis for me and my gums are receded terribly. A long string of bad luck!

      • Anne Marie Champagne says:

        Thank you so much for all your information you are providing on root canals. I understand so much more and feel better about going to see the endodentist next week. I also would like to say that I had an implant done less than a week ago and its going well so far. I was very nervous as I didn’t know anyone personnally who had this done.

  34. John Smith says:

    Very informative post. I had a root canal done about a month back. I felt some irritation and pain for about 2 weeks but it seems better now, although not fully gone. However, I have developed some sensitivity to the molar next to the root canal molar. I would really appreciate it if you could look at the xray and give me your opinion. Thanks

  35. Hello Dr. Burhenne
    I recently went to the dentist which I was apprehensive about because it is difficult to fully trust a dentist due to a past negative experience. I finally took the courage after 3 dentist and the Dr. found two cavities right next to each other which involved two teeth. After the filling all of the sudden I start having a night throbbing pain. He prescribes antibiotics and ibuprofen. The pain is now deminished and he took another xray and he is not sure if i have an infection but he does notice some sort of sinus with a gray shade on the xray on top of my filled teeth. He then prescribes Dexamethasone and said to give it a couple of days and if the pain comes back he will do a root canal or have it extracted. I asked which one is the tooth he believes is infected and he said he does not know he will tap it and if he has to he will do a root canal on both. I want to know how I can have a reversible pulpitis. I dont want to wait for the antibiotic to wear of and get a severe infection. How can I know if I may still avoid a root canal. Thank you for your advise the lack of communication with other dentist has made it difficult to trust one.

  36. Dear Dr. Mark Burhenne,
    I had a cap that fell out a few weeks ago with no pain. I went to the dentist who told me the tooth that was left under where the cap was had decayed and broken down requiring a bridge with the tooth next to it. He prepared both teeth for the bridge and placed a temporary bridge on. As I waited the two weeks for the bridge to be made this area remained very sore and painful which he said was because he had cut down the gum quite low in preparation for the bridge. When I went in for the bridge, as he tried to place it on the teeth, the tooth which he had filed down next to the broken one(the broken one had a previous root canal) began to cause extreme pain which became absolutely intolerable when he placed the permanent adhesive on it. I told him and he gave me more numbing shots. When the shots wore off the tooth began to throb again and the only way to make the pain tolerable was high doses of ibuprophen. It’s now two weeks later and I’m having on and off lingering pain. The dentist said I could have a root canal”if I want” but his X-ray does not show a clear need for it.i am completely lost as to what is happening and what I should do. I’m a teacher and keeping that smiling face for a job I love is becoming more and more difficult. Please advise. Thank you so much!

  37. I went to the dentist today and my top back tooth was opened because the dentist noticed some holes in the tooth. I lost the two bottom teeth several years ago and therefore haven’t made contact with this upper tooth. When she drilled down she said that the tooth needed a root canal and that the nerve was dead. Here’s my question I never felt any pain I don’t use the tooth, so do I need to have a root canal? I read all comments but never came across anything about having an already dead tooth that not being used.ô

  38. Hi doc Mark,ur page was very informative, thank you so much.I had a root canal four years ago but I didn’t crown it.last week I had severe pain following with swollen face on that same tooth.And I consulted a dentist nearby,she did a temporary filling and now my pain is what is the case now? Do I have to get another root canal treatment or have a crown around it or was my earlier root canal treatment unsuccessful…??

  39. Hi. I’ve had a root canal done about 9 months ago I know I shouldn’t have waited so long!! But I never went back to get the crown put on. Meaning I just have the clay(or mood) on my tooth. I’ve made a dentist app but I’m super scared because it feels like the clay has been pushed down into my gums I know it’s going to be really painful! It hasn’t cracked & it’s still connected to my tooth. Do you think I might have to get another root canal because I waited so long?

  40. Grace Turner says:

    I didn’t know that people could die of tooth infection. That is CRAZY! I’m like 90% sure I have a root canal, I obviously need to get to the dentist soon. I would like to know before I go if I should just get the whole thing removed and replace it with an implant or should I try out root canal first. It looks like it is something you really have to ask your dentist about. Also if root canals are never 100% clean, why even do them?

  41. Angie Snow says:

    Hello. My husband started in October noticing sensitivity on one of his upper teeth when chewing so he finally went to our local dentist and they did an x-ray and said he must have bruised it and sent him home . Several weeks passed and pain worsened so he returned and they told him he must have a cracked tooth so they grinded it down and put a particle. Then 3 weeks later he returned for the permanent crown , keep in mind he continued having pain. Had crown about 2 weeks and pained continued. They told him to take a round of antibiotics and see if it helped. So this week he has been on his 2nd round of antibiotics and pain is worse than ever . So today he called in work and went in and they did a root canal and by the way didn’t remove the crown but just drilled thru it. Is that a normal procedure and will that crown be effective? Also they said his root went up into his sinus and had a crooked end. They showed him pus like stuff that they pulled out. His pain has gotten some better. They told him to come back Monday and they would fill the hole in the Crown. We are just feeling uneasy about all this. Any suggestions? Thank you

  42. My dentist said she wouldn’t give me a filling because she could damage my healthy, uninfected root (big cavity on #14) but then recommended I have a root canal (obliterate my healthy, uninfected roots). I also have a tooth that has a very tiny hole in the side, no pain, that she says I need a root canal on. I’m seriously beginning to think she’s in this for just the money, and not for the health of her patients. She told me she makes the crowns in her lab in her practice. Should I get a 2nd opinion? Does this sound fishy?

    Thanks so much!

    • aribadabr says:

      I concur with you – getting a second opinion in your situation is a must.

  43. Dear Dr. B
    I have a very urgent question to ask you on behalf of my father who is not very comfortable with his English. My father went to the endodontist this morning for a root canal and after 1 hr of working on the tooth, his dentist informed him that there are 3 canals but he could only find 1, and that my father would have to come back for another appointment, which is understandable. However, the dentist did comment that if he is not able to find the rest of the canals, the tooth will have to be extracted.

    – Upon hearing the news, my father was extremely worried and upset for the following reasons:

    1) From the X-rays, the endodontist must have known that there are 3 canals, would he not be able to tell if the canals seem easy or tricky/difficult to find?

    2) Realizing that it’s possible for an endodontist to NOT be able to find all the canals, is it common for an endodontist to eventually give up on the root canal?

    3) If yes, who would be responsible for covering the extra cost of the work that will be performed by the endodontist?

    – My father’s tooth pain was intermitten and had been dealt with by taking antibiotics. He would have continued using antibiotics had he known that doing a root canal would cause an issue.

    Dr. B, thank you very much for your time! Your comments would be much appreciated!

    Vi Nguyen

  44. Hi Doctor Mark, I just went to student doctor in Temple univercity last week, the student doctor took almost 15 x-trays for my one tooth while she did root came out for my tooth, I had terrible experience, right now she filled temporary materials in my tooth, I decide not go back, I read some risks in root canals and people got sick after, I worried the unsafe materials in my teeth, any guide ? thank you so much.

  45. I have no pain, no gum swelling, but I do have a large, oval shadow on my x-ray…so, do I need a root canal? I have had one before, about 15 years ago, and only yesterday got a crown on it.

  46. Thanks for the great info. What is your opinion of second root canals? My 7 year old root canal in a back molar has failed, and I now have infection under the root in the bone (no symptoms right now, but I’m sure it’s only a matter of time.) Yikes. You’re right — the endo recommends a second root canal! The oral surgeon recommends extraction, implant, bone graft if necessary! What to do, what to do…

    I’m worried about smoldering infection affecting my health. I already have A-fib. But if I have an extraction, then I don’t know if I would tolerate an implant because of metal sensitivity. It’s complicated!

    Thanks for any input. Much appreciated!


  47. Anonymous says:

    I was so glad I found this article, it seems truthful and down-to-earth, thank you. However, in reading the Comments, it is quite disconcerting that there are so many urgent, worried, scared questions asking for help that….were never answered. I know how it feels to be so worried and desperate that you beg for an answer…and then get none. It’s sad. For me – I have had such a bad dental experience in my life -25 years ago- (a botched root canal!) –it actually dramatically changed my life-I was never again the same person – that I now have the most extreme and extensive dental phobia you can imagine. I was forced to go to a dentist for pain two years ago, but it had been decades since I was last in a dental chair. I have to have a valium-type pill first, an antibiotic to prevent infection going around the heart, then a drug that makes you forget what happens, altho you can still answer some questions, AND “gas”. THAT’s what it takes for me to be at the dentist’s office – even just for a cleaning! SO….tell me how I can have a root canal. OR an implant!! I have had two teeth pulled rather than have a root canal, (with IV sedation same as for an operation) but I have irregular heartbeat and am getting worried about “being put to sleep” in a dental office – is that JUST AS SAFE as in a hospital operating room?????? Can you BE “put to sleep” for a root canal? –I’m asking this because I have off-and-on extreme pain in my gum line, and am scared beyond all reason to start up with a dentist again. I am 65 years old, and I cannot understand how we can be in the year 2016 and still not have dental procedures be –ABSOLUTELY, totally painLESS. Your article says you can die from untreated dental problems. But you can also die from sedation not being administered properly, or from such extreme fear causing a heart attack. This off-and-on pain almost caused me to pass out one night, then there was none for two days, then the 3rd night it started out bad but stopped after a while. I’m living on Advil. Do you have any help or advice for me?

  48. I really need your opinion if I really need a root canal procedure. I had no pain at all before redoing my old filling. After the new filling, I start having a light pain every time I chew my food. I went back twice to adjust my bite (but I still feel the nerve not enough to be alarmed by it but it bothers enough to avoid using that side of the teeth.) The dentist said that if that didn’t work, I need redo the filling again. So I went back the other day after waiting 2 month, he now saying that I need a root canal, saying that I would feel better by taking amoxicillin and after finish taking the pill I still feel the same. I feel uncomfortable how I was told one thing and out comes are always different than what he said it would. Do I need a second opinion or that kind of situation could happen?

  49. Hi there! Has a question I was wondering if you could help me with. Recently went to a dentist where they determined from a pulp test that I would need a root canal in my tooth #8. Previously i fell on my tooth as a kid and it chipped, and this doctor was saying that he thought the nerve damage was due to the trauma. I am a little confused only because I haven’t experienced any pain in my tooth at all. I also had some feeling left in my tooth when they did the testing I just noticed it was little. Wondering if you could shed any thoughts on the fact that I haven’t had any pain in the tooth but it is slightly discolored.
    I also didn’t have the best experience with this dentist and I am going to another dentist to get a second opinion this next week. Wanting to be educated and cautious if i am to get a root canal done.

  50. Hello,

    How long does it take to have a root canal and a crown done on a tooth?

  51. I haven’t been to a dentist in several years, I’m ashamed to say. I finally went to a new dentist last week because I had extreme pain in my back tooth next to a broken tooth. The pain went away, but I made an appointment anyway to be safe. The new dentist immediately suggested a root canal & crown. The assistant told me it would take 2 hours. I already have jaw pain if I talk or sing or bite too much. I’m worried that having my mouth open for that long will really hurt my jaws. Is there any way to have a root canal without forcing my mouth open for that long? What if I have to sneeze or cough or move? I’m worried about the whole procedure. Going to the dentist, as well as getting a root canal, gives me extreme anxiety, which is one reason why I’ve avoided going for so long. Any reply would be welcomed!

  52. Donna Demers says:

    I posted & sent. Why is it not still here. Was it deleted?

  53. I’m really in a quandary not sure what to do. I had a root filling done by a private practice in 2006 I thought all went well however I do remember something going wrong and the dentist and assistant said not to worry something broke but it was all ok. After I was happy thought nothing of it however in the last few years I’ve had terrible headaches nasal problems even had to go for MRI to find out problem in the end just put sown to stress. Last Thursday however I went to my dentist with terrible pain in my tooth that came on prior to that I hadn’t slept for a few days with really bad headache The dentist got me in as emergency and after xrays discovered that it was a root filling that was done 10years ago apparently too short and was never done properly. It was a previous colleague that is no longer at that practice. She never apologised for him etc just gave me antibiotics and said she could either pull or get a specialist to re do it but would cost thousands. She sent me away and told me to think about it. A day later I had to call her because I was still in a lot of pain she told me to double up on medication and if still in pain she would pull tooth. I doubled up but for three days later although pain went I became very very sick throwing up every 5 mins my husband had to call 111 who got me seen by Dr he said because I’m allergic to penicillin n there was not much option but in his opinion it should be done In a hospital, yet dentist has me booked in for 23rd of this month I don’t know what to do.

  54. Nathan Johnson says:

    I think I still have bad memories of a root canal from when I was a child. Now my wife actually needs to get one done. Knowing how this procedure goes gives me a little more comfort. Thanks for posting!

  55. I don’t like going to the dentist since I still feel the drilling after the maximum injections of novacaine. My tooth cracked months ago, but I was too afraid to go to the dentist. It became highly infected with severe tooth pain that seemed to travel to my brain. I finally got the tooth removed. But in its empty socket is a very soft grey tissue. I don’t know what it is and I’m taking antibiotics. I still have a strange taste in my mouth…

  56. This was a great read! I wish you were my dentist.

    I’ve had about 3 root canals in the past couple years and i’m a little skeptical whether i needed them but i trust the dentist.

    Other than the cost, if root canals remove feeling, theoretically why not have root canals done on ALL teeth to avoid pain, infection, etc?

    • Thanks, Sheldon. It’s not a good idea because root canals aren’t perfect and they may not last forever. They do weaken the teeth structurally. It would just get out of hand in terms of cost and time. A real, healthy tooth is always best! Generally in dentistry and medicine, the best treatment is NO treatment, if possible.

      • Harry millward says:

        Hiya I’m 13 and I just had a root canal but I’m have to have it done it in two parts so they cleaned it out today and then in a few months they are going to fill it but idk when I can eat or drink because I don’t want to mess it up and be in pain or something so can u plz tell me how long I’ll have to wait thank you Harry millward

  57. Hello. My previous dentist told me my tooth was 90% gone and the tooth would need a crown. I didn’t have any pain but, I said okay. The dentist cut the tooth down, fitted me for a permanent crown, and put a temporary crown on the tooth. I went back to the dentist to have my permanent crown put on. I experienced a lot of pain and bleeding once the temporary crown was removed. The dentist had to get the bleeding under control before seeing if the permanent crown would fit. The crown didn’t fit. The dentist didn’t know I never had a root canal. Once she realized that, she gave me a referral to get a root canal. I never got the root canal because, I moved out of state and my new insurance will not pay for me to get a root canal. I found a new dentist. She asked me why the previous dentist cut my tooth down and put the temporary crown on. I told her. The new dentist said she didn’t see any indication that I needed a root canal. A year and a half has passed and the same dentist still say she doesn’t see any indication that I need a root canal. Part of my filling has come off the tooth and now I’m experiencing some sensitive when eating and drinking and the tooth aches on and off. The dentist says she can’t fill the tooth again because, it was prepared for a crown. She says my options now are to get a root canal if I’m in pain or an extraction. She explained to me if I get an extraction, my teeth will start to gap over a period of time. The dentist says I can get a bridge or implant after the extraction. Was the previous dentist right about her decision? Should I contact the previous dentist who started the work on my tooth? I would think she would’ve known I didn’t have a root canal. Now it seems that I’m facing more dental work when it may not have been necessary.

  58. Suzanne Lanoue says:

    Hi. Just wanted to let you know that you typed “cracker” above when you meant “crack.”

    Also, it’s interesting that you say it takes hours. Mine only takes a half hour. Also, only one visit.
    My dentist didn’t give me antibiotics before the root canal, either.

  59. I had a root canal and crown done 3 years ago. Recently, I have had extreme pain when biting on that tooth. It turned into a throbbing. Went to my regular dentist and he gave me amoxicillin. Then went to root canal specialist. They do not see a problem with the root canal but are doing a retreatment to relieve pain. They completed half way and I go back next week. I have been on the antibiotics for 5 days, throbbing is gone because of pain meds but still hurts to touch, tap, or chew. Is this because the retreatment is not complete? Does the medication need longer? If so, how much to I do not feel pain? They weren’t sure of infection but gave the antibiotics in case because I was in so much pain.

  60. Dr. Sachin P. Desai says:

    After going through this post, it seems that you have explained everything about root canal very clearly like its pros, cons and its procedure very well. I think this post is really truthful and down-to-earth. Thank you so much for sharing.

  61. angela l fighera says:

    DR B CAN MY TOOTH BE SAVED. I HAVE 4 STENTS post heart attack 3 yrs ago. DR TOOK CROWN OFF ,BUT SAVED SMALL PART FOR TEMP CROWN ON ONE TOOTH THAT IS THE START OF The crown,that was done 15 yrs ago,a perm bridge,covering 3 teeth one ,tooth is missing ,now I will have 2 teeth missing.In the back bottom of my mouth. I cannot afford implants.

  62. I had a root canal done on 3 of my teeth but before I could go back to get the crowns put on I was informed that my dentist had quit and she was the only dentist who would accept my insurance and the very next day all 3 teeth broke completely. Are these teeth salvageable?

  63. If a root canal is needed, is it always evident in an X-ray? How do you know for sure that it is needed?

  64. Taryn Uhlmann says:

    Hi Dr Burhenne

    Thank you for your detailed and helpful post in what has been a very stressful few days for me.

    Id like to ask your opinion – I had a root canal done a few years ago by a not-so-skilled dentist who didn’t even crown it. I am now at a new dentist who is great and after some xrays he motivated to redo the root canal and crown it because he thought there was some infection. Before I could go in to do this, I had severe pain all around the left side of my face (it was the top left molar) and unfortunately had to fly over the weekend which didn’t help. I went in yesterday and he opened it up (after prescribing antibiotics over the weekend I was away), and oddly it didn’t have a big abscess as expected but rather a kid of black oily material and some blood. He said it was decayed. He also said there was a crack at the bottom. He cleaned all the canals well although one of the canals was hard to clean to the tip so he did what he could and I am going back in a week when everything is settled to clean the last canal at which point he said if we cant get it cleaned an implant is better. The pain has definitely subsided although I am bit sensitive in the area. My questions are:
    1. What was the black material and is it toxic and would it have been seeping into my blood stream all this time? what should I do to ensure there is no long term effect?
    2. If he can get everything clean in the canals but the crack is there, even though he is skilled, should it nonetheless be removed rather than root canal-ed?
    3. If it is root canal successfully, will the crack have long term consequences even with a really good root canal and crown?
    4. Lastly, how can I determine if there is bone degradation from the old root canal which would affect the success of an implant or my long term health?

    Thank you for your time,
    Kind regards

  65. I had a cavity on the side of one of my lower molars, i didn’t notice it until it started to hurt occasionally when i bit down on something hard, or after drinking soda pop, or chocolate, Immediately I made a Dentist appointment within a few days. Based on much of what i have read online i feared the worst (root canal etc). However – It turned out that the decay didn’t quite make it to the root yet and a normal filling fixed it. The dentist said it was hard to say for sure – but most likely within a few months to a year, it probably would have decayed too much to save it. So to now specifically address this thread. If you notice your tooth starting to hurt and you see a cavity on it, it doesn’t always mean root canal. My advise ? Skip the fun money for now and make the sacrifice today, because extractions can change your look, or require expensive root canals or cosmetic dentistry (2500+ dollars vs a few hundred, or less with Dental insurance). Call your dentist and get an estimate for what a cavity filling appt. an average should cost, even loan the money if you need to, dont wait !

    • Anonymous says:

      Great advice. I had a cavity on the side of my upper molar. Didn’t do anything about it because it wasn’t bothering me. Finally had a cleaning and the dentist scared me by saying I might need a root canal. I didn’t feel comfortable with this dentist, so saved a bit of money and went to a better dentist thinking I would need a root canal. Turns out, I just had a really big cavity. The doctor fixed it and filled it and said that hopefully this will prevent me from having to get a root canal.

      I should have taken care of this sooner.

      • Good deal. Ive had two teeth pulled due to decay, one wisdome tooth (took 30 minutes to pull, along with at least 5 or 6 shots to numb, sore jaw for a week after that one), and one lower canine. At least you cant see the gaps, lucky) I finally got a deep cleaning upper and lower that was nearly 900 bucks (tartar removal drilling and scraping fest under the gum line), and 7 additional cavities filled. Dr said If i brush and floss every day moving forward i should be good to go.

  66. “Hello Dr Burhenne,

    This informative post may help many patients undergoing root canal. Thank you for sharing your knowledge through this detailed post which may guide many patient before the treatment of root canal.

  67. Paul Langley says:

    This is some really helpful information about the root canal procedure. I had no idea that they were only performed on teeth that are already deemed beyond saving. But your videos and graphics were very helpful for explaining the basic process. Thanks so much for writing!

  68. Anonymous says:

    God Bless you for sharing this information to the general public.
    It is rare nowadays to find a doctor who would share his expertise to people for free.
    More blessings will come your way doctor. Thank you.

  69. Hi Dr Burhenne,

    About 15 years ago I got my root canal done. last year I changed the crown. I told my dentist that I want to remove it and add implant, he did not agree. The reason, I want to remove it is because I have Rhaynauds Phenomenon which is an Auto Immune Desease. I told him that I have done some research and found out that root canal can cause Auto Immune Desease, he disagree. He claims that is 100% accurate. My dentist told me that the dentist that did my root canal is blind now for over 10 years. I really want to remove this tooth and get implant to see if my Rhaynauds symptoms will decrease. Please advise. Thank you!

  70. Hello Doctor,

    My dentist will be putting a crown on my tooth. They want to use a rubber dam during the procedure. Is it really nessessary to use the rubber dam for just getting a crown? No root canal will be done on this tooth. They are charging me an extra 150.00 for the rubber dam. Please let me know what you think.

  71. I am presenting under root canal process now my dentist is telling that my canal is having an blockage or obstacle so he is not filling that canal, so will it be safe or not and is it possible. I m confused please guide me.

  72. I recently began getting a root canal. I was told it would be a 2 part process because of infection. My regular dentist said I would be able to wait until my benefits start over to get a crown, but now I am being told I should get the crown right away after my second appointment. Should I have the tooth removed if I am not willing to pay the large amount of money I am being charged?

  73. I need help now! My father had two teeth pulled because they were cracked and infected because of a bridge. Dentist pulled teeth but never gave him anitbiotics and now he has been sick with nausea and diarrhea-should he have been given antibiotics?- a trip to the hospital and everything else checks out okay but they don’t check teeth-blood work from hospital not back yet-what should I tell my mom to do-this seems to need immediate attention-B

  74. I scheduled a visit to a dentist because I had a funny taste in my mouth, sick to my stomach, and a feeling of “fullness” in a tooth that has a lot of fillings. BUT NO PAIN. While waiting for the appointment, I started rinsing frequently with peroxide. By the time I got to the dentist, the taste and nausea were gone. The dentist took and XRAY and said I MIGHT have an abscess of the roots. He also thought there was some new decay… He told me the tooth would be too fragile after a root canal, and sent me to an oral surgeon, to have an extraction. The oral surgeon, who also does implants told me it was not clear that I had an abscess, or any new decay. He didn’t want to extract the tooth. Instead, he is sending me to an endodontist for a root canal. That does not make sense to me. If they are not certain there is any abscess, why do a root canal?

    • Jimbo:

      The presence of an abscess is not predictive of the need for a root canal. It only confirms the death of the tooth, and therefore the need for the root canal. Other criteria, like pulp testing can show that the tooth is non vital but no abscess is present. Many times the abscess is delayed after the death of the pulp. Your dentists have other info indicating that this tooth will indeed abscess and needs a root canal at this time.

      • Dr.,

        Thank you for your reply. I don’t understand.. Are you saying that root canals may be indicated even if there is no abscess? And that any tooth with a dead nerve will eventually abscess?

        This tooth has given me a lot of grief over the past three years. The fillings kept falling out, and it was very hard for the dentist to deaden for drilling. I know a root canal gives me a shot at keeping the tooth, but I question how strong it will be. In the last 6 months, I have seen two dentists and an oral surgeon. The first dentist said there was nothing wrong with the tooth. The second said I should have it pulled at an oral surgeon (because it has a curved root, and is so weak). The oral surgeon didn’t want to pull it, and is sending me to an endodontist tomorrow to get evaluated for a root canal! I have no pain, and the bad taste went away. The only remaining symptom is the sense that I have something STUCK in the tooth. I don’t know what to do……

      • Brent Petrson says:

        I been reading all ur post. So I have a tooth in the mid upright side hurts very very bad pass 3 days and yes I can see cavity on it. I believe I have to get a Root Canal cause I believe I got took that few months ago but I did not have dental inc. But why do diffract Dentist charge diffinft prices and what can I do to get this pain gone? I try everything and trying to get in tomorrow Oct 23 before work.

  75. Phelps Jeganathan says:

    I have an infection on one of my wisdom teeth. the tooth is almost dead according to the doctor. But it gives slight pain. Can i get a root canal filling done on it to save it since i have already lost two rear teeth extraction done already on the other side.


  76. Katheryn Haddad says:

    I had two root canals done on a molar on each side of my lower jaw. Now my gums have a little gnawing pain over both my upper and lower mouth.

  77. One day, I felt a pain in my mouth and the pain intensified over time. I went to the dentist and was given an X-ray. Based on the X-ray, I had a small chip at the bottom of one of my teeth. I was given the choice whether to do a root canal treatment or pull out the tooth. I opted for root canal but the dentist cemented the tooth temporarily and asked me to see a hygienist first as I have bleeding gums. It has been a few weeks since then, I didn’t feel any pain and gum looks healthy. I’m wondering if these are signs that my tooth can recover and I won’t need the root canal anymore.

  78. Mohammed Zafar says:

    Sir, i’m from India. i have read this article,. it was very helpful. sir, i have same problem in my teeth. it pains almost all the time and there is hole at the root of my teeth. when i went to the dentist, he did an X-Ray of infected teeth and told me that i have to do root canal treatment. he prescribed some medicine for pain and told me to come after three days and he will do the root canal treatment. sir i’m worry about the future side effect of this treatment. since they remove the nerves so it sounds me like something horror.please help me. Thank you sir!

    • destucker says:

      Try a pulp cap before a root canal. If it saves the tooth, great, if not, have the root canal or have the tooth pulled.  I had a root canal done on a perfectly healthy root (no infection) and had no pain before the root canal. Now I can’t brush that tooth without pain.
      I told my dentist, from now on, I will always try a pulp cap (basically a filling that covers on, or very close to the root), and then, if that doesn’t work, I’ll have it pulled.  After a root canal, you need a crown, which is eventually going to break. A crown is roughly $1200, where I live, in addition to the cost of root canal. If it’s a back tooth, try the pulp cap. If it doesn’t work, (and it won’t, if the root is infected), I’d just have the tooth pulled. If it’s a front tooth, do the pulp cap, after successful treatment with an antibiotic. If that isn’t successful, I’d do the root canal.  My dentist looked embarrassed when I asked her why she didn’t try a pulp cap. I know she referred me to the endodontist  (root canal specialist) and was paid for her referral. I think there are way too many denyists driven by greed, instead of what’s best for the patient. 

      • Thanks for your advice. No one in this community is doing “pulp caps”. Never even heard of them before today. I had my appointment with the endo-dontist, and although he said he would be glad to charge me $1400 for the root canal, he would give no guarantees. He also said the tooth would be VERY fragile. I would have to endure AT LEAST an hour of drilling. Now given that my old dentist could never get this tooth deadened effectively for fillings, the last thing I want to do is endure an hour of drilling. I tried get a return appointment with the oral surgeon pull the molar, but he wouldn’t let me return. (He took offense at a minor complaint I made after the initial consultation.) I never realized these guys were so thin skinned. Anyway, I am now scheduled for an extraction at a regular dentist who is confident he can get it out quickly.

        • ugh; no options are good but you WILL still need a tooth where the extraction is. I had one root canal done where I had to be put to sleep and they cut through the gum due to a “Hooked” root. Another thing, I was just taken in by my formerly “trusted” dentist and talked into four root canals. When I complained, he said “I thought you had a good job”…well…so I went to another dentist for the crowns and he said I didn’t need the root canals but sure needed the crowns, now. I think it is important for everyone to get a second opinion now since even your “trusted” dentist could be a con man at heart. There, apparently, is no way to prove his judgment calls, either, so they are pretty protected. in any event, I think you should still get a root canal by someone else and save your tooth. There are many issues with extractions but they seem like such a logical answer to expensive procedures–but they can also cause other problems and need an implant or something else. Implants are a problem, too.

      • Well duh. Think about it this way. Knowing how much it costs to go to the dentist everyone knows they make bank. If it werent that way how many would become a dentist because aint nobody going to be wanting to go into peoples mouths all day everyday for free. Although there is a legit need and still decent persons who actually care enough to do it as a profession to help people. You want a less greedy dentist you gotta go to tijuana mexico my friend

  79. Hi there,
    i have just been to the dentist today who said i may need a root canal removed on a large filling which he wants to crown.
    I have no problem about a having a crown but don’t want a root canal removed. How can he tell
    I need a root canal. I have no pain at all and no signs of infection.
    thanks in advance for your answers.

    • Get a second opinion; they all seem to have different opinions on this. Have him show you on the x-ray, too. Sometimes they can watch the area, but then if they did a root canal later, they would be drilling through your new crown. So get someone else’s opinion for now.

  80. Kim johnson says:

    So my dentist is going to place crowns on two with my teeth that doesn’t need root canals. Is there any reason for that. Can’t I just keep my natural teeth without doing a crown?

  81. My recent dental experience allowed me to form my final opinion on this topic.
    This is as short as possible explanation.

    My 2 experiences say that dentists are STRONGLY pro-root-canal-procedure oriented.

    Dentist will say:

    1. We want to heal your tooth.

    Healing is when you restore the healthy state of something. Is a tooth without it’s blood vessels and nerves a healthy one ?

    2. We are saving your tooth, then. At least.

    Is a tooth without it’s blood vessels and nerves actually a tooth ?
    Or is it some remnant of a tooth ?

    3. Imagine how useful a tooth or two in your mouth would be if you lose all your teeth and need something to hold your dental prosthesis.

    This one, after a few days of contemplating, formed my final opinion on this topic.

    The only thing that a root canal procedure is accomplishing is saving the FUNCTION of a tooth.

    Sure, that could be an useful thing, but AT WHAT COST ??!

    A tooth without it’s blood vessels and nerves has no immune system capabilities/protection nor it has a mechanism to report if something bad is going on inside of it (the pain).

    I had many instances of having to show the dentist where I have noticed a cavity in my tooth (I have been checking my teeth often and thoroughly and was able to notice cavities in very early stages).
    How will then a dentist notice a pathological process in a DEAD TOOTH, especially when such process starts from inside of the tooth, and such process on a DEAD tooth WILL more often start from the INSIDE than on the outside ?

    When such tooth goes bad it takes an enormous time for it to be noticed.
    That time is of great importance, because of enormous damage that gets done during it.

    The thing that presents the most serious health issue in this story and the one on which to decide whether to go with this procedure or whether to go with the tooth extraction, are FOCAL INFECTIONS.

    You may search the internet on this topic if you are really interested in your health and I won’t enter into explaining what FOCAL INFECTIONS are. All I can tell you is that they present a serious risk in root canal procedure (actually after it), and they affect your health in a SERIOUS WAY.

    Those health risks are a consequence of very powerful bacteria who secrete VERY POWERFUL toxins into your body.
    They make a hotspot inside your DEAD tooth, secrete those toxins locally which get into your blood stream.

    These bacteria are of the same toxic grade as Botulinum bacteria, Tetanus bacteria or other life threatening bacteria and their respectful toxins.
    Think about it for yourself on this.
    Ask yourself, if you go to a medical doctor with symptoms caused with such bacteria, how many of them will tell you: “You should go check your teeth.”

    So, in the end, there is a choice in front of you.

    Weather to save the FUNCTION of some ZOMBIE “TOOTH” or to take it out.

    You think you will lose something if you take it out ?

    Are there any means of having that functionality without that zombie tooth ?


    Implants, of course.

    I won’t go into the subject of the implants here but there is one more obstacle before you get that tooth out.

    It is your dentist.

    For some reason, he will do everything to get you to keep that dead zombie tooth inside your mouth.
    My both experiences confirm this.

    Although you agree to tooth extraction, say that you understand all the risks and pros and cons, take all the risk on yourself, release the dentist of any consequences of your decision, although you are the ONLY ONE to suffer the consequences of your decision, although your decision isn’t hurting anyone else or affecting anyone else’s life in any way, etc. etc. … he will still be firmly against it.

    If you decide on tooth extraction, stay strong with your decision.

    I am not saying here that you should listen to me. If you are interested in your health, do your own research, research as long as needed for you to have your own opinion on it, make a decision on your own and stick with it.

    Although implants exist now, root canal procedure practice is something that should have ended even before it started.
    The same as the primitive, barbaric and, above all, IDIOTIC practice of tonsillectomy.


    Tag: root canal procedure pros and cons tooth teeth danger health risk positive negative toxic toxins bacteria cavity anaerobic spore clostridium botulinum tetani tetanus heart failure kidney brain back pain death

  82. David Hawkins says:

    That’s good to know that an infection could spread to to other teeth or bones if left untreated. I recently had a dentist tell me that I need to get a root canal on a tooth since it was giving me pain. I’ll have to ask all these questions you’ve laid out to my dentist. Thanks for the info!

  83. 3 days ago I developed an increasing pain which I believe started under the upper 6th tooth to the left which is crowned. Pain was quickly increasing & spreading along the upper & lower gums & teeth etc. & only ice cold woud dull it. I had a consultation with my dentist (who informed me she was leaving town to practice elsewhere) & would refer me to a specialist but the wait could be long (live in small city). She gave me antibiotics & said to use tylenol. Also a prescription for tylenol 3 which I have been a bit afraid to use. The pain is not subsiding & can be intolerable at times with only cool water now causing it to very temporarily decrease. When the pain is bad I feel awful all over.Any idea what I should do. Should I take the antibiotics for the week & wait for possibly weeks to see the specialist or ?????

  84. Ben William says:

    Hello Dr. Mark Burhenne,
    excellent illustrations with visual images and videos. According to me , it can be great resources for patient and newbie dentists as well . First of all , i am not dental profession though i have bit intention to understand different types of health issues.
    According to me
    1. Exactly what questions to ask your dentist =) Yeah , it clear my self. how to talk and point out with my dentists. thanks

    2.What to expect during the procedure =) Nice , bit confusing . is there any alternative way rather having root canals.

    3. What to expect in terms of pain =) yeah, i got your point .

    4. How to not get ripped off =) thanks for your kind tips

    Overall, it took while to understand each things with video, However, thanks for your great post

  85. I had a large filling that the dentist said needed to have a crown. After removal of the filling I was in a lot of pain and antibiotics didn’t help so the dentist recommended a root canal. The dentist said he could save me money by doing the procedure himself so I went for it. Before he did the root canal he took an x-ray but didn’t do any other tests. Once the root canal was finished my pain didn’t go away. Another round of antibiotics didn’t help either. So I went to the specialist who tested my teeth and found that the tooth next to the one I had the root canal done on was cracked and also needed a root canal. So I went back to my dentist and had him do a second root canal on the tooth next to the one he had just dona a root canal on. After the second root canal I was still having pain on the first root canal tooth, it is sensitive to hot and cold and hurt’s to chew on it. I returned to the specialist who recommended I have the first root canal redone to see if there were any canals the dentist missed. My insurance was maxed so I had to wait. It’s been almost a year and still in pain. Two questions, what does this sound like to you and what would happen if the dentist did a root canal on a healthy tooth, how would the tooth react? I feel like when he pulled out the filling from my tooth he cracked the one next to it in the process, then thinking it was the tooth that had the filling removed needed a root canal but really it was the tooth next to it. Before i went into the dentist for my cleaning my teeth were fine, now I have two root canals and really soar teeth. What would you suggest I do?

  86. Thanks for writing this in depth article. I just had my first root canal today. A new dentist because a new city, I think he’s good. And a new insurance policy thank Allah Jehovah no thank Ernst and Young. Anyway it was actually day 2 because tu first day he said it was leaking. Great to read that h did it right. He also used a damn. I have to go back and get a crown next week. I didn’t realize it was so fragile.

    I don’t want any more cavities or decay. These last few years I’ve had so many cavities filled and spent so much money, which I could have put into my house or travel. Oh well. What makes me so angry though is ancel keys, and senator McGovern. Before I knew who these people were, I was under their influence. I’m convinced the reason I had so many cavities was high carb vegan low fat diet for several years. Now I learn that cholesterol is good and saturated fat doesn’t cause heart disease! Better to learn this now, but bacon is better for you than apple juice! Who knew? It makes sense, that bacon won’t rot your teeth and what should be healthy for one body part should be healthy for them all. I’m a meat eater! Specifically fatty bits. And the more fat I et the less I crave sugar. But at the public cafeterias, they offer yogurt but it’s loaded with sugar, or milk but it’s reduced fat. I’m convinced it’s a conspiracy. It is, of ancel keys and George McGovern. They landed me in the dental chair because I was a soft hearted animal loving health obsessed fool. And that thinking, lipid hypothesis, influenced the people who influenced me. McDougall and campbell and others, who, especially now that I’m into weight lifting, look like walking skeletons. If it turns out vegan as opposed to paleo diet doesn’t even prevent heart disease, they are bankrupt. They were true believers. So sad, alas. But fat and cholesterol help balance your hormones as well, and be fatherly or motherly, manly or womanly. So sad our sugar culture, which even I’m allured to on empty stomach. It’s a drug food we promote. They take the ft out of foods do teeter-totter, they put sugar in instead. And Huggins or what’s his name, the dentist who was anti amalgam, he said the same thing, cholesterol wasn’t bad. People didn’t listen. Maybe now with my expensive mouth and good diet, things will be different. Maybe I’ll feel better now than I ever have. That root canalled tooth maybr could have been avoided. A sedative was placed on there over a year ago. Since it was then asymptomatic, I ignored it, waited for start date, then suddenly, soreness and pain, right around insurance day! Would have been horrible to wait all that time to still have to pay out of pocket. Still I wonder if root canal could have been avoided, and I might have still paid he same out of pocket, around 800. Alas, decisions. Or maybe I could have done a pulp cap? But it was hurting, now it’s not. Believe me I’m grateful for miracles of modern dentistry, and people who care, especially when they’re up to date

  87. Leviticus Bennett says:

    I like how you pointed out how root canals don’t save teeth, they preserve them. That’s interesting. I always think it’s a good idea to ask a dentist about his sedation options as well. I like having nitrous oxide to help me feel comfortable during procedures like this.

  88. Kelly ~ It took me 10 years to lose 10 pounds says:

    Thanks for this thorough post.

  89. About 3 months ago, I had a pain in my upper right jaw area. It honestly felt like the pain I have had previously whenever I had tooth problems. I felt the pain coming from one particular tooth –but in the upper gum area. The issue was that I was not sensitive to hot/cold, no tooth sensitivity, and that particular tooth had already had a root canal & crown some years back. Dentist couldn’t find anything wrong. He put me on antibiotics until I could meet with the endodontist. The antibiotics did nothing for my pain. The endodontist couldn’t see anything wrong either and wanted me to wait until my pain localized. After a few days, I did find that my gum hurt in one particular spot (the original area that bothered me). The gum actually hurt to the touch. The endodontist performed a new root canal- cleaning up the old root canal- but said he didn’t see any sign of infection and we would just have to “wait & see” if the pain went away. Unlike my previous root canals, the pain didn’t go away in a day or two. It did start to lessen over the next week though. It got better but I would have days when it would hurt again- just for a little bit- in the same area of the gum line. I would put Oragel numbing agent on it and that would help relieve the pain. So, overall- most days felt back to normal except for little episodes of irritation in that area that I would help with Oragel. Now, last Wed, the pain returned- but on the gumline just above the tooth that is NEXT to the one we just did the root canal on. So, back to the dentist and he takes XRAY & all looks good. Same situation as before- no sensitivity to hot/cold, etc. The dentist is sending me back to the endodontist and he wants to do another root canal and this other tooth. My question is- should I have another root canal done ? Since we are in same situation I was 3 months ago, I wonder if this is truly a tooth/root issue or if this is something else entirely- like Pre-trigeminal neuralgia instead? Currently, the pain kind of comes and goes but it is sensitive to touch on that one spot on my gum inside my mouth and that is where the pain seems to be coming from. I would really appreciate your thoughts on whether you think this pain is tooth related when Xrays and examination show no sign of anything. thanks so much- I would really really appreciate a reply

    • Stacy:

      Something doesn’t sound right. Don’t do a root canal unless you are absolutely sure that the tooth is infected and dying.

      Have they entertained a periodontal access? Do see a periodontist first to rule out that condition.

      Let me know what happens. And good luck.


  90. Burt Silver says:

    Thanks for the information on root canals. I have one scheduled for next month, and I haven’t known what to expect. Thanks for mentioning to bring a book on tape or something similar to pass the time. I will make sure I do that so the procedure doesn’t seem as long.

  91. Thank you so much for the helpful information. You mentioned that you don’t recommend or do posts. Could you please tell me what other options I have? I had a metal post taken out from #8, redid the root canal, and will need to go in for a crown. There is hardly any tooth left below the gumline.

  92. Michelle Johnson says:

    I have a question concerning the root of a tooth. A dentist told my friend today that she can’t have a root canal done because the root has a cavity on it. She said it would have to be pulled instead. That this is the only option for this tooth. The infected tooth is one of my friends front teeth and she is devastated. Is this always the case if the root has a cavity on it or is it possible to still keep the tooth? Thank you for all the info. Very appreciated.

  93. Peter M Wilson says:

    Thank you, Dr Mark, for the information that you have posted for us, the patients.
    I have a question. My dentist sent me to the endodontist for a root canal on #31 (rear molar) . Only one of the two roots were treated, as clearly visible in x-rays. The tooth had cavities, but was not hurting. No abscesses either. My dentist said to get the root canal so that the proposed gold crown wouldn’t have to be destroyed, if the root ever got infected. He has always recommended this for all of my 9 crowns that he did, over a period of 30 years. Every tooth that he crowed, I always had a root canal done. My question is why would the endodontist treat only one of the two canals for my rear molar (#31)? It would seem that the other root could get infected one day, forcing the eventual removal, and probable destruction of the gold crown. Should the endodontist have treated both roots ?
    I thank you, in advance, for your opinion about this.
    Sincerely, Peter M.Wilson

    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


    • Hi Peter:

      There’s no such thing as only treating some canals when doing a root canal. They are all part of one continuous system and need to be treated as a whole. Otherwise, the other canals will become infected.
      Also it is highly unusual to root canal all teeth that have or need crowns. I’d go get a second opinion right away on this matter. Good luck Peter!


  94. Hello Dr mark, is pulp removal painful (as it contains nerves, blood vessels, etc.) ? If yes, is the pain can be prevented by the dentist?

    • John:

      absolutely painful if not numb before the procedure. find a dentist that is compassionate and good with local anesthesia. you won’t feel a thing.


    • John:

      absolutely painful if not numb before the procedure. find a dentist that is compassionate and good with local anesthesia. you won’t feel a thing.


    • John:

      absolutely painful if not numb before the procedure. find a dentist that is compassionate and good with local anesthesia. you won’t feel a thing.


    • John:

      absolutely painful if not numb before the procedure. find a dentist that is compassionate and good with local anesthesia. you won’t feel a thing.


  95. My wife had a molar crack and she had an endodontist do the root canal. The treatment worked but no temporary crown was placed on the tooth. She had a new appointment after 3 weeks to the regular dentist and was expecting the new permanent crown. During the 3 weeks the tooth cracked more although she has been chewing on only the other side. So she was back there today and they would only put on a temporary crown now. She has to wait another 2 weeks for the permanent now. A chunk of the tooth was now removed (accidentally with a bit of gums!) and the dentist said he had to shave down the gum line to fit the temporary. I am surprised that a temporary crown was not applied by the endodontist, probably leading to further fracturing of the tooth. The excessive wait between the appointments is also surprising to us. Your opinion please.

  96. Monsieur Trois says:

    I have two teeth with the pulp in tact but the dentist wants to do a root canal on both because decay has sat in above it and on one they made a minute hole in toward the nerve then stopped. The question is, in the case of still healthy pulp, is ever possible to remove as much decay as possible then seal off the rest (perhaps even a layer of euganol based filling as a deterrant and use a filling? I’ve essentially done that very thing to this point on one using temporary material and it has lasted 4 years and not progressed, surpassing the root canal and crown that failed after 3 on another tooth, and the two that fractured 2 weeks after root canal.

    I suppose you can see my hesitancy and desire to save what is still working for now.


  97. charlotte says:

    i have a big hole in one tooth that my dentist has told me needs a large filling and possibly root canal treatment, but she wont be sure until shes removed the decay etc- my issue is, i have severe anxiety and would much rather the tooth just be extracted than have to face the lengthy, stressful procedure of a root canal/ filling, but my dentist said she doesnt want to remove the tooth because im too young. should i get a second opinion? i would so much rather just have the tooth out.

    • Monsieur Trois says:

      You should definitely just go for the filling and hopefully it isnt too far decayed. If its asymptomatic and they tell you you need a root canal you might try a dentist that is conservative and would consider direct or indirect pulp cap in the right scenario of course (but probably better to do that before they drill down through the floor in the process of decay removal as they did mine). There are many studies ive read now showing that partial removal of decay and placement of a calcium hydroxide layer or MTA, and or using step-wise excavation can be successful. Changing your diet will also help in the future. If you are young consider that you might keep losing teeth and you cant just keep pulling. your chewing suffers.

  98. Can pain of a tooth needing root canal on upper jaw cause pain in a tooth on lower jaw?

  99. Went to my dentist and without even looking at my teeth proceeded with yearly x-ray. Found that a minor untreated cavity on a premolar had become bigger and close to the nerve. I have no pain, I am not sensitive to hot or cold but was advised to do a root canal. Without proof that the pulp is indeed infected is a root canal warranted? Is filling a better option?

    • Monsieur Trois says:

      Xrays are only part of the story and two dimensional. Might want to go with a second opinion with a conservative-oriented dentist. Just my 2 cents.

  100. Surrey Endodontic Centre says:

    Great illustrations. Thanks for featuring the root canal. This article will best explain the important aspects of the procedure. We will share this superb article.

  101. Terrible article. Did you honestly think calling a tooth a dead pharaoh would make people feel better about this procedure?

    • I think ensuring people are well informed about the procedure was the intention of the article. I don’t want anyone to sugar coat things when it comes to my health. Having read the comments here it appears there are dentists who are recommending root canals to their patients when it’s not 100% necessary. Knowing what a root canal is and what the risks are will help give people the confidence to ask informed questions and seek a second opinion if they’re worried.

  102. Delores Yates says:

    Is it safe to do back to back root canals? My grown son, needs several, so they did two root canals and prepped his teeth for crowns, last week. He goes back this week for two more root canals and prep this week.

  103. This is a great article and very well written. A lot of thorough and detailed information that has made me feel more comfortable with having to get a root canal tomorrow. I feel as if I know what to expect to a certain degree. Thank you for this great article!

  104. Angelrose says:

    I have recently undergone a procedure to put an implant in my mouth and whilst doing the procedure the surgeon found decay in a tooth next to the space. The decay was very low near the jaw so it wasn’t visible until he had open a flap of gum. He filled the tooth during the procedure and mentioned I should now have a root filling. Having seen my other dentist a week later he checked the tooth for sensitivity of cold but everything seemed very dull at the time, so he finally recommended a root canal. Having seen the dental surgeon today to check the surgery he tested the filled tooth again and it is now sensitive to cold but only when it is in contact, the feeling goes away very quickly. He told me that I must let my other dentist know that I felt the cold and that the feeling went away quickly before I have the root filling. I am not sure what he means and why he said that. Should I not have a filling? Not being a dentist I am not sure what to do say next week when I go back to have a root canal done.

  105. I had a temporary root canal operation done recently and the pain went away almost instantly. The following month I had it done permanently at my own dentist. After about a week I started getting a weird tingly dull pain in my cheek, or thereabouts, on the same side as where the root canal was done. It’s not nearly as bad as the initial pain though. I’m going back in tomorrow to see what this is all about as it’s been about 5 days now and the dull pain is still there – doesn’t let up for a minute.

  106. Carla Thompson says:

    My husband’s ENT scanned his sinuses and found that a tooth root has grown into his sinus. He said my husband should “go see a dentist”. However, on the scan it appears the tooth root is taking up about half of that sinus. Should my husband see an endodontist instead. Can I trust a dentist to recommend an endodontist or oral surgeon if it is really bad, or is there a chance the dentist will try to fix it when he shouldn’t. Just trying to be safe rather than sorry.

  107. I have my front two teeth with a small crack in it, and the last dentist I went to said I would most likely need a root canal.
    They have to “carve open” the tooth to get the tooth fixed.
    My question is would the tooth be able to be “fixed” meaning would it feel and look like regular normal teeth? Would it be harder than a normal toot

  108. John Molitor says:

    Hello. I’m in the military and stationed here at Fort Gordon, GA. My Army dentists have said I need a crown on one of my molars and suggested that I most likely need a root canal to be done first (going to see the specialist tomorrow). It makes sense to have the root canal done prior to getting a crown. However, I have never experienced any pain associated with this tooth. Just wondering if the root canal is necessary.

    • it’s possible it’s dead tooth and is not exhibiting pain, but i’d get a second opinion just in case. you don’t want a root canal unless absolutely necessary


  109. Hi,

    I went to a dentist who suggested that I do a root canal, but then I asked another dentist and she said that she will first apply a temporary filling on my tooth and wait for 5 days. She told me if I feel no pain after 5 days, she will just apply a permanent filling.

    HOWEVER, during the cleaning process she just stopped suddenly and said let us do a root canal instead. I was really confused and declined her suggestion, I just told her to continue with the filling for the time being.

    I generally feel no pain, but very slight pain when I eat or drink something cold, otherwise I feel fine. What do you suggest? Shall I go for a root canal as she suggested later?

  110. I had a root canal 6 months ago because I had an abscess that was very swollen and painful. The endodontist did say I had the option to have the tooth removed, but my dentist and she thought it was OK to proceed with the root canal. After the procedure, she told me that in my case she did not want me to have a crown placed on it right away. She recommended waiting a year to make sure I don’t get a complication. Does this mean she most likely saw a fracture? I will have an appointment with her soon. Do you recommend I ask her for a crown immediately, instead of waiting another 6 months?

  111. Thank you for the informative article. I’ve always been nervous about the prospect of a root canal after having read about the links to cancer and heart disease but a year ago I found out that one of my front teeth had died. I had the first stage of the root canal done two days ago (it was irresponsible to leave it so long but I was hoping my tooth might magically come back to life). My tooth has been quite painful since the anaesthetic wore off and it feels looser than it did previously. The dentist did mention that there could be some tenderness afterward but it’s a lot worse than I expected it to be given there was no pain in the tooth beforehand. I’m a little worried as the dentist who originally diagnosed the tooth referred me to an Endodontist but as I’d since moved I visited a new dentist who did the procedure herself. She’s young and was quite quick to do the procedure so now I’m a little worried that she made a mistake somehow and this has led to the pain I’m experiencing.

  112. Sam Wilkins says:

    I like how you recommended checking with your dentist to see whether they can complete a root canal in one visit or if it will take several. That definitely be something worth asking ahead of time. I also like how you expounded upon your point and explained how you handled the situation by taking two days to be thorough.

  113. Hi Dr. Mark, I went to my dentist today on account of throbbing pain (not severe) in my lower canine tooth (which I can also feel when I touch my chin in the area below the tooth). I’d had the tip of my canine filed down (slightly) about 10 years ago because pressure from my upper teeth on the tip was causing pain and had been pain-free and without incident until last week when the throbbing pain/discomfort started. After examining my tooth and checking for sensitivity (I didn’t feel any direct pain until after a few taps), he couldn’t find anything wrong with the tooth itself – there was no cavity even though he noted recession in the gum area – and so I had an x-ray done so he could examine the internal structure of my tooth for the cause of the pain.

    According to the dentist, the X-ray showed that the bones supporting my canine and a few other teeth leaving my dentines vulnerable. More importantly, the X-ray showed there’s some infection at the base of my tooth support area (specifically in the bone area of my tooth support and affecting some nerves) even though the tooth itself is intact. He then recommended a tooth canal to clean out the infection and fill up my nerves, and filling my gum area to cover up the exposed parts of my teeth.

    My first question was if my tooth is still intact – no cavities or holes in it, pulp cavity is fine – is a root canal absolutely necessary? Can’t the problem be solved by a course of antibiotics? Is the only way to rid the tooth support area of the infection to physically clean it and the tooth (via a root canal)? His answer was that antibiotics wouldn’t be effective and that my only option for permanent pain relief and to stop the infection from causing further damage is a root canal.

    I’m fine with filling my gums but wary of a root canal, not because I’m scared of the procedure but because the process (drilling a hole into my tooth) will involve compromising an intact tooth on account of a weakened support area – isn’t there a way to treat the degradation and infection of my tooth support in a way that’s non invasive to the tooth? Basically, my question is, based on my description of my tooth examination and the doctor’s findings, is a root canal necessary/my only option (I can send you a photo of my X-Ray)? Many thanks in advance for your response.

  114. I just had dentist clean out my tooth and sealed it.. he is sending me to an endodontist because he said it’s too complicated for him to do. My tooth is still in some pain. Do u think there may be some infection still? Also he told me I don’t have to take my amoxicillin anymore because he administered the medication in the tooth. If it is still hurting should I still use amoxicillin until my next visit with endodontist?

  115. Rachel Wallace says:

    Hi, Dr. Mark.

    Six years ago I had root canal therapy performed on my #19 tooth. This occurred because an old mercury filling had leaked in that tooth, causing an infection. I had no symptoms of an infection then, and the infection was discovered on bitewing X-rays. I also got a second opinion just to make sure a root canal was absolutely necessary. Ultimately the root canal therapy was completely successful, as was the fitting of the crown. Everything has held up wonderfully.

    Fast forward to May, 2017 and I’m experiencing very mild, very occasional pain in that same tooth (maybe popping ibuprofen once or twice a month). I mention this to my dentist at my 6 month cleaning and routine bitewing X-rays are taken. My dentist sees nothing suspicious, but offers me a referral to an Endodontist as they can offer more precise ways of examining teeth. My dentist also says I shouldn’t be having to take anything for tooth pain. I keep the referral just in case…

    In November, 2017, on the morning of my 6 month cleaning, I discover that the base of my crown has started to become discolored. At my appointment my dentist says that the sealant on my crown is not up to par anymore and that my crown must be replaced in order to keep bacteria out. He wants to replace my current crown with an all porcelain one. No big deal to me, as we have pretty good dental insurance. I make an appointment for a new crown.

    In the meantime, my #19 tooth is a little sensitive. (It’s mainly been sensitive right before my monthly period or when my sinuses are bothering me.) I decide to make that appointment with the Endodontist just in case something is going on; I don’t want to pay for a new crown and turn around and have it drilled through should I have a badly infected tooth down the road.

    Bitewing X-rays and a fancy 360 CT scan is done of my tooth. The Endo looks at the X-rays and points out a very, very small area at the root of my tooth. So small that twice I said, “are you talking about this area?” She said that because she had nothing to compare my X-rays to, she didn’t know if what she was looking at was a new gray area or an area the Endo missed 6 years ago. She said I had 3 options: 1. new root canal, 2. pull the tooth (if finances are an issue), 3. do nothing.

    She never asked me if my tooth was sensitive to hot/cold, but she did perform a percussion test and nothing hurt. I doesn’t feel great to have your teeth banged on, but nothing made we wince in pain. She also didn’t prescribe any antibiotic. Aren’t antibiotics routine prior to root canal treatment?

    I would never have my tooth pulled even though I realize I’m just preserving its current state (I’m only 33), but I’m not sure that I need root canal therapy done on this tooth again at this time. Should I have a root canal done even if the gray area was about 1/2 the size of a pencil eraser?

    My biggest concern, as I mentioned, is not treating the tooth again before my new crown is put on. The Endo said she’d like to perform the treatment while my temporary crown is on.

    Should I discuss my concerns with my dentist? Perhaps I should have all bitewing X-rays from 2014-2017 sent to the Endo for review before an invasive procedure?

    Thanks so much,

  116. Rick Lariviere says:

    What a wonderfully written and informative article! Thanks!

  117. Karen Watson says:

    I am 75 years old and have approx. 8 bottom teeth left plus one wisdom tooth. Problem is the remaining teeth roots are exposed and causing pain due to receding gums. I have upper dentures. I cannot afford dental implants…poor s/s lady. Do I invest in root canals or do I have them pulled and a lower denture made.

  118. Years ago I knocked my front tooth out and now (about 5 years after that) the tooth is dying and my dentist said I need a root canal. My question is, when I knocked my tooth out all those years ago (my front left one) it broke off right at the nerve, my dentist (a different one) just glued it back on basically. I haven’t had any problems with it until recently it started to just hurt. Do you think a root canal is a good idea since I have that fracture in my tooth? Or should I just go straight to the false tooth?

  119. I am 45 years old and had a root canal 1 week ago . The problem is my tooth is worst of than before the pain is still there . When I phoned the endo today I was told I needed to pay again “( to see him and honestly I am no position to pay another 8000 for a tooth which had only one canal .

    I am so depressed as I lost most of my teeth and dont want to lose my last few I have left. I thought once I fix up my teeth I will go for my dentures as I cant afford implants. Is it fair for the endo to charge me again . Surely he can check if there is something wrong with what he did . I am at my wits ends really dont know what to do anymore . The reason I went to him and not my regular dentist is because I wanted to make sure my tooth would be saved . I honestly dont know what to do . I blame myself I should have asked . It is my fault .

  120. Callum Palmer says:

    There really is a lot that you have to consider when deciding to get a root canal. I particularly like that the article mentions the fact that you don’t have to extract the tooth. After all, a root canal is a great way to fix the problem without having to sacrifice the tooth.

  121. my no.19 molar had a crown with a deep cavity growing under it. the crown was removed and the cavity cleared out. a root canal was done. one of the canals was severely calcified and could not be cleared out. my dentist rebuilt the tooth, and a permanent crown was put in. a month later my jaw around the tooth still aches. i can tap on the tooth, chew, etc without pain. i can brush and floss without pain, but the tooth area feels ‘arthritic’? i especially notice it when i have sinusitis. is this common? did my dentist screw me over by crowning over a calcified root? they already screwed me once by installing a zirconia crown that my plan did not cover without asking me. i had to pay the cost not covered by the plan. i would hate to think that i just wasted $1000 on a tooth that will end up having to be yanked. :/ i made the mistake of looking up data on root canals and hit on vertical root fractures too. when will i ever learn?

  122. So i just got a root canal done yesterday. I told the dentist that I wasnt feeling any pain and I haven’t in the past.even though I have an abscess where my back right bottom molar is. The dentist kept insisting that its was dead and said I had a crack in my tooth which was a lie. The root was curved and he could not get it done right. Also i kept feeling pain. Now today the abscess is much bigger than before I went in.
    Can you please give some feedback as to what i should do? Thank you!

  123. Hi to all, it’s actually a good for me to visit this website, it consists of helpful Information.

  124. Raymond Cooper says:

    I’ve been having some lingering pain that gets worse when I eat anything cold. You mentioned that this could be a sign that I may need a root canal. What tests would a dentist utilize to see if the pulp inside my tooth is infected and requires a root canal?

  125. Benjamin Andrews says:

    I found it interesting that you ask about all your options. My mother has been having tooth and gum problems for a while, so I have been looking into how we can take care of it for her. I will send her this information, so she can seek out advise from a dentist.

  126. Thanks a ton Dr B for the valuable friendly insider info. My tooth has a cavity but doesn’t hurt or sensitive yet. I saw a new dentist who referred to root canal specialist- very pricey. Do I need a root canal or just a filling? Should I get a second opinion?

    • Mark Burhenne, DDS says:

      Hi there, Swati.

      If you’re not confident with the recommendation your dentist gave, a second opinion is a great idea.

      For early cavities or preventing them in the future, you should consider my ebook “Dr. B’s Guide to Reversing Cavities.” It’s a detailed step by step process.

      Best wishes,
      Dr. B

  127. Thank you for this informative article. I am currently debating on whether or not to move forward with a route canal. About two months ago, an onlay was completed due to a large/deep tooth decay. I did not feel much pain during the process but it was quite painful afterwards. The dentist said that it was deep and had reached the gum baseline. Two weeks later, the permanent onlay was placed and boy was that a painful procedure. The dentist used a little bit of anesthesia but it felt as if she had used none. Ever since, the tooth has been super sensitive, particularly to cold food. I avoid eating on that side of the mouth as much as possible. The pain usually does not linger. However, I did wake up twice with pain on that side of my mouth. The dentist ordered a mouth guard since I often grind my teeth. I have noticed also that anything with peppermint, such as gum for example, causes pain in the area. Sometimes its a sharp pain which I also feel on the jaw. I did see a root canal specialist last week. He tapped the tooth various times, applied pressure and asked me to bite down on some stuff. I did not feel pain. The only time I felt pain was when air was blown onto the tooth and a cold item was placed on it. He gave me the option of waiting one more month to see if it improves. However, I will be traveling in early Aug and my biggest fear is being in pain during the flight. I had a root canal done years ago on another tooth and it was such a bad experience since one canal was missed, the pain was awful. At this point, should I wait another month or ask the specialist to proceed now with the root canal?

    • Mark Burhenne, DDS says:

      You may want to get a second opinion before your trip to make sure you are informed about your options.

  128. Susan Logue says:

    My dentist did some work with a broken thumb which made my bite become out of alignment. I was hitting hard on both second top molars #3 & #14. Nothing was done to fix it. I grind my teeth when my bite is off so after 3 months I was told I needed a root canal in #3 even though there was no swelling or infection. It still hurt after from muscular pain which didn’t resolve until someone finally adjusted the tooth. The endodontist said the canals were open and there weren’t any cracks but now I have jaw pain. The tooth has a crown, could I have cracked the tooth or the root after the root canal from grinding? It’s been over 2 years #14 has been hurting now it seems to have something on x-ray. Can grinding on a high tooth cause it to need a root canal?

    • Mark Burhenne, DDS says:

      Hi Susan,

      Yes, this is possible. I would recommend mouth tape and a sleep study. Also, look on for a knowledgeable dentist in your area.

      Dr. B

  129. Rickles McPickles says:

    Mouth open for a few hours? That’s crazy, I’ve had lots of root canals and never had to have my mouth open anywhere near that long.

    • Mark Burhenne, DDS says:

      It’s great to hear that all of your root canals went so quickly.

  130. I appreciate that you explained how a rubber dam works, and how it isolates the tooth to help dentist do a root canal. I wish I had known how to recognize signs that I needed to go to the dentist before one of my teeth broke a few days ago. Now, I am guessing I will need to get a root canal to stop the pain from it, but I need to find a good dentist in the area first.

  131. I had a root canal on my front tooth a year ago, by endodontic, I have had discomfort on and off and had read that sometimes it takes 6 months to calm down. About a 3 weeks ago I bite down hard on something and I have been in discomfort every since. He did not recommend a crown. I will be seeing him in week 1/2, I am so worried that the tooth is fractured and I will have to have an implant. I wish now after reading your article I had gone to him at that 6 month point when I was having on and off pain.

  132. Oh no, I wish I had done research before I accepted a root canal. I was told I had no choice even though I had literally no tooth pain, not even when chewing or drinking cold stuff.

    My root canal only took my dentist 45 minutes and he was very unwilling to communicate during the procedure.

    I’m now experiencing deep pain in my tooth, it’s been about 3 weeks. I dont feel comfortable going back to that dentist anymore does anyone have any recommendations of next steps? If there is a problem with my root canal would my dentist pay for it? Or would I have to pay again?

  133. nice article and informative ,good blog ,thanks dor sharing

  134. i went to well known endodontist specialist to check my re-infected root canal tooth, after x ray and check, he said that he able to do the re-rct on my tooth with condition the tooth not crack yet (infection can be caused by tooth crack) but since the tooth already crowned from previous root canal, he need to dig through the crown and check before do the re-rct
    1. if he find the crack, he will abort the procedure and send me back to dentist to do extraction , worse i will still liable to pay 30-40% of re-rct cost depend on how deep is the observation
    2. If no crack he will do the re-rct, since this is retreatment , cost is 30-40% higher than normal RCT with lower prognosis compared with tooth with initial RCT

    Now i am conflicted whether should i do the re-rct or not : ((

    Can help me give insight ?

  135. nice article and awesome blog ,thanks for sharing

  136. Merritt C Olsen says:

    Just finished with my 3rd visit for #19. Finally got all 3 canals cleared which were calcified. I had RCs done on #25 and #26 which I felt during the procedure despite being given septocaine by infiltration. #28 was deep as well and the pulp chamber was hit. They put Glycine then composite and said we would wait to see if it became a root canal too (fortunately it hasn’t). Unfortunately for me the dentistry professor has to give me a block because my nerve is not in the expected place.

  137. Thank you for this wonderful information. Most dentists will try and perform root canals in my country but sometimes they fail. Endodontists might be a better choice.
    I’ve had 6 root canals done and they’ve all failed after 3-6 months. Some of them done by acclaimed local endodontists. My canals are hard or impossible to clean, one endodontist even stated ‘what sort of tooth is that?’ while performing a root canal procedure.
    I’m having a hard time trying to beg my dentist to simply extract the teeth, most dentists don’t care that 6 root canals failed, they still want to try, but I, as a patient, have felt the pain and failing of this procedure.
    It’s a hard life to have teeth with hard-to-clean canals.

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