Does Root Canal Treatment Hurt?
Root canal treatment is usually done under local anaesthetic, and NHS guidance says you should not feel pain during it. Research suggests pain is more common before treatment than after it. This guide, for anyone facing root canal treatment, explains what you may feel during and after it, why a very inflamed tooth can be harder to numb, how long tenderness lasts and when to get help.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, the practice's principal dentist, reviewed this page. He is a General Dental Practitioner (GDC number 301711) with BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry and PG Cert Restorative and Aesthetic Dentistry.
Does root canal treatment hurt?
In general, no: Leeds Teaching Hospitals NHS Trust says pain during root canal treatment is rare, because it is done under local anaesthetic.
NHS guidance says you will usually be given a local anaesthetic, so you are awake but should not feel pain. Mild discomfort afterwards is more common, Leeds adds, and can be managed with painkillers. The honest exception is a very inflamed tooth, which can be harder to numb.
Why does root canal treatment have a painful reputation?
Research suggests much of the pain linked with root canal treatment comes before it, from the infected or inflamed tooth being treated.
NHS guidance says root canal treatment may be recommended if you have tooth pain caused by an infected tooth. A 2011 systematic review of 72 studies (Journal of Endodontics) found that, on average, about 81% of patients had pain before treatment, and that pain became less common and less severe afterwards, falling to minimal levels within a week.
The review's authors call root canal pain a major source of fear, one that patients anticipate, remember and share.
What do you feel during root canal treatment?
In general, the tooth is numbed with local anaesthetic before treatment starts. NHS Lothian's leaflet says a top-up of the local anaesthetic may be required.
The British Endodontic Society links rubber dam, the sheet that isolates the tooth being treated, with patient comfort.
At Deepcar Dental Care, topical numbing gel is applied before every injection, and rubber dam is used routinely. Root canal treatment here typically takes 1 to 2 visits and is carried out by a dentist with a special interest in root canal treatment. Our guide to what happens during root canal treatment walks through each stage.
Why can a very inflamed tooth be harder to numb?
A tooth with an acutely inflamed pulp, sometimes called a 'hot tooth', can be much harder to numb than a healthy tooth.
The pulp, inside each root canal, contains the nerve and blood supply to the tooth (Leeds Teaching Hospitals NHS Trust). A 2015 review in the British Dental Journal describes acutely inflamed teeth as up to eight times more difficult to anaesthetise than healthy ones, with an inflamed lower molar arguably the most testing case.
Leeds Teaching Hospitals NHS Trust says that if the nerve is very inflamed, local anaesthetic may be less effective, but strategies are available to manage this.
In general, the British Endodontic Society lists extra injections a dentist can add for a hard-to-numb tooth: around the tooth (intraligamentary), into the bone beside it (intraosseous), or into the pulp once reached (intrapulpal). The 2011 review found supplemental injections were often needed across the root canal treatments it studied.
Questions about this treatment? Book online or call the practice.
What does root canal treatment feel like afterwards?
After root canal treatment, NHS guidance says your jaw and face may stay numb for several hours, and the area may feel swollen and sore.
It advises taking paracetamol or ibuprofen if you are in pain and being careful not to bump or knock your mouth.
Our guide to recovery after root canal treatment covers aftercare.
How long does pain last after root canal treatment?
For most people, pain after root canal treatment has faded within about a week, research suggests.
In the 2011 review, about 40% of patients had pain a day after treatment and about 11% a week after. Leeds Teaching Hospitals NHS Trust says the tooth may feel sore for 3 to 4 days, and sometimes longer, which painkillers can manage. NHS guidance says soreness should get better in a couple of weeks.
When should you contact a dentist about pain or swelling after root canal treatment?
After root canal treatment, Cardiff and Vale University Health Board advises seeing your dentist if pain persists or swelling increases. NHS toothache guidance says to see a dentist if toothache lasts more than 2 days, does not go away when you take painkillers, or comes with a high temperature, pain when you bite, red gums or a bad taste in your mouth, or if your cheek or jaw is swollen. If you do not have a dentist or cannot get an emergency appointment, NHS guidance says to call 111 or visit 111 online.
Leeds Teaching Hospitals NHS Trust describes a flare-up in some people, with increasing pain or swelling 3 to 4 days after treatment, which might need antibiotics.
If you think you have a dental abscess, NHS guidance says to ask for an urgent dentist appointment or get help from NHS 111.
NHS guidance on dental abscesses says to call 999 or go to A&E if you are finding it hard to breathe, speak or swallow, have a swollen or painful eye or suddenly start having problems with your eyesight, have a lot of swelling in your mouth, or are finding it hard to open your mouth. Its toothache guidance adds A&E if your neck or the area around your eye is swollen. Do not drive to A&E: ask someone to drive you, or call 999 and ask for an ambulance.
If you have toothache now and have not yet had treatment, our page on severe toothache and what to do today explains your options.
What if you feel anxious about root canal treatment?
If you feel anxious about root canal treatment, tell the practice, because support for nervous patients is available.
For anxious patients, the practice's approach includes longer appointment slots, quiet appointment times on request, a stop signal agreed before treatment starts, music or headphones, and bringing someone into the room. Our page on dental anxiety explains the approach.
Sedation is available in house and arranged on request, and root canal treatment is one of the treatments that can be carried out under it. It is for adults aged 18 and over, suitability is checked at a separate pre-assessment appointment, and you need an escort for the whole day. Our page on sedation for nervous patients explains how it works.
Where can you read more about root canal treatment?
Our main guide to root canal care explains how root canal treatment can save a tooth that would otherwise need to come out.
Root canal treatment is part of restorative dentistry, which focuses on saving natural teeth rather than replacing them with implants.
Frequently asked questions
Can root canal treatment be done without anaesthetic?
Root canal treatment is normally done with local anaesthetic, not without it. NHS guidance says you will usually be given one, and Leeds Teaching Hospitals NHS Trust describes the treatment as performed under local anaesthetic. If injections are what worries you, tell your dentist before treatment starts.
Do antibiotics stop the pain of an inflamed tooth?
No, antibiotics do not treat the pain of an inflamed pulp. The British Endodontic Society says antibiotics should not be prescribed for irreversible pulpitis and have no efficacy in treating it. It says drugs should only be used alongside treatment of the tooth itself, with antibiotics needed only in very limited circumstances.
Can you take painkillers before root canal treatment?
Yes, in general. Leeds Teaching Hospitals NHS Trust advises eating as normal beforehand and taking any medicines, including painkillers, as normal unless your dentist or doctor has told you otherwise. NHS toothache guidance adds that a pharmacist can advise on painkillers, and children under 16 should not take aspirin.
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You can contact Deepcar Dental Care online or by phone.
The practice, at 334 Manchester Road, Deepcar, Sheffield, S36 2RH, is on the ground floor and wheelchair accessible, with free parking directly outside. You can also read our patient reviews.
334 Manchester Road
Deepcar, Sheffield S36 2RH
0114 288 2121
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