A root canal removes infected or inflamed pulp from inside a tooth, then seals it to prevent further damage. The procedure typically takes one to two visits, causes little to no pain thanks to modern anesthesia, and allows you to keep your natural tooth instead of losing it to extraction.
“You need a root canal” is a sentence that makes most people’s stomachs drop. Decades of jokes and old wives’ tales have turned a routine dental procedure into something patients dread before they even understand what it involves. The reality looks nothing like the myth.
Root canal treatment stops tooth pain and saves a tooth that would otherwise need to be pulled — it does not cause the pain people associate with it. At Prime Dental Center in Stratford and Marlton, NJ, Dr. Akshay Rajpal has personally performed over 10,000 root canal procedures, a specialty he’s built his practice around since graduating from New York University’s dental program in 2009.
This post breaks down what happens during a root canal, what you’ll feel (and won’t), and why saving your natural tooth matters more than you might think.
What is a root canal, exactly?
A root canal is a dental procedure that removes infected or damaged tissue from inside a tooth — the pulp — to eliminate pain and stop the spread of infection. The pulp sits inside the tooth’s root canal system, a network of narrow channels running from the crown down through the roots. It contains nerves, blood vessels, and connective tissue that helped the tooth develop.
A fully grown tooth can survive without its pulp, because the surrounding tissue continues to nourish it. That single fact is what makes root canal treatment possible: your dentist removes the damaged pulp, cleans out the canal, and seals it, leaving the outer tooth structure intact.
Why would you need a root canal?
You need a root canal when the pulp inside your tooth becomes infected or inflamed beyond the point of healing on its own. Left untreated, that infection can spread to the bone surrounding the tooth and cause an abscess — a painful pocket of infection that can threaten the tooth entirely.
Common causes include:
- Deep decay that has reached the pulp
- Repeated dental procedures on the same tooth, which can weaken it over time
- Cracks or chips that expose the inner tooth to bacteria
- Trauma to the tooth, even if there’s no visible crack
The warning signs are usually hard to ignore: persistent tooth pain, sensitivity to hot or cold that lingers after the stimulus is gone, swelling or tenderness in the gums, or a tooth that’s darkened in color. Some infections produce no symptoms at all until they show up on an X-ray during a routine exam. That’s one reason regular checkups matter, even when nothing seems wrong.
What happens during a root canal procedure?
A root canal follows a predictable sequence designed to remove infection and protect the tooth for the long term. Here’s what to expect, step by step:
- Numb the area. Your dentist applies a local anesthetic so the tooth and surrounding gum tissue are fully numb before any work begins. This step is responsible for the pain-free experience most patients report.
- Access the pulp. A small opening is made in the top of the tooth to reach the infected pulp chamber and canals.
- Remove the damaged tissue. Using specialized instruments, your dentist clears out the infected or inflamed pulp from the canal system.
- Clean and shape the canals. The empty canals are disinfected and shaped to prepare them for filling.
- Fill and seal the tooth. A biocompatible material called gutta-percha fills the canals, and the access opening is sealed to keep bacteria out.
- Restore the tooth. Most root canal–treated teeth need a crown afterward to restore strength and function, since the procedure can leave the tooth more brittle than before.
Most patients need one or two appointments, depending on the tooth’s condition and the extent of the infection. The procedure itself feels similar to getting a filling: the anesthesia handles the discomfort, and most people report feeling only pressure, not pain.
Does a root canal hurt?
A properly performed root canal does not hurt more than a filling. The pain people associate with root canals comes from the infection itself, not the treatment that resolves it. Once the infected pulp is removed, the source of the pain is gone.
Some mild soreness in the days following treatment is normal, similar to what you’d feel after any dental procedure. Over-the-counter pain relievers typically manage this without issue. Contact your dentist if you experience severe pain, swelling, or pressure that doesn’t improve after a few days — that’s not typical, and it should be checked.
Why save the tooth instead of pulling it?
A root canal preserves your natural tooth, which keeps your bite, jawbone, and surrounding teeth functioning the way they were designed to. Natural teeth handle chewing forces more efficiently than replacements, and keeping your own tooth prevents a cascade of issues that often follow an extraction.
When a tooth is pulled and not replaced, neighboring teeth can shift out of position over time, and the jawbone in that area can begin to lose density from lack of stimulation. Replacing an extracted tooth with a bridge or implant also costs more — in dollars and in the number of procedures required — than treating and crowning the natural tooth in the first place.
Choose root canal treatment if your tooth’s root structure is still healthy and the infection hasn’t compromised the tooth beyond repair. Choose extraction only when the tooth is too damaged to save, a determination your dentist makes through an exam and X-rays.
What happens after a root canal?
Most patients return to normal eating and speaking within a day or two after a root canal, especially once the permanent crown is placed. Avoid chewing on the treated tooth until it’s fully restored with a crown, since the tooth is more vulnerable to fracture in the interim.
A root canal-treated tooth can last a lifetime with proper care: regular brushing, flossing, and dental checkups. Dr. Rajpal and the team at Prime Dental Center follow up after treatment to confirm the tooth is healing properly and the crown fits comfortably.
Frequently asked questions
How long does a root canal take?
Most root canals take one to two appointments, each lasting between 60 and 90 minutes, depending on the tooth’s location and the complexity of its root canal system.
Is a root canal more expensive than an extraction?
The root canal itself may cost more upfront than a simple extraction. Factor in the cost of a replacement tooth — a bridge or implant — and root canal treatment is often the more affordable option in the long run.
Can a tooth need a second root canal?
Yes, though it’s uncommon. If a tooth becomes reinfected or a canal was missed during the original procedure, a retreatment can address the issue and still save the tooth.
What are the risks of skipping a root canal?
Leaving an infected tooth untreated allows the infection to spread to the jawbone, potentially causing an abscess, bone loss, or the eventual loss of the tooth altogether.
Who is a good candidate for a root canal?
Anyone with a tooth that has infected or inflamed pulp — but still has a healthy root structure and enough surrounding bone support — is typically a good candidate for root canal treatment rather than extraction.
Getting the care you need, without the fear
Root canal treatment has a reputation that no longer matches reality. Modern anesthesia, refined techniques, and experienced hands make the procedure far more comfortable than its old stigma suggests, and far less daunting than living with an untreated infection.
Don’t wait for persistent tooth pain or sensitivity to get worse. Dr. Akshay Rajpal and the team at Prime Dental Center in Stratford and Marlton, NJ, bring over a decade of specialized experience in root canal therapy to every patient who walks through the door. Request an appointment today and find out what a pain-free path to saving your smile actually looks like.
