Let’s get straight to the question most people are actually asking: does root canal treatment hurt?
The honest answer is that with modern local anaesthesia, most patients find root canal treatment feels very similar to having a large filling done. The area is completely numb before anything begins, and if at any point you feel discomfort during the procedure, we stop and address it. The reputation root canal has for being painful is largely inherited from decades past — and it’s worth understanding why that reputation developed, because it tells a very different story to what treatment looks like today.
Why root canal has a painful reputation
Root canal treatment developed its reputation at a time when dental anaesthesia was significantly less sophisticated than it is now. In earlier decades, achieving complete numbness in an infected tooth was genuinely difficult — inflamed tissue alters the local pH, which can reduce how effectively anaesthetic works. Techniques were also less refined, and the process itself was more time-consuming.
Today, anaesthesia options are better, delivery techniques have improved, and dentists have a much more nuanced understanding of how to manage a tooth that’s harder to numb. The result is that the vast majority of patients are surprised by how manageable the experience actually is.
When is root canal treatment needed?
Root canal treatment (also called endodontic treatment) becomes necessary when the soft tissue inside the tooth — known as the pulp — becomes infected or significantly damaged. This can happen because of:
- Deep decay that has progressed through the outer layers of the tooth and reached the nerve
- A cracked or fractured tooth that exposes the pulp to bacteria
- Repeated dental procedures on the same tooth, which can sometimes irritate the pulp over time
- A dental abscess — an infection at the tip of the root that can cause significant pain and swelling if left untreated
The symptoms that often bring people in include persistent toothache, sensitivity to heat or cold that lingers after the stimulus is removed, darkening of the tooth, or swelling around the jaw or gum.
In some cases, there are no obvious symptoms at all — the issue shows up on an x-ray before it causes pain.
What actually happens during treatment?
Here’s a step-by-step picture of what root canal treatment involves:
1. Anaesthesia The area around the affected tooth is numbed with local anaesthetic. We wait until the area is fully numb before starting — this is non-negotiable. If you can still feel anything after the initial injection, more anaesthetic is given.
2. Isolation A thin rubber sheet called a rubber dam is placed around the tooth. This keeps the area clean and dry, and prevents anything from the procedure going into your mouth. It might feel slightly unusual at first but most patients quickly forget it’s there.
3. Access to the pulp chamber A small opening is made through the top of the tooth to access the inner pulp chamber. Because the area is numb, you won’t feel this — you may feel pressure or vibration, but not pain.
4. Cleaning and shaping the canals Small, flexible instruments are used to remove the infected or damaged pulp from the root canals and shape them for filling. This is the core of the procedure, and it’s done carefully and methodically. Depending on the number of canals in the tooth and how complex the anatomy is, this stage can take some time.
5. Filling the canals Once the canals are clean and shaped, they’re filled with a biocompatible rubber-like material called gutta-percha. This seals the canals against future infection.
6. Temporary or permanent restoration In most cases, a temporary filling is placed at the end of the appointment while you arrange the next step. In some situations — particularly where CEREC same-day crowns are available — the final restoration can be placed sooner.
What about recovery?
After the anaesthetic wears off, it’s common to have some tenderness around the treated tooth for one to three days. The tooth may feel slightly different when you bite down on it. This is a normal response to the procedure and not a sign that something has gone wrong.
Most patients manage post-treatment discomfort well with over-the-counter anti-inflammatory pain relief like ibuprofen. Your dentist will advise you on what to take and when. It’s sensible to avoid chewing hard food on that side until the tooth has been properly restored.
Why keeping the tooth matters
Root canal treatment is sometimes framed as a difficult option — but the alternative is extraction. Losing a tooth creates its own set of consequences: the remaining teeth can shift, bone loss can occur at the extraction site over time, and replacing a missing tooth (with an implant, bridge, or denture) involves its own cost and treatment timeline.
Your natural tooth, however damaged, is generally worth preserving if it can be. A tooth that has had root canal treatment can function normally for many years with appropriate restoration and care.
The crown question
After root canal treatment, the tooth is typically weaker than it was before — the removal of the pulp and the access opening both affect its structural integrity. For back teeth in particular, a crown is almost always recommended afterward to protect the tooth from fracture.
At Smile Spot, we offer CEREC same-day crowns, which means the crown can be designed, milled, and placed in a single appointment. This is particularly useful if you’ve already taken time out for the root canal — consolidating visits is often more practical.
Booking at a time that works for you
One thing worth knowing: we’re open Monday to Thursday until 7pm. If you’ve been putting off a dental appointment because you can’t easily get away from work, an evening appointment removes that barrier. You can come in after work, have treatment done, and be home at a reasonable hour.
If you’ve been told you may need root canal treatment, or if you’re experiencing tooth pain and want to understand what’s going on, book an appointment online or call us on (08) 8258 0650. We’re open Monday to Thursday until 7pm.
You can also read more about our general dentistry services at Smile Spot Mawson Lakes.
Any surgical or invasive procedure carries risks. Before proceeding with treatment, you should seek a second opinion from an appropriately qualified health practitioner. Individual results may vary.