Root canal treatment: separating fact from fiction

Ask anyone about a root canal and you'll hear dramatic stories. The truth is that modern root canal treatment is one of the most effective, comfortable and important procedures in dentistry — designed to relieve pain, not cause it, and to save a tooth that would otherwise be lost.

What a root canal is (and isn't)

Every tooth contains a soft tissue core — the pulp — with nerves and blood vessels. When the pulp becomes infected or inflamed from deep decay, a crack, a leaking filling or trauma, it does not heal on its own. A root canal (also called endodontic treatment) removes that damaged pulp, cleans and disinfects the internal canals, and seals them to prevent re-infection. The outside of the tooth stays exactly as it was.

Is it painful?

With modern anaesthesia, magnification and rotary instruments, a root canal today is typically no more uncomfortable than getting a filling. Most patients are surprised at how uneventful it feels. The pain patients usually associate with root canals is the pain that led them to need one — and that pain almost always disappears once treatment is complete.

How many visits it takes

Many root canals are completed in a single visit of 60–90 minutes; more complex teeth (typically molars with curved canals, or teeth with existing infection) may need two visits. Between visits, the tooth is sealed with a temporary filling and, if needed, a course of antibiotics if there's active infection.

Why saving the tooth matters

Extracting a tooth may seem simpler and cheaper, but it comes with real long-term consequences: neighbouring teeth drift into the gap, the opposing tooth over-erupts, the bite changes, chewing becomes less efficient, and jawbone in the area shrinks over time. Replacements — a bridge or an implant — are almost always more expensive and more invasive than the original root canal would have been.

The crown afterwards

Molars and heavily restored teeth usually need a crown after a root canal. The reason is simple: root-treated teeth become more brittle over time, and a full-coverage crown protects them from fracture, giving them a life expectancy similar to a healthy natural tooth. Skipping the crown is the most common reason a well-done root canal eventually fails.

Success rates

Modern root canal treatment has a success rate of around 85–95 percent over 5–10 years when completed properly and followed by a crown. In the small number of cases where a root canal doesn't heal, options include re-treatment, a small surgical procedure called an apicoectomy, or (if all else fails) extraction and replacement.

Common myths, briefly

Root canals do not cause other illnesses — this myth was disproved decades ago and has no basis in modern research. Root canal teeth do not need to be extracted after a set number of years. And a tooth that stops hurting hasn't necessarily healed — pain often fades as the nerve dies, while infection quietly continues underneath.