The Root Canal Dental Procedure. Nothing to Fear

root canal dental procedure

A lot of people are really scared about getting a root canal. We hear people say things like, “it was worse than a root canal!”

In reality, the root canal dental procedure is not particularly unpleasant. In fact, it is quite common for my patients to express surprise at how relaxed they felt during the root canal treatment.

A root canal is usually done in one hour appointments. Sometimes the procedure can be done in only one appointment, but it is more common for the procedure to be done in two or three appointments.

As you read through the root canal procedure below, keep in mind the steps will usually be the same whether the procedure is done in one, two or three appointments.

1.The dentist will numb the tooth up so you won’t feel any pain

dental needle

Photo credit: Tijmen,

The dentist will place some numbing gel on the gum next to the tooth that will be getting the root canal treatment. This gel is usually flavoured with something like cherry or strawberry, but to be honest, is usually still a bit bitter and unpleasant tasting.  The top layer of the gum will be numb after a minute or two of having the gel placed.

Now that the top layer of the gum is numb, the dentist will thoroughly numb you up using an injection of anaesthetic. This has to be done to allow the anaesthetic to soak very deeply into the tooth’s nerve.

Usually you will feel a slight sharp pinch, but sometimes you won’t feel anything as the needle is inserted into the gum. Honestly, you will typically feel more pain during the day from many other things like bumping into things and exercising. The problem of course is it is very unnatural to let somebody put something sharp into your mouth. I get it!

I swear you will be surprised how little the needle hurts!

dental root canal procediure2.  The dentist places a rubber dam over the tooth (not all dentists do this)

Now the tooth is thoroughly numbed up, the dentist will fit a rubber dam over the tooth. This acts as a barrier preventing the chemicals needed to treat the tooth from going into your mouth (they taste very bad) and it also prevents the bacteria in your saliva from entering the root canals of the tooth and possibly re-infecting it.

3. A hole is cut into the tooth to access the nerve inside the tooth

access cavity

“Vier kanalige endo ondermolaar” by Sloterdijk Tandzorg Kliniek, Licensed under CC BY-SA 2.5 via Wikimedia Commons –

The hole has to be quite large to allow enough space for the instruments that remove the tooth’s nerve to fit inside the tooth. Unfortunately, this large hole does weaken the tooth a lot.

That is why often the dentist will recommend you get the tooth crowned after the root canal is finished. If the tooth isn’t crowned, you run the risk of the tooth breaking, perhaps so badly that it will need to be extracted.

Having to get the tooth pulled after you have spent two or three hours sitting in the dental chair, taken time off work and spent around $1000 is something you will want to avoid!

4. Special miniature files are used to remove the nerve

root canal file

Photo credit: BruceBlaus. Licensed under CC BY 3.0 via Wikimedia Commons –

Teeth generally have one, two or three roots. Each of these roots will have its own nerve and blood supply within it. The dentist now removes the nerve and blood tissue from each of these canals using very small files. This can be a bit fiddly and takes up much of the time needed to do the root canal procedure.

If the root canal is being done on one of your back teeth, you will have to keep your mouth open quite wide at times to allow the dentist to get in there with the files. Your mouth getting tired is often the most uncomfortable part of the root canal procedure.

5. Antibacterial chemicals rinse out the nerve remnants

The file will take out most of the nerve tissue, but small amounts of nerve tissue will be left behind. That is why bleach and other chemicals are used to wash out most of the remaining nerve tissue.

If the tooth is very infected, a liquid antibiotic is inserted into the root canal spaces where the nerve used to be and is given a week to a monthto thoroughly soak through the tooth and kill the remaining bacteria. This is why a root canal can take more than one appointment.

6. The root canal space is filled with a natural rubber

Now that the root canals are thoroughly clean and free of bacteria, a rubber material called gutta percha is used to fill in the canals. This rubber prevents bacteria travelling back down the canals and also entombs any remaining bacteria preventing them from reinfecting the tooth.

7. The access hole is filled

Now  that the root canals are sealed, the hole the dentist cut through the top of the tooth is filled. This will strengthen the tooth a bit, but nowhere close to the strength of the tooth before the hole was cut into it. For this reason, teeth at the back of the mouth that experience very high biting forces really should be crowned to prevent them breaking.

Now that the tooth has all the infected nerve tissue removed and filled with gutta percha, the root canal treatment is finished and the rubber dam, if used, can be taken off. You are now free to get on with your day.


Photo credit, Adam Ciesielski,

You can expect that the tooth will hurt for a few days. Over the counter medications like Tylenol will usually be effective at managing this pain.

A root canal procedure works most times but not every time.

The success rate is very high, somewhere between 90 percent and 95 percent, but when a root canal doesn’t work you will need to have the tooth extracted. If you can’t live with a gap in your smile, there are a few options to replace the missing tooth. Click here to read an article discussing these options.

Summary Diagram

Photo credit: Jeremy Kemp; SVG conversion by Jellocube27. Licensed under CC BY-SA 3.0 via Wikimedia Commons –

Now you have a better understanding on what happens during a root canal procedure I hope you have less fear about having a root canal done. If you have any questions about root canals or would like to share your own root canal stories, please do so in the comments section.






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2 thoughts on “The Root Canal Dental Procedure. Nothing to Fear

    1. David

      Hi Patrick. I am glad you found the information useful. If you have any dental related questions, feel free to get hold of me.



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