The idea of a root canal might make you nervous, but the procedure's reputation for being particularly painful is decades out of date. What is a root canal, anyway—and what should you expect if you're facing one?
A root canal is one of the most common dental procedures in the United States, with more than 15 million performed every year1. It involves removing infected or damaged tissue from inside the tooth, cleaning and sealing the inner canals, and restoring the tooth with a filling or crown. Discover how it works and learn how it can provide relief for your dental pain below.
What Is a Root Canal?
To understand how a root canal works, it helps to understand the makeup of your tooth. Every tooth has a soft inner core, known as the "pulp," which is made up of blood vessels, nerves, and connective tissue. That pulp extends from the visible crown of the tooth down through its roots, all the way into the jawbone. Sometimes, that pulp can get infected or damaged, which can be extremely uncomfortable2.
A root canal removes the infected or damaged pulp, cleans the inside of the tooth, and then seals it to prevent further infection. A crown is often placed over the tooth afterward to protect it and help restore full function3. A professionally performed root canal can last a lifetime, and the procedure generally has an extremely high success rate of more than 95%4.
What Causes Someone to Need a Root Canal?
Understanding what causes the need for a root canal can help you prevent one. Trauma or injury is one cause. If a tooth is cracked or chipped, bacteria can enter the pulp and cause an infection. This can occur even if the damage isn't visible3. Protecting your teeth against damage, for example, by wearing a mouthguard during contact sports, can help prevent issues.
In other cases, a root canal is needed due to deep tooth decay. This happens when superficial decay—a cavity—isn't addressed and progresses, spreading into the enamel (the hard outer layer of the tooth) and dentin (the soft layer beneath it) into the deeper layers of pulp. This is known as deep decay4. Good oral hygiene is your best preventive measure.
Once bacteria enter the pulp, the tissue starts to break down and can't repair itself. Bacteria then multiply, which can worsen the situation (and related pain). If left untreated, such infections can spread to surrounding bone and tissue, in some cases leading to tooth loss5.
What Happens During the Procedure?
OK, but what is a root canal procedure, exactly? First, the dentist will take X-rays to assess the extent of the infection and make sure that a root canal is the appropriate solution. Once that is confirmed, they will schedule your appointment. You will usually need one to two appointments to complete the procedure, each one lasting 60 to 90 minutes3.
Before the procedure begins, you will be given a local anesthetic to numb the area. This ensures that you feel little to no pain during the process. A dental dam—a small sheet made of rubber or latex—is placed around the tooth to keep it clean and dry, protecting it during the appointment3.
The dentist will then create a small opening in the crown of the tooth to access the pulp chamber. Tiny dental instruments are used to remove the infected pulp and to clean and disinfect the inner pulp chambers3. Remember, a local anesthetic has been given, so although this may sound intense, it's all relatively pain-free.
Once the infected pulp is removed, the empty canals are filled with a rubber-like material and sealed5. A temporary filling is then placed; a permanent crown is placed over the tooth in a follow-up visit, restoring its strength and full functionality3.
Is a Root Canal Painful?
Without a doubt, the most common question people have before the procedure is: How painful is a root canal? In short, not very. Thanks to modern anesthesia and techniques, most patients report that a root canal feels no more uncomfortable than getting a routine filling.
The problem is that root canals have such a bad reputation—and a lot of the "pain" is the mental stress that comes beforehand. According to the American Association of Endodontists, patients who have had a root canal are six times more likely to describe it as "painless" than patients who have never had the treatment6. Ultimately, leaving an infected tooth untreated will cause significantly more pain and long-term damage than getting it treated with a root canal.
Experiencing tooth pain? Schedule an appointment with Beam Dental today—we'll help you find out if a root canal is right for you.
Frequently Asked Questions
How do I know if I need a root canal?
Common indicators include persistent tooth pain, swollen or tender gums, small pimples on your gums, or lingering sensitivity when consuming hot or cold food or drinks5. However, some infections may show no symptoms, which is why regular dental checkups are so important.
How long does a root canal take?
After "how painful is a root canal?" this is probably the second most-asked question about the procedure. Most root canals are completed in one to two appointments lasting 60 to 90 minutes each3.
What happens if you avoid a root canal?
Skipping a recommended root canal allows the infection to continue spreading throughout the surrounding bone and tissue. This can worsen the pain and may lead to further damage, including abscess, bone loss, or tooth loss2.
Sources:
- Hecht, M. (20 December 2019). Do You Need a Root Canal? 7 Telltale Symptoms. Healthline. Retrieved March 25, 2026, from https://www.healthline.com/health/do-you-need-a-root-canal-7-common-telltale-symptoms
- (5 September 2025). Root Canal Treatment. Mayo Clinic. Retrieved March 25, 2026, from https://www.mayoclinic.org/diseases-conditions/tooth-abscess/in-depth/root-canal/art-20585454
- (7 March 2025). Root Canal. Cleveland Clinic. Retrieved March 25, 2026, from https://my.clevelandclinic.org/health/treatments/21759-root-canal
- (3 July 2025). An Overview of Root Canals. WebMD. Retrieved March 25, 2026, from https://www.webmd.com/oral-health/root-canals
- Catanese, L. (6 March 2025). Need a Root Canal? Here's What to Expect. Harvard Health. Retrieved March 25, 2026, from https://www.health.harvard.edu/diseases-and-conditions/need-a-root-canal-heres-what-to-expect
- (Winter 2015). Endodontics: Colleagues for Excellence. A 3D Approach for Treating Acute Pain. American Association of Endodontists. Retrieved March 25, 2026, from https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/07/ecfeacutedentalpain.pdf
