Root Canals: The Ultimate Guide

Gentle Dental

Teeth can suffer damage from many different causes, including gum disease, untreated cavities, and accidental injuries. While there are many ways of treating these issues, surgical intervention is sometimes necessary. In many cases, the procedure needed to address the damage, and save the tooth, is root canal treatment.

While root canals are extremely safe, effective, and straightforward, they are often not well understood, which is why we put together this guide to explain the procedure, why it’s needed and how it works.

What is Root Canal Treatment?

When a tooth’s pulp is damaged or infected, either as the result of tooth decay, gum disease, or a tooth injury, it becomes inflamed and painful. Left untreated, the abscess in the bone can grow, deteriorating the bone around the tooth and even leading to a full body infection.

Root canal treatment is a dental procedure that removes the infected pulp from inside the tooth while preserving the tooth structure. It provides an alternative to the extraction of a severely damaged, infected, or decayed tooth. In most cases, a root canal is an outpatient procedure and will not require general anesthesia, time off work, or an extended recovery period.

Common Reasons for Root Canal Treatment

While causes may vary, they often begin with a tooth injury such as a crack, chip, fracture, or damage to the tooth pulp. The three most common causes of root canal system infections include:

Tooth Decay

Tooth decay is the single most common reason for root canal treatment. Brushing your teeth twice daily, flossing once per day, and visiting your dentist regularly are the most important steps you can take to prevent future problems.

Tooth Fracture

The second most common cause of root canals is tooth fracture caused by grinding or clenching your teeth. Hairline-type fractures allow bacteria to enter the pulp chamber of your tooth and multiply, which leads to inflammation and infection.


Falls, sports and work-related injuries can cause nerve damage, hairline fractures, and even tooth infection. While inflamed nerves can calm down after some time, often they remain painful and require root canal treatment for relief.

When Do I Need Root Canal Treatment?

When it is no longer possible to use more conservative treatments, you may be presented with the options of either having the tooth pulled or undergoing root canal treatment. Reasons you may need root canal treatment include:

  • Deep tooth decay
  • Teeth with large cavity fillings
  • Tooth chips or cracks
  • Severe gum disease
  • Dental trauma and injuries

Signs That You May Need Root Canal Treatment

The following signs and symptoms indicate that you need to visit your dentist immediately: 

  • Severe toothache upon chewing
  • Darkening or discoloration of teeth
  • Swollen and tender gums
  • Rotten taste in mouth
  • Dental abscess
  • Painful sensitivity to heat and/or pressure

Is Root Canal Treatment Completed Easily?

While an extraction may sound more straightforward than root canal treatment, losing a tooth has significant drawbacks. Even if the extracted tooth is towards the back of your mouth where its absence isn’t as visible to others, it can make it difficult to chew food and there is a risk that your adjacent or opposing teeth might start to drift into the space left by the extracted tooth. This can cause serious bite and alignment problems, putting you at greater risk for damage to your other teeth, so it is likely that your dentist will recommend a dental implant, bridge or denture to fill that space, all of which can be more costly than Root Canal Treatment in the long run.

A root canal, however, can save your natural tooth, avoiding the complications and long term cost of extractions. If you are unsure about which option is best for you, talk with your dentist who can break down your options and give you a review of both the initial and long term costs involved.

How Is Root Canal Treatment Done?

After numbing the area with a local anesthetic, your dentist or specialist will drill a small hole in the tooth. He or she will then remove the infection, shape the tooth’s interior, and then pack it with a material to medicate and protect it. If the procedure is completed by a specialist, you will need to return to your own dentist for the next step. Because the tooth becomes brittle after the procedure, with its core structure compromised, it is highly susceptible to breaking, so, in order to protect your tooth, your dentist will need to place a crown (sometimes called a cap) over the tooth. The crown is custom-made to look and feel just like your own natural tooth.

Who Normally Performs Root Canal Treatment?

While any licensed dentist can legally perform root canal treatment, many will refer you to an endodontist who is an expert in the care and treatment of the dental pulp, especially if it is for a molar tooth. Generally an endodontist will be able to complete the procedure much more quickly than a general dentist would.

Do I Need a Crown After Root Canal Treatment?

In many cases the answer is yes. A crown is a cap that covers your natural tooth and helps prevent it from fracturing. The need for a crown sometimes depends on the location of the tooth in your mouth. For the most part, teeth in the back of your mouth (molars) require crowns, while incisors or canines may not always need one. Some additional factors considered by your dentist when determining the need for a crown after root canal treatment are:

  • Oral Health: The severity of the break or decay of the tooth will determine the dental crown placement. If the crack or decay is minor, the tooth may be filled with resin rather than a full dental crown. 
  • Bruxism: Clenching or grinding can weaken healthy teeth, as well as damage a recently hollowed out tooth. Those who suffer from bruxism will most likely require a dental crown following root canal treatment. 
  • Tooth Damage: Teeth with root canals are more susceptible to breakage. Dental crowns can help strengthen the tooth and prevent it from fracturing. 

Does Root Canal Treatment Hurt?

You’ve probably heard jokes about root canals and how they can be unpleasant experiences. However, modern dental techniques minimize discomfort and most patients find that they can resume normal activities shortly after the procedure. If the root canal treatment is done in response to a severe infection or inflammation, you will most likely find that the pain before the procedure was much worse than during or after it. While you may experience some discomfort following root canal treatment, you should be able to treat it with an over-the-counter painkiller or, if necessary, a medication prescribed by your dental professional. Sometimes antibiotics are also required to treat the infection.

If you have anxiety around dental procedures and are nervous about experiencing pain, you should speak to the dental professional who will be performing your root canal treatment. He or she may be able to provide you with sedation options to help you relax during the procedure.

When Is Root Canal Treatment Not Appropriate?

Not everyone is a candidate for root canal treatment. In some cases, a tooth may be so severely damaged or decayed that it is impossible to save it, even with specialist care. Talk to your dentist about which options are right for you. Even if your dentist doesn’t recommend root canal treatment, you can always ask for a referral to an endodontist and schedule a consult for a second opinion.

What is the Cost of Root Canal Treatment?

As with most dental procedures, the cost of root canal treatment depends on multiple factors, including the complexity of your case and where the tooth is in your mouth (because front teeth have fewer canals in them to be treated). In general, costs can be between $300 and $1,000 for the root canal treatment. Dental insurance can significantly reduce your out-of-pocket costs however, with many plans covering 80% of a root canal (for in-network dentists). Here is the average cost of root canal treatment for different types of teeth:

  • Front (anterior) tooth: $600 – $900
  • Bicuspid tooth: $700 – $1,000
  • Molar tooth: $1,000 – $1,400
Quick Tip: the longer you postpone treatment the more you risk the chances of saving your tooth.

Does Insurance Cover Root Canal Treatment?

Most dental plans will cover a portion of your root canal, but not all of the procedure. The extent of your coverage will also depend on your specific insurance plan, including its limits, co-pays, and deductibles. In general, insurance providers will cover up to 80% of root canal treatment and 50% of crowns.

Can I Get Root Canal Treatment Without Insurance?

Yes. If you do not have a dental insurance plan, the full cost of the procedure will need to be paid in full, however, at Gentle Dental, we offer discount plans with significant savings for uninsured patients, as well as flexible payment plan options (which may require an application for credit).

Final Word

Only a dentist can tell you whether you need root canal treatment. If you haven’t seen a dentist in a while, call your neighborhood Gentle Dental office and make an appointment. And remember, the longer you postpone treatment the more you risk the chances of saving your tooth. We offer day, evening, and weekend hours at most locations for your convenience.  Many of our practices have specialists on staff so that you can treat all of your oral health concerns in one place.

We are committed to providing you the gentlest of dental care. This includes offering options that are gentle on your wallet so that you can get the services that you need. We accept most major dental insurance plans, credit cards, discount plans, and also offer financing options. Our staff is experienced in working with insurance companies and maximizing your benefits. Call today for more information.