How a root canal saves your tooth, step by step

Short answer: a root canal saves a tooth whose inner pulp has become inflamed or infected. The dentist numbs the tooth, removes the damaged pulp, cleans and disinfects the canals, then fills and seals them. A crown usually goes on top. The pain settles and you keep your own tooth instead of having it pulled.

Many people put off a root canal because they expect it to hurt. In practice the toothache before treatment is usually far worse than the treatment itself. This guide explains when a tooth needs one, what happens in the chair, and what to expect afterwards.

Why does a tooth need a root canal?

Because bacteria or damage have reached the pulp, the soft tissue with nerves and blood vessels inside the tooth. Once the pulp is infected it cannot heal on its own. The common causes are:

• Deep decay that has gone past the enamel and dentine into the pulp.
• A crack or chip that lets bacteria in, sometimes too fine to see in a mirror.
• A knock or injury, even years ago, that damaged the pulp.
• Repeated work on the same tooth, such as several large fillings over time.

What are the signs you may need one?

The clearest sign is a toothache that keeps coming back or wakes you at night. Other signs include:

• Pain that lingers for a while after something hot or cold.
• Pain when you bite or press on the tooth.
• Swelling in the gum or face near the tooth.
• A small pimple-like bump on the gum that may leak.
• A tooth that has turned darker than its neighbours.

Some infected teeth give no pain at all and only show up on an X-ray. Not every toothache means a root canal either: sometimes a deep filling is enough. Our post on whether a toothache always means a root canal goes through the difference. Only an examination and X-ray can tell you for sure.

What happens during a root canal?

It is done under local anaesthetic, much like a filling, and most cases are finished in a single visit of 45 to 90 minutes. The steps are:

1. Check and X-ray. The dentist examines the tooth and takes an X-ray to see the infection and the shape of the roots.
2. Numbing. Local anaesthetic numbs the tooth and the gum around it.
3. Opening. A small opening is made in the top of the tooth to reach the pulp.
4. Cleaning. The infected pulp is removed, and the canals are cleaned, shaped and disinfected.
5. Filling and sealing. The canals are filled with a rubber-like material and sealed. An X-ray confirms the seal.
6. Core build-up. The tooth is rebuilt from inside so it can hold a crown.
7. Crown. A crown is fitted at a later visit to protect the tooth.

Front teeth usually have one canal and take less time. Back teeth can have three or four. If there is pus or a lot of swelling, the dentist may spread the treatment over two visits and place medicine inside the tooth between them.

Does a root canal hurt?

For most people it feels like having a filling. The tooth is numb, so you feel pressure and vibration rather than pain. The tooth may be sore for two or three days afterwards, and ordinary painkillers such as paracetamol or ibuprofen usually handle it. If a tooth is very inflamed it can take a little longer to numb, and the dentist will wait until it is fully numb before starting.

Why save the tooth instead of pulling it?

Your own tooth is usually the best tooth you can have. Saving it keeps your bite, your chewing and the bone around the root, and it costs much less than replacing the tooth later.

• The pain stops once the infection is cleared.
• You chew normally on the treated tooth once the crown is on.
• Neighbouring teeth stay in place. A gap left after an extraction lets nearby teeth tilt and drift.
• The jawbone stays healthy, because the root is still there.

Sometimes a tooth is too broken or the infection has done too much damage to save. Then removing it and replacing it with a dental implant or a bridge is the better choice. Our guide to root canal or implant compares the two side by side.

How much does a root canal cost?

At Smile Dental Clinic, root canal treatment is ₹7,500 including X-rays. Most teeth also need a core build-up and a crown, so you get the full figure before anything starts.

A back tooth nobody sees can do well with a simpler crown; a front tooth often looks better with zirconia. The full breakdown by crown type is in our root canal cost guide.

What should you expect after a root canal?

Most people go back to work the same day. Keep to soft food for the first day, and avoid biting hard on the tooth until the crown is fitted, because a treated tooth is more brittle until it is protected. The tooth usually feels normal within a few days.

• Brush and clean between your teeth as usual, gently around the treated tooth.
• Take painkillers as advised if the tooth is sore.
• Come back for the crown visit, usually two to three weeks later.
• Keep up six-monthly check-ups so the tooth can be watched on X-ray.

With a good seal and a crown, a root-canal-treated tooth can last for many years.

When should you call the dentist after treatment?

Call if the pain gets worse after the first few days instead of better, if swelling appears or grows, if the temporary filling or crown comes off, or if your bite feels high when you close. These are usually simple to fix when seen early.

What are the risks?

Root canal treatment is a routine procedure, but like any treatment it has some risks. A tooth can crack if it is left without a crown for too long. Occasionally an infection returns, for example if a canal was very narrow or curved, and the tooth needs retreatment. Rarely the tooth cannot be saved and has to be removed. Fitting the crown on time and keeping up check-ups lowers these risks.

Root canal treatment at Smile Dental Clinic

We treat root canals at both our clinics, in Kondapur (Hyderabad) and Vizag. Your first visit is a ₹500 consultation with an iTero 3D scan (an X-ray, if needed, is ₹200 to ₹500), and you leave with a written plan and the exact price. If a filling will do instead of a root canal, we tell you. Read more about root canal treatment in Kondapur and Vizag, or message us on WhatsApp to book a time.

Is a root canal better than pulling the tooth?

In most cases, yes. Saving your own tooth keeps your bite, your chewing and the bone around the root, and it costs less than an extraction followed by an implant or bridge. If the tooth is too broken to save, removing and replacing it is the better option, and the dentist will tell you which applies.

How long does a root canal take?

Most root canals are done in one visit of 45 to 90 minutes. Front teeth with one canal are quicker than back teeth with three or four. If there is pus or heavy swelling, the treatment may be spread over two visits. The crown is fitted at a separate visit, usually two to three weeks later.

Do I need a crown after a root canal?

For back teeth, almost always. A treated tooth becomes more brittle, and chewing on it without a crown can crack it beyond repair. Some front teeth with little damage can manage without one; this is decided tooth by tooth.

Can I go to work after a root canal?

Yes. Most people go back to work the same day. The numbness wears off in a few hours, and any soreness for the next two or three days is usually handled with ordinary painkillers. Eat soft food for the first day.

What happens if I ignore a tooth that needs a root canal?

The infection does not heal on its own. It can spread into the bone around the root and cause swelling or an abscess, and the tooth may reach a point where it cannot be saved. Treating it early is simpler and costs less.

How much does a root canal cost at Smile Dental Clinic?

Root canal treatment is ₹7,500 including X-rays. Core build-up is ₹2,000 to ₹3,000 and a crown ₹6,000 to ₹25,000 depending on the material, so a typical total for one tooth is ₹15,500 to ₹25,000. You get the exact figure in a written plan after the ₹500 consultation.

Can a root canal tooth get infected again?

It can, though it is not common. It is more likely if the crown is delayed, if a new cavity forms, or if a canal was very narrow or curved. Regular check-ups with an X-ray help catch it early, and a retreatment can often still save the tooth.