Everyday Dentistry
Root Canal Treatment
The procedure with the worst reputation in dentistry, and one of the most misunderstood. A root canal relieves pain — it does not cause it.
Treated by
Dr. Jonathan Berkowitz, DMD
Residency-trained Prosthodontist
- University of Michigan prosthodontic residency
- Ten years attending prosthodontist, Northport VA
- Implants placed and restored in-house
Why a tooth needs one
Inside every tooth is a chamber containing nerve and blood vessels, called the pulp. When decay reaches it, or a crack lets bacteria in, or trauma damages it, the pulp becomes infected. Infected pulp does not recover on its own.
The result is often severe pain — throbbing, keeping you awake, sensitive to heat, sometimes with swelling. Occasionally there is no pain at all and the infection is found on an X-ray, which does not make it less serious.
Root canal treatment removes the infected tissue, disinfects the canals inside the root, and seals them. The tooth stays in place and continues to function. The alternative is extraction, and replacing an extracted tooth with an implant or bridge is more involved and more expensive than saving the one you have.
What it is actually like
The reputation dates from an era of less effective anesthesia. With modern anesthetic, the procedure is comparable to having a filling placed — longer, but not more uncomfortable.
The pain patients associate with root canals is nearly always the pain of the infection that made the treatment necessary. That pain typically resolves within a day or two of treatment.
Most teeth are completed in one or two visits. Afterward there is usually some tenderness on biting for a few days as the ligament around the root settles.
The crown afterward matters
A tooth that has had root canal treatment loses its blood supply and becomes progressively more brittle. Back teeth in particular are under substantial force during chewing, and an untreated root-canalled molar has a real risk of fracturing.
A fractured root is generally not repairable, and the tooth is lost — which means the root canal treatment was wasted. Placing a crown afterward is not an upsell; it is what protects the work.
We will always tell you when a crown is needed and when it is not. Front teeth with small access openings sometimes do not require one.
Questions
Things people ask
If your question is not here, call the office. Nobody will pressure you into booking.
Call 212-874-1700Does a root canal hurt?
The procedure is done under local anesthetic and should be comfortable. If you feel anything during treatment, tell us and we will add more anesthetic — occasionally an acutely infected tooth is harder to numb and needs a different technique.
Afterward, some tenderness when biting for a few days is normal and responds to over-the-counter pain relief.
Would it be simpler to just pull the tooth?
It is faster and cheaper on the day, and considerably more expensive over time. An extracted tooth leaves a gap, the neighbouring teeth drift, the opposing tooth over-erupts, and the bone at the site begins to shrink.
Replacing it properly with an implant costs several times what saving it would have. Where a tooth is saveable, saving it is almost always the better decision.
How long does a root-canalled tooth last?
Properly treated and protected with a crown, it can last a lifetime. Success rates for root canal treatment are high — generally reported above ninety percent.
The most common reason for later failure is a fracture in a tooth that was never crowned.
Related
You may also want to read about
Crowns & Bridges
Porcelain restorations that protect a damaged tooth or replace a missing one, designed to match the teeth beside them.
Learn more about Crowns & BridgesGeneral & Preventive Dentistry
Cleanings, examinations, digital X-rays, fillings, and the steady preventive care that keeps bigger problems from ever starting.
Learn more about General & Preventive DentistryDental Implants
A permanent replacement for a missing tooth that looks, feels, and functions like your own — placed and restored under one roof.
Learn more about Dental ImplantsTalk it through with a specialist.
Most people considering implants or major reconstruction have been thinking about it for a long time. A conversation costs nothing and there is never any pressure.
40 West 86th Street, Suite 1C · New York, NY 10024