Root canal = agony?

September 28, 2007 1:12 AM

Next week I'm having a root canal done on my upper back molar, and I'm worried about the pain. What can I expect, pain-wise?

So today the x-rays came back and my tooth is rotten to the core--my dentist was surprised that I wasn't already rolling on the ground in agony. Years ago I had two cavities filled, and that was cake, virtually no pain at all. Though when they scrape off all that tartar, that's pain. What about root canals? I have to have this done in three stages.

I know, I need to ask the doctor all these questions. I will, but basically I didn't have time to--I just came back home and want to get a number of opinions on how painful root canal can be.

posted by zardoz to Health & Fitness (32 answers total)

You'll be fine after the first day. Don't stress, at least it's just about giving life to a tooth that is already practically dead.
posted by parmanparman at 1:19 AM on September 28, 2007

I had a root canal done over the course of several appointments, and it didn't hurt in the slightest. I don't know how typical that is, but the dentist didn't prescribe painkillers or anything like that, so I suppose he didn't expect it to be painful.
posted by robcorr at 1:25 AM on September 28, 2007

My root canal itself didn't really hurt, but I found the process stressful. And in the middle of the night, after the first round, I woke to a couple of pulses of intense pain (very brief, almost like an electric shot). Thankfully, my doctor prescribed Hydrocodone as a precaution because I was in a lot of pain before hand. I took that, and had no more pain at all. So, you might want to have something as a "just in case".
posted by kimdog at 1:45 AM on September 28, 2007

I had one 'emergency' root canal. It hurt like hell, but when it was over I didn't suffer too much afterwards - and I was glad the original pain of the inflammation was gone.

The second one was done based on X-rays (it didn't notice any problems with that particular molar). Actually, this hurt less than a normal cavity filling. So with proper anaesthetics it may not be too bad for you. The pain /feeling afterwards was a bit uncomfortable, but nothing to stay home for.
posted by swordfishtrombones at 1:46 AM on September 28, 2007

My root canal didn't hurt at all. The feeling of the dentist poking around in my upper jaw was a bit uncomfortable but there was no pain.

If you're not in pain now all the nerves in that tooth are probably dead anyway. I wouldn't worry.
posted by uandt at 1:59 AM on September 28, 2007

Having had a lot of dental work due to "soft enamel" and somewhat poor dental hygiene practices, I am all too familiar with root canals. The basic purpose of the root canal (more properly a pulpectomy) is removing the living part of the tooth, which includes the nerves. If you are asking about pain you might have after leaving the dentist, you probably won't need anything stronger than aspirin/ibuprofen/etc. For me, it was less than any pain I had after having cavities filled, which was not much.

If you are asking about the pain of the procedure, that depends entirely on your dentist's skill with anaesthetics and your willingness to tell him when you have pain. My dentist is pretty good with the needle sticking so I've never had any pain other than the needle sticking itself (man, I hate needles).

For a pretty good writeup of root canals (and a picture of a tooth root still attached to a removal tool; eww), Wikipedia is a good place to check.
posted by CuJoe at 2:00 AM on September 28, 2007

Take a couple of xanax before the procedure - tell the dentist - and then sit back and chill out.

If he doesn't play music or DVDs, take an iPod or something to distract you during the procedure.

It shouldn't hurt at all - and if you feel any pain, indicate to the dentist and he/she will increase the local anaesthetic to deal with it.
posted by strawberryviagra at 2:02 AM on September 28, 2007

Response by poster: Thanks for the answers, all. I neglected to mention the reason I'm stressed out is that my wedding day is in about 3 weeks, and it looks like the final treatment will have to wait until after that's all over. My dentists confirmed that for my wedding I would have a "hole" in that tooth. I'm still trying to wrap my head around that one...
posted by zardoz at 2:03 AM on September 28, 2007

My root canal was completely painless. The process was very stressful but there was no pain whatsoever. If it helps, I went to an endodontist, not a dentist.

Now, the pain leading up to the root canal was terrible. Worst pain I've ever experienced. Curled-up-in-a-ball pain. My tooth was infected. Huge YMMV.
posted by neilkod at 2:03 AM on September 28, 2007

I've had two. The first one sounded very much like yours - the tooth was falling apart and the dentist was surprised there wasn't an abscess. The only part that hurt were the injections of local anaesthetic and they weren't so bad. It didn't hurt afterwards - a little sore maybe. The biggest problem I had was with keeping my mouth wide open for the amount of time needed for the dentist to dig around and remove all the root - apparently there can be hidden roots so your dentist will probably do lots of x-rays and poking around to make sure, along with all the drilling and whatever the else they're doing (not sure I want to know, personally).

With the second one I had the tooth was still mostly alive but a normal filling wouldn't suffice as the cavity went down to the root. The procedure went the same as the first one, without pain, but the minute the anaesthetic began to wear off it REALLY hurt. I took co-codamol (codeine and paracetamol), which seemed to do the trick. Didn't hurt like that again after that, just a little tender.

Just make sure the dentist has anaesthetised the tooth properly and if there's any pain, make it known, because it shouldn't hurt. I think most of the horror stories you hear are people who haven't had the tooth properly numbed rather than any inherent awfulness of the root canal procedure. Good luck with the wedding!
posted by terrynutkins at 2:41 AM on September 28, 2007

a root canal isn't bad at all. I got a bunch of them done over the years (my dental hygiene sucked as an adolescent and I paid for that).

make sure you get some really good shots (numbness all over, up into the tongue) and a prescription just in case it's really bad if you are that scared. but all you will feel is this strange feeling of a hook being pulled out of your tooth and it's actually not necessary. it's really only uncomfortable and unusual and not painful. oh, and it takes a while.

again, this won't hurt at all and if it does, tell them to stop and hit you with another shot. you will be numb all over pretty much for the rest of the day, so forget chewing until later in the evening. swallowing is kind of strange as well when you are that doped up. you just can't feel anything and your mouth feels huge.
posted by krautland at 2:50 AM on September 28, 2007

I've had two root canals, both were done without any pain relief, and didn't hurt at all. This is because I had no root left in the teeth.

The sensation of the screws being put into the roots was weird though.
posted by sycophant at 2:58 AM on September 28, 2007

Read this page for a really cool breakdown of what the dentist will do (and what pain would result if you *didn't* have it done).

Basically the pain side of it is 50% down to you and your physiology and 50% down to the dentist and his technique. If you're particularly hard to numb and your dentist has poor technique, there can be pain. If you're easy to numb and your dentist is good, you should be pain free (sharp pain, that is, you're bound to have pressure, cold sensations, etc).

The really important thing to remember is that if you're not properly numbed, GET THEM TO DO IT AGAIN. This is the biggest cause of dental surgery pain.. people not letting the dentist know they need more shots!
posted by wackybrit at 3:15 AM on September 28, 2007

I had a lower back molar done. Like others, the biggest trouble was keeping my mouth open. I had never before so wished that I was a snake.

They gave me Vicodin, but I never used it. Afterwards, it hurt far less than it did before I went in.
posted by stevis23 at 5:10 AM on September 28, 2007

I had root canal on a bicuspid, and there was no pain. Novcaine and a touch of nitrous oxide helped during the actual procedure. If you get stress during dental work, DO ask for nitrous and/or valium.

Other than regular post-dentistry soreness, I didn't experience any pain at all afterwards.
posted by The Deej at 5:12 AM on September 28, 2007

Ditto the didn't hurt. Uncomfortable in the doing perhaps, but no pain, not even after
posted by A189Nut at 5:36 AM on September 28, 2007

This isn't the 18th century; if no necessity for you to have sensation wherever they're working, then by golly they'll numb you till you can't form consonants. I had 4 teeth pulled at once and didn't feel a thing.
posted by tehloki at 5:53 AM on September 28, 2007

I've had at 2-3 root canals and didn't find any of them that painful. I felt much worse after I got my wisdom teeth removed. My theory is that root canals just have a bad rep because they used to hurt really bad.
posted by drezdn at 6:19 AM on September 28, 2007

About the "hole it your tooth", my dentist put some sort of temporary cap (grey, putty stuff) over my tooth between the sessions. Maybe you can ask about getting the same thing.
posted by kimdog at 6:40 AM on September 28, 2007

I had my root canal in one go, other than placing the permanent crown (so technically two stages but the second stage was sort of nothing). They prescribed percocet for me, which I did not need and did not take. Ibuprofen was sufficent, but apparently I have a decent tolerance for pain.

Fair warning - there will be a dental dam involved. To me that was the worst part because it felt like I was suffocating, and my tongue actually poked a hole through the thing during the procedure. No one told me about the thing and it's honestly from my POV the worst thing about a root canal.

Also, depending on how they numb you up and how much pain killer you need, your mouth will feel a bit like hamburger. Using Peroxyl cleared that up for me fairly quickly.
posted by Medieval Maven at 6:41 AM on September 28, 2007

I had two done a few years ago and it just felt like a normal cavity filling, except it took about an hour and a half to complete instead of the 15 minutes or so it takes to do a cavity.

Ask for nitrous oxide before the procedure, it'll calm you down and take away the stress while they work on your mouth (zone out with an ipod on as well).
posted by mathowie at 7:07 AM on September 28, 2007

My advice to you is that nothing is more painful than letting it rot to the core and NOT having it fixed. I let this happen because of a crippling dental phobia - for months there was no pain, but when it did arrive it was crippling. The electric-shock style nerve pain described elsewhere, but going on for ten minutes or more at a time. I tore a cupboard door off and smashed it to splinters to try and get away. In the end I had to go under general anaesthetic to have it removed because I still had panic attacks every time I sat in the chair, despite several weeks of a pitta bread and yoghurt diet (this was about all that didn't irritate my mouth, if eaten carefully).

By God, just get it fixed if you can.
posted by Ted Maul at 7:09 AM on September 28, 2007

I would advise calling your dentist and asking for a script for Valium (or another benzodiazapene). I've had two dentists give me prescriptions for one or two pills prior to a procedure. I tell them that I have extreme anxiety about dental procedures and would prefer to have a mild sedative (especially if they give me two, so I can take one the night before my appointment so I can sleep).

I've had 4 root canals done, three on front teeth, and one on my farthest back molar on the top side (worst place to get a root canal, ever). For the last one, my dentist did it all in one go (including the permanent cap). He has a system that takes a digital picture of the tooth and "prints" a crown using a milling machine. If you live in Philadelphia, I recommend him highly (Dr. Mouradian).

None of my procedures hurt, other than the injection of the anesthetic, which was pretty mild. The dental dam does suck. I would also advise taking some form of sudafed or other anti-congestant before you go, just in case of random stuffy-nose attacks. Your jaw will ache after a while, and you won't be chewing toffees that night.
posted by nursegracer at 7:10 AM on September 28, 2007

The actual pain (if you're properly frozen) is not that big a deal at all. The worst pain comes when the freezing begins to wear off, and even that's a sort of achy-what-the-hell-did-they-do-to-me-anyway? pain. The dam is uncomfortable, and although not really painful, it may leave your mouth feeling sore afterwards. Just be sure to tell your dentist pronto if the tooth does begin to hurt. He/she should be willing to give you more freezing, and at that point, you'll be frozen already and won't even feel the needle prick.

If you're really worried about it, call your dentist and ask if they do any sort of 'sedation dentistry'. That's where they give you a pill to take beforehand (mine was something called Halcion, from the Valium family). You'll still be awake, but really dopey, and won't really care what the dentist is doing to you. If you're really lucky, you won't even remember the procedure much at all afterwards, either. Of course, you'll need someone to drive you to and from your appointment (and don't plan on going back to work that day), but that's a small price to pay. As someone who's had multiple root canals and too many cavities filled to count, i recommend sedation dentistry to everybody who will listen. I find that the anticipation of pain and it's associated anxiety makes any real pain worse, and being doped up handles this nicely.
posted by cgg at 7:21 AM on September 28, 2007

Ditto what everyone else has said. As to the "hole" in your tooth, there shouldn't actually be a gaping hole in your tooth. The dentist will either put a temporary crown on while waiting for your permanent crown, or fill it with whatever they fill it with.

You'll want to baby this temporary crown/fill stuff while you have it. No caramels, etc. because you don't want that thing popping off during your vows!

Really, with modern dentistry, this should be no problem. But don't be afraid to speak up if you can feel something!!! I used to never do that and suffered thru lots of fillings not knowing it wasn't supposed to hurt.
posted by misanthropicsarah at 7:22 AM on September 28, 2007

As my endodontist explained at my last root canal, it's only painful if you wait until the tooth gets infected. And, indeed, it was virtually painless. It's the infection that causes that horrible pain, not the dental procedure itself. A little Novocaine and you should be good to go.
posted by Taken Outtacontext at 10:25 AM on September 28, 2007

Go to an endodontist. An endodontist is a dentist who specializes in treating tooth pulp and the tissues surrounding the root of the tooth. An endodontist will be able to do your root canal with more skill and less time in your mouth.

I had my first root canal by my regular dentist. There were multiple sessions. My face swelled up with the resulting, post procedure infection. It sucked.

I had my second root canal by an endodontist. He only had to see me once for the root canal. I saw him for a follow up in which he checked his work. I then returned to my dentist for my crown. I'll only ever have an endodontist do the work if I ever have to have a second root canal. No infection. Only one session of cleaning out the bad root. MUCH easier.

BTW, no matter who does the work, they should put a temporary filling into the root canal hole.
posted by onhazier at 10:49 AM on September 28, 2007

Just a few weeks ago I had my first root canal ever on an upper back molar. I hadn't been to a dentist in 10 years and was definitely scared. It really was no big deal. I was a little sore the next couple of days, but after about a week it was like it never happened. No pain - nothing. The only discomfort was having my mouth open for approx 1-1 1/2 hrs during the procedure. I was hoping for some Vicodin or Tylenol 3 after the procedure, but all they prescribed was Ibuprofen and I only needed a few of those!
posted by philad at 1:43 PM on September 28, 2007

mine hurt a little bit for a couple days. Enough that I took one of the codeine they prescribed.

A few years later I had to have my gum cut open to have the root canal wire & molar roots ground down because they were protruding into my sinuses. That was much less fun than the root canal.
posted by lastobelus at 3:17 PM on September 28, 2007

I had a root canal a couple of years ago, and it was a piece of cake. I went in very worried, and was pleasantly surprised to discover that there was no discomfort (if you can handle getting your teeth cleaned, you can handle this). I realize that it also depends on your dentist, but my experience was definitely not traumatic. Also, no pain following the procedure.
posted by I_love_the_rain at 4:29 PM on September 29, 2007

Another vote for "painless if done right" (and if you case is not too complex). I had two a few years ago, with an endodontist (and I would definitely go that way if you can) rather than a normal dentist.
I was awake during, and could feel pressure/pulling and smell burning etc as with a normal filling. But no pain. Afterward, some pain from jaw muscles having been clenched etc, and tenderness (no hard chewing for a while), but no real pain from the teeth.
The bad reputation of root canals is from a prior age of dentistry.
posted by LobsterMitten at 6:49 PM on September 29, 2007

The endodontist who did mine showed me some x-rays of other patients (no names), who had improperly-done first root canals -- where the dentist didn't bother taking out all the root tissue and it later got infected etc. (This was in the context of a conversation that did NOT have to do with "selling" me on endodontists; these were the films he had on his desk for procedures after he did mine.) It was as compelling a case as I can imagine for getting a specialist to do it the first time, if you possibly can.
posted by LobsterMitten at 6:53 PM on September 29, 2007