The Worst Pain I’ve Ever Felt

The Worst Pain I’ve Ever Felt

The other day over dinner, my mom says to my aunt “oh gosh, I just shudder at the thought of getting a root canal.  It’s got to be the worst pain ever.” This may sound like a normal comment but my mother has never had a root canal!

She has only ever gotten cleanings at the dentist.  And here she was, spreading the fear of pain and death to other people.  

But I guess this experience raises a very important point – people are terrified of root canals.  When I tell a patient their tooth needs a root canal, the first question they ask is “Don’t root canals hurt? Like a lot?” or if they’ve previously had a root canal, they say “That was the worst pain I’ve ever felt in my life!”.  

A root canal treatment should not be painful.  Like many dental treatments, if the tooth is properly anaesthetized, a patient should be quite comfortable during a root canal and not feel pain.  

So where does this myth about painful root canals come from?  

There are a few possible explanations:

  1. A tooth requires a root canal when the nerve of the tooth gets damaged beyond repair.  When the nerve starts to die, bacteria multiply and eventually causes an infection inside the nerve space.  This acute infection can cause one heck of a toothache. This is usually the pain patients remember associated with root canals, even though the toothache preceded the root canal.

2.  The tooth is not fully anaesthetized before the dentist starts the root canal.  When there is an acute infection in a tooth, it takes more local anaesthetic to numb it.  Sometimes complete numbing of the tooth is not possible if there’s a lot of swollen tissue from the infection.  Under these circumstances, starting a root canal is just asking for trouble. Patients may need antibiotics before proceeding with the root canal to avoid pain during the treatment.

3.  Not all the nerve tissue was removed during the root canal treatment. In this instance, the pain before and after root canal treatment remains the same because there is still residual nerve tissue sending pain signals.

4.  The tooth has a fracture in it and needs to be pulled because a root canal will not fix the problem.  In this instance, the pain before and after root canal treatment remains the same.

Here’s a little more background information on root canals to help understand when this treatment is appropriate and also the full step by step procedure of a root canal.

Anytime the nerve in a tooth is irreversibly damaged, the pain is going to be remarkable so it’s true that root canals will always be associated with pain.  However, it’s unfortunate that a root canal is often seen as the cause of the toothache instead of the cure for the pain.

Getting a root canal (or any invasive dental treatment) can be a very stressful time for patients so be sure to tell your dentist is you’re uncomfortable or in pain during the procedure.  If your tooth is properly and completely anaesthetized, it is very unusual for you to feel pain during a root canal.

I hope this clears up some of the misconceptions about root canals.

Phuong Luu, DDS