Did you know that our teeth, despite their hard and resistant appearance, can be very vulnerable? Tooth decay is one of the most common oral and dental problems that, if left untreated, can reach the tooth’s nerve. In this case, the only way to save the tooth is root canal treatment, also known as endodontic therapy.

But is root canal treatment painful? How long does it take? How is this procedure performed and in how many stages? Can we use the treated tooth afterwards?

What is Root Canal Treatment?

Root canal treatment (Root canal therapy) is an important dental procedure performed to save damaged or infected teeth.

This process, also known as endodontic therapy, involves removing infected and damaged tissue from inside the tooth and filling it with suitable materials.

Root canal treatment not only helps maintain dental health but also prevents further damage to surrounding structures and relieves pain caused by infection.

This treatment is particularly essential for teeth with inflamed or infected pulp and can help improve individuals’ quality of life.

Root Canal, Endodontic Therapy, or Root Canal Treatment: Which Name is Correct?

All names such as root canal, endodontic therapy, endo, root canal, Endodontic therapy, and Root canal therapy, all mean the same thing and are used as a solution for treating root canal infections.

However, the most appropriate term for removing the nerves inside the tooth and repairing the damaged tooth is “endodontic therapy.” But because in this process, the nerves are pulled out of the tooth, the common term for this procedure is root canal, and the less common term is nerve extraction.

Reasons for Damage to the Dental Nerve

In most cases, endodontic therapy is performed when the dental pulp has suffered irreversible damage due to one of the following reasons. For example:

• Trauma or sudden injury to the tooth.
• Decay of the tooth crown reaching the pulp or proximity to the pulp chamber.
• Fracture and chipping of the tooth.
• Severe decay resulting from untreated decay.
• Performing various dental treatments on a tooth.
• Tooth damage such as that caused by a blow to the jaw.
• Class V caries on the cervical surface of the tooth, mostly caused by smoking.

However, these are not the only reasons for root canal treatment. Because sometimes, without any damage to the dental pulp, the tooth may develop a cyst or lesion, in which case, despite the tooth’s health, the dentist is forced to perform a root canal or apicoectomy on that tooth.

Advantages and Disadvantages of Root Canal Treatment

Disadvantages	Advantages	Aspect
Sometimes the tooth becomes weak and brittle after treatment.	The tooth is preserved and does not need to be extracted.	Preservation of the natural tooth
Sensitivity or pain may remain for some time after treatment.	Pain from infection or inflammation is relieved.	Pain relief
If treatment is incomplete, the infection can return.	Prevents the spread of infection to other teeth and jawbone.	Prevention of infection spread
In some cases, the tooth color changes (becomes darker).	The treated tooth maintains its natural appearance.	Natural appearance
If the treatment fails, retreatment or apicoectomy surgery is needed.	More expensive than extraction and cheaper than replacement with an implant.	Cost compared to implants
In severe cases, the tooth needs a reinforcing crown.	Natural chewing function is maintained.	Chewing function
Treatment time may be long (especially in complex cases).	Treatment is completed in one or a few sessions.	Treatment time
Without a crown or protection, the risk of tooth fracture increases.	With proper care, the tooth can last for many years.	Longevity

Signs Indicating the Need for Root Canal Treatment

Signs that, after seeing them, you can be sure about the definite need for root canal treatment.

• Pain while biting or chewing food due to pressure on the tooth.
• Pain while drinking cold or hot substances due to temperature.
• Unexplained, severe, and persistent pain.
• Swelling and enlargement of the gum surface in the form of white-headed or firm pimples, generally known as a dental abscess.
• Nighttime pain.
• Mouth sores (aphthous ulcers).
• Tooth discoloration due to severe decay.
• Loose tooth.
• Pus discharge from the gums and swollen gums (which are signs of tooth infection).

It should be noted that in some cases, teeth that require endodontic therapy show none of the mentioned symptoms. Here, the importance of regular visits to the dentist becomes apparent.

Stages and Method of Root Canal Treatment

Dr. Bonyanian explained that:

Before starting the root canal stages, the dentist first examines the patient’s dental condition and, with the help of X-ray images, diagnoses the extent of decay and damage. If the decay has reached the pulp and involved the nerve canals, the root canal procedure begins immediately (depending on the dentist’s time).

However, if the tooth has a severe abscess (such that the face is severely swollen), the dentist first prescribes antibiotics for the patient so that the infection and inflammation can subside before any action is taken.

Then, after about 3 to 6 days, the patient’s endodontic therapy process begins. The use of antibiotics reduces the severity of swelling and tooth pain. Usually, root canal treatment is performed in the following stages:

1. (1) Administering Anesthetic:
   In the first stage of root canal treatment, the dentist numbs the target tooth and its surrounding tissue by injecting an anesthetic, so that the person does not experience any pain or discomfort during the procedure. The anesthetic injection is accompanied by a slight stinging sensation, but don’t worry. This sensation will go away very quickly.
2. (2) Locating the Nerve Endings:
   The dentist uses a turbine drill to create an opening in the tooth’s dentin to reach the pulp chamber and find the entrance to the tooth’s canal or canals. The number of canals in a tooth usually varies from 1 to 4 canals.
3. (3) Cleaning the Root Canals:
   After finding the canals, it’s time to clean them. The root canal is completely emptied of nerves, blood vessels, and infection by the dentist using special instruments.
   It’s interesting to know that the nerve canals of each tooth are different from others. If the root tips have infection and lesions, the dentist usually performs the root canal in 2 stages.
4. (4) Irrigating the Canals:
   This stage is the most important part of endodontic therapy and the irrigation of the root canal must be done correctly at each stage. Even the best root canals will fail if the internal canal irrigation stage is incomplete.
5. (5) Shaping the Canals:
   After cleaning and irrigating the canals, it’s time to shape them. Experienced dentists usually use a device called an apex locator and rotary instruments for this task.
   Using this device, provided the dentist has sufficient skill in working with it, makes the root canal treatment cleaner and significantly reduces the error rate.
6. (6) Filling the Canals:
   Finally, it’s time to fill the empty space of the tooth nerve using a special material called gutta-percha and sealer. Here, it is very important that the dentist fills the canal to the very end with gutta-percha.
   Most novice dentists have problems in this part and cannot clean and fill the canal to the end, in which case the tooth will develop a lesion after some time and will need retreatment, extraction, and replacement with a dental implant.

The stages of root canal treatment are very simple and comfortable and are performed within 15 to 30 minutes and in one to three sessions. You can easily return to your daily activities after the root canal without experiencing any pain or discomfort.

Root Canal Treatment for Front Teeth

Due to the very high sensitivity of the front teeth, their root canal treatment is also of very special importance. Because these teeth have a direct impact on how we speak and the beauty of our face.

So, if you experience pain, throbbing, or gum inflammation around one of your front teeth, you should see a dentist at the earliest opportunity so that the dentist, after a thorough examination of the tooth and taking an OPG image, can diagnose problems such as decay or damage to the root of your front tooth.

However, experiencing pain is not the only symptom of a tooth nerve being affected. In many cases, a tooth with an affected nerve has no pain or sensitivity, and its problems are only diagnosed after a medical examination. That is why dentists usually recommend their patients to visit the dentist every 6 months for a dental check-up.

Is Root Canal Treatment Painful?

One of the main reasons people avoid root canal treatment is the fear of pain during this procedure. The truth is that root canal treatment is not as uncomfortable and painful as you might think.

As we discussed in the section on the stages of endodontic therapy, the dentist uses an anesthetic injection to numb your teeth before starting the root canal procedure.

Complications of Root Canal Treatment | Is Root Canal Treatment Harmful?

Root canal treatment is so common and prevalent that almost 80% of people have had it done at least once. But despite all these root canals being performed daily around the world, no severe or dangerous complications have been reported from this dental procedure so far.

However, this method, like any other medical treatment, may be accompanied by some unwanted and mild side effects. But these side effects are very rare and usually controllable with proper care.

Some of these potential complications include:

• Pain in the gums
• Discomfort in the jaw area and other teeth
• Headache
• Infection in the area of the root-canaled tooth
• Sinus congestion
• Tooth fracture
• Tooth discoloration
• Pain during root canal treatment

Root Canal Treatment for Primary (Milk) Teeth in Children

Some parents imagine that because primary teeth are going to fall out, caring for them is not very important. While this notion is fundamentally wrong.

Primary teeth act as guides for permanent teeth and help them to erupt in their correct place. If a primary tooth falls out prematurely, permanent teeth may erupt crookedly or out of place due to lack of sufficient space.

Furthermore, primary teeth play an important role in shaping a child’s speech. Losing them prematurely can lead to speech impediments and difficulties in articulation.

Considering these factors, and of course, other factors such as the impact on nutrition, it is necessary for parents to take care of their children’s primary teeth and, in case of any problems such as decay, to proceed with root canal treatment for their child’s primary teeth.

How Long Does a Root-Canaled Tooth Last?

The lifespan of a root-canaled tooth depends on various factors, and we cannot determine an exact number for it. However, this tooth can last for many years in your mouth with proper care.

Among the factors affecting the lifespan of a root-canaled tooth, we can mention the following:

• Quality of treatment: If the root canal treatment is performed correctly and the root canals are completely cleaned and filled, the probability of success and increased lifespan will be higher.
• Post-treatment care: Regular brushing, flossing, and regular visits to the dentist for check-ups are among the most important factors that increase the lifespan of your root-canaled tooth.
• Type of crown: Using a suitable and high-quality crown is very important for protecting the root-canaled tooth.
• Oral habits: Habits such as bruxism (teeth grinding) or chewing hard objects can damage your root-canaled tooth.
• General health: Underlying diseases such as diabetes or osteoporosis can also affect the healing process and lifespan of your tooth.

Dental Crown for a Root-Canaled Tooth

The recommendation of doctors after root canal treatment is to use a dental crown. A dental crown is a fixed cap that covers your entire restored and root-canaled tooth and gives it a beautiful appearance.

The use of a dental crown, in addition to beautifying the appearance of the tooth, is for tooth care. Because a tooth without blood vessels, without nerves, and without blood flow is a dead tooth that becomes more brittle day by day over time.

By placing a crown on the root-canaled tooth, its lifespan and strength are increased. In situations like the following, a crown is more important than in other cases:

• When your tooth has fractured and lost its natural structure.
• When the dentist has had to make changes to a large surface of the tooth.
• When the tooth is filled with dark materials.

A dental crown is also used in other cases, which we have explained in detail in the article on dental crowns.

Reasons for Pain in a Root-Canaled Tooth

In some cases, the patient may still experience pain and discomfort in that area after root canal treatment. Dentists divide the root-canaled tooth into three time frames in these situations:

• Pain in a root-canaled tooth, up to one month after root canal treatment
• Pain in a root-canaled tooth, from one month to one year after root canal treatment
• Pain in a root-canaled tooth, several years after root canal treatment

Studying the article “Causes of Pain in a Root-Canaled Tooth” (link to be inserted here) will provide you with more complete information about this pain.

Root Canal Retreatment (Re-Treatment)

Root canal retreatment (Re-Treatment) refers to a process in which a tooth that has previously undergone root canal treatment but has developed problems due to various reasons such as reinfection, incomplete treatment, or fracture in the previous treatment, is treated again.

In this method, the previously filled materials are removed from the root canals, the canals are carefully cleaned and disinfected, and then refilled and restored with suitable materials. The goal of root canal retreatment is to preserve the natural tooth, prevent the need for extraction, and restore complete health to the damaged area.

What Happens After Root Canal Treatment?

After the completion of the endodontic therapy stages, the tooth must be filled with filling materials and its appearance restored with a crown. However, if a crown or unsuitable filling materials are not used, the teeth will fracture after some time, and the tooth structure will lose its strength and resistance.

Many people mistakenly believe that once the tooth root is treated, there is no possibility of future decay. However, any tooth without an open root canal is still susceptible to decay, and the likelihood of its structure being damaged is high.

Therefore, observing hygiene tips and visiting the dentist for more detailed check-ups are very important. Try to do your best to keep your natural teeth healthy.

Infection in a Root-Canaled Tooth

Infection in a root-canaled tooth is a relatively rare event that occurs in some cases and for various reasons. This infection usually occurs between one week to ten days after the root canal treatment.

Signs of infection in a previously root-canaled tooth include the following:

1. Feeling pain and discomfort
2. Dental abscess
3. Swelling in the adjacent gum
4. Appearance of a small pimple-like bump
5. Pus discharge from the gum

The importance of the dentist’s expertise and skill in performing root canal treatment will become clear at this time. Because if there is any mistake in the root canal process, you will face subsequent and more severe problems such as tooth infection.

In some cases, you may have to go through all the stages of root canal treatment again from the beginning. However, in situations where the infection has spread and is damaging other teeth, you may have to extract your tooth.

Post-Root Canal Treatment Care

The following are among the post-root canal treatment care measures:

1. Refrain from eating chewy foods for up to 1 hour after treatment.
2. You may experience pain and discomfort for up to two weeks after endodontic therapy. In this case, you can use painkillers (as prescribed by your dentist).
3. Swelling in the treated tooth area is normal. However, if it occurs, consult your dentist to receive appropriate antibiotics and avoid self-medicating.
4. You may experience pressure and pain when chewing for up to about a month after endodontic therapy. This sensitivity will decrease over time. If the pain persists or increases, consult your dentist.
5. A tooth that undergoes endodontic therapy becomes brittle. Crown the tooth and do not apply pressure to it.

Costs Associated with Root Canal Treatment

Many factors influence the cost of root canal treatment. Factors such as the number of roots or canals in the tooth, the difficulty of accessing posterior teeth, the condition of the tooth’s infection, and the dentist’s skill and expertise.

Considering these factors, determining the exact cost of root canal treatment is difficult. For this reason, we have addressed the price of root canal treatment (link to be inserted here) on a separate page.

Dr. Bonyanian’s dental clinic, in addition to providing high-quality services to you dear ones, has also made it possible to pay for root canal treatment in installments. Because our goal is the health and beauty of your teeth.

Filling a Tooth Without Root Canal Treatment

In situations where your tooth nerves are healthy, your dentist may suggest filling the tooth without endodontic therapy. This procedure is more common for children’s primary teeth that have just erupted from the gums and their nerves have not yet fully formed.

Also, in cases where your tooth damage is superficial, such as trauma, decay, and cavities, you can use the method of filling the tooth without root canal treatment.

In such circumstances, the dentist uses composite fillings (which have a color similar to tooth tissue). With this, the beauty of your tooth will be preserved.

Preventing Re-damage to a Root-Canaled Tooth

Performing daily oral and dental care prevents the need for retreatment of endodontic therapy. If you take good care of your oral and dental health, the likelihood of infection and decay will decrease, and no bacteria will threaten the dental pulp.

Most of the helpful actions to prevent retreatment of root canal treatment include the following:

• Brush your teeth regularly throughout the day.
• Rinse your mouth after every meal.
• Use dental floss daily.
• Maintain a proper diet.
• Prevent frequent consumption of very sugary snacks such as sweets, cakes, or soda.
• Prevent consumption of hard foods that put a lot of pressure on the teeth.

Best Root Canal and Endodontic Specialists

Given the very high sensitivity of the root canal procedure, we recommend that you definitely have this procedure done by an endodontic specialist or a dental surgeon. By doing so, you will both be at ease regarding the correctness of the surgery and your treatment will be performed with minimal pain.

In a separate article titled “Best Endodontic Specialists,” (link to be inserted here) we have introduced the best specialists in this field from various cities in Iran. You can refer to the best specialist in your city, wherever you are in Iran, and proceed with your endodontic therapy.

Final Summary

On this page from Dr. Bonyanian’s dental clinic, we discussed what root canal treatment is and what stages it involves. We further stated that root canal treatment is one of the practical methods for treating damaged teeth. Almost all individuals who undergo treatment with this method can enjoy its positive results for the rest of their lives.

However, the longevity of the results largely depends on how you care for your teeth. That is, just as other healthy teeth require oral and dental hygiene, a root-canaled tooth is no exception to this rule.

If you are also experiencing tooth pain and live in Tehran, you can visit Dr. Bonyanian’s dental clinic located at Unit 7, No. 22, West 6th Street, Ahmad Qasir (Bokharest) Street, Arjantin Square, for root canal and endodontic services from our clinic.

Dr. Nazi Bonyanian

Dental Surgeon (DDS) — Medical Council Number: 138662
Graduate of Isfahan University of Medical Sciences with over 15 years of experience in implants, laminates, and oral and dental surgery.

Dr. Bonyanian Dental Clinic

Address: No. 22, Unit 7, West Alley 6, Bokharest Street, Argentina Sq., Tehran, Iran
Phone: +98-21-88539720 | WhatsApp: +98-912-514-2202
Email: info@drbonyanian.com

Working Hours: Sat–Wed 09:00–20:00 | Thu 09:00–14:00 | Friday Closed

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Last Reviewed: 24 May 2025

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