Root Canal Treatment: What to Expect

The name alone makes patients nervous. Root canal treatment has a reputation built on decades-old stories and procedures done before modern anaesthetics. What most patients actually experience today is a procedure that feels much closer to getting a filling than anything worth dreading.

What Is a Root Canal?

Your tooth has a hard outer shell made of enamel and dentin, and a soft inner chamber called the pulp. The pulp contains nerves, blood vessels, and connective tissue. When the pulp becomes infected or severely damaged, it cannot heal on its own. Left alone, the infection spreads, and you will eventually lose the tooth.

A root canal removes the infected pulp, cleans and shapes the inside of the root canals, then seals the tooth to prevent reinfection. The tooth stays in place, functional and intact, without the nerve that was causing the problem.

When Is a Root Canal Necessary?

The most common reason is untreated decay that has progressed deep enough to reach the pulp. Our post on what happens when a cavity goes untreated walks through that progression stage by stage. Other common causes include:

• A deep crack or fracture that exposes the inner tooth

• A dental abscess, an infection at the root tip that causes swelling and pain

• Repeated dental procedures on the same tooth, which can irritate the pulp over time

• A tooth injury that damages the nerve, even without visible external cracks

You may or may not feel it coming. Some patients have no pain until the infection is well established. Common warning signs include a persistent or throbbing toothache, sensitivity to hot or cold that lingers after the source is removed, swelling near the tooth, and a pimple-like bump on the gum. If you notice any of these, do not wait.

What Happens During the Procedure

Most root canals are completed in one appointment lasting 60 to 90 minutes. Complex cases, particularly molars with multiple canals, may require two visits. Here is what each step involves:

Anaesthetic. Your dentist numbs the tooth and surrounding tissue completely. This is the step patients dread most, and the one that surprises them most. With good local anaesthetic, you should feel nothing beyond pressure. If you feel any sharpness during the procedure, say so immediately so more freezing can be added.

Isolation. A small rubber dam is placed around the tooth to keep the area dry and bacteria-free during the procedure.

Access. A small opening is made through the top of the tooth to reach the pulp chamber.

Cleaning and shaping. Using fine instruments, the dentist removes the infected pulp and carefully shapes each canal. The canals are then flushed with an antimicrobial solution to eliminate remaining bacteria.

Filling. The cleaned canals are filled with a biocompatible rubber material called gutta-percha and sealed.

Restoration. Most treated teeth need a dental crown to protect them from future fracture. Your dentist will place a temporary filling and schedule a crown appointment, or proceed to the final restoration at the same visit depending on the case.

Does a Root Canal Hurt?

During the procedure: not with proper local anaesthetic. The area is fully numb. Most patients say they were braced for something terrible and were genuinely surprised at how manageable it was. The discomfort people associate with root canals is usually the pain they felt before the treatment, not from the procedure itself.

After the procedure: mild soreness and sensitivity for two to four days is normal. Over-the-counter anti-inflammatories like ibuprofen handle it well for most people. Significant or worsening pain past the first week is not normal, and you should call your dentist.

If dental anxiety is making you hesitant to book, our post on managing dental anxiety has practical strategies for patients who have been putting off treatment.

Root Canal vs. Tooth Extraction: A Quick Comparison

Factor	Root Canal + Crown	Tooth Extraction
Upfront cost (Ontario, 2026)	$1,900 to $4,100	$200 to $400
Long-term cost (with tooth replacement)	Same, if tooth lasts for years	$3,000 to $5,000+ to replace with an implant
Recovery time	2 to 4 days mild soreness	3 to 7 days
Keeps natural tooth	Yes	No
Preserves jawbone	Yes	No (bone loss begins over time)

Recovery and Aftercare

Most patients return to normal activities the same day or the next. A few things to keep in mind while you heal:

• Avoid chewing on the treated side until the permanent restoration is in place

• Complete any prescribed antibiotics for the full course

• Brush and floss normally, including around the treated tooth

• Call your dentist if swelling, pain, or discharge develops or worsens after the first few days

A tooth that has had a root canal and a crown can last just as long as a natural tooth with proper care. The goal is always to keep your tooth in your mouth.

Frequently Asked Questions

How long does a root canal appointment take?

Most cases take 60 to 90 minutes. Complex cases, such as molars with multiple canals, may require two appointments. Your dentist will give you a realistic estimate after reviewing your X-rays.

How much does a root canal cost in Ontario?

Costs vary by tooth. The procedure alone ranges from approximately $700 for a front tooth to $2,100 for a molar. A crown typically adds $1,200 to $2,000, bringing the combined total to roughly $1,900 to $4,100. Most private dental insurance plans in Ontario cover a portion of both, often 50 to 80 percent. Ask the clinic about a pre-authorization if your insurer requires one before starting treatment.

Can I just have the tooth pulled instead?

You can, but replacing a missing tooth costs more over time than saving it. A dental implant or bridge to replace an extracted tooth typically costs more than the root canal and crown combined. Keeping your natural tooth is almost always the better outcome for chewing, bone preservation, and long-term oral health.

What happens if I don't get the root canal my dentist recommends?

The infection will not resolve on its own. It will spread into the surrounding jawbone and adjacent teeth, and eventually become a dental emergency requiring extraction. Our post on what happens when a cavity goes untreated explains what that progression looks like at each stage.

Worried about a tooth that might need treatment? The sooner you come in, the more options you have. Book an appointment at Lornview Dental and let us take a look before the problem gets bigger.