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Does a Root Canal Hurt, and How Long Does It Take?
By the Celestial Dental Centre clinical team · Published
Root canal treatment has a reputation as the most painful thing a dentist can do to you. In reality the opposite is usually true: the pain people dread is almost always the toothache that brings them in, and the root canal is what takes that pain away. With modern anaesthetic, the procedure itself is much like having a filling, just longer. Here is what really happens and what to expect.
What is a root canal, in plain terms?
Inside every tooth is a soft core of nerve and blood vessels called the pulp. When a deep cavity, a crack or an injury lets bacteria reach that pulp, it becomes inflamed or infected, and that is what causes severe, throbbing toothache. A root canal removes that damaged pulp, cleans and disinfects the hollow canals inside the roots, and seals them. The outer tooth stays in place. In short, it treats the inside of the tooth so the tooth itself can be kept rather than pulled out.
Does it hurt?
During the treatment, no, not when it is done properly. The tooth and the area around it are fully numbed with local anaesthetic first, and the dentist does not start until you cannot feel the tooth. Most people are surprised at how ordinary it feels, closer to a long filling than to the agony they imagined.
The pain people remember is usually the infection beforehand, not the procedure. If your tooth is already very inflamed, it can occasionally be harder to get fully numb, and your dentist has ways to manage that, including giving the infection time to settle or adjusting the anaesthetic. Tell your dentist if you feel anything sharp, so they can top up the numbing.
Afterwards, it is normal for the tooth to feel tender or bruised for a few days, especially when biting, as the area settles. That ache is usually mild and manageable with ordinary over-the-counter painkillers taken as directed, and it fades steadily. Pain that gets worse rather than better, or swelling, is a reason to call the clinic.
How long does it take?
That depends on which tooth and how infected it is. As a rough guide:
- A front tooth has a single canal and is often the quickest.
- A back tooth, a molar, has several canals and takes longer to clean thoroughly.
- A heavily infected tooth may be treated over two visits, with medicine sealed inside between appointments to clear the infection.
A single appointment commonly runs from around forty-five minutes to over an hour and a half. Some cases are finished in one visit, others are split into two. Your dentist will tell you which after the examination and X-ray. It is worth allowing enough time and not booking it against a tight schedule, so you are relaxed rather than rushed.
Why not just pull the tooth out instead?
Extraction is quicker and sometimes cheaper on the day, and occasionally a tooth is too broken or infected to save. But keeping your own tooth is almost always the better long-term choice. A natural tooth root keeps the jawbone stimulated, holds its neighbours in place, and lets you bite normally. Once a tooth is removed, the gap tends to cause the surrounding teeth to drift and the opposing tooth to over-erupt, and replacing it later with an implant, bridge or denture is its own project. The trade-offs between saving and replacing a tooth are set out in our articles at celestialdental.org/cavity-treatment-filling-root-canal-or-extraction and celestialdental.org/missing-tooth-implant-bridge-denture-or-crown.
Will I need a crown afterwards?
Often, yes, particularly on back teeth. A tooth that has had a root canal can become more brittle over time, and a molar takes heavy chewing forces. A crown caps and protects it so it does not crack later. Front teeth that still have plenty of healthy structure can sometimes be restored with a filling instead. Your dentist will advise based on how much sound tooth is left. Budgeting for the crown as part of the plan, rather than a surprise afterwards, saves disappointment.
How do I look after the tooth while treatment is ongoing?
If your root canal is split over two visits, the tooth will have a temporary seal in between. Chew on the other side, keep the area clean, and avoid hard or sticky foods on that tooth. If the temporary filling comes out or the tooth flares up between visits, call the clinic rather than waiting for the next appointment. Once the treatment and any crown are finished, the tooth is cleaned and cared for like any other.
Is the pain a sign I have left it too late?
Not necessarily, but severe or night-time toothache does mean the tooth needs attention soon rather than someday. A dying or infected nerve does not heal on its own, and the pain sometimes eases just as the infection is spreading, which can be falsely reassuring. If you have had significant toothache, get the tooth checked even if it settles. Why toothache flares at night, and how to get through until your appointment, is covered at celestialdental.org/why-toothache-gets-worse-at-night.
Does insurance or SHA cover root canal treatment?
Cover depends on your insurer, your scheme, your member category and the specific tooth and treatment. Celestial Dental accepts SHA for eligible schemes and bills more than 20 private insurers directly, including Jubilee, AAR, Madison, CIC, Britam, APA and Equity Bank Insurance. Send us your insurer or SHA scheme name, your member category, the treatment discussed and your preferred branch, and the team will verify eligibility and arrange any pre-authorisation before your visit.
Book an assessment
If you have toothache, sensitivity that lingers, or a tooth that has darkened, an examination and X-ray will show whether a root canal can save it. Celestial Dental Centre has clinics in Kasarani (Nairobi), Kamakis (Ruiru) and Eldoret, open every day from 07:00 to 20:00.
Call or WhatsApp +254 707 535 000 or book online at celestialdental.org. The sooner an infected tooth is treated, the more comfortable the process and the more likely your own tooth is saved.