Does a Root Canal Hurt? Pain Levels Explained

With proper anesthesia—and your dentist will make sure you're completely numb before starting—you should not feel sharp pain during a root canal. Here's what you will experience:

Pressure and vibration
You'll feel your dentist working on the tooth, including pressure from instruments and vibration from the dental drill. This sensation is perfectly normal and shouldn't be painful, just unusual. Many patients find it helps to focus on breathing or listen to music with headphones.

Pushing and pulling sensations
As your dentist cleans out the canals inside your tooth, you may feel pulling or tugging sensations. The instruments need to reach deep into the root, and you'll be aware of this movement even though it shouldn't hurt.

Jaw fatigue
Root canals typically take 60-90 minutes, and your mouth needs to stay open the whole time. This can cause jaw stiffness and muscle fatigue. If you need to rest your jaw, let your dentist know—short breaks are completely fine.

Occasional sensitivity
Some teeth are difficult to numb completely, particularly those with severe infections. If you feel any sharp pain at any point, raise your hand immediately. Your dentist can administer additional anesthesia. Never suffer through pain—speak up.

Pain level during the procedure: 1-2 out of 10 for most patients

The procedure itself should be boring, not painful. Many patients are surprised by how anticlimactic it is compared to what they feared.

Post-procedure discomfort is normal but manageable. Here's what to expect in the days following your root canal:

First 24-48 hours
Once the anesthesia wears off (typically 2-4 hours after the procedure), you'll likely notice some soreness. The tooth and surrounding area have been through a procedure, and some inflammation is natural. Most patients describe this as:

• Tenderness when biting down on the treated tooth


• A dull, achy feeling in the jaw


• Mild throbbing that comes and goes


• Sensitivity to pressure

Pain level: Typically 3-5 out of 10, well-controlled with over-the-counter medication.

Days 3-7
Each day should bring improvement. The inflammation decreases, and your tooth feels more normal. By the end of the first week:

• Tenderness when biting should be minimal


• You can likely chew soft foods on that side


• Throbbing should have stopped


• The area may still feel slightly different but not painful

Warning signs that something's wrong:
While some discomfort is expected, certain symptoms indicate a problem that needs attention:

• Severe pain that gets worse instead of better


• Swelling that increases or spreads


• Fever over 100.4°F


• Visible pus or discharge


• The temporary filling falls out


• Pain that doesn't respond to over-the-counter medication


• Allergic reaction (rash, difficulty breathing)

If you experience any of these, contact your dentist immediately.

Here's the irony that most people don't understand: the root canal procedure doesn't cause the pain—it stops it.

By the time you need a root canal, the nerve inside your tooth is usually infected, inflamed, or dying. This is what causes the severe, throbbing toothache that brought you to the dentist in the first place. Some patients describe pre-root-canal pain as:

• The worst toothache of their life


• Pain that kept them up at night


• Throbbing that matched their heartbeat


• Agony that made eating impossible


• Pain that radiated through their entire jaw and head

The root canal procedure removes this infected or dying nerve tissue. Once it's gone, the source of your pain is eliminated. Most patients feel significant relief within 24-48 hours of the procedure—a dramatic improvement from the agony they experienced before.

Think of it this way: if you have an infected splinter deep in your finger, removing that splinter hurts momentarily but brings relief. The root canal works the same way. The treatment isn't the problem; the infection was the problem. The treatment is the solution.

While most root canals go smoothly, some patients do experience more discomfort. Understanding why can help set realistic expectations:

Severity of infection
Teeth with severe, active infections are harder to numb effectively. The acidic environment created by infection can neutralize the anesthetic. If your tooth is severely infected, your dentist may prescribe antibiotics for a few days before the procedure to reduce the infection and improve anesthesia effectiveness.

Tooth location
Lower molars (back bottom teeth) can be more challenging to numb because of how the nerves are positioned in the jaw. Multiple injections may be needed, and supplemental anesthesia techniques are sometimes required.

Anatomy variations
Some teeth have unusual canal configurations—extra canals, curved canals, or calcified canals. These take longer to treat and can cause more post-operative discomfort simply because more instrumentation was required.

Inflammation level
If the tissue around the root tip is highly inflamed (periapical inflammation), you may experience more soreness after the procedure. This inflammation takes time to resolve.

Individual pain tolerance
People genuinely experience pain differently. What's a 3/10 for one person might be a 5/10 for another. This is normal and doesn't mean anything is wrong.

Before your appointment:

• Take 600mg ibuprofen 30-60 minutes before your appointment (unless contraindicated for you). This pre-emptive anti-inflammatory can reduce post-procedure discomfort.


• Get a good night's sleep. Fatigue lowers pain tolerance.


• Eat a meal before your appointment. You'll be numb for hours afterward and won't want to eat.


• Arrive calm. Consider listening to relaxing music or using stress-reduction techniques.

After your appointment:
The key to comfortable recovery is staying ahead of the pain rather than chasing it:

• Take your first dose of pain medication before the anesthesia fully wears off


• Alternate ibuprofen (400-600mg) and acetaminophen (500-1000mg) every 3-4 hours for the first 24-48 hours


• Apply a cold pack to your cheek (20 minutes on, 20 minutes off) to reduce swelling


• Stick to soft foods for the first few days


• Avoid chewing directly on the treated tooth until your permanent crown is placed


• Sleep with your head slightly elevated to reduce throbbing


• Avoid very hot or very cold foods and beverages

If prescribed antibiotics:
Take the entire course as directed, even if you feel better. Stopping antibiotics early can allow resistant bacteria to survive and cause problems later.