A root canal has a worse reputation than it deserves. It’s done to stop pain. The dentist removes an infected or dying nerve from inside the tooth so you can keep the tooth instead of having it pulled. With modern numbing, most patients say it felt like a long filling.
When a tooth needs a root canal
Every tooth has a soft core of nerve and blood vessels called the pulp. When decay reaches the pulp, or a tooth cracks, or a tooth takes a hard knock, the pulp can become inflamed or infected. Once that happens, it doesn’t heal. Signs to watch for:
- Toothache that throbs, lingers, or wakes you at night
- Pain when you bite or press on the tooth
- Sensitivity to hot or cold that lasts more than a few seconds after the trigger is gone
- Swelling or a pimple-like bump on the gum near the tooth
- A tooth that has darkened
Sometimes there are no symptoms at all and the infection shows up on an x-ray as a dark spot at the tip of the root. That’s one of the reasons for routine x-rays at checkups.
If you’re in pain now, don’t wait for an opening. Call the office nearest you and tell them it’s an emergency. Our emergency dentist page explains what to do in the meantime.
What happens during a root canal
Numbing. The tooth and surrounding area are fully numbed. An infected tooth can be harder to numb, so the dentist may use more anesthetic or a different technique, and won’t start until you’re comfortable.
Cleaning the canals. A small opening is made in the top of the tooth. The dentist removes the pulp, then cleans, shapes and disinfects the canals inside each root. Front teeth usually have one canal. Molars have three or four, which is why a molar root canal takes longer.
Sealing. The cleaned canals are filled with a rubber-like material and sealed. A temporary filling closes the opening.
The crown. A tooth that’s had a root canal is more brittle, so back teeth almost always need a crown afterward to protect them from cracking. Front teeth can sometimes get by with a filling. Your dentist will tell you which you need and why.
Most root canals are done in one or two visits of 60 to 90 minutes, with the crown as a separate step. If there’s a lot of infection, the dentist may place medication inside the tooth and finish at a second visit.
Does a root canal hurt?
The procedure itself shouldn’t, because the tooth is numb. What hurts is the infected tooth before treatment, and for most people the root canal is the thing that finally makes the pain stop. Afterward, the tooth and the gum around it can be sore for a few days, especially when biting. Over-the-counter ibuprofen or acetaminophen usually handles it. If pain gets worse instead of better after three days, or you develop swelling, call us.
Root canal or extraction?
Pulling the tooth is cheaper on the day. It’s rarely cheaper over time. When a back tooth is missing, the teeth next to the gap drift and the tooth above or below it over-erupts, which affects your bite and makes cleaning harder. Replacing it later with a bridge or implant costs more than the root canal and crown would have. When a tooth can be saved, saving it is usually the better call. When it can’t, because the crack runs below the gum or there’s too little tooth left, we’ll say so and talk about extraction and replacement instead.
Root canal cost and insurance
The fee depends on the tooth: front teeth cost less than premolars, which cost less than molars, because of the number of canals. The crown is a separate fee. Both will be on your written treatment plan before you decide.
Insurance: Most dental plans cover root canals as a major or basic service at 50% to 80%. MassHealth covers root canals for children and adults (other than on wisdom teeth) at all 15 of our Massachusetts offices. HUSKY covers root canals for children and adults at all 10 Connecticut offices, once per tooth, with prior approval that we submit for you. Our insurance pages for Massachusetts, Connecticut, New Hampshire and New Jersey have the details.
No insurance: The $25 look-and-see visit gets you the diagnosis, x-rays and a price. The treatment itself can be paid over time with our monthly payment plans.
Common questions about root canals
How long does a root canal take?
60 to 90 minutes per visit. Front teeth are often finished in one visit, and molars sometimes take two. The crown is placed at a later appointment.
Can I drive home after a root canal?
Yes. Only local anesthetic is used, so you’re fully alert. You’ll be numb for a few hours.
What can I eat after a root canal?
Stick to soft foods on the other side of your mouth until the numbness wears off. After that you can eat normally, but don’t chew anything hard on the treated tooth until the permanent crown is on, because the temporary filling can break.
Does MassHealth cover root canals?
Yes, for children and adults, except on wisdom teeth. For adults, the root canal and the crown both count toward the $1,750 yearly limit that starts August 1, 2026, so we’ll help you plan the timing.
Does HUSKY cover root canals?
Yes, once per tooth, with prior approval from CTDHP. We handle the paperwork. For adults, the cost counts toward HUSKY’s $1,000 calendar-year limit.
Do I need a specialist?
Usually not. Root canals are a routine procedure at Dr. Dental. Unusually complex cases, such as a canal that’s blocked or sharply curved, may be referred to an endodontist, and we’ll tell you if that applies to you.
If a tooth is hurting right now, call the closest office today. For anything less urgent, you can request an appointment online. This page is also available en español.
