5 Common Misconceptions About Root Canals

Root canal therapy often gets a bad rap, but as dental professionals with years of experience treating patients, we know the reality is very different. Understanding the facts helps reduce anxiety, make informed decisions, and ensure you receive the best care possible. Below are some frequently heard myths about root canals, followed by evidence-based truths and additional context to help you feel more confident.

Myth #1: Root Canals Are Painful

Reality / Truth:
Root canals are designed to relieve pain, not cause it. With modern anesthetics (such as local anesthetic agents), precise techniques, and advances in dental technology, most patients report discomfort before the procedure but very little to no pain during the procedure.

• What to expect: You may feel pressure or vibrations—but numbness ensures you do not feel sharp pain.
• Tools that help: Digital imaging, ultrasonic instruments, and advanced irrigation systems make the procedure more accurate, with less trauma to surrounding tissues.
• After-care pain: Mild soreness for 1-2 days is common; over-the-counter pain relievers usually handle this. If pain persists or worsens, follow up immediately.

Myth #2: Root Canal Treatments Always Take Multiple Visits

Reality / Truth:
Many root canal treatments are completed in a single visit, especially on front or single-canal teeth. However, factors like the tooth’s location, anatomy, extent of infection, and patient health may require extra time or follow-up.

• One appointment vs. two:
    • Single-visit root canals are efficient when no complications are present.
    • Two visits may be recommended if there is severe infection, complex anatomy, or swelling requiring medication in between.
• Crown/restoration timing: After root canal, a crown (cap) or other permanent restoration typically follows within a few weeks to protect the tooth. Delay may increase risk of recontamination or fracture.

Myth #3: Root Canals Can Make You Sick / Are Harmful Systemically

Reality / Truth:
Modern dentistry and research show that root canal treatments are safe and do not cause systemic disease in healthy individuals. Concerns from outdated theories have been largely debunked by scientific studies.

• History note: Early concerns (early 20th century) suggested bacteria in root-filled teeth could cause general health problems. These theories have been disproven by modern microbiological and epidemiological research.
• When risks do exist: If proper sterilization, cleaning, or follow-up is not done, there is a risk of persistent infection or re-infection. Good technique, use of rubber dams, modern disinfection, and regular dental follow-ups minimize these risks.

Myth #4: A Tooth That Has Had a Root Canal Will Eventually Fall Out

Reality / Truth:
A properly treated and restored tooth can last a lifetime. It is not going to “fall out” simply because it had endodontic (root canal) treatment.

• What determines longevity:
    • The extent of decay or damage before treatment
    • How well the tooth is restored (e.g., with a crown)
    • How well you maintain oral hygiene and avoid excessive forces (like grinding or chewing very hard foods)
• Common risks for failure: Fracture, inadequate restoration, re-infection due to cracks or leakage.

Myth #5: Root Canals Remove the Root of the Tooth

Reality / Truth:
The root canal procedure removes the infected or inflamed pulp (the soft tissue inside the canals of the tooth), not the bony root. The structural roots that anchor the tooth into the jaw remain in place.

• What gets removed: The pulp tissue inside the roots; nerve and blood supply within those canals.
• What remains: The hard tooth structure (dentin, enamel) and the roots that hold the tooth in the jawbone. After treatment, there may be nerve tissue outside the roots (in the gum tissues) that still transmit sensation like temperature in the area around the tooth.

Additional Myths & Helpful Information

To enhance your understanding further, here are more myths and professional insights:

• Myth #6: Root Canals Are Expensive / Not Worth It
  Truth: They may seem costly upfront, but saving a natural tooth prevents additional costs of extraction, replacement (implants, bridges), bone loss, shifting teeth, etc.
• Myth #7: Antibiotics Alone Can Cure a Severe Tooth Infection
  Truth: Antibiotics can help manage infection temporarily or reduce swelling—but they don’t remove the source of infection (the infected pulp). Root canal therapy is necessary to eliminate the cause.
• Myth #8: Root Canals Cause Illness Later On
  Truth: No trustworthy evidence connects root canal teeth to diseases like heart disease, kidney disease, or arthritis when properly treated. Studies continue to monitor long-term outcomes.

What You Should Ask Your Dentist / What to Look For

• Experience: Is the dentist or endodontist experienced in root canal treatment?
• Tools & Technology: Use of digital imaging (CBCT), rubber dam isolation, proper illumination, magnification (microscopes or loupes) helps increase precision.
• Restoration Plan: What kind of filling or crown will be placed post-treatment, and how quickly?
• Infection Control: What methods are used to ensure sterilization and prevent re-infection?
• Cost & Insurance: What will your out-of-pocket costs be? Is follow-up care included?

Summary & Key Takeaways

• Root canals are more about saving teeth and alleviating pain than causing problems.
• Modern techniques make them comfortable, efficient, and safe.
• Longevity depends largely on restoration quality and maintenance.
• If you have concerns—about pain, cost, or outcomes—ask your dental provider for their credentials, their success rate, and what to expect in your particular case.