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Root Canal!  Does that word scare you?  Many people fear the word root canal and have for generations.  However, most of that comes from the pain that thanks to advances in technology has long ago left behind.  Thanks to advancements in techniques and products, root canals are faster and more thorough.  As a result of these newer techniques and products chances of post procedural pain and complications has decreased, as well as the amount of time you spend in the dental chair.

What are the major signs of needing a root canal?

Do you have a tooth that is or has been hurting you? Is it sensitive to cold or hot beverages? Does it hurt to chew on it? These are all signs that a tooth may be in need of a root canal. This is not as scary as you may have been led to believe.  In fact the painful part of a root canal is likely happening to you right now.  The root canal is what eliminates the pain, unless done incompletely which unfortunately happens quite a bit.

root canal from decay

Decay progression of a tooth needing a root canal.

Root canal pain levels?

The pain from a root canal is often very minimal. Most of the pain people feel from these teeth is the infection or tissue still left alive BEFORE we do the root canal. Once done there will be some residual pain but within a day or two there should be none.

Root canal recovery time?

This depends on the severity of the infection of pain when you start but I tell patients 2 to 3 days and things should be feeling back to normal.

Do you have a tooth that still hurts after the procedure is done?

After a few days of healing a tooth should not continue to hurt or at the very least should be feeling better every day. Things your doctor does ruing treatment such as preflaring, Özlek 2023 JOE, will impact on much pain you have. If it still hurts there may be something wrong. It may be that there is another canal inside your tooth, which is the most likely. Many teeth have unusual and complex anatomy that we can not treat completely. Very rarely you be unlucky and develop post-traumatic trigeminal neuropathic pain.

What a Wheaton root canal done by Dr. Bauer looks like

need a root canal

These images show Dr. Bauer’s root canals. Notice the number of canals (lines) that were treated on each tooth. If your tooth still hurts there is a VERY GOOD chance anatomy was missed.

The images above shows Dr. Bauer’s root canals and especially relevant, notice that they all have 4 or 5 lines. When we clean the canals within the tooth they look like individual lines on the x-rays. Upper molars nearly always have 4 canals and it is difficult to find the fourth one so many root canals only have 3 treated. As a result it is very common for upper molar root canals to continue to hurt. If your molar tooth still hurts after a root canal there is a VERY GOOD chance anatomy was missed and it doesn’t look like the x-rays above.

What are the symptoms of a tooth that needs treatment and what causes these symptoms to occur?

What are the steps?

How much does a root canal cost?

The fee in our office differs depending on which tooth we are treating.  Front teeth are always cheaper than back teeth because they are on average much easier.  A back tooth that needs a root canal will cost around $1300-1400 in our office in 2019.  When thinking of the cost, it’s important to find out what other procedures the dentist is recommending to keep the tooth.  A build up, or post, and a crown will often be done after the root canal, especially when talking about a back tooth.  A build up and crown will add $1,500-2,000 more to the cost of the procedure.  To check out a fair fee for your zip code you can check fair health consumer website.

What is the survival rate of a tooth with a root canal?

We feel a median survival rate of 20 years is a very good estimate for our patients Thyvalikakath 2022 JDR. Our patients receive their filling the same day as the root canal so that puts them in the highest category of survival according to this study. We feel this is a great real world study as if looks at many offices around the country to see what is really happening.

What is the success rate?

You will often see 87-97% given as a number for a 10 year success rate but we think that is likely higher than reality. There is a difference between success rate and root retention rate that we feel is very important. Root retention rate, which is likely what a patient would call a success, is around 90% but we dentists often subjectively measure success by a lack of observable periapical lesion. Dental films show this success rate to be around 90% BUT CBCT shows this rate to be around 70%! A recent study showing real life data in 99 general dentist practices shows an average survival rate of only 11 years. This number will be much higher than any success rate as a tooth can survive in the mouth but have a lesion and thus not be a “success” anymore. That goes against the standard number given of upper 80% to 90 something %.

The success rate is subjective to our technical ability to see a radiolucency at the tip of a tooth. We do not consider asymptomatic radiolucencies a success yet they can be left in the mouth without issues for decades and often are. The advent of CBCT technology allows us to see more of these lesions and thus the success rate drops but in reality it is just us “seeing” more of the failures. Our opinion is if one did micro-CT the success rate would be even worse and if one did histology reports on the apical areas the success rate would be near zero. Add to this that some lesions are true periapical cysts and are self-sustainable regardless of the root canal. Tian JOE 2019 references 10-12

Why some of these areas are never painful but then all of a sudden act up is still a mystery.  Some feel a viral attack may be the cause.

Another interesting finding is that statin medication increases the chances of root canals healing properly. Alghofaily JOE 2018 The same medication helps dental implants heal, likely due to similar mechanisms. Another group of medications that help teeth heal are the biological medications adalimumab (Humira) and infliximab (Remicade). Cotti JOE 2018

What factors impact success rates?

We really like what this study shows as factors for a couple of reasons. First of all it agrees with other research we have seen. Secondly it looks at over 2.5 million teeth. That is a lot of data. Old age has a negative impact on the success of treatment. The two main reasons are that older teeth have more calcification and are harder to treat and older people heal more poorly. There is no evidence to support doing root canal treatments in two steps instead of just one step. Success rates are very slightly higher with a rubber dam. Kwak JOE 2019 Liu JOE 2023 meta-analysis shows that diabetes has a negative impact on the success of root canals. The initial size of the lesion does not seem to impact success rate which seems counter intuitive. Baseri 2023 EBD

Another issue may be infection control. The enhanced infection control protocol is not common but does seem to increase success rates quite a bit. Zahran IEJ 2021


Dr. Bauer is a licensed general dentist and is not a licensed specialist in endodontics so we can do both the root canal and your crown or build up filling at the same time. Give us a call today for a complimentary consult and evaluation of the area that is hurting you and let us get you out of pain.

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“Bauer Dentisty is great! I used to hate going to the dentist but they make me feel comfortable as soon as I walk in the door. Thanks for everything!”

– Frank B

“Bauer Dentisty is great! I used to hate going to the dentist but they make me feel comfortable as soon as I walk in the door. Thanks for everything!”

– Frank B

“Bauer Dentisty is great! I used to hate going to the dentist but they make me feel comfortable as soon as I walk in the door. Thanks for everything!”

– Frank B