Is Root Canal Treatment Painful? The Truth from a Dentist | Smile Hub Clinics Lahore
Root Canal · Patient Guide

Is Root Canal Treatment Painful? The Truth from a Dentist

BDS, FCPS · Smile Hub Clinics
June 2026 · 6 min read

Root canal treatment has a reputation that is completely out of proportion with reality. Ask most people what they fear most at the dentist and root canal comes up almost every time — usually from people who have never actually had one.

Here is the truth: a properly performed root canal under adequate anaesthesia is no more painful than a routine filling. The reputation comes from an era of inadequate anaesthesia and poor technique. Modern endodontics has changed completely.

Why Does Root Canal Have Such a Terrible Reputation?

The reputation originates from two sources. First, historical experience — decades ago, dental anaesthesia was less effective, equipment was more primitive, and root canals were genuinely more uncomfortable. Second, and more importantly, people confuse the pain of the infection with the pain of the treatment.

By the time most patients present for root canal treatment, they have been in significant pain from an infected tooth for days. That pain — the throbbing, the sleepless nights, the sensitivity to everything — is from the infection. The root canal removes the infected tissue and relieves that pain. The treatment is not the source of suffering. The infection is.

What Actually Happens During Root Canal Treatment?

Root canal treatment — formally called endodontic treatment — removes the infected or inflamed pulp (nerve and blood vessels) from inside the tooth, cleans and shapes the root canals, and seals them to prevent reinfection.

At Smile Hub Clinics, root canal treatments are performed by Dr. Athar Parvez — BDS, FCPS(R) — a postgraduate-qualified endodontist. This distinction matters: an FCPS endodontist has 3–4 years of additional specialist training specifically in root canal treatment beyond general dental qualification.

The procedure under local anaesthesia typically feels like: pressure and vibration, but no pain. The tooth and surrounding tissues are completely numb. Patients who tense up expecting pain are often surprised when they feel nothing sharp at all.

Does It Hurt Afterwards?

Some tenderness when biting is normal for 3–7 days after root canal treatment as the surrounding tissues heal. This is managed with over-the-counter pain relief and settles on its own. It is significantly less than the pain that brought the patient to the clinic in the first place.

Severe pain after root canal is not normal and should be reported — it may indicate incomplete treatment, a missed canal, or a fractured root requiring further assessment.

The real choice is not root canal vs no pain — it is root canal vs extraction

When a tooth has an infected nerve, it will not get better on its own. The choice is root canal treatment (saving the tooth) or extraction (removing it). An extracted tooth then needs replacement — usually an implant or bridge — at considerably greater cost and complexity. Root canal treatment, followed by a protective crown, gives the tooth a chance to last decades.

How Many Appointments Does It Take?

Most root canal cases at Smile Hub Clinics are completed in 1–2 appointments. Single-rooted teeth (incisors, canines) are often completed in one visit. Multi-rooted teeth (molars) with complex canal anatomy may require two appointments. After completion, a crown is recommended to protect the tooth — this is a separate restorative phase.

What If I Am Very Anxious?

Dental anxiety around root canal is extremely common and completely understandable given the procedure's reputation. At Smile Hub Clinics we handle anxious patients regularly. The key approaches are:

Thorough anaesthesia — we do not begin until the area is fully numb. Clear communication — you are told exactly what each step involves before it happens. Signals — you can raise your hand at any time to pause and we will stop immediately. No rushing — there is no pressure to proceed faster than you are comfortable with.

For patients with severe dental phobia, we can discuss additional options at consultation.

Do I Need a Crown After Root Canal?

For back teeth — yes, almost always. Root canal-treated teeth become more brittle over time and are at high risk of fracture under chewing forces without the protection of a crown. A fractured root-treated tooth is often unrestorable and requires extraction — defeating the entire purpose of the root canal. The crown is not optional for molars and premolars — it is essential.

For front teeth with adequate remaining structure, a crown may sometimes be avoided, but this is assessed case by case.

Frequently Asked Questions

Is root canal treatment painful?
No — root canal treatment performed under adequate local anaesthesia should be painless. You will feel pressure and vibration but not pain. The procedure has an undeserved reputation based on outdated experience. Modern root canal treatment with a qualified endodontist is no more painful than a routine filling.
How long does root canal treatment take?
A single-rooted front tooth root canal typically takes 60–90 minutes in one appointment. A multi-rooted molar may take 90 minutes over two appointments. Treatment time depends on the number of canals, the complexity of canal anatomy, and whether the tooth has active infection.
What happens if I don't get root canal treatment?
An infected tooth will not heal without treatment. The infection typically spreads to the surrounding bone, causing an abscess. This can progress to facial swelling, become medically serious, and ultimately result in tooth loss. Delaying root canal treatment almost always leads to a worse outcome — either a more complex treatment or extraction.
Can a root canal fail?
Root canals have a high success rate — approximately 85–95% over 10 years when performed correctly and protected with a crown. Failures can occur due to missed canals, reinfection, root fracture, or insufficient coronal seal. Failed root canals can sometimes be retreated (root canal redone) or treated with apical surgery.
Why choose an FCPS endodontist for root canal?
An FCPS endodontist has completed 3–4 years of specialist postgraduate training specifically in root canal treatment. They are more experienced with complex multi-rooted teeth, curved canals, calcified canals, and retreatment cases. For difficult cases, a specialist endodontist achieves significantly better outcomes than a general dentist performing the same procedure.
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Dr. Abdullah Karamat — BDS, FCPS, Certified Implantologist & Aligners Provider

Prosthodontist and co-founder of Smile Hub Clinics, Johar Town, Lahore. Assistant Professor of Dentistry. Dr. Abdullah writes to help patients understand their dental options clearly so they can make informed decisions without pressure.

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