Nothing to Fear

Root canal therapy, explained properly.

The procedure with the worst reputation in dentistry is the one that stops the pain. Here is what actually happens, and why the tooth is worth keeping.

The short answer

A root canal removes infected or inflamed tissue from inside a tooth, disinfects and seals the space, and keeps the natural tooth in place. It is performed with local anesthetic, usually takes one or two appointments, and relieves the pain of an infected tooth rather than causing pain. Better Health Dental performs root canal treatment at 127 E. Trinity Pl in Decatur, Georgia, and holds same-day slots for patients in acute pain. Call (404) 446-2776.

The reputation is a generation out of date. It was earned in an era of weaker anesthetics and cruder instruments, and it has outlived the facts by about forty years. What has not changed is what happens if an infected tooth is left alone, which is considerably worse than the treatment.

LocalAnesthetic throughout

1–2 visitsTypical course

Same daySlots held for acute pain

Tooth keptRather than extracted

Why would I need a root canal?

Inside every tooth is a chamber containing nerve and blood vessels, called the pulp. When decay reaches it, or a crack lets bacteria in, or trauma damages it, the pulp becomes inflamed and then infected. Pulp tissue is sealed inside a rigid tooth, so it has nowhere to swell, which is why the resulting pain can be severe and why it does not resolve on its own. Left untreated, the infection progresses out of the root tip into the surrounding bone and forms an abscess.

At that point there are exactly two options: remove the infected pulp and keep the tooth, or remove the tooth. Antibiotics can temporarily reduce the swelling but cannot reach the dead tissue inside the tooth to resolve the source, which is why an infection that improves on antibiotics and then returns is such a common story.

Signs a tooth may need endodontic treatment

Persistent, severe toothache, often worse lying down
Lingering pain to heat or cold that continues after the stimulus is gone
Pain on biting or on releasing a bite
A single tooth turning gray or dark, with or without pain
Swelling of the gum or face, or a tender lump near the gumline
A recurring pimple-like spot on the gum that drains and returns
Nothing at all — a dead nerve is often found on a routine radiograph

Facial swelling, fever, or difficulty swallowing is urgent. Call us first thing, and if the swelling is spreading or affecting your breathing or swallowing, go to an emergency room. See emergency dental care.

What happens during a root canal?

The tooth and surrounding tissue are anesthetized until the area is fully numb — this is confirmed before anything begins. The tooth is isolated to keep it clean and dry. A small opening is made in the top of the tooth, the pulp chamber and root canals are cleaned out with fine instruments and disinfecting solutions, the canals are shaped, dried, and then filled with a sealing material so bacteria cannot re-colonize the space. The access opening is closed.

What you feel during this is pressure and the vibration of instruments, not pain. Most patients are surprised by how ordinary it is. A tooth that was acutely painful beforehand usually feels dramatically better the same evening, with some tenderness to biting for a few days as the surrounding ligament settles.

Will I need a crown afterward?

Almost always, for back teeth. A tooth that has had a root canal has lost its blood supply and an access opening has been made through its biting surface, both of which make it more liable to fracture under load. A crown covers the tooth and takes that load. Fracture of an un-crowned root-treated molar is the single most common reason a successful root canal ends in an extraction anyway, which makes the crown part of the treatment rather than an optional extra.

Front teeth with small access openings are sometimes restored with a filling instead. Dr. Walker will tell you which category your tooth falls into and why — see restorative care for how crowns are made.

Is it better to just pull the tooth?

	Root canal and crown	Extraction
Up-front cost	Higher	Lower
Total cost to a restored gap	Usually lower	Higher once an implant or bridge is added
Bone	Root retained, bone maintained	Bone recedes where the root was
Neighboring teeth	Untouched	May drift or tilt; a bridge requires preparing them
Chewing	Normal	Reduced until the gap is restored

Extraction is cheaper on the day and more expensive by the end, once the gap is properly restored. There are real cases where extraction is the right call — a tooth split below the gumline, severe bone loss, a root that cannot be cleaned — and you will be told plainly when yours is one of them. Otherwise, keeping your own tooth is almost always the better outcome.

What should I expect while it heals?

Tenderness to biting for two to four days is normal and responds to over-the-counter anti-inflammatory medication. Eat on the other side until the final restoration is in place, especially if there is a temporary filling. Call us if pain increases rather than decreases after the first couple of days, if swelling develops, or if a temporary filling comes out. Root canal treatment has a high long-term success rate, and the small proportion of cases that do not settle are usually manageable — either by retreatment or by referral to an endodontist.

Questions we are asked most.

Answers from Dr. Sharifa Walker, DDS. If yours is not here, call (404) 446-2776 and ask — the front desk will put the clinical questions in front of her.

Does a root canal hurt?

The procedure itself should not hurt. It is performed with local anesthetic and the area is confirmed fully numb before treatment begins; what you feel is pressure and vibration. The pain people associate with root canals is the pain of the infected tooth that led them to the appointment, and that is what the procedure relieves. Expect tenderness to biting for a few days afterward, manageable with over-the-counter anti-inflammatory medication.

How many appointments does a root canal take?

Most are completed in one or two appointments, depending on which tooth it is, how many canals it has, and whether there is active infection that needs a medicated dressing before the canals are sealed. Front teeth are usually simpler than molars. A crown to protect the tooth follows separately, normally two to three weeks later once the laboratory has made it.

Can antibiotics fix an infected tooth instead?

No. Antibiotics reach infection through the bloodstream, and the dead or dying tissue inside a tooth has no blood supply left for them to travel through. They can reduce swelling and buy time, which is why a course sometimes makes the pain subside, but the source remains and the infection returns. The source has to be removed mechanically, either by a root canal or by extracting the tooth.

How much does a root canal cost in Decatur?

Cost varies with which tooth is involved, since a molar with three or four canals is substantially more work than a single-canal front tooth, and the crown that follows is quoted separately. Most dental benefit plans cover endodontic treatment as a major service, typically at a percentage rather than in full, and an annual maximum may apply. We verify your coverage and give you a written estimate of your share before treatment, and Sunbit and CareCredit financing is available.

How long does a root-treated tooth last?

Root canal treatment has a high long-term success rate, and a properly restored root-treated tooth can last decades — often for the rest of the patient’s life. The two things that shorten it are not getting the crown placed, which leaves the tooth liable to fracture, and new decay at the margin of the restoration. Both are preventable with timely restoration and routine maintenance visits.

My tooth stopped hurting on its own. Am I fine now?

Not necessarily, and this is a pattern worth knowing. Severe toothache that suddenly stops often means the nerve inside the tooth has died, which ends the pain but not the infection — bacteria continue to progress out of the root tip into the bone, frequently with no symptoms until an abscess forms. If a tooth has had significant pain and then gone quiet, have it looked at. Call (404) 446-2776.

Reviewed by Dr. Sharifa Walker, DDS — general dentist and owner of Better Health Dental, 127 E. Trinity Pl, Decatur, Georgia. More than twenty years in practice. Read Dr. Walker’s full background →Last updated October 14, 2026

Around the procedure.

Emergency VisitsAcute pain, swelling, or a broken tooth — same-day slots held every day.Crowns & RestorationThe crown that protects a root-treated tooth, and what else restorative care covers.Preventive CareMost root canals began as a cavity found too late. This is where that is caught.On Dental AnxietyIf fear is what has kept you away, start here rather than with a procedure page.

In pain? Call us first thing.

Call (404) 446-2776