Root canal treatment, which most people simply call a root canal, has a bad reputation in dentistry that it doesn't deserve. Today, with modern anesthesia, most patients say it feels a lot like getting a large filling. What really hurts is the toothache that brings you in.
PureSmile Miami opens November 1, 2026 in Kendall. We will offer root canal treatment with digital imaging for diagnosis, a clear explanation of what's happening inside the tooth and a fixed price in writing before we start.
Inside every tooth there is soft tissue, the pulp, with nerves and blood vessels. When deep decay, a crack or a blow lets bacteria in, that pulp becomes infected or dies. That's what causes the intense pain, the sensitivity to heat that doesn't go away, and sometimes swelling.
A root canal consists of removing that infected pulp, cleaning and disinfecting the canals inside, and sealing them. The tooth no longer has a nerve, but it is preserved: it still works for chewing and still supports the bone.
When the nerve is affected there are two paths: a root canal or an extraction. It's worth understanding the real difference.
Extracting is cheaper at the time, but it leaves a gap. That gap causes the bone to resorb, the neighboring teeth to tip and your bite to change over time. And if you later want to close it properly, an implant costs considerably more than the root canal that would have prevented the problem.
When it's technically possible, saving your own tooth is usually the preferred option. No replacement works exactly like your natural tooth.
Severe pain when chewing or pressing on the tooth. Sensitivity to heat or cold that keeps hurting after the stimulus is removed. A tooth that has darkened. Swelling or tenderness in the nearby gum. A small bump or fistula on the gum near the root. Sometimes, especially if the nerve has already died, there is no pain and it's found on a routine X-ray.
1. Diagnosis. X-rays and vitality tests to confirm that the nerve is affected and to see the anatomy of the canals.
2. Anesthesia. The area is fully numbed. If the tooth is very inflamed, extra anesthetic is sometimes needed, and that's no problem. The aim is for you not to feel pain during the treatment.
3. Access and cleaning. The tooth is opened from the top, the infected pulp is removed, and the canals are cleaned and shaped with fine instruments and disinfectant.
4. Sealing. The canals are filled with a biocompatible material that keeps bacteria from getting back in.
5. Restoration. The tooth becomes more fragile, so it almost always needs a crown to keep it from fracturing. This is important and many people skip it: a root canal without a crown often ends in a fracture and an extraction.
It's normal to feel mild discomfort or tenderness when biting for a few days, especially if there was an infection. It's managed with over-the-counter pain relievers. It's best to chew on the other side until the permanent crown is placed. If you have severe pain, swelling or your bite feels high, come back so we can check it.
Does a root canal hurt?
The treatment is done under local anesthesia, so you shouldn't feel pain during it. What hurts is the infection beforehand. Many patients find it easier than they expected.
How many visits does it take?
Many cases are completed in one or two visits, depending on the tooth and whether there is an active infection. Molars have more canals and take longer.
Does my Medicare Advantage plan cover root canals?
Many Medicare Advantage plans come with a dental benefit that can cover part of the root canal and the crown that follows, and PPO plans often cover a portion as well. It varies from plan to plan. We verify yours for free and tell you clearly what is and isn't covered before your appointment, with the price in writing. And keep in mind: in most plans the dental benefit renews every year and whatever you don't use is lost.
Do I really need a crown afterwards?
For molars and premolars, almost always. The tooth loses structure and becomes fragile. The crown is what keeps it from cracking and keeps you from losing it anyway.
How long does a tooth with a root canal last?
Done well and properly restored with a crown, it can last for decades or even a lifetime.
