Let's get this out of the way: a root canal doesn't hurt. The infection that made you need one — that's what hurts. The root canal is what stops it.
If you've been told you need a root canal, or if you're living with a deep, throbbing toothache and hoping it goes away on its own, here's the truth: it won't. But the treatment is straightforward, effective, and far more comfortable than most patients expect. At PureSmile Miami in Kendall, we perform root canals with modern technology and a gentle approach that changes how patients think about this procedure.
Inside every tooth, beneath the hard enamel and dentin, there's a soft tissue called the pulp. The pulp contains nerves, blood vessels, and connective tissue. When bacteria reach the pulp — through a deep cavity, a crack in the tooth, or repeated dental work — the pulp becomes infected and inflamed.
That infection is the source of your pain. Left untreated, it forms an abscess at the root tip — a pocket of pus that can destroy the bone around your tooth and spread to your jaw, your sinuses, or worse. A root canal removes the infected pulp, cleans and disinfects the inside of the tooth, and seals it. Your tooth stays in your mouth, fully functional, pain-free.
You might need a root canal if you have:
Severe, lingering pain when you eat or drink something hot or cold — not the brief sensitivity that everyone gets, but pain that stays for minutes after the stimulus is gone. Spontaneous pain that comes out of nowhere, especially at night. A darkening tooth — when a tooth turns grey or dark compared to its neighbors, the nerve inside may be dying. Swelling or a pimple on your gums near a specific tooth. Pain when you press on a tooth or bite down on that side.
Knowing exactly what happens removes the fear. Here's the honest walkthrough:
Step 1 — Anesthesia. We numb the tooth and surrounding area completely. You should feel zero pain during the procedure. If you feel anything at any point, we stop and add more anesthesia. We don't proceed until you're fully comfortable. For anxious patients, we can discuss additional comfort options before starting.
Step 2 — Isolation. We place a small rubber dam around the tooth. This keeps the area dry and clean, prevents bacteria from your saliva from entering the tooth, and keeps the tiny instruments we use from falling toward the back of your throat. It sounds uncomfortable but most patients forget it's there within minutes.
Step 3 — Access and cleaning. We create a small opening in the top of the tooth to reach the pulp chamber. Using specialized instruments and an irrigation solution, we carefully remove the infected pulp tissue and shape the canals inside the root. This is the part that sounds dramatic but actually takes about 30 to 45 minutes and feels like nothing more than light pressure.
Step 4 — Filling and sealing. Once the canals are clean and shaped, we fill them with a biocompatible material called gutta-percha and seal the access opening. This prevents bacteria from re-entering the tooth.
Step 5 — Restoration. In most cases, a tooth that's had a root canal needs a crown to protect it from fracturing. We'll take impressions or digital scans for a custom crown that matches your natural teeth. A temporary restoration protects the tooth until your permanent crown is ready.
This is the question everyone asks, so let's address it directly.
Modern root canal treatment, with proper anesthesia, is comparable to getting a filling. The American Association of Endodontists reports that patients who have had root canals are six times more likely to describe the experience as "painless" than patients who haven't had one yet. The fear is worse than the reality.
What about after? You may have some tenderness for a few days — your body is healing from the infection, and the area around the tooth was inflamed. Over-the-counter ibuprofen manages this effectively for most patients. The severe, throbbing pain that brought you to us? That's gone immediately.
The real pain comparison isn't "root canal vs. nothing." It's "root canal vs. letting the infection get worse." An untreated tooth infection causes escalating pain, potential hospitalization, and eventual tooth loss. The root canal ends all of that in one visit.
Some patients ask us to "just pull it." We understand the impulse — it seems simpler. But here's what happens when you lose a tooth:
The teeth next to the gap shift over time, changing your bite. The bone where the tooth was starts to dissolve (resorption) because it's no longer stimulated by a root. Your options for replacement — implant, bridge, or partial denture — all cost significantly more than a root canal with a crown. And none of them are as good as your natural tooth.
A root canal with a crown can last a lifetime with proper care. It's your tooth, in your mouth, doing its job. From a cost perspective, a treatment perspective, and a long-term health perspective, saving the tooth is almost always the better choice.
How long does a root canal take?
Most root canals take 60 to 90 minutes in a single visit. Some cases — particularly molars with multiple canals or complex anatomy — may require two visits. We'll tell you what to expect before we start so you can plan your day accordingly.
How much does a root canal cost?
Cost varies depending on which tooth is involved (front teeth are simpler; molars are more complex) and whether you need a crown afterward (most patients do). If you have insurance, root canals are typically covered as a major procedure with your plan's copay. Medicaid covers root canals when they're deemed medically necessary. We'll give you a complete cost breakdown before any treatment begins.
Does Medicaid cover root canals?
Yes, Florida Medicaid covers root canals when medically necessary — particularly for front teeth and premolars. Coverage for molars may depend on the specifics of your plan. PureSmile Miami is a Medicaid provider, and we'll verify your coverage and explain your options before starting treatment. Our goal is that cost never prevents you from saving a tooth.
Can I go back to work after a root canal?
Most patients return to work or normal activities the same day. You'll be numb for a few hours after the procedure, so avoid eating on that side until the numbness wears off. The tenderness is typically mild enough that ibuprofen handles it. If your job involves heavy physical labor, you might prefer to take the rest of the day easy.
What happens if I don't get a root canal when I need one?
The infection doesn't resolve on its own. It will worsen — more pain, more swelling, potential abscess rupture, spread of infection to surrounding tissues. In severe cases, untreated dental infections require emergency hospitalization. What starts as a root canal need can become an extraction need, then an implant need, multiplying both the cost and the complexity at every stage.
Is the office bilingual?
Fully. Every team member speaks English and Spanish fluently. From the initial phone call to the post-treatment instructions, you'll be understood in whichever language you prefer. For a procedure like a root canal where understanding each step reduces anxiety, this matters.
PureSmile Miami is opening soon in Kendall with experienced, gentle care for patients who need root canal treatment. We'll tell you exactly what's happening, what your options are, and what it will cost — before anything starts.
We'll accept Medicaid, PPO, Medicare Advantage, and cash. Bilingual team.
