Do they put you to sleep for a root canal?

Are you asleep during a root canal?

Cleveland Clinic lists numbing the area with anesthesia as the first step of a root canal and describes you feeling pressure during treatment, which tells us you are awake. It does not mention general anesthesia. The American Association of Endodontists says local anesthesia numbs the tooth and the area around it, that you may feel pressure or movement, but that you should not feel pain, and that most patients report being comfortable during the procedure. Its page does not mention sedation at all.

What does the numbing actually do?

The endodontists' page explains that numbness works by temporarily blocking nerve signals. You may still sense touch, vibration or movement, but sharp pain should not occur. If you do feel pain, tell the dentist, because more anesthetic can be given. Cleveland Clinic says root canals are usually no more painful than getting a filling. Our guide on whether a root canal is painless covers the pain question in more detail.

Can they sedate you for a root canal?

Yes, if you are nervous. Cleveland Clinic's root canal page says you may be given medication to help you relax and may be drowsy afterwards. Its sedation dentistry page sets out the options: nitrous oxide (laughing gas) breathed through a mask or nosepiece, oral sedation as a prescription pill taken about an hour beforehand, and IV sedation through a line in the arm, the deepest sedation available in a dental office. People who need it include those with significant dental anxiety, a sensitive gag reflex, claustrophobia, or long treatments.

Will you fall asleep with sedation?

Cleveland Clinic says sedation dentistry generally keeps you awake and able to respond, and you should not feel pain. With oral or IV sedation you may fall asleep, and your dentist will wake you if needed. With IV sedation you usually will not remember the procedure afterwards. That is the closest most people get to being put to sleep, and it is not the same as general anesthesia.

What about general anesthesia?

Cleveland Clinic says general anesthesia for dentistry is given by an anesthesiologist in a hospital or ambulatory surgery center so that a dentist can treat you, and that dentists who use it need advanced specialized training. Neither of the root canal pages we read says when it would be used for a root canal. Whether it is appropriate, for example for a young child or a person who cannot stay still, is a question for your dentist.

Who gives the sedation?

Cleveland Clinic says nitrous oxide and oral sedation are given by your dentist, and IV sedation by an oral surgeon if you are seeing one, otherwise a dental anesthesiologist while your dentist does the procedure. Not every practice offers every option, so ask when you book. You may need to review your medications beforehand, possibly stop some, and fast for several hours.

Can you work after a root canal?

Neither of the root canal pages we read says when you can return to work or normal activities. Cleveland Clinic says most people recover in under a week, that the procedure takes about 60 to 90 minutes and sometimes more than one visit, and that you can rest briefly in the office afterwards. The endodontists say mild soreness or tenderness for about three to five days is typical. With sedation the picture changes: Cleveland Clinic says nitrous oxide recovery takes 15 to 30 minutes and you can drive afterwards, while oral or IV sedation means arranging a lift and not driving for 24 hours, with recovery within about 24 hours.

So whether you can go straight back to work depends on the sedation you chose and your own recovery, and we cannot give a general answer from these sources. Ask your dentist, and plan the rest of the day off if you are having oral or IV sedation.

Aftercare in the first days

Cleveland Clinic recommends soft foods for a few days and avoiding biting on the treated tooth until the permanent crown is placed, and the endodontists give the same advice until a crown or permanent filling is in place. The endodontists say over-the-counter pain relief is often enough and a cold compress on the outside of the cheek can help with swelling. Our guides on eating and drinking after a root canal cover the practical details.

Questions to ask your dentist

Take these to your appointment.

• Will I have local anesthetic only, or is sedation an option?
• If I am sedated, will I need someone to take me home?
• How long will I stay numb, and when can I eat?
• Can I go to work afterwards?
• Who will place the crown, and when?

Frequently asked questions