Nervous about root canal treatment? How we make it manageable

If the words “root canal” make your stomach tighten, you are in good company. Most of the dread, though, comes from stories about treatment decades ago, not from what happens today. Here is how we approach it — and what you can ask for.

What the appointment actually feels like

With the tooth properly numb, root canal treatment feels like a long filling: pressure, vibration and the sound of instruments, but not pain. We test the anaesthetic before we begin, and if any sensation breaks through we stop and add more. A rubber sheet isolates the tooth, so you can swallow normally and nothing is in your mouth that should not be.

Tell us before you arrive

Letting us know you are anxious when you book changes how the appointment is planned. We allow more time, explain each step before it happens and agree a signal — a raised hand is enough — that means stop. You will never be rushed, and you can take a break whenever you need one.

Things that help

• Eat something beforehand; low blood sugar makes anxiety worse.
• Bring headphones and music or a podcast if that helps you switch off.
• Ask as many questions as you like at the assessment — knowing what will happen removes much of the fear.
• Bring someone with you if it helps; they can wait nearby.
• Avoid caffeine on the day if it makes you jittery.

Sedation

For patients whose anxiety is severe, sedation can be discussed after the assessment. The options and whether they are suitable depend on your medical history and the treatment planned; nothing is decided without talking it through properly. Angel Ognemirov has undertaken training in oral and intravenous dental sedation at Guy’s Hospital, London.

Why acting is kinder than waiting

Anxiety tends to delay treatment, and delay tends to turn a simple root canal into an emergency, with more pain and less tooth to save. The first visit is an assessment only — nothing is done to the tooth that day unless you are in pain and choose to go ahead. It is a low-pressure way to find out exactly what you are dealing with.