If you’re experiencing tooth pain, swelling, or trauma, you don’t have to wait for relief. At Columbia Smiles, we will assess your pain to determine whether you need a root canal to preserve your natural tooth, eliminate infection, and restore comfort, all with care, precision, and a local touch.
Under the leadership of board-certified Dr. Michael Hsu, our dental team combines advanced diagnostics and relationships with highly esteemed endodontists to ensure compassionate patient care to make your root canal therapy as comfortable and effective as possible.
On this page, you’ll learn:
- What causes a tooth to need a root canal
- What signs and symptoms to watch for
- How we keep patients comfortable and ease dental anxiety
- Exactly what to expect during treatment and recovery
Columbia Smiles serves clients in Columbia, MD, and throughout Howard County.
Why do I need root canal therapy?
What causes a tooth to need root canal therapy? Decay, dental trauma, chips, or cracks to a tooth can all cause damage to the tooth’s nerve tissue or pulp (the soft area inside of a tooth). Infection or inflammation can lead to other issues, such as toothaches and bad breath. It’s important to act quickly if you need root canal therapy. Delaying treatment allows infection to worsen, potentially spreading to adjacent teeth, your jawbone, or even deeper into your system, increasing risks and possibly making treatment more intensive.
Warning signs that you might need a root canal
Below are symptoms to watch for. If you experience any of these, get a professional assessment at Columbia Smiles to see if root canal therapy is needed.
- Severe pain, especially when chewing or biting down: Pain may be sharp or throbbing, sometimes worsening when you apply pressure.
- Long-lasting sensitivity to hot or cold: If hot or cold temperatures cause pain that lingers long after the stimulus is gone, it may be a sign of inflamed or damaged pulp.
- Tooth discoloration or darkening: A tooth that becomes darker than neighboring teeth may indicate pulp necrosis or internal damage.
- Swollen or tender gums: Gum swelling around the tooth, tenderness, or even a boil‐like bump on the gums (an abscess) can be a sign that infection has spread beyond just the tooth.
- Facial swelling: Sometimes the infection causes swelling of the face, jaw, or neck near the affected tooth. This is more serious and should be addressed immediately.
- Chipped, cracked, or fractured teeth: Even if there is no pain yet, damage like this can allow bacteria to enter and infect the pulp.
With root canal therapy, the dental team at Columbia Smiles, and our network of specialists, can often save the tooth, avoid extraction, and prevent spread of infection.
What to expect during root canal therapy
At Columbia Smiles, our goal is to address your need for a root canal and to assure you receive the appropriate care as soon as possible. Below is a detailed walk-through of the treatment process, timing, and what you’ll need to do afterward to support healing.
The Treatment Process
Here’s what happens during a routine root canal treatment:
- Diagnosis & X-rays: An endodontist will begin by taking digital X-rays to locate the full extent of decay or infection. CBCT imaging may be used if needed for complex cases.
- Local anesthesia / numbing: Before any work begins, your endodontist will numb the tooth and surrounding area with local anesthetic. For patients with dental anxiety, we can discuss options to make you more comfortable.
- Isolation & access: The tooth is isolated with a rubber dam to keep it dry and free of saliva. A small opening is made through the crown (top) of the tooth so the endodontist can access the pulp chamber, where infection or inflammation is present.
- Cleaning & shaping the canals: Using specialized small files and antibacterial irrigants, the infected pulp is removed. The inside of the root canals is cleaned, shaped, and disinfected to remove all bacteria and debris.
- Filling & sealing: The canals are dried and filled with a biocompatible material (typically gutta-percha) and sealed with adhesive cement. Any access opening is also filled temporarily or permanently.
- Restoration (crown or filling): For many teeth, especially for molars or those that have lost a lot of structure, we place a crown after the root canal to protect and restore full chewing function. In other cases, a more modest restoration or filling may be sufficient.
- Follow-up care & monitoring: We’ll schedule follow-up visits to ensure healing is going well, manage any post-treatment sensitivity, and finalize the restoration.
How long it takes
For many root canals, treatment takes one to two appointments. Most single-canal or front-tooth root canals take around 60-90 minutes. More complex molars with multiple canals often take longer. If additional treatments are required (like placing medication, temporary restoration, or more extensive imaging), it may require extra time or visits.
How root canal therapy relieves pain
If you’re dealing with persistent toothache, sensitivity, or swelling around a tooth, here’s how root canal therapy helps, and what an endodontist will do to make the process as comfortable as possible.
Anesthesia & pain control during treatment
- Local anesthetic: Before any invasive work begins, your endodontist will numb the area. This blocks the nerves so you won’t feel pain while the procedure is done. Modern anesthetic agents allow root canal treatment to be completed with little to no pain.
- Supplemental techniques: In more challenging cases, the endodontist will use additional techniques or anesthetic delivery methods to ensure full comfort.
- Sedation options: If dental anxiety or past negative experiences make you nervous, the endodontist may offer sedation options to ensure your comfort.
What happens after the procedure
- Immediate relief: Many patients report that the sharp or throbbing pain they had due to infection or inflammation subsides right after the root canal treatment. Removing the infected tissue and sealing the tooth prevents further irritation and spread of infection.
- Mild post-treatment discomfort: It’s normal to experience some soreness or mild sensitivity in the days following treatment while the area heals. This tends to be manageable with over-the-counter pain medications and rest. The endodontist we refer you to will give you instructions for care during this period.
- Recovery support: We’ll check in with you, monitor your healing, and make sure any discomfort is not a sign of complications. Good oral hygiene, avoiding chewing on the treated tooth until fully restored, and following aftercare guidelines all help.
Addressing fear & anxiety
We realize that worry about pain is one of the biggest obstacles for many people. At Columbia Smiles, we communicate clearly about what to expect from your endodontist and how they will assist you before, during, and after your root canal.
Relaxation techniques, distractions like music, and pauses during the procedure are part of the endodontist’s approach.
Will I need another root canal?
Most of the time, a single root canal done correctly and followed by good care will successfully resolve the infection and protect your tooth for many years. But in some cases, a previously treated tooth may require retreatment. Here are common reasons a root canal may need to be redone:
- Missed canals or complex anatomy: Some teeth have extra tiny root canals, curved or narrow roots, or unusual anatomy. If a canal is missed or not cleaned fully, bacteria can remain and lead to reinfection.
- Poor sealing or breakdown of restoration: If a crown, filling, or temporary restoration leaks, becomes cracked, or wasn’t placed soon enough, saliva and bacteria can seep in and reinfect the canal.
- New decay or damage: Even after a root canal, new tooth decay, fractures, or trauma (e.g. biting on something hard) can compromise the treated tooth and cause pain or infection again.
- Delayed restoration: Waiting a long time to place a crown or permanent restoration after treatment creates risk, because the treated tooth remains more vulnerable without proper protection.
- Reinfection: Bacterial contamination can occur if the seal fails over time, or if previously clean canals become re-infected via microleakage, cracks, or from adjacent areas.
What signs suggest you might need retreatment
If any of the following occur, you should contact us right away so we can evaluate:
- Pain or sensitivity returns in that tooth, especially when biting or to hot/cold
- Swelling or tenderness around the gums of the treated tooth
- A darkening or discoloration of the tooth
- A loose, damaged, or broken crown/filling over the treated tooth
- Persistent abscess, drainage, or sinus tract near the tooth
- New symptoms even if the previous treatment seemed successful initially
Ready to get relief with a root canal in Columbia, MD?
Don’t let tooth pain or infection interfere with your daily life. If you suspect you need a root canal, Columbia Smiles is here to help you every step of the way. Our warm, experienced team led by Dr. Michael Hsu is dedicated to restoring your smile with precision, comfort, and compassion.
Call us at 410-690-4855 to schedule your root canal consultation. You can also use our contact form to get started. We are located at 10630 Little Patuxent Parkway, Suite 104, Columbia, MD 21044. We proudly serve residents in Columbia, Wilde Lake, Kings Contrivance, Hickory Ridge, Long Reach, Oakland Mills, and across Howard County.
Take that first step toward relief: a healthy, pain-free smile is closer than you think.