With a local anaesthetic (an injection that numbs the area), most dental treatment does not hurt while it is being done. You may feel pressure or vibration, but not sharp pain. The procedure that usually hurts most afterwards is surgical removal of a wisdom tooth.
Root canal treatment: less painful than its reputation
Root canal treatment is the procedure people fear most. The dentist removes the infected or dead tissue from inside the tooth, cleans the canals in the root, and seals them.
It is done under local anaesthetic, so you are awake but should not feel pain. Many people say it feels much like having a filling. It can take longer, though. The NHS says treatment usually needs 2 or more appointments of 1 to 2 hours each.
Afterwards, the area may feel sore or swollen. The NHS says this should get better within a couple of weeks. The toothache that leads to a root canal is often much worse than the treatment itself.
What usually hurts most
Surgical wisdom tooth removal. A wisdom tooth that is stuck under the gum or bone (impacted) may need a small operation. The dentist or surgeon cuts the gum and sometimes removes some bone. You will be numb during it. The NHS says the procedure often takes a few minutes and should take no more than 40 minutes.
The recovery is what people remember. For up to 2 weeks, you will usually have some pain and swelling. It should start to get better after 1 or 2 days. Your jaw may be stiff, and chewing may be hard.
Dry socket. This can happen after any tooth is taken out. The blood clot in the empty socket does not form properly or comes away too early. The NHS describes it as painful. If pain gets worse a few days after an extraction instead of better, go back to your dentist. They can clean the socket and put in a dressing.
Deep cleaning for gum disease. This means cleaning the roots of the teeth below the gum line. It is usually done with local anaesthetic. Your gums may be sore and your teeth sensitive for a few days afterwards.
Several extractions at once. Taking out several teeth in one visit means a longer appointment and more sore areas while you heal.
What usually hurts less than people expect
Dental implants. An implant is a small metal post placed in the jawbone to replace a missing tooth. It is done under local anaesthetic. Many people say the recovery was easier than they expected. The median lowest published price for a single implant in London is £2,100. Our guide to dental implant costs in London explains the full cost.
Fillings. A small filling with local anaesthetic is usually quick and painless.
Leaving a problem makes it hurt more
The biggest thing that decides how much treatment hurts is how early you get it. A small cavity is a short appointment with a small filling. The same tooth left for months can become infected and form an abscess (a pocket of pus). Then you may need root canal treatment or an extraction, and you will often be in pain before you get it.
We often hear from people who stayed away from the dentist because they feared pain, and then needed bigger treatment because of the delay. If something hurts, get it checked early. Our emergency dentist page lists practices with urgent appointments in London.
If you are nervous about pain
Tell the practice when you book, and tell the dentist before treatment starts. They can:
- explain each step before they do it
- agree a signal, such as raising your hand, for when you want them to stop
- give extra anaesthetic if you can still feel something
- offer sedation
Sedation helps you feel relaxed during treatment. The most common types are inhalation sedation (a gas you breathe through a nose mask) and IV sedation (a drug given through a vein in your arm). For some surgery, such as difficult wisdom tooth removal, a general anaesthetic (where you are asleep) may be offered in hospital.
On the NHS, if you are very anxious, your dentist may be able to refer you to a service that offers sedation. Privately, the median lowest published price for sedation at London practices is £300. Our sedation dentistry London directory lists practices that offer it.