Before anyone touches your tooth
The room is set up differently for this kind of work. A microscope on a long arm hangs over the chair, there is often a screen on the wall showing what the lens sees, and the tray carries far more small instruments than a routine appointment does.
Two things usually happen first. Your tooth is tested — cold, tapping, sometimes an electrical pulp test — to confirm what is actually going on inside it. And images are taken. A conventional X-ray is normally enough; where the anatomy looks unusual or a previous treatment has left questions, a 3D X-ray (DVT) gives a proper three-dimensional view of the root. In our practice a DVT costs 178 €, and we tell you beforehand if we think one is needed rather than adding it to a bill afterwards.
Then the plan is explained: how many canals are expected, whether this is likely to be one sitting or two, and what the tooth will need afterwards to be properly rebuilt.
The rubber sheet nobody warns you about
This is the part patients ask about most, and almost nobody is told about in advance. A thin sheet of rubber (Kofferdam) is stretched over a small frame and clipped around the tooth being treated. Only that tooth pokes through. Everything else — tongue, cheeks, the other teeth — is behind the sheet.
It looks alarming and feels strange for about ninety seconds. After that, most people forget it is there, and several find it makes the appointment easier: your tongue has nothing to do, nothing tastes of disinfectant, and no water runs down your throat.
It is also not optional. Root canal treatment is an exercise in keeping bacteria out of a space you have just cleaned, and saliva is full of them. The sheet also means that small instruments and rinsing solutions cannot be swallowed. If you are worried about breathing, say so — you breathe entirely normally through your nose, and a corner can be trimmed away from the sheet if you have a blocked nose or feel claustrophobic.
Getting numb — and what "numb" should feel like
The anaesthetic goes in first, and you should give it time. Properly numb means the tooth and the surrounding gum feel thick and distant; you will still feel touch and pressure, because pressure travels through bone regardless.
Inflamed teeth are sometimes harder to numb than healthy ones — a well-known effect that has nothing to do with your pain threshold and nothing to do with the dentist’s skill. Extra anaesthetic, a different injection technique or a small amount placed directly into the tooth usually solves it. The important part is that you say something. Nobody in the room can tell how numb you are except you, and “I can still feel that” is a completely normal thing to say.
If dental anxiety is the real obstacle rather than the tooth, we offer laughing gas (Lachgas) and sedation. Both let you stay awake and able to respond, but take the edge off the situation.
The long middle: what you actually feel
Once the tooth is opened, the appointment settles into a rhythm that is far less dramatic than most people expect.
Vibration and a high sound. Fine instruments rotate inside the canals, driven by a small motor. The pitch is higher and quieter than a drill on the outside of a tooth.
Water, and the suction taking it away. Canals are rinsed repeatedly with disinfecting solutions. You may notice a faint chlorine-like smell — that is the rinse, working.
Pressure, in short bursts. When the canal is measured or a filling material is compacted, you feel something being pushed. It is pressure, not pain.
Pauses. The dentist stops frequently — to look through the microscope, to take a measurement, to check an image. These gaps are the reason the appointment is longer than a filling, and they are also where the work actually gets done.
What most people notice more than any of this is the atmosphere. Magnified work is slow work. There is no rushing, and there is very little of the hovering-over-your-face proximity that people find unpleasant at the dentist. The dentist is typically a good arm’s length away, upright, looking through the lens.
The magnification itself matters clinically — canals are narrow, curved and often not where the textbook says they are — but that is a separate subject, covered in What are the benefits of dental treatment under a microscope?.
How you say something when you cannot speak
Agree a hand signal before you start: raise your left hand and everything stops. It sounds trivial. In practice it is the single thing that most reduces the sense of helplessness, because you are no longer waiting to be noticed.
A small rubber bite block can be placed between your teeth on the opposite side so that your jaw rests on something rather than holding itself open. Ask for it. Jaw fatigue, not the tooth, is what makes long appointments tiring, and by minute forty a bite block is worth a great deal.
If your German runs out under stress — which is entirely normal in a medical setting, even for people who manage fine at work — the answer is to have the appointment in a language you are comfortable in. We treat patients in English as a matter of routine, and the team also works in German, Russian, Turkish, Ukrainian, Arabic, Kurdish and French. English-Speaking Dentist in NRW explains how that works in practice.
Ending the appointment: two ways it can finish
Sealed and finished. The canals are filled and the tooth is closed. You leave with a permanent or long-term temporary seal on top.
Dressed and continued. A disinfecting dressing is left inside the tooth and a temporary seal placed over it, with a second appointment to come. This is not a sign that something went wrong; for infected teeth it is often the deliberate plan.
Either way, the tooth is not finished until it has been properly rebuilt — frequently with a crown or partial crown on back teeth. How many visits the whole thing takes, and how far apart they sit, is set out in How long does a root canal take?.
The first evening and the days after
Some soreness after root canal treatment is the tissue around the root reacting to being disturbed. That is different from an infection flaring up, and the difference matters — it is set out in detail in Inflammation after a root canal treatment.
Most people go back to work the same day or the next. If you had sedation or laughing gas, you will need someone to take you home and you should not drive.
Often, yes. The microscope can send its image to a screen, and photographs taken during treatment can be shown to you afterwards. Many patients find seeing the inside of their own tooth genuinely reassuring — it turns an abstract procedure into something concrete. Just say you would like to see it.
It should not hurt at all once you are properly numb. What differs is duration, not intensity: you are in the chair considerably longer, and afterwards the tooth is usually tender to bite on for a few days in a way a filling is not. Pain during the appointment is a reason to raise your hand, not something to endure.
Sometimes. A single-canal front tooth with a straightforward diagnosis is often completed in one sitting. Molars with several curved canals, and teeth with an established infection, are more commonly done in two. The decision is clinical, and your dentist should tell you which they expect before starting.
Because a great deal of the time now goes into finding, measuring, disinfecting and checking rather than simply drilling. Magnified, isolated, measured work is slower by design. German dental associations consider thorough cleaning and sealing of the whole canal system the decisive factor in whether a treated tooth survives long term.
Yes, and it is a good idea. Headphones with music or a podcast make a long appointment feel very different, and there is nothing about the treatment that requires you to listen to it. Let the team know so they can get your attention when they need to.
Raise your hand; everything stops. The rubber sheet can be removed in a couple of seconds, the chair can be brought upright, and you can sit for as long as you need. Nothing about this treatment has to be pushed through in one go — and if anxiety is a recurring problem, sedation or laughing gas turns a difficult appointment into a manageable one.
A root canal under a microscope is a long, quiet, technical appointment rather than a dramatic one. The parts people find hardest are rarely the ones they feared: the rubber sheet turns out to be a relief, the jaw gets more tired than the tooth, and the strongest impression is usually how slowly and carefully the work proceeds.
Knowing the sequence in advance takes most of the tension out of it. You lie back, you are isolated and numbed, you feel water and vibration and pressure, you raise your hand whenever you want to stop, and you go home with a lip that will wake up in a couple of hours.
Zahnarztpraxis Tsypin · Wuppertal. This article was medically reviewed and is provided for information; it does not replace an examination. Updated August 2026.
