Prior to placing the rubber dam and beginning treatment, try saying:
"There is a possibility that one or more of your teeth may be infected, and if that infection spreads to the centre of your tooth, I'd like your permission to treat the infection before it spreads into the bone."
Using words like "infection" and "bone" helps the patient understand the seriousness but also the control you offer.
Avoid saying: "This won't hurt."
If it does hurt, you'll lose trust. Instead:
"I know how you feel. Your comfort is my first concern."
"We have a name for people like you - normal."
"If I promise not to hurt you, what else would you like to know?"
This simple, direct question helps the anxious patient relax, shows you care, and invites them to participate in the conversation.
"I know you're not feeling it now, but that tooth is hurting you. The infection is eating away at the bone, and eventually the spreading infection will cause pain — usually at the most inconvenient time."
This phrasing helps the patient grasp that "no pain now" doesn't mean "no problem now."
For patients who ask why root canal therapy is needed when they have no visible cavity:
"We don't always know exactly which event broke the camel's back, but the nerve inside the tooth has been irritated over time — maybe a deep cavity, perhaps a large filling, or heavy chewing habits — and now this tooth needs therapy."
Be clear and upfront:
"Root canal therapy takes care of the pain and infection, but it also hollows out the tooth, leaving what's left vulnerable to splitting. Because this is a back tooth with a lot of biting force, we'll need to protect it with a crown or cap. Without that, even a successful root canal might still result in tooth loss."
When asked how long the treated tooth will last:
"Generally speaking, once your tooth is properly restored, it will last longer than a new car or a trip to Hawaii."
"After your tooth is properly restored, it will be as healthy as any other tooth in your mouth."
Also explain that a very small percentage of patients may have a "reaction" to the treatment — framed as a normal body response, not the dentist doing something wrong.
"I'm going to place a protective shield around your tooth to make sure you don't swallow the disinfectants we'll be using. Once this shield is in place you'll be comfortable; you can still breathe through your nose or mouth if you like."
Avoid jargon like "rubber dam" or "clamp" when speaking with patients, especially children. Use terms like "protective shield" or "raincoat for your tooth."
If an instrument separates in the canal:
Pause, sit the patient up, make eye contact.
Then explain:
"Mrs Smith, let me tell you what happened today. Root canals are curved and complex. While we were working, a tip of one of the sterile instruments separated inside the canal."
If you can see it on the image/x-ray, show it to the patient. Don't wait for them to ask or discover it later.
Explain what the plan is: you might say you don't anticipate a problem or that you'll refer to a specialist if needed.
If you perforate the canal:
Explain:
"During the search for the canal we made an extra opening in the tooth. I've repaired it (or we'll need to monitor it/consult a specialist). Because of this, the long-term outlook is more guarded."
Informing the patient doesn't eliminate risk of litigation, but good communication helps build trust, reduces surprises, and supports professionalism.
Here's a helpful video you can share (or embed) to help patients visualise what a root canal is and why it's needed:
This animation demonstrates the process simply and clearly. It can be a great tool to support your conversation.
Additionally you might use:
Using visuals helps patient understanding, reduces anxiety, and supports informed decision‑making.