Root canal treatment
Key points about root canal treatment
- A root canal is a procedure to remove infected soft tissue from inside your tooth to stop the infection spreading.
- It aims to save your tooth, so that it doesn’t have to be removed completely.
- Your dentist will numb the area first, so a root canal shouldn’t feel painful.
What is root canal treatment?
Root canal treatment is a procedure to remove infected soft tissue (pulp) from inside your tooth to save it from extraction.
Inside your tooth, there are the following:
- Pulp: soft tissue deep inside your tooth that contains nerves and blood vessels.
- Tooth roots: these anchor your teeth to your jawbone (similar to roots of a tree).
- Root canals: small passages within the root which contains the pulp.
A root canal procedure involves:
- removal of the infected pulp
- cleaning the inside of your tooth
- filling the cleaned canal space
- sealing the tooth to prevent infection
- restoring the tooth with a crown or filling
Your tooth can survive without the pulp as the tissues around it can nourish it.
Root canal treatment is also called endodontics or endodontic treatment. An endodontist is a dentist who specialises in root canal treatment.
Root canal treatment is available privately and with the NHS. Root canal treatment cost will depend on things like:
- which tooth needs repairing
- if you need a crown which will be a separate charge
Root canal treatment may be needed when a nerve is exposed through tooth decay or when the nerve becomes painful.
During the procedure, the inside of the tooth is cleaned out right down into the roots. This is often carried out by a dentist who specialises in root canal treatment.
Many patients are frightened by the term "root canal treatment" because they imagine it is going to be very painful. However, if the dentist performing the treatment ensures the area is completely numb, there is no reason to be afraid of it.
Why is root canal needed?
You might need root canal treatment if the pulp inside your tooth becomes infected. This could happen if you have:
- Severe tooth decay: deep cavities can lead to bacteria infecting the dental pulp.
- A cracked tooth: physical damage can create openings in your tooth enamel, allowing bacteria to easily enter and contaminate the pulp.
- A broken crown: problems with crowns can cause injury to the nerve of the tooth, causing it to become inflamed and die.
- Cracked or loose fillings: bacteria can get under a filling and cause decay.
- Gum disease: inflamed pulp may lead to permanent nerve damage, requiring root canal treatment. In some cases, infection from a dead nerve can contribute to localised gum disease.
- Repeated dental procedures: having many repeated dental procedures such as fillings can damage dental pulp.
- Injury to your teeth: a direct blow to the mouth or other trauma can damage the tooth's internal blood supply and nerves, even if there are no visible cracks. This can lead to the pulp dying.
- One tooth much darker than the others: which is a sign the nerve inside is dead or dying.
- A tooth that has undergone extensive orthodontic movement.
It’s important to get help from a dentist if you have a tooth infection, because it won’t heal on its own. If left untreated, an infection could spread and cause a painful abscess to develop.
The root canal procedure: a step-by-step guide
Most root canal procedures take one or two appointments to complete, but this can vary. Here’s what you can expect during the treatment:
Anaesthesia and isolation: Your dental professional will begin by injecting a local anaesthetic into the area around the affected tooth. Once it’s numb, they’ll place a thin rubber sheet called a dental dam inside your mouth. This isolates the tooth being worked on to protect it from saliva. It also stops you swallowing any chemicals used to disinfect the tooth.
Accessing the pulp: A small opening is carefully made in the top surface of your tooth using a dental drill. This provides access to the infected or inflamed dental pulp chamber and the root canals.
Cleaning and shaping: The empty spaces within the root canals are meticulously cleaned, disinfected with a special liquid solution, and shaped. This process ensures all bacteria and debris are flushed out and prepares the canals for filling.
Sealing: The cleaned and shaped root canals are then filled with a biocompatible, rubber-like material called gutta-percha and sealed with an adhesive cement to prevent re-infection.
Temporary or permanent filling: Your dentist will put in a temporary or permanent filling. A temporary filling will protect your tooth until your next visit where it will be replaced with a permanent filling or crown.
Final restoration: If you had a temporary filling, it will be removed at a follow-up appointment. The tooth is checked to ensure no infection remains. You’ll then have a permanent filling or crown fitted to restore the tooth.
How to prepare for root canal treatment
Preparing for a root canal treatment primarily involves a thorough consultation with your dental professional. They will ensure you are well-informed and comfortable before your procedure. Here's what typically happens and what you might consider:
Initial examination: your dentist will conduct a comprehensive examination of your mouth, discuss your symptoms, and review your medical history. They will also take X-rays of your tooth to see if the tooth is healthy enough to be treated and that a root canal is the best treatment.
Discussing your provider: root canal treatment is commonly performed by a general dentist. However, if your case is particularly complex or presents unique challenges, your dentist might refer you to an endodontist, who is a specialist in root canal procedures.
Managing anxiety: if you feel nervous about the treatment, let your dental team know as they can take measures that help you feel more at ease, including reassurance techniques and, if appropriate, various sedation options.
Medication review: your dentist will want to know what medications you’re taking, especially blood thinners or those for other medical conditions, as adjustments may be needed.
Eating before your appointment: you can usually eat normally before a root canal. But if you have sedation, you may need to stop eating some time before the procedure. Make sure to ask your dental professional if you need to stop eating and when.
Transportation: arrange for someone to take you to and from your appointment beforehand if you have sedation, which can affect your ability to drive.
Is root canal treatment painful?
Getting a root canal shouldn’t hurt. Your dentist will use local anaesthetic to numb the area to stop you feeling pain. The treatment's main purpose is actually to relieve the severe pain and discomfort caused by the initial infection, not to create it. Any mild tenderness or sensitivity after the anaesthetic wears off can typically be managed with over-the-counter pain relief.
Root canal treatment cost
Root canal treatment is available privately and on the NHS. The cost of treatment will vary depending on your individual needs. Your dentist will be able to give you a breakdown of costs once they’ve assessed exactly what treatment you need.
Spread the cost of your treatment
Patient finance is available for treatments that cost between £250 and £50,000 at 0% APR** when you choose a repayment term of between 3 months and 36 months (subject to the amount of credit), this means that you can spread your treatment cost over a term that suits you, and you don’t pay back any more than you would pay otherwise.
Once you have agreed your treatment plan with your dentist, you’ll have the option to apply.
Terms and conditions apply. Learn more about patient finance.
What to expect after your root canal treatment?
Recovery
You'll typically be able to go home straight after a root canal treatment and can often return to your usual routine. It usually takes 2 to 4 hours for the anaesthesia to wear off. While most patients experience a smooth recovery, your tooth might feel sensitive or slightly swollen for a few days following the procedure.
Post-op care
Proper care after your root canal treatment is crucial for a comfortable recovery and long-term success. Here is how to avoid any unwanted effects of the root canal treatment:
Numbness: It's best not to eat until your mouth no longer feels numb to avoid accidentally biting your cheek or tongue.
Pain management: To help manage any mild discomfort, you can take over-the-counter painkillers like ibuprofen or paracetamol as needed.
Diet: Stick to soft foods such as soups, smoothies, and yoghurt for the first few days and avoid hard or sticky foods until the tooth has been fully restored with a permanent filling or crown. Chew on the other side of the treated tooth.
Risks and complications
Most root canal procedures are successful with excellent long-term outcomes. However, as with any medical procedure, there can sometimes be potential, albeit rare, complications:
Persistent infection: If some bacteria are inadvertently left behind, or your tooth isn't sealed back up properly, the infection might return, potentially requiring another root canal or further treatment.
Damage to surrounding tissue: In very rare instances, the tissues or nerves near your tooth could experience temporary or permanent damage during the procedure.
Tooth removal: If the tooth is severely damaged or the root canal treatment isn't successful in resolving the infection, your dentist might, as a last resort, need to remove your tooth completely to prevent infection from spreading. If this occurs, replacement options for the missing tooth will be discussed.
Benefits
Root canal treatment offers significant benefits, primarily saving your natural tooth from extraction. This helps maintain your natural bite, allows you to continue eating the foods you love, and preserves your natural smile. By removing infection, it also alleviates pain and prevents further spread of disease to adjacent teeth and tissues.
What options do I have if I don't want root canal treatment?
The main alternative to a root canal is tooth extraction followed by replacement by an implant or bridge to fill the gap.
Tooth extraction and replacement
Tooth extraction: removing the infected tooth can stop pain and infection. If you have your tooth taken out, this will leave a space.
Dental implants: A dental implant is a small titanium screw that’s placed in your jaw where the root of your old tooth used to be. It acts as a strong base for your dentist to attach a false tooth (crown) on top of.
Bridge: A dental bridge is a false tooth that’s held in place by cementing it to the teeth on either side. It bridges the gap left by a missing tooth.
Dentures: Dentures are removable plastic or metal plates that carry one or multiple false teeth used to fill the gaps left by missing teeth.
Conservative treatment (if root canal is not needed)
Pulp capping: A procedure used if the pulp is not yet infected, your dentist seals the pulp to protect it.
Pulpotomy: Removal of only the infected part of the pulp, leaving the healthy part intact.
Apicectomy: A minor surgical procedure that removes the infected tip of the tooth root, which may be done if root canal alone cannot save your tooth.
Crowns
A dental crown is a tooth-shaped cap that’s placed over your tooth.
Tooth removal
If your tooth is too badly damaged, decayed or infected to be repaired, removing it might be the safest option.
Tooth fillings
A dental filling is used to fill a cavity (a hole that has formed in your teeth) or other damage such as a chipped tooth.
Tooth abscesses
To get rid of a tooth abscess, you need treatment from a dentist as soon as possible.
Other helpful websites
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