Root canal

A root canal is a procedure to remove an infection from deep inside your tooth. It aims to save your tooth, so it doesn’t have to be removed completely. Your dentist will numb the area first, so a root canal shouldn’t feel painful.

About root canal treatment

Root canal treatment gets its name from the part of your tooth that’s being treated. Deep inside your tooth lives a soft tissue known as pulp. Pulp contains nerves and blood vessels that run all the way down through the roots of your teeth. Your tooth roots anchor your teeth to your jawbone – much like the way the roots of a tree hold it in the ground. Even further inside your tooth roots, are small passages called root canals.

If your tooth becomes badly damaged or infected, bacteria can spread to the pulp inside it. Root canal treatment aims to stop the infection getting worse and save your tooth. To do this, your dentist will clean any bacteria from inside your root canal, before filling and sealing it back up again. After the procedure, your tooth might be restored with a filling or crown to protect it.

You might sometimes hear root canal treatment referred to as endodontics or endodontic treatment. This is because an endodontist is a dentist who specialises in root canals.

Root canal treatment is available privately and with the NHS. Root canal treatment cost will depend on things like which tooth needs repairing, and whether or not you also need a crown. Your dentist will explain the full cost to you before you go ahead with any treatment.

When 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
• a cracked tooth
• a broken crown
• cracked or loose fillings
• Gum disease
• repeated dental procedures
• an injury to your teeth, like being hit in the mouth
• 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

Preparing for root canal treatment

Root canal treatment is usually carried out by a dentist. But if your treatment is complex, they might refer you to an endodontist instead. This is a dentist who specialises in root canal treatment. If you feel very nervous about having root canal treatment, let your dentist or endodontist know. They’ll do everything they can to reassure you, and can sometimes offer sedation to help you relax.

Before you have root canal treatment, your dentist or endodontist will do a thorough examination of your mouth, ask you about your symptoms and medical history. They’ll also take x-rays of your tooth to check how far the infection has spread and make sure your tooth isn’t so badly damaged that a root canal wouldn’t work.

The procedure

Most root canal procedures take one or two appointments to complete.

Your first appointment

Your dentist or endodontist will start by injecting a local anaesthetic into the area, so a root canal may be uncomfortable but shouldn’t be painful. Once it’s numb, they’ll place a thin rubber sheet called a dental dam inside your mouth. This covers everything except the tooth being worked on and helps to keep the area around your tooth dry and clean.

Then, they’ll make a small hole in the top of your tooth using a drill and remove the pulp. They’ll clean the empty space using small tools, use a liquid to disinfect the inside of your tooth, and make sure all the infected material is flushed out.

Once your canals are clean, your dentist will put in a soft, temporary filling to seal your tooth again.

Your second appointment

At your next appointment, your dentist or endodontist will remove your temporary filling and check that all the infection is gone. Then they’ll fill your root canal with a permanent filling. If your tooth is badly worn or at risk of further damage, your dentist may suggest you come back again to have a crown fitted. This is an artificial cap that fits over your tooth to protect and strengthen it.

How long does it take to recover from a root canal?

You’ll be able to go home straight after a root canal treatment and get back to your usual routine if you want to. It usually takes 2-4 hours for the anaesthesia to wear off, so it’s best not to eat until your mouth doesn’t feel numb anymore.

Your teeth might feel sensitive or swollen for a few days after the procedure. To help:

• Take over-the-counter painkillers like ibuprofen or paracetamol.
• Eat soft foods like soups, smoothies and yoghurt.
• Avoid hard foods and chewing with the tooth that’s been treated.

Complications of root canal treatment

Most root canal procedures are successful, but as with any procedure, there can sometimes be complications, like:.

• Infection. If some of the bacteria is left behind, or your tooth isn't sealed back up properly, the infection might come back and you may need to have another root canal.
• Damage to the surrounding tissue. Sometimes, the tissues and nerves near your tooth can get damaged during the procedure, but this is rare.
• • Removing your tooth. If your tooth is very badly damaged and the root canal doesn’t work, your dentist might need to remove your tooth completely to stop the infection from spreading. If this happens, they’ll discuss ways to replace your tooth with an artificial one.

Alternatives to root canal treatment

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. If you’re worried about having root canal treatment, let your dentist know so they can help put your mind at ease. They’ll also numb the area with a local anaesthetic, so a root canal should feel similar to having a routine filling.

Your dentist will always try and save your natural tooth where they can, but if your tooth is very badly damaged and can’t be saved, you might need to have it removed completely. If you do need to have your tooth taken out, your dentist will explain all the ways they can replace your tooth with an artificial one.