Endodontics - Root Canal Treatment

Root canal treatment (also called endodontic treatment) is the process where a dentist removes the pulp (the blood and nerve supply) from an infected or dying tooth and replaces it with dental filling material.
Why would I need root canal treatment?
The pulp of your tooth can become infected when decay passes right through the hard parts of the tooth into the root canal system in the middle. It can also happen if the tooth is accidentally damaged. When an infection starts it can spread throughout the root canal system, eventually leading to an abscess. If you don’t have root canal treatment the infection can spread into the surrounding tissues, causing pain and swelling, and your dentist may have no choice but to extract the tooth. It is always better to avoid an extraction if possible.

You won’t necessarily feel any pain in the early stages: but just because a tooth isn’t hurting yet doesn’t necessarily mean that it is healthy. As with many illnesses, there isn’t any pain or discomfort until the latter stages of the disease and treatment is often more effective and more likely to succeed if started early.
What will the dentist do?
The aim of root canal treatment is to eradicate the infection in the root canal and save the tooth.

The dentist will remove the damaged and diseased tissue from the tooth by making an “access cavity” through the top, then shaping the root canal system using ultra-strong and flexible rotary Nickel Titanium files. The root canal system is thoroughly cleaned using special chemicals to remove all the infection.

The dentist will fill the root canal system inside the tooth with a special filling material to stop any infection getting back in and will dress the access cavity above with a temporary filling material.

The upper part of the tooth will then be permanently restored with a filling to make a “core” for a crown to sit on. Next the dentist will fit a crown to hold the remaining structure together and to create a realistic tooth-like appearance.
Will the dentist use anaesthetic?
Yes. You will be given a dental anaesthetic before work begins so that you don’t feel anything.
How long will a tooth last after it is root filled?
Our own clinical audit data (compiled in 2003) showed that 90% of all the teeth we root fill last for more than 10 years. Even if the infection comes back it is often possible for your dentist to repeat the root canal treatment to get rid of the infection again and avoid extracting your tooth.
What does root canal treatment cost?
Each private treatment costs from £280 - £400. The exact price depends on which tooth is to be filled (some teeth have more root canals than others so it takes longer to treat them since each canal has to be done separately).
What will happen if I don’t have root canal treatment?
The only other effective treatment option is for the dentist to extract the tooth (and if the decay and/or infection has spread too far this may be the only option). Antibiotics will NOT by themselves "cure" an endodontic infection. If you had no treatment at all then even if the tooth hasn’t yet caused you any pain it will eventually do so. The pain from dental infections can be extremely intense. There can also be unpleasant swelling. Delaying treatment also reduces the prospects of success and it may prove impossible for your dentist to save the tooth at a later stage.
What happens after root canal treatment?
Teeth often last for many more years after a root filling has been placed. Nonetheless, root filled teeth are more brittle and prone to damage than "live" teeth. This often means that it is necessary to place a crown on the tooth after root canal treatment. The crown helps to hold what remains of the tooth together and to protect it. The ongoing health of the tooth will be monitored by your dentist. This involves taking x-rays regularly to see whether any infected area on the end of the roots (see diagrams above) has disappeared. If it doesn't disappear, it may be necessary to repeat the procedure. If it does disappear within 4 years, the root canal treatment is considered a complete success and no further x-rays will be necessary (other than for your routine check-ups).