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Root Canal Treatment Explained: Symptoms, Procedure, Cost and Recovery
If you have been told you need a root canal, or you suspect you might, this guide covers everything you need to know. From what a root canal actually is, to what the procedure involves, how long it takes, and what to expect afterwards.
Quick Summary
- Root canal treatment removes infected pulp from inside a tooth to eliminate pain and save the tooth.
- It is performed under local anaesthetic and is no more painful than a standard filling.
- Most treatments are completed in one to two appointments.
- Success rates are high, with the majority of treated teeth lasting at least eight years, and many lasting a lifetime.
What Is a Root Canal?
A root canal is the natural hollow channel running through the root of a tooth. It houses the dental pulp, a soft tissue containing nerves, blood vessels, and connective tissue.
When this pulp becomes infected or damaged, root canal treatment (also called endodontic therapy) is needed. The procedure cleans out the infected pulp, disinfects the canal, and seals the tooth to prevent reinfection.
What Is Endodontics?
Endodontics is the branch of dentistry concerned with diseases of the tooth pulp and surrounding tissues. A specialist who performs root canal procedures is called an endodontist.
What Causes Root Canal Infection?
Root canal infections occur when bacteria enter the pulp. The most common causes are:
- Untreated tooth decay (cavities): Bacteria gradually eat through the enamel and dentine until they reach the pulp.
- Cracked or chipped teeth: Even a hairline crack can allow bacteria inside.
- Dental trauma: A knock or impact to the tooth can damage the pulp even without an obvious crack.
- Repeated dental procedures: Multiple treatments on the same tooth can weaken it over time.
- Faulty dental crowns or fillings: Gaps around old restorations can let bacteria in.
Symptoms: Do You Need a Root Canal?
Not every toothache means you need a root canal, but these signs suggest the pulp may be infected. See your dentist promptly if you notice any of them.
1. Persistent, Throbbing Tooth Pain
Pulp infections typically cause a constant, deep ache that worsens over time. Pressure from biting or chewing intensifies the pain. The discomfort may also radiate to the jaw, face, or neighbouring teeth, making it difficult to pinpoint exactly which tooth is the source.
2. Prolonged Sensitivity to Heat and Cold
Normal teeth may ache briefly when exposed to hot or cold temperatures, but sensitivity that lingers for more than a few seconds after the stimulus is removed is a warning sign.
3. Swollen or Tender Gums
An infection in the root can cause the surrounding gum tissue to become swollen, tender, and red. In some cases, the jaw may also swell.
4. A Pimple or Boil on the Gum
A small raised bump on the gum near the painful tooth often indicates an abscess (a pocket of pus). If it drains, you may notice an unpleasant taste or odour in your mouth.
5. Tooth Discolouration
An infected tooth can take on a greyer or darker hue because the blood supply to the pulp has been compromised.
6. A Loose Tooth
As an infection progresses, pus can soften the bone and ligaments supporting the tooth, causing it to feel loose.
7. A Cracked, Chipped, or Damaged Tooth
Even without immediate pain, any tooth that has been cracked or chipped should be assessed by a dentist as soon as possible. Bacteria can enter the pulp through damage that is invisible to the naked eye.
Important: If you have any of these symptoms, do not wait. A pulp infection cannot heal on its own and will worsen the longer it goes untreated.
What Happens During Root Canal Treatment?
Root canal treatment is a routine dental procedure carried out under local anaesthetic. Here is what to expect, step by step.
Step 1: Examination and X-rays
Your dentist will take X-rays of the affected tooth to assess the extent of the infection and confirm that root canal treatment is the right approach.
Step 2: Local Anaesthetic
The area around the tooth is numbed thoroughly. Modern anaesthetics are highly effective, and most patients report feeling pressure rather than pain during the procedure.
Step 3: Dental Dam Placement
A small rubber sheet (dental dam) is placed around the tooth to keep it clean and dry throughout the treatment.
Step 4: Accessing the Pulp
Your dentist drills a small opening through the crown of the tooth to reach the infected pulp chamber.
Step 5: Removing the Infected Pulp
The infected or dead pulp tissue is carefully removed using fine instruments. If an abscess is present, it is drained at this stage.
Step 6: Cleaning and Shaping the Canals
The canals are cleaned, disinfected, and shaped to prepare them for filling. Because root canals can be very narrow, this step may take time to ensure every part of the canal is properly treated.
Step 7: Filling the Canals
The cleaned canals are filled with a biocompatible rubber-like material called gutta-percha and sealed with dental cement.
Step 8: Restoring the Tooth
A temporary or permanent filling is placed. In many cases, a dental crown is recommended to protect the tooth from fracture, as a tooth that has had root canal treatment is more brittle than a healthy tooth.
How Many Appointments Will I Need?
For straightforward cases, treatment is often completed in a single appointment. More complex cases, particularly those involving multiple canals or severe infection, may require two or more visits.
How Many Root Canals Does a Tooth Have?
The number of root canals varies depending on the type of tooth:
| Tooth Type | Typical Number of Root Canals |
|---|---|
| Incisors and canines | 1 |
| Premolars | 1 to 2 |
| Molars | 2 to 3 (sometimes more) |
The more canals a tooth has, the longer the treatment typically takes.
Does Root Canal Treatment Hurt?
This is the most common concern patients have, and the short answer is no, it should not hurt. The procedure is performed under local anaesthetic, so you should feel numb throughout. Many patients say it feels similar to having a filling.
After the anaesthetic wears off, it is normal to experience some tenderness or mild soreness for a few days. Over-the-counter pain relief such as ibuprofen or paracetamol is usually sufficient to manage this.
How Successful Is Root Canal Treatment?
Root canal therapy has a high success rate. The majority of treated teeth last at least eight years, and with good oral hygiene, it is entirely possible for a tooth with root canal treatment to last a lifetime.
If a root canal treated tooth becomes reinfected, retreatment is often possible and can successfully extend the life of the tooth further.
A note on discolouration: Some teeth darken after root canal treatment. This is manageable with internal whitening, and modern techniques have significantly reduced how often it occurs.
What Happens if You Do Not Get a Root Canal?
An infected tooth pulp cannot heal on its own. Delaying treatment allows the infection to:
- Spread to the surrounding bone and gum tissue
- Form a painful abscess
- Cause the tooth to become loose or unsaveable
- In serious cases, spread to other areas of the face, neck, or jaw
The only alternative to root canal treatment is extraction. While an implant or bridge can replace a missing tooth, preserving your natural tooth is always preferable where possible.
How to Prevent Root Canal Infection
Good dental habits significantly reduce your risk of ever needing root canal treatment:
- Brush twice a day with fluoride toothpaste.
- Floss daily to remove bacteria and plaque from between the teeth.
- Attend regular check-ups so your dentist can catch problems early.
- Treat cavities promptly. A small filling is far simpler than root canal treatment.
- Reduce your sugar intake to lower the risk of tooth decay.
- Quit smoking. Nicotine increases the risk of gum disease and infection. Vaping is also harmful; propylene glycol can damage enamel, and the combination of vegetable glycerin and flavouring agents can double plaque formation.
- Wear a mouthguard if you play contact sports, to protect against dental trauma.
Frequently Asked Questions
How long does root canal treatment take? A single-canal tooth can often be treated in 60 to 90 minutes. Multi-canal teeth or complex cases may require two or more appointments.
Can I eat after root canal treatment? It is best to wait until the anaesthetic has fully worn off before eating. Avoid hard or chewy foods on the treated tooth until a permanent restoration has been fitted.
Will I need a crown after a root canal? Not always, but it is often recommended, particularly for back teeth that bear the pressure of chewing. A crown protects the treated tooth from fractures.
Is root canal treatment available on the NHS? Root canal treatment is available on the NHS in some circumstances. Private treatment offers more flexibility in terms of appointment availability and materials used.
How soon can I return to work? Most patients return to their normal activities the same day. Any post-treatment soreness is usually mild and well managed with over-the-counter pain relief.
Book Your Root Canal Consultation on Harley Street
Dr Richard London provides expert root canal treatment at his Harley Street practice in London. Whether you are experiencing tooth pain, have been referred by your dentist, or simply want a second opinion, the practice welcomes new patients.
Call: 020 7637 1672 Book online: doctorrichardlondon.com