Root canal treatment

The inflamed or infected nerve inside a tooth is removed and the root canals are cleaned and sealed, so the tooth can be kept.

Inside every tooth is the pulp: the nerve and blood vessels that run down narrow canals in the root. Deep decay, a crack or a knock can let bacteria in. The pulp becomes inflamed and, if it isn’t treated, infected, which can cause severe toothache, swelling or an abscess at the root tip. Root canal treatment removes the pulp, cleans and disinfects the canals and seals them, so you keep the tooth instead of losing it.

Who it’s for

You may need root canal treatment if a tooth:

  • aches on its own, especially at night
  • stays sensitive to hot or cold long after the drink is gone
  • hurts when you bite
  • has a swelling or a small spot on the gum next to it
  • shows an infection at the root tip on an X-ray, sometimes with no pain at all

This matters if you are planning crowns or veneers. A tooth with an infection under it is treated first, so we check for it on the panoramic X-ray at your first appointment, free of charge.

How it’s done

The tooth is numbed with local anaesthesia and kept as dry and clean as possible while the dentist works. The dentist opens the top of the tooth, removes the pulp, and cleans and shapes each canal with fine instruments and disinfecting rinses. The canals are then filled with a rubber-like material called gutta-percha and a sealer, and the tooth is closed with a filling.

Simple cases are finished in one appointment of one to two hours. If there is a lot of infection, a medicated dressing is left in the canals for a few days and the treatment is completed at a second appointment. Back teeth then usually need a crown to protect them.

Afterwards

The tooth can be tender to bite on for a few days. Avoid chewing hard food on it until the final filling or crown is in place. Brush and floss normally. If swelling increases or the pain gets worse rather than better after three or four days, contact us.

Risks and alternatives

Root canal treatment has a good record, but it doesn’t always work. A canal can be curved, blocked or hidden, an instrument can fracture in a canal, or infection can come back years later. In those cases the treatment can sometimes be redone, or a small operation at the root tip can help. A root-filled tooth can also darken over time.

The alternative is to remove the tooth and replace it with an implant, a bridge or a partial denture, or leave the gap. Keeping your own tooth is usually the better choice where it can be saved.

Which option suits your teeth?

Send photos or an X-ray and we’ll write, tooth by tooth, what we recommend and why.

Get my treatment plan

Questions and answers

Is root canal treatment painful?

The tooth is numbed with local anaesthesia, so the treatment itself feels much like a large filling. The tooth can be tender to bite on for a few days afterwards; ordinary painkillers usually help. It is the infection, not the treatment, that causes the severe pain people associate with it.

My root-filled tooth hurts. What should I do?

See a dentist first, because the pain sometimes comes from a neighbouring tooth or one in the opposite jaw. If the root-filled tooth is the cause, the options range from redoing the root canal to removing the tooth. Until then, avoid chewing hard food on that side and don’t put anything on the tooth or gum.

Do I need a crown afterwards?

Back teeth usually do, because a root-filled tooth becomes more brittle and can crack. Front teeth often only need a filling. Your plan says which applies.

Can I fly after a root canal?

Yes. Once the tooth is sealed, flying doesn’t affect it. If a temporary filling is in place between appointments, the dentist will tell you whether to finish before you fly.