Root canal treatment

Inside every tooth is a soft tissue containing the nerve and blood supply. If decay, a crack or trauma allows bacteria in, that tissue becomes inflamed and eventually dies, and infection spreads to the bone at the root tip. Root canal treatment removes the infected tissue, cleans and shapes the canal, and seals it. It is how a tooth that would otherwise be lost gets kept — which is almost always preferable to replacing it, because no replacement is as good as a tooth.

• Persistent toothache, particularly one that wakes you at night
• Pain on biting, or lingering pain after something hot or cold
• A tooth that has darkened after an injury
• Swelling or a gum boil near a tooth
• Infection at the root tip visible on an X-ray, sometimes without any symptoms
• Deep decay reaching the nerve, or a tooth prepared for a crown where the nerve is subsequently affected
• A previous root treatment that has failed

• Extraction, followed by an implant, bridge, denture or leaving the gap
• Monitoring, where the nerve may still recover and symptoms are mild
• Pulpotomy or pulp capping, in specific circumstances where the nerve is only partly affected
• Root-end surgery or retreatment, where a previous root treatment has failed

• X-rays of the tooth and the bone around its root tip
• Sometimes a CBCT, particularly for retreatment or complex anatomy
• Tests of whether the nerve is alive
• How much sound tooth structure remains above the gum
• Whether the tooth has a crack
• Your medical history and any medication

1. 1

   Diagnosis

   Establishing which tooth, whether the nerve is affected, and whether the tooth is restorable afterwards. A tooth that cannot be restored is not worth root treating.

   Carried out by: Partner clinic

2. 2

   Access and cleaning

   Under local anaesthetic and usually under rubber dam isolation, the canals are located, cleaned and shaped.

   Carried out by: Partner clinic

3. 3

   Sealing

   The canals are filled and sealed. This may be at the same appointment or a subsequent one, depending on the tooth and any infection.

   Carried out by: Partner clinic

4. 4

   Restoring the tooth

   A root-treated tooth is more brittle and needs a definitive restoration — often a crown or onlay on back teeth. A tooth left in a temporary filling is at real risk of fracture.

   Carried out by: Partner clinic

5. 5

   Review

   Healing at the root tip is checked on an X-ray, typically after a year. This is difficult to arrange from another country.

   Carried out by: Partner clinic

Often one or two appointments, and it can generally be completed within a trip alongside the restoration. The follow-up X-ray a year later is the part that needs a dentist where you live — ask for your records so they can compare.

• How much sound tooth remains above the gum line
• Whether the tooth is cracked, which changes the outlook considerably
• The condition of the bone and gum supporting it
• Canal anatomy — some teeth are considerably more complex than others
• Whether the tooth has been root treated before
• Whether the tooth is worth keeping within your overall plan

• Which tooth — front teeth have fewer canals than molars and take less time
• Whether it is a first treatment or a retreatment
• Whether a specialist endodontist carries it out
• Whether a CBCT is needed
• The subsequent restoration, which is a separate cost and frequently the larger one

We do not publish price ranges for this treatment. Any figure we could give before a clinic has approved it would be a guess presented as guidance. Your final price comes from the partner clinic in writing, after a dentist has reviewed your case.

• Treatment can fail, and infection can persist or recur
• Instruments can separate within a canal, and canals can be missed
• Root-treated teeth become more brittle and can fracture, sometimes unrestorably
• Post-operative discomfort for a few days is common
• Discolouration of the treated tooth, particularly front teeth
• The tooth may still eventually be lost
• Numbness or altered sensation, rarely, where a root lies close to a nerve

• Is this tooth restorable after root treatment, or am I spending money on something that will be lost anyway?
• What are the realistic alternatives, including extraction?
• Will this be done under rubber dam?
• What restoration does the tooth need afterwards, and is that in the price?
• **If a tooth being crowned turns out to need root treatment, is that included?**
• Who reviews the healing in a year, and will you send my X-rays?

These are worth asking of any clinic, including ours. A clinic that answers them clearly and in writing is telling you something useful.

This treatment would be carried out by a licensed dentist at the partner clinic you choose, working in endodontics. Dental Anchor does not provide treatment and does not employ dentists.

• Dental crowns
• Tooth extraction

• What should be included in a dental treatment quote?

  7 min read