Root canal treatment
If the nerve inside a tooth is dying or has become infected, root canal treatment can often relieve pain and help save the tooth.
Do I need a root canal?
If you're wondering whether you might need root canal treatment, Dr Jon Cowie explains the common signs, why treatment may be needed and how it can help save a tooth.
What is root canal treatment?
Inside every tooth is soft tissue called the dental pulp, which contains the nerve and blood supply. Sometimes the nerve can become irritated or inflamed and settle again. Root canal treatment is usually needed when the nerve has become irreversibly inflamed, is dying or has become infected.
This can happen because of decay, a crack, trauma or previous dental treatment. The tooth may become painful, although an infected tooth does not always cause symptoms.
Root canal treatment removes the dying or infected tissue from inside the tooth. The root canals are then carefully cleaned and disinfected to remove bacteria before being sealed to help prevent bacteria from re-entering the tooth.
Once treatment is complete, the tooth can usually be restored with a filling, onlay or crown so that it can continue to function as normally as possible.
Signs you may need root canal treatment
Not every painful tooth needs root canal treatment, but these are some of the signs that the nerve inside a tooth may be dying or infected.
Persistent toothache
A deep, throbbing or persistent toothache can sometimes indicate that the nerve inside the tooth is badly inflamed, dying or infected.
Pain when biting
Tenderness or pain when biting on a tooth can occur when tissues around the root become inflamed.
Lingering sensitivity
Pain from hot or cold that continues after the stimulus has gone can sometimes indicate irreversible damage to the nerve.
Swelling or abscess
Swelling, a gum pimple, tenderness or an unpleasant taste can sometimes be associated with infection around the root.
Why save your natural tooth?
Where a tooth can be predictably treated and restored, keeping your natural tooth is usually preferable to removing and replacing it.
Keep your own tooth
Root canal treatment can allow a formerly infected tooth to remain naturally within your smile.
Relieve pain
Treatment removes the dying, inflamed or infected tissue that is often responsible for toothache.
Treat infection
The root canals are carefully cleaned and disinfected to remove bacteria from inside the tooth and help prevent infection spreading through the end of the root into the surrounding tissues.
Avoid extraction
Many teeth that would otherwise need to be removed can be preserved with root canal treatment.
Maintain your bite
Keeping the tooth helps preserve your natural chewing function and supports neighbouring teeth.
Restore for the future
Once treated, the tooth can usually be restored to protect it and allow it to function again.
Specialist root canal care at Triangle Dental
More complex cases can be treated in-house by Dr Justin Underwood, a Specialist in Endodontics with advanced training dedicated to root canal treatment.
Dr Justin Underwood
Specialist in Endodontics
GDC: 210724
Justin is a registered Specialist in Endodontics, the branch of dentistry dedicated to diagnosing and treating problems affecting the nerve and root canal system of teeth.
Specialist status reflects the highest level of recognised training and experience in this area of dentistry.
Justin completed four years of specialist endodontic training at King's College London, where he qualified with distinction and received the Pitt-Ford Prize.
He accepts referrals for both routine and more complex root canal treatment, including teeth that have previously been treated but need further care.
Justin particularly enjoys helping patients get out of pain and save teeth that might otherwise be lost. He understands that root canal treatment can feel daunting and takes a calm, gentle approach, explaining treatment clearly and helping patients feel at ease.
Does root canal treatment hurt?
Root canal treatment should not be painful. The tooth is carefully numbed with local anaesthetic before treatment begins, and we make sure you are comfortable before we start.
Root canal appointments are usually longer than routine filling appointments, but many patients are surprised by how relaxed they feel. Because you can simply lie back while the dentist works carefully on the tooth, it is not unusual for patients to become relaxed enough to nearly fall asleep.
Modern root canal treatment is very different from its old reputation. The purpose of the treatment is to remove the dying or infected tissue causing the problem and help you become comfortable again.
If you're nervous, we'll take time to explain what is happening, answer your questions and make sure you're comfortable throughout.
What happens after root canal treatment?
Once the infection has been treated, the next priority is protecting and restoring the tooth for the future.
Allow the tooth to settle
It is normal for a tooth to feel mildly tender for a short time after treatment, particularly if it was painful beforehand.
Restore the tooth
Depending on the position of the tooth and how much healthy tooth remains, it may be restored with a filling, onlay or crown.
Protect it long term
Good oral hygiene, regular dental examinations and an appropriate final restoration all help support the tooth's long-term health.
What if the tooth cannot be saved?
Unfortunately, not every tooth can be predictably treated. A tooth may be too badly fractured, have too little healthy structure remaining or occasionally have an infection that cannot be successfully managed.
If we don't believe root canal treatment offers a predictable outcome, we'll explain why rather than recommending treatment that is unlikely to succeed.
If removal is the healthiest option, we can also discuss whether the tooth needs replacing and the options available, including dental implants, bridges and dentures.
Questions about root canal treatment
How long does root canal treatment take?
Most root canal treatments can be completed in one appointment, although occasionally more than one visit is required. Root canal treatment normally takes longer than a routine filling because the canals inside the tooth need to be carefully located, cleaned, disinfected and sealed. An appointment is often around two hours, depending on the tooth and the complexity of treatment.
Can antibiotics cure a root canal infection?
Antibiotics cannot remove bacteria from inside an infected root canal system. They are occasionally required when infection has spread into the surrounding tissues, but the source of infection within the tooth still needs to be treated.
Will I need a crown after root canal treatment?
Most back teeth that have had root canal treatment will benefit from a crown or onlay to help protect the remaining tooth from fracture. Front teeth often do not require a crown if enough healthy tooth structure remains, although occasionally they do. Your dentist will assess the tooth and recommend the most appropriate restoration.
How successful is root canal treatment?
Root canal treatment has a high success rate. Around 85–90% of appropriately treated teeth can still be functioning successfully several years after treatment. The outlook for an individual tooth depends on factors such as its condition before treatment, the complexity of the root canals, whether it has been treated before and how well the tooth can be restored afterwards.
Can a root canal treated tooth become infected again?
Occasionally a tooth can develop further infection after previous root canal treatment. In suitable cases, further treatment or retreatment may allow the tooth to be saved.
Is it better to have the tooth extracted?
Where a tooth can be predictably saved and restored, keeping your natural tooth is usually our preferred option. However, every situation is different. We will explain the likely prognosis, treatment involved and the alternatives so that you can decide which option is right for you. The final decision will always be yours.
Can I drive after root canal treatment?
Root canal treatment is normally carried out with local anaesthetic only, so most patients can drive afterwards. If anything different applies to your treatment, we'll let you know beforehand.
What happens if I leave an infected tooth untreated?
An infection inside a tooth will not usually resolve by itself. Pain can sometimes reduce temporarily as the nerve dies, but bacteria may remain inside the tooth and the infection can continue to develop. Over time this may lead to further pain, tenderness, swelling or a dental abscess.
Worried you may need root canal treatment?
Book an appointment and we'll assess the tooth, explain what is causing the problem and discuss the most appropriate way to relieve your symptoms and save the tooth wherever possible.