Root canal treatment
Root canal treatment, otherwise known as endodontics, is treatment aimed at saving a damaged tooth. It should be painless, and feel no more uncomfortable than having a normal filling. Poor techniques and treatment have unfortunately meant that some people feel worried about having the procedure, but there is no need to when you are in the hands of a registered root canal specialist (endodontist), such as Dr Gahan.
Our aim is always about saving teeth. While there are good tooth replacements, nothing will feel, look or functions better than your own natural tooth.
What is a root canal?
The centre of the tooth is called the pulp. It houses the nerve tissue and blood vessels. The root canal system contains the pulp and extends down to the root or roots of the tooth.
What are the symptoms of a root canal infection?
Quite often it is painless
Lingering pain after consuming hot or cold food and drink
Pain when biting or chewing
Sore gum next to tooth
A loose tooth
You may develop an abscess – an inflamed area where pus collects
Swelling of the gums or face
Why do I need root canal treatment?
If you have a damaged tooth - perhaps due to tooth decay, infection or an injury - bacteria that live naturally in the mouth can enter the pulp, causing it to become infected. If this infection spreads through the root canal system, the nerve of the tooth can die and lose its blood supply. The infection and dead nerve tissue need to be removed or you may lose the tooth. It is often more expensive to replace a tooth than save it.
You may also have root canal treatment recommended before crowns or bridges are fitted, if your dentist deems there’s a risk the nerve could die afterwards.
Root canal work is a specialist treatment. Registered specialists called endodontists (of which there are less than 300 in the UK) have had years of additional training to undertake complex cases and perform the treatment to the highest standard. While most general dentists do provide root fillings, many prefer this treatment to be carried out by an endodontist. Years of research have shown that it is more difficult to remove an established infection at an old root filling, so it is better to have it done by a root canal specialist in the first place.
How long does root canal treatment take?
This depends on how many root canals your tooth has and what treatment, if any, has already been done to the tooth. Front and canine teeth usually have one root canal, whereas premolars and molars have two or three - each containing one or two root canals. You can expect your appointment to last between 1 and 1.5 hours.
Can root canal treatment be done in one visit?
Yes, in most circumstances it can. However, if your case is particularly complex, you may need a second appointment.
What will happen at my root canal treatment appointment?
A thorough assessment will be carried out before treatment.
Dr Gahan will take X-rays to identify if the pulp has become infected and to get a clear picture of the root canal. In some cases a special 3D scan to reveal the internal anatomy of the tooth is required, especially if there is an old filling. If infection is found, the tooth will be thoroughly numbed and a small entry point made into the inside of the infected tooth. Dr Gahan will then remove the infected pulp tissue and clean and shape the canals to make them bigger and easier to disinfect. Finally, the canals are filled to stop bacteria regrowing or re-infecting the root canal.
If there is an old filling or swelling, a second appointment may be needed to complete the treatment. A filling is then placed on top of the root canal treatment to seal it. Some teeth need crowns (most back teeth for instance) to make them stronger and last longer. Your own dentist may provide this or they may want Dr Gahan to do it.
We have leaflets that provide further information and they include part of Dr Gahan's thorough consent process.
Is root canal treatment painful?
No. Dr Gahan uses advanced techniques to make sure the tooth is numb. After treatment, about 20% of teeth can be a little sore but this can be managed with normal painkillers.
What does root canal treatment feel like?
The sensation you’ll feel is similar to having a deep filling. But your tooth will be completely numbed, so you won’t feel any pain.
Will root canal treatment save my tooth?
Root canal treatment is usually successful at saving teeth and clearing the infection for more than 10 years, with a success rate of around 90%. The survival rate for teeth treated by a specialist endodontist is very high.
The success rate is lower for re-treatment, which is why endodontists prefer to do the initial root filling rather than remove an old infected one. If the infection returns, treatment can be repeated or the root tip removed.
Retreatment works up to 8 times out of 10, depending on the initial cause of the problem.
What happens if root canal treatment doesn't work?
In some cases, your immune system may not be able to get rid of the infection on the root service – despite how well the treatment has been provided. This is more likely in long-standing (chronic) infection, when the root tips have been damaged or the immune system is severely compromised. Thankfully, in the hands of a specialist such as Dr Gahan, the risk of this is low. However, if root canal treatment isn’t successful, the root tip can be surgically removed or occasionally a tooth will need to be removed and an implant or bridge fitted.
Will root canal treatment last forever?
No, unfortunately nothing lasts forever. But keeping a natural tooth is generally best and there are two further options to save a tooth should a root filling not work, such as endodontic surgery. Dr Gahan will be able to advise you on this.
People with untreated tooth infections are 2.7 times more likely to have cardiovascular problems than people who have had their infections treated
One study found that 93% of root-treated teeth survived for more than 10 years
9 out of 10 dental educators would seek root canal treatment from an endodontist
How do I care for my tooth after root canal treatment?
Provided you look after your tooth, you can expect it to last for a reasonable amount of time. Root canal aftercare is no different to your usual oral hygiene routine — brushing twice a day and cleaning between your teeth with floss or an interdental brush once a day. The main risks to root-filled teeth are still decay, gum disease and breakages rather than re-infection.
Are root canal treated teeth more sensitive?
Not normally. If you do experience prolonged sensitivity, then speak to your dentist.
Can I see an endodontist on the NHS?
In some circumstances, root canal treatment may be offered at a hospital, but this is mainly for certain situations like trauma, mouth cancer and congenital abnormalities. Your dentist can advise you if you meet the criteria. But in the vast majority of cases root canal treatment is not offered on the NHS - even if it’s difficult and beyond what a general dentist is comfortable doing.
Is root canal treatment safe?
Yes, very. Dr Gahan is an experienced root canal specialist and has been saving teeth through root canal treatment for over 21 years. He'll be happy to talk through any concerns or questions you may have about the procedure.