Root canal (endodontic) treatment is needed when the pulp inside a tooth, often called the "nerve", is inflamed, infected or has died. Its purpose is to keep the tooth rather than have it extracted.
What it is
Inside every tooth is a space containing blood vessels and nerves, the pulp, which extends down through the root canals. When bacteria reach it, usually through deep decay, the pulp becomes inflamed and may eventually die, and an abscess can form at the tip of the root.
During root canal treatment the affected pulp is removed, the root canals are cleaned and disinfected, and then they are sealed.
When it may be needed
Common causes:
- Deep decay, including under old fillings.
- A cracked or broken tooth.
- A knock to the tooth (trauma), even years earlier.
- Repeated treatment on the same tooth.
Possible signs:
- Pain with hot or cold that lingers for several minutes.
- Spontaneous pain, often at night.
- Pain when biting or tapping the tooth.
- Swelling of the gum or face, or a "spot" on the gum.
- Darkening of the tooth.
Sometimes there are no symptoms at all and the problem only shows on an X-ray. The diagnosis is made with a clinical examination and X-rays.
What usually happens
- Examination and X-ray. We confirm that root canal treatment is needed and that the tooth can be saved.
- Local anaesthetic and isolation. The tooth is isolated with a rubber dam to keep it clean and dry.
- Cleaning the canals. A small opening is made, the pulp is removed and the canals are cleaned, shaped and rinsed with disinfecting solutions.
- Filling the canals. The canals are sealed with a special material. If more time is needed, for example when there is an abscess, a medicated dressing is placed and treatment is completed at a later visit.
- Restoring the tooth. The tooth is then restored with a filling, inlay or crown, depending on how much structure is left.
Treatment may be completed in one or more visits. In complex cases (for example re-treating an old root filling or difficult anatomy), we may refer you to a specialist endodontist colleague.
Afterwards
- For a few days the tooth may be tender when chewing. Common painkillers, as advised by the dentist, are usually enough.
- If you have a temporary filling, avoid chewing hard food on that side until the final restoration.
- Contact the practice if the pain gets worse rather than better, if swelling appears, or if the temporary filling comes out.
- A root-filled tooth is more brittle, so the final restoration should not be delayed for long.
- A follow-up X-ray is usually taken after some months.
Frequently asked questions
Is root canal treatment painful?
It is done under local anaesthetic. Often the pain that brought the patient in eases after the first visit. Some tenderness when chewing may last a few days.
Wouldn't it be better to take the tooth out?
Where possible, keeping your natural tooth is generally preferable. An extraction leaves a gap that often later needs a bridge or implant. Sometimes, however, a tooth cannot be saved, and we will discuss that openly.
Will I always need a crown afterwards?
Not always. Back teeth that have lost a lot of structure often need a crown or onlay to protect them from fracture. Front teeth with little tissue loss may only need a filling.
Do I need antibiotics?
Usually not. The infection is treated by cleaning the inside of the tooth. Antibiotics are given only in specific situations, such as spreading swelling or feeling generally unwell, and always after assessment by the dentist.
Related treatments
Pain or swelling? Call the practice on +30 210 6743342. If swelling spreads towards your eye or neck, or you have difficulty breathing or swallowing, call 166 or 112 immediately.
Appointments and questions: +30 210 6743342 · [email protected]