What is root canal (endodontic) treatment?
The aim of root canal (endodontic) treatment, regardless of the nature of treatment is to keep/maintain teeth healthy and functional. Your own natural tooth is the best dental implant!
The objective of root canal treatment is to remove the inflamed and/or infected nerve tissue from within the root(s) of the tooth and then disinfect and sealing the root canal(s), thus returning the tooth back to health again.
Root canal treatment takes place in two phases; initially the tooth is stripped down, the root canals are located, disinfected using bleach and shaped with very flexible files after which the disinfected root canals are then sealed with a root filling material after which the top part of the tooth is restored with a permanent tooth coloured bonded filling.
When performed by a specialist endodontist, root canal treatment reliably saves teeth that would otherwise require extraction — including teeth that have been significantly damaged by deep infection, decay, or trauma. Clinical studies have shown that root canal treatment performed by specialist endodontists is associated with higher survival rates than treatment performed by general dentists
When is root canal treatment needed?
The pulp — the soft tissue at the centre of a tooth, containing the nerve and blood vessels — can become inflamed or infected as a result of deep decay, a crack, trauma, or a leaking filling/crown. Once the pulp is irreversibly damaged, it cannot recover on its own. Common symptoms include:
- Persistent toothache, particularly to heat or cold
- Spontaneous pain, including at night
- Tenderness when biting, or swelling around the tooth or gum
- Discolouration of the tooth
- A recurring abscess or sinus on the gum
In some cases, an infected tooth causes no pain at all and is identified on a routine X-ray. This does not make treatment less urgent — untreated infection quickly develop into acute pain and/or an abscess.
What does treatment involve?
Under local anaesthetic, the root canals are accessed and the damaged or infected tissue is removed. The canals are cleaned and shaped using fine instruments under magnification, and disinfected — in complex cases, using laser-activated irrigation. The canals are then sealed with a permanent composite filling. Most (pre)molar teeth will then need to be restored with a crown to protect it from future fracture.
Before treatment begins, Professor Patel takes a CBCT scan. This three-dimensional imaging gives a complete picture of the canal anatomy — identifying additional canals, calcifications, or anatomical features that a regular dental X-ray may miss.
What can I expect?
Most patients experience little or nothing during treatment. Mild tenderness for one to two days afterwards is normal and manageable with over-the-counter pain relief. Most cases are completed in one appointment, in some cases additional appointments may be required for example a very chronic, deep seated infection or dental trauma). A CBCT scan is carried out by our in-house radiographer, there is no need for a separate imaging referral before treatment can begin.
Will a root have treated tooth last?
A well-treated and well-restored root treatment tooth can function for several years, if not decades. Long-term outcome data, including a research paper Professor Patel co-authored confirmed high survival rates of 94% after 4 years when root canal treatment was carried out at specialist level and correctly restored after treatment. These results are similar to implant retained crowns. Many of the teeth Shanon root treated 25+ years ago are still fine.
How does this different from re-root canal treatment?
In some cases, a tooth has already been root canal treated but has become (re-)infected. In these cases, re-root canal treatment may be indicated to return the tooth back to healthy and function. In these cases, the existing root filling material is carefully removed, the canals are cleaned and disinfected again and the canals are resealed. In some cases, surgical endodontics (an apicoectomy) may be the most appropriate route. Before any re-root canal treatment begins, a CBCT scan is taken to fully understand the anatomy and identify what may have led to failure.
Is re-root canal treatment predictable?
YES! The survival rate of teeth which have undergone re-root canal treatment is over 95%. Saving a natural tooth, even one that has been root treated before, is almost always preferable to extraction. Professor Patel will be transparent with you: if he does not believe retreatment is likely to work, he will say so and explain your alternatives.
Do I need a referral from my dentist?
A referral from your dentist is the usual route. However, you are also welcome to contact us directly if you have a specific concern and your dentist is unsure whether to refer. We’re happy to advise.
What makes a specialist endodontist different from my regular dentist?
All dentists receive some training in root canal treatment. Specialist endodontists spend a further three or more years in postgraduate training dedicated entirely to this area. They use operating microscopes, 3D imaging and specialist materials that general dental practices don’t routinely use. Success rates for complex cases are meaningfully higher with a specialist.
Can my tooth definitely be saved?
Not always — but the honest answer is that far more teeth can be saved than patients are sometimes led to believe. Professor Patel will give you a clear, evidence-based assessment of whether treatment is likely to succeed, what the alternatives are, and what we’d recommend. We don’t carry out treatment we don’t think will work.