Clinical review: Dr. Samreen Ejaz, BDS, RDS ·
Why a tooth needs a root canal
Inside every tooth is soft tissue called the pulp, which holds the nerve and blood vessels. Deep decay, a knock to the tooth or a leak under an old filling can let infection in. You might notice pain with hot or cold that lingers, pain when you bite, or a swelling on the gum. Some teeth give very little warning at all. Dr. Samreen will examine the tooth and take an X-ray before deciding what it needs.
Can your tooth be saved?
Before we start, we check how much healthy tooth is left, the gum and bone around it, and whether there are any cracks. Cleaning the canals won’t help if the tooth is split or too broken down to rebuild afterwards. So we’ll talk about the whole tooth, not just the root filling. If what we find is complicated, we may refer you elsewhere.
What happens in the chair
We numb the tooth and keep it isolated and dry while we work. Then we remove the infected or inflamed tissue, clean and shape the canals, and seal them. Many teeth take one or two visits, sometimes more, depending on the infection and how the roots are shaped. Between visits we close the tooth with a temporary filling.
Rebuilding the tooth afterwards
A root canal clears out the inside of the tooth, but the top still needs a proper repair. Depending on how much tooth is left, that could be a glass ionomer filling, a tooth-coloured composite filling, or a core with a PFM or zirconia crown. A post is only used when there isn’t enough tooth left to hold the core. Most root canal teeth don’t need one.
Other options
Depending on what we find, a smaller treatment that keeps the nerve alive, taking the tooth out, or a second opinion might make more sense. If the tooth has had a root canal before, it may need retreatment instead. We can’t promise any tooth will heal. The state of the tooth and how well it’s rebuilt both make a difference.
After your appointment
Try not to chew hard on the tooth until the final filling or crown is in. Call us if the pain gets worse, the temporary filling falls out, or you notice swelling. If swelling spreads across your face, or you have a fever or trouble swallowing or breathing, go to a hospital emergency straight away. Please come back for the final repair even once the pain has gone. No pain doesn’t mean the job is finished.
BEFORE YOUR APPOINTMENT
Questions about root canal treatment
Does a root canal hurt?
We numb the tooth first, so most people feel pressure rather than pain during treatment. The tooth often feels tender for a few days afterwards. Tell us if it’s getting worse instead of better.
How many visits will it take?
Usually one or two, sometimes more if there’s a lot of infection or the roots are tricky. We’ll give you a better idea once we’ve seen the tooth and the X-ray.
Will I need a crown, and is it included in the price?
It depends on how much tooth is left. Ask us for a written plan that lists the canal treatment, the filling or core, and any crown separately, so you can see the full cost.
Can a treated tooth need treatment again?
Yes. Infection can come back or new problems can start. If the tooth is still worth keeping, retreatment or surgery at the root tip may be options.
This is general information. What’s right for your tooth depends on what Dr. Samreen finds when she examines it.
Background reading: AAE: root canal treatment explained. These are overseas sources, so their prices and rules don’t apply here.