Root Canal: What Happens
What a root canal involves, what you'll feel, the fees, and how we protect the tooth once it's done.
What Does Root Canal Treatment Involve?
Root canal treatment removes the inflamed or infected pulp from the centre of a tooth, then disinfects, shapes and seals its root canals so you can keep it. With local anaesthetic it feels much like a filling, and it normally takes one or two appointments. The tooth is then rebuilt, usually with an onlay or crown if it's a back tooth. At Peninsula Dentists on Greenwich Peninsula, fees start at £590 for a front tooth, £690 for a premolar and £790 for a molar, and an endodontic consultation is £59.
When Is a Root Canal Needed?
At the centre of each tooth is the pulp, a living core of nerve fibres and tiny blood vessels. If bacteria get in, most often through deep decay, a crack, a hard knock or a large old filling, the pulp first becomes inflamed and then infected. Because it is enclosed in rigid tooth structure, it has no way to recover by itself. Untreated, the infection moves out through the root tip into the jawbone and can develop into an abscess.
Typical signs are a throbbing ache that disturbs your sleep or returns for no obvious reason, pain from hot food or drink that lingers after you've swallowed, soreness on biting, a swelling or small spot on the gum beside the tooth, and a tooth that darkens or turns grey after an injury. Some infected teeth cause no symptoms at all and are found only on an X-ray during a routine dental examination.
How the Treatment Works
Most teeth are completed in one or two appointments.
- Assessment. We examine the tooth and take an X-ray to pin down the cause and make sure it can be saved. You get your options and the fee before we begin.
- Anaesthetic. We numb the tooth. Infected teeth can be stubborn to numb, so we allow extra time and test it before starting.
- Isolation. A rubber dam, a thin sheet of rubber that fits around the tooth, keeps it dry and free of saliva while we work.
- Cleaning. Through a small access hole in the top of the tooth we remove the damaged pulp, then clean and shape each canal and rinse it with an antibacterial solution.
- Dressing. If the tooth is very sore or badly infected, we place a medicated dressing and complete the work at a second appointment once things have calmed down.
- Sealing and rebuilding. We fill and seal the canals, then restore the tooth: a filling for most front teeth, and normally an onlay or crown for a back tooth.
Advised to Have a Root Canal, or Struggling with Toothache?
Book in with Dr Pei and we'll check the tooth, explain your options and give you the fee in writing.
Is It Painful?
For most people, it feels no different from having a filling. With the tooth numb, you'll notice pressure and vibration rather than pain. The treatment takes away the pain of an infected tooth instead of adding to it, and many patients tell us afterwards that it was far easier than they expected.
The tooth may be tender for a few days, particularly on biting, and over-the-counter painkillers taken as the packet directs usually manage that. Most people return to work the same afternoon. If you're nervous, let us know when you book: we use numbing gel before the injection, agree a signal for you to pause us, and for longer appointments Dr Imran Riaz can provide IV sedation.
What It Costs
| Treatment | Fee | Plan member |
|---|---|---|
| Endodontic consultation | £59 | £53 |
| Emergency first stage, per canal, from | £199 | £179 |
| Incisor (front tooth), from | £590 | £531 |
| Premolar, from | £690 | £621 |
| Molar, from | £790 | £711 |
| Re-treatment of an old root filling, supplement | £100 | £90 |
| Ceramic onlay afterwards, from | £650 | £585 |
| Ceramic crown on a back tooth, from | £650 | £585 |
Molars are priced higher because they have three or four canals, often narrow and curved, which take longer to clean and seal. You'll have the fee in a written plan before we start, with 10% off for dental plan members.2 Protecting a back tooth with an onlay or crown is charged on top. If you come in with pain, the first stage can be done straight away and the balance follows when the tooth is complete. Our fee guide lists the rest.
Looking After the Tooth Afterwards
- A few days of tenderness is expected, and everyday painkillers taken as the packet directs normally keep it comfortable
- Don't chew anything hard on that side until the tooth has its final restoration, particularly while a temporary filling is in
- Keep brushing and cleaning between your teeth as usual, including around the treated tooth
- If the temporary filling falls out between appointments, ring us so we can replace it before bacteria get back into the canals
- Arrange the onlay or crown soon if we've recommended one, because a root-filled back tooth left unprotected can crack
- Get in touch if swelling appears, or if the pain is building instead of easing after the first few days
Once it has been restored, a root-filled tooth needs nothing beyond the usual: thorough brushing, daily interdental cleaning and your usual dental examinations, at which we'll check it and occasionally X-ray the root to confirm it has healed.
Why Keep the Tooth at All?
In the long run, saving your natural tooth is usually the better option and the more economical one. A properly restored root-filled tooth can serve you for decades, keeping your bite, the surrounding gum and bone in place. Replacing a tooth costs more: a single implant and crown starts at £2,250, while each unit of a resin-retained bridge starts at £550.2
Antibiotics won't cure an infected tooth on their own. We prescribe them only when infection is spreading or you're feeling ill, and even then the tooth must still be treated. Root canal treatment works because it removes the source of the infection. Dr Pei Xian Chen carries out root canal treatment here and is completing a postgraduate certificate in endodontics, the branch of dentistry that deals with the inside of the tooth.
If a Root Filling Fails, or the Tooth Can't Be Saved
The great majority of root canal treatments succeed. Now and then an older root filling breaks down, usually because a canal was missed first time or the seal has leaked, and the tooth becomes sore or infected again. Re-treatment is often possible and carries a supplement of £100 on top of the standard fee. For a complicated tooth we may suggest a CT scan, from £120, which maps the canals and the bone around them in three dimensions and is taken on our own scanner at the practice.
Occasionally a tooth is beyond saving, because the root has split or too little tooth remains to rebuild. We'll be straightforward with you about that and talk through the replacement options, such as a bridge or a dental implant. For what an implant involves, see our guide to implant costs in Greenwich.
Questions
This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.