Root Canal Treatment — what it actually is
Inside every tooth is a canal containing the nerve and blood supply. When deep decay, a crack or an injury lets bacteria reach that tissue, it becomes inflamed and then infected. That is the toothache that keeps people awake. Root canal treatment removes the infected tissue, disinfects and shapes the canal, and seals it so bacteria cannot return.
The alternative to a root canal is losing the tooth. Replacing a lost back tooth costs several times what the root canal costs, and nothing replaces a natural tooth root as well as the root you already have. Root canal treatment is how a badly infected tooth stays in your mouth.
Signs you may need it
One of these on its own is worth a look. Two or more, and it is worth booking rather than waiting to see whether it settles.
- Severe, throbbing pain, often worse at night or lying down
- Pain that lingers for minutes after something hot or cold
- A tooth that hurts to bite on or even to touch
- Swelling of the gum or the face near one tooth
- A pimple-like bump on the gum that drains and refills
- A tooth that has turned grey or dark after an old injury
- Pain that stopped by itself — the nerve may have died, and the infection has not gone
How it is done here
The tooth is numbed and isolated with a rubber dam so the canal stays clean and nothing reaches your throat. The infected tissue is removed, the canal is shaped and irrigated, and it is filled with an inert material and sealed. Most teeth are completed in one or two visits; a tooth with active swelling is dressed with medicament first and completed once the infection has settled. Because a root-treated back tooth becomes brittle, it is then protected with a crown.
What to expect, step by step
These are genuinely sequential — each step depends on the one before it, which is why some treatments cannot be finished in a single visit.
- 01
X-ray and diagnosis
Confirming the tooth, the number of canals and their length before anything is started.
- 02
Anaesthetic and isolation
Fully numb, and the tooth isolated with a rubber dam.
- 03
Cleaning and shaping
Infected tissue removed, canal disinfected and shaped along its full length.
- 04
Sealing
The canal is filled and sealed so bacteria cannot re-enter.
- 05
Crown
A crown is fitted afterwards. A root-treated back tooth without a crown will eventually split.
Questions patients ask about root canal treatment
Is root canal treatment painful?
The reputation comes from the toothache that sends people in, not from the procedure. The tooth is fully anaesthetised, and for most patients the treatment is comparable to having a filling — the relief usually begins in the same appointment. Tell Dr Pooja if you feel anything at any point and more anaesthetic is given.
How long does a root canal take?
Between 45 and 90 minutes per visit. A straightforward front tooth is often finished in one sitting. Molars have more canals and commonly take two.
Do I really need a crown afterwards?
For a back tooth, yes. A root-treated molar has lost its blood supply and a large part of its structure, and chewing forces will eventually split it. A crown holds it together. Splitting is the most common reason a root-treated tooth is eventually lost, and it is avoidable.
Can the tooth get infected again?
It is uncommon but possible, usually where a canal was missed, the seal has leaked, or new decay has got in underneath the crown. Most such teeth can be re-treated rather than extracted.
Is it better to just extract the tooth?
Almost never, if the tooth is restorable. Extraction is quicker and cheaper on the day, then the neighbouring teeth drift, the opposing tooth over-erupts, and replacing the gap costs more than the root canal would have. Dr Pooja will tell you plainly when a tooth is genuinely not worth saving.
My pain stopped on its own. Can I cancel?
No — that is often the point at which the nerve has died. The pain is gone because the tissue that could feel it is dead, but the bacteria are still there and the infection continues into the bone. This is the stage at which teeth are quietly lost.