Root Canal Treatment

Endodontic treatment (also known as root canal therapy) can be classified as

  • Initial endodontic treatment. This is by far the most common endodontic procedure and is completed on a daily basis at SCED. This treatment is common and 14 million root treatments are completed in the United Kingdom every year.
  • Endodontic re-treatment. This is required when the initial root treatment starts to fail. With the advent of new technologies and techniques, a repeat endodontic procedure is very often all that is required.
  • Apicectomy. Occasionally, even after the completion of careful endodontic treatment, a minor surgical procedure known as apicectomy can be required.

Initial endodontic treatment. What is this?

Endodontics is a highly skilled procedure involving treatment of the pulp (or root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or "root canal" contains a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, gum disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontist removes the diseased pulp to save the tooth and prevent further infection and inflammation. After successful endodontic treatment, the tooth continues to perform normally.

With modern methods endodontic treatment is very predictable and a success rate between 85 and 90% can be expected.

When a tooth requires endodontic treatment the only alternative is extraction. While many options are now available to replace missing teeth, endodontic treatment and restoration is generally more cost effective than replacement with an implant and it is accepted that an implant should be a replacement for a missing tooth rather than a tooth that can be restored.

Endodontic re-treatment

Sometimes a tooth that has been root treated can still give problems. These problems are invariably associated with recurrent infection but can be complicated by the treatment that has already been completed. Usually the root canal treatment can be repeated. The most common complicating factors are:

  • Difficult and complicated root canal anatomy. Regrettably the human body does not always provide us with easy anatomy and very fine or tortuous root canals can be difficult to negotiate.
  • Missed root canals. Some teeth have one root canal while some others can have four or more. These canals can be extremely fine and it is possible that a root canal can remain untreated. Fortunately, the use of operating microscopes at SCED can allow us to see deep into your tooth and identify these complicated areas.
  • A leaking filling or crown. No matter how well your root canal treatment has been completed in the past, if there is a leaking restoration bacteria can re-infect the root canal system. This is why it is usual to recommend that a good restoration such as a crown or inlay will be recommended following completion of root canal therapy.
  • Recurrent decay. A root treated tooth needs looking after just like every other tooth. If decay returns following completion of treatment, this can also allow the root canal system to become reinfected.

Apicectomy

Sometimes some of the obstacles described above just can’t be overcome. In these cases, a minor surgical procedure called apicectomy can be required. This procedure is usually completed under local anaesthetic and accesses the problematic area directly rather than through the tooth.

The gum covering the root of your tooth is peeled back, a bit like taking the skin off an orange and the end of the root visualized. The problematic area is cleaned out and very often a small filling is placed in the end of the root to prevent re-infection. The wound is then carefully closed with sutures and allowed to heal.

At SCED we have highly trained clinicians equipped with state of the art technology which make this procedure very predictable. If required and for your comfort, this procedure can be completed with sedation administered by a consultant anaesthetist.

How will treatment progress?

Initial Consultation

Your initial appointment will consist of a consultation explaining what’s wrong with your tooth and treatment options. The cost of treatment depends on what is required but be rest assured that this will be fully discussed and confirmed in writing.

Please assist us at your initial visit by returning the completed medical history questionnaire which you will have received in your introductory welcome pack. In addition, please remember to bring any correspondence which might include x-rays from your dentist since this will help to plan your treatment.

Arrangement of treatment appointment

Once you are comfortable with the treatment being proposed we will schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to progress your treatment as soon as possible.

The appointment time for endodontic treatment varies between 90 and 150 minutes. Some teeth only have one root canal whilst others may have four canals or even more complex anatomy. It is not unusual to complete treatment at one visit but successive appointments may be required for more complex cases.

How much will the treatment cost?

Every tooth is different. The number of root canals involved, the nature of the problem and whether or not the procedure is being repeated influence costs. Please be reassured that all costs will be confirmed prior to proceeding, but as a guide:

  • Fees for a single root canal in a front tooth vary from £360.00 to £480.00.
  • Fees for a premolar tooth vary from £480.00 to £550.00.
  • Fees for a molar tooth vary from £650.00 to £750.00.
  • In cases of exceptional difficulty, extra appointments may be required and further costs may be incurred.
  • Fees for surgical treatment start at £500.00.

Advice before and after treatment

Before Treatment

Endodontic procedures are normally performed using local anaesthesia. There are usually no restrictions after the procedure concerning driving or returning to work. A dentist is available for consultation at all times should a problem arise after your treatment.

Continue with all prescribed medicines unless specifically advised otherwise. If there is a question, please call our office prior to your appointment.

Please eat a full breakfast or lunch as applicable.

After Treatment

It is not unusual for a root treated tooth to be a bit tender following treatment and this may last for four to seven days. This tenderness is normal and is no cause for alarm. The discomfort is invariably controlled with paracetamol or ibuprofen. It is important to continue with your regular dental hygiene regimen.

Should swelling develop, please contact the clinic immediately.

What happens after completion of your endodontic treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You will be given specific instructions on what to do next but generally your dentist will decide on what type of restoration is necessary to protect your tooth. It is not unusual for the a root treated tooth to be restored with a restoration which protects the remaining vulnerable tooth substance and seals the root filling from bacteria and this is very often a crown.

It is rare for endodontic patients to experience complications after routine endodontic treatment. If a problem does occur, however, we are available at all times to respond.

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