FAQs

Your guide to endodontic treatment a.k.a root canal treatment.

You are probably reading this because your dentist or specialist endodontist has said you need root canal or endodontic treatment. If so, you are not alone. Millions of teeth receive root canal or endodontic treatment each year. By choosing endodontic treatment, you are choosing to keep your natural teeth as a healthy foundation for chewing and biting for years to come. If you have never had root canal or endodontic treatment or if it has been many years since your last procedure, you may have questions or outdated expectations. This section answers your questions and explains how today's root canal or endodontic treatment saves teeth. Please also check the "Root Canal" section of our website, which explained what root canal treatment is. If you would like to know more, be sure to talk with your specialist endodontist.

Who performs root canal treatment or endodontic treatment? Why have I been referred?

All dentists, including your general dentist, received training in endodontic treatment in dental school. General dentists can perform endodontic procedures along with other dental procedures, but often they refer patients needing endodontic treatment to a specialist endodontist, who is a valuable partner and collaborator on your general dentist’s team of trusted caregivers. A specialist endodontist is a dentist who specialises in saving teeth. Specialist endodontists become specialists by completing five years of dental school followed by at least an additional three or more years of advanced specialty training in the treatment of diseases of the dental pulp.

They perform routine as well as difficult and very complex procedures, including root canal treatment, root canal retreatment and endodontic microsurgery (also called root-end surgery or apicectomy). As a result of their specialty training, specialist endodontists are skilled in finding the cause of oral and facial pain, treating traumatic injuries to teeth, diagnosing cracked teeth and performing other procedures that save teeth. Specialist endodontists also are the experts in local anaesthesia, ensuring patients are completely numb and comfortable during their procedures.

In addition, specialist endodontists often utilize state-of-the-art technologies such as digital imaging, operating microscopes, ultrasonic instrumentation and cone beam computed tomography (CBCT), an innovative imaging technique that provides specialist endodontists with three-dimensional views of the patient’s teeth and supporting structures. Advanced technologies, together with specialised techniques and training, give specialist endodontists a very accurate view of the inside of the tooth, and allow them to treat the tooth quickly, efficiently and comfortably.

How does root canal or endodontic treatment save the tooth?

The specialist endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth will function like any other tooth.

Will I feel pain during or after the procedure?

Many root canal or endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anaesthetics, most patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive and bruised, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your specialist endodontist’s instructions carefully. Your tooth may continue to feel slightly different from your other teeth for some time after your root canal or endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your specialist endodontist.

What happens during treatment?

Root canal or endodontic treatment occasionally can be completed in one appointment, depending on the condition of your tooth and your personal circumstances. However, most teeth require multiple visits. You will be well informed of the procedure, the number and length of the appointment during your consultation.

The treatment involves the following steps:

1. The specialist endodontist examines and X-rays the tooth, then administers local anaesthetic to numb the tooth. After the tooth is numb, the specialist endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and dry during the procedure.
2. The specialist endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
   
3. After the space is cleaned and shaped, the specialist endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “guttapercha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling, or part of it, will be removed by your dentist before the tooth is restored.
   
4. After the final visit with your specialist endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect it and restore it to full function. If the tooth lacks sufficient structure to hold the restoration in place, your dentist or specialist endodontist may place a post inside the tooth. Ask your dentist or specialist endodontist for more details about the specific restoration planned for your tooth.

How much will the procedure cost?

The cost varies depending on the severity of the problem and the specific tooth that is affected. Molars are more difficult to treat and usually cost more. We will be able to assist you with the details and during the consultation the cost will be confirmed. Generally, root canal or endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration.

Please check our Fees page for further details on the exact costs and payment methods

Will the tooth need any special care or additional treatment?

You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full coverage restoration as soon as possible. Once the tooth is restored, continue to practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings. Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment fails to heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this happens, another endodontic procedure can save the tooth.

What causes an endodontically treated tooth to need additional treatment?

New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the specialist endodontist may discover very narrow or curved canals that could not be treated during the initial procedure.

Can all teeth be treated endodontically?

Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. And, when endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

The most common endodontic surgical procedure is called an apicectomy or root-end surgery. When inflammation or infection persists in the bony area around the end of your tooth after endodontic treatment, your specialist endodontist may perform an apicectomy. In this procedure, the specialist endodontist opens the gum tissue near the tooth to expose the underlying bone, and the infected tissue is removed. The very end of the root is also removed. A small filling may be placed to seal the end of the root canal, and a few stitches or sutures are placed in the gum to help the tissue heal properly. Local anaesthetics make the procedure comfortable, and most patients return to their normal activities the next day.

What are the alternatives to endodontic treatment?

Although root canal or endodontic procedures are intended to help save your tooth, this is not always possible. Occasionally, the only alternative to root canal or endodontic treatment is extraction of the tooth. Missing teeth can make you self-conscious, affect your ability to bite and chew, cause other healthy teeth to shift and have a negative impact on your overall health. For these reasons, the extracted tooth should be replaced with an artificial one. Though nothing looks, feels or functions exactly like your natural tooth, dental implants are a viable alternative to help you maintain a beautiful smile only if your tooth can’t be saved.

This list of FAQs covers the questions we are asked most frequently by patients at our consultation clinics. Hopefully you will find the answer here to anything that may be concerning you about root canal treatment also known as endodontic treatment.

First and foremost, it is not painful. The procedure stops existing pain and/or prevents the development of pain in the future.

If you have any concerns that are not addressed here, please call us or email me and we will answer your individual questions. We believe in providing tailored treatment for all our patients and will keep you fully informed every step of the way.