Treatment

Root canal treatment

The infected pulp is taken out, the canals are cleaned and shaped, and the space is sealed. It is the procedure that keeps a tooth you would otherwise lose — which is why it is worth more than the implant that would replace it.

Visits: One, usually
Anaesthetic: Local
Chair time: 45–90 minutes
Imaging: Digital X-ray, CBCT

What it is

Inside every tooth is a chamber of soft tissue — the pulp — running down the roots in canals. Deep decay, a crack or a knock can inflame or infect it, and once that has happened the pulp does not recover. The pain that follows is the pressure of an infection inside a sealed space.

A root canal empties that space. The pulp is removed, the canals are cleaned, shaped and disinfected along their whole length, and then filled and sealed so nothing can re-colonise them. The tooth stays; only the tissue that was causing the pain leaves. A back tooth is usually crowned afterwards, because a tooth that has lost its pulp is more brittle than one that has not.

An implant is a good answer to a lost tooth. It is never a better answer than the tooth you still have.
Dr. Kaan

Which one you need

Single-canal treatment
One root, one canal, and the most straightforward version of the procedure. Usually one appointment.
Front teeth
Multi-canal treatment
Two to four canals, sometimes more, and canals that curve. It takes longer and it is where the imaging and the operator matter most.
Molars and premolars
Retreatment
The old filling material is removed, the canal system re-cleaned and re-sealed. Often a canal was missed the first time; the CBCT is what finds it.
A root canal that has failed
Pulpotomy
Only the crown portion of the pulp is removed and the living root pulp is left. Less procedure, kept for the cases that qualify for it.
A pulp inflamed but not yet dead
Emergency treatment
The tooth is opened, the pressure released and the infection controlled the same day; the rest of the treatment follows once you are out of pain.
Pain that cannot wait
Apicoectomy
A small surgical procedure to remove the tip of the root and seal it from below, where retreatment through the crown cannot reach.
Infection at the root tip after treatment
Laser-assisted disinfection
Used alongside the cleaning rather than instead of it, to reach the parts of the canal system an instrument cannot.
Canals that are hard to sterilise

What happens to you

Two visits, and a wait at home in between

Before you fly
A photograph and an X-ray
Send what you have, including any X-ray your own dentist took. You will be told whether this is one appointment or two, and what it costs, before you travel.
The appointment
Imaging first
A digital X-ray and, where the anatomy needs it, a CBCT scan. Root canals are decided by how many canals a tooth actually has, not by how many it usually has.
The same visit
Cleaning and shaping
Local anaesthetic, the pulp removed, and the canals cleaned along their whole length with rotary instruments and irrigation. Most cases finish here, in one sitting.
The same visit
Sealing
The canals are filled and sealed so that nothing can get back into them, and the access is closed.
After
The crown
A back tooth is usually crowned once the treatment has settled — a tooth without a pulp takes a bite the same way but breaks more easily. Where you have it done is your choice; if it is here, it is the second half of the same trip.

Before you fly
A photograph and an X-ray
Send what you have, including any X-ray your own dentist took. You will be told whether this is one appointment or two, and what it costs, before you travel.
The appointment
Imaging first
A digital X-ray and, where the anatomy needs it, a CBCT scan. Root canals are decided by how many canals a tooth actually has, not by how many it usually has.
The same visit
Cleaning and shaping
Local anaesthetic, the pulp removed, and the canals cleaned along their whole length with rotary instruments and irrigation. Most cases finish here, in one sitting.
The same visit
Sealing
The canals are filled and sealed so that nothing can get back into them, and the access is closed.
After
The crown
A back tooth is usually crowned once the treatment has settled — a tooth without a pulp takes a bite the same way but breaks more easily. Where you have it done is your choice; if it is here, it is the second half of the same trip.

Before you fly
A photograph and an X-ray
Send what you have, including any X-ray your own dentist took. You will be told whether this is one appointment or two, and what it costs, before you travel.
The appointment
Imaging first
A digital X-ray and, where the anatomy needs it, a CBCT scan. Root canals are decided by how many canals a tooth actually has, not by how many it usually has.
The same visit
Cleaning and shaping
Local anaesthetic, the pulp removed, and the canals cleaned along their whole length with rotary instruments and irrigation. Most cases finish here, in one sitting.
The same visit
Sealing
The canals are filled and sealed so that nothing can get back into them, and the access is closed.
After
The crown
A back tooth is usually crowned once the treatment has settled — a tooth without a pulp takes a bite the same way but breaks more easily. Where you have it done is your choice; if it is here, it is the second half of the same trip.

Before you fly
A photograph and an X-ray
Send what you have, including any X-ray your own dentist took. You will be told whether this is one appointment or two, and what it costs, before you travel.
The appointment
Imaging first
A digital X-ray and, where the anatomy needs it, a CBCT scan. Root canals are decided by how many canals a tooth actually has, not by how many it usually has.
The same visit
Cleaning and shaping
Local anaesthetic, the pulp removed, and the canals cleaned along their whole length with rotary instruments and irrigation. Most cases finish here, in one sitting.
The same visit
Sealing
The canals are filled and sealed so that nothing can get back into them, and the access is closed.
After
The crown
A back tooth is usually crowned once the treatment has settled — a tooth without a pulp takes a bite the same way but breaks more easily. Where you have it done is your choice; if it is here, it is the second half of the same trip.

Questions

Is it as painful as people say?

The reputation comes from what the tooth felt like before the treatment, not during it. The appointment is done under local anaesthetic; the pain that brought you in is what the procedure removes. The tooth can be tender to bite on for a few days afterwards.

How long does it take?

Forty-five to ninety minutes for most teeth, and most cases are finished in one appointment. A molar with curved canals, or a retreatment, can want a second.

Will the tooth go dark?

A front tooth sometimes discolours after root treatment. It is treatable — internal whitening, or a veneer or crown if it has gone far enough.

Does it last?

A well-treated and properly restored tooth can last for the rest of your life. The two things that lose it are a missed canal and a tooth left un-crowned long enough to split.

Should I just have it pulled instead?

Extraction is quicker and cheaper on the day and more expensive afterwards: the gap wants an implant or a bridge, and the bone under it starts to go. Keeping the tooth is nearly always the better answer where it can be kept.

Patients

The people who already came

Six of our patients, filmed at the clinic and talking about their own treatment. They are the clinic’s patients rather than any one procedure’s — what each of them had is in the film.