Root canal therapy (also called root canal treatment, RCT or endodontic treatment) is needed when the soft parts in the middle of the tooth – the blood supply and nerves, referred to as the “pulp” – are damaged or infected. The process involves opening up the tooth to make an “access cavity”, removing the infected tissues, cleaning the inside of the root canals and then filling them with a rubbery, impermeable material to prevent any bacteria getting back in. The tooth is then sealed over, ideally with a crown.

There are a number of possible reasons:
• Often, a tooth becomes infected because bacteria from the mouth get inside the pulp chamber (usually because there are defective restorations, like fillings, or very deep dental decay in the tooth)
• Occasionally, a tooth can die off because it has suffered physical traumaIf left untreated, a dead tooth will eventually become infected. You may not feel any pain in the early stages of an infection but it can lead to the formation of an abscess. This is an area of inflammation where pus collects. You may experience anything from a mild ache to intense, severe pain. If root canal therapy isn’t performed, you may have to have your tooth extracted.The aim of the treatment is to clean out the tooth and get rid of any bacteria so it can heal.

Local anaesthetic is used so it shouldn’t feel any different to a normal filling – though it takes longer. On occasion, if a tooth is still in the process of dying off, it can be harder to anaesthetise so it’s difficult to get you “numb” – but that’s not the norm. Sometimes there is residual soreness afterward but that’s nothing compared to the pain an untreated tooth can cause.

This depends on which tooth is to be treated. Teeth have different numbers of roots and root canals, mostly depending on where they are in the mouth, and this greatly affects the time that the treatment takes and, therefore, the cost. Current prices are given on the website (see “pricing”) and on display in reception. Also, the cost of your root canal therapy will be given on your estimate / treatment plan. As a guide, root canal therapy costs from £960 on a front tooth and £1,080 on a back tooth – PLUS the cost of a crown to restore the tooth afterwards and sometimes a core (rebuilding the centre of the tooth) and a post (to anchor a core firmly into the roots).

You usually need either one or two appointments. Total treatment time is approximately two hours, but it may be more or less depending on which tooth is being treated.If the treatment is very complicated, or there is infection present that is hard to treat, the tooth will need to be dressed with an antibacterial agent and left to settle, so further appointments will be needed. It’s impossible to predict this before treatment begins. If it’s necessary in your case then we’ll tell you and let you know if this affects the charge.

Many factors affect the longevity of root-treated teeth. For example:• Whether there was an infection on the end of the root(s) when the treatment was started;
• How good your oral hygiene is;
• Whether the tooth is restored with just a filling or with a crown.It’s impossible to predict exactly how long the tooth will last but our audit data show that where Joanne Giddy performs root canal treatment on a tooth, 90% will still be there after 5 years and 87% after 10 years.The decision to place a crown on the tooth after root canal treatment is probably the most important factor. It’s vital that your tooth remains sealed. If it doesn’t – EG because it breaks or decays again – bacteria will be able to re-enter the tooth and cause a fresh infection. This means that the root canal treatment will fail and you will be back where you started. Crowns are the best choice to ensure a good seal because they completely cover the tooth. Audit data show that where Joanne Giddy crowns a tooth following root canal treatment, 91% survive for 5 years without further treatment and 86% survive for 10 years without further treatment. Where the tooth is sealed with just a filling, only 69% survive for 5 years without further treatment and just 65% survive for 10 years.

If root canal treatment fails, it is possible to perform repeat treatments to keep your tooth for longer. Published studies indicate the success rate for repeat root canal therapy is around 65 to 80%.

The alternative is an extraction. This will leave a gap. Your options then are:

• Accept the space
• Fill in the space with a denture / plate (this is removable, not fixed in place)
• Fill in the space with a bridge (this is fixed in place & not removable)
• Fill the space with an implant (a titanium screw that is placed in the bone and a crown is then placed on the top).

Overall, root canal treatment is more conservative than extraction – it keeps the tooth in place – and you’ll still have all these other options open for the future. It also works out less expensive than removing the tooth and filling in the space afterwards.

Brush your teeth with fluoride toothpaste last thing at night and at least one other time during the day and cut down on how often you have sugary foods & drinks. Also, visit the dentist regularly – as often as they recommend – so they can check that the tooth is still sealed. This will help keep all your teeth in good condition.