Deep decay, cracks or trauma may cause inflammation or infection of the pulp inside a tooth. Root canal treatment removes this tissue where appropriate, with the aim of retaining the tooth. Not every tooth can be saved: the remaining tooth structure, roots and surrounding tissues must be assessed.
What is root canal treatment?
The pulp contains blood vessels and nerves. During treatment, damaged or infected pulp is removed, and the root canals are shaped, disinfected and filled with suitable materials. The upper part of the tooth is then restored to support its seal and function.
Symptoms that need assessment
- Spontaneous toothache or pain that becomes more noticeable at night.
- Sensitivity that continues after a hot or cold stimulus is removed.
- Pain when chewing or biting on the tooth.
- Darkening or a grey colour change.
- Swollen gums, a draining opening or facial swelling.
These signs do not establish the need for root canal treatment by themselves. Some teeth need treatment without causing symptoms.
1. Examination and X-rays
Your symptoms, clinical tests and necessary periapical X-rays help assess the roots and surrounding tissues. The clinician considers whether the tooth can be restored, whether a crack may be present and whether pain has another source. Treatment is planned from these findings.
2. Local anaesthesia and isolation
Local anaesthesia is used to control pain. Some inflamed teeth need additional anaesthesia; tell your dentist if you feel discomfort. A rubber dam isolates the tooth from saliva and supports procedural safety.
3. Cleaning and shaping
An access opening is prepared and damaged pulp is removed. The working length of the canals is determined. Hand instruments or rotary systems shape the canals while aiming to preserve tooth structure.
4. Irrigation and disinfection
Special irrigating solutions reduce the microbial load. Complete sterilisation cannot be guaranteed. Some cases require medication within the canals and a temporary filling between appointments. The choice of one or several visits depends on all clinical circumstances, not just whether an infection is acute.
5. Root filling and final restoration
When appropriate conditions are achieved, the canals are filled with materials such as gutta-percha and sealer. Depending on remaining tooth structure and chewing forces, the tooth receives a composite filling, inlay/onlay or crown. Timely completion of the upper restoration is important for protecting the tooth.
Common misconceptions
Is root canal treatment always very painful? With anaesthesia, treatment is usually tolerable, although experience varies with the person and the condition of the tooth.
Does a treated tooth immediately become fragile? Although the pulp is removed, the tooth retains its connection to surrounding tissues. Fracture risk is particularly related to tissue loss and chewing loads. An appropriate restoration may allow long-term function, but no lifespan can be guaranteed.
Aftercare
Avoid chewing and very hot drinks until numbness has worn off. Some sensitivity may occur in the first few days; use medication only as advised by your clinician. Avoid loading the tooth with hard foods until its permanent restoration is complete. Increasing or persistent pain, swelling or loss of a filling require review. Spreading swelling with difficulty swallowing or breathing needs urgent assessment. Continue regular cleaning and check-ups.