Root canals

It is the treatment for the pain, not the cause of it.

A root canal has a reputation it earned fifty years ago. With modern anaesthesia the appointment is comparable to having a filling, and the toothache people dread is what it removes.

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When a tooth needs one

Pain that lingers

Sensitivity that continues after the hot or cold has gone, or that wakes you at night, suggests the nerve is inflamed beyond recovery.

An abscess

Swelling, a bad taste, or a tender lump on the gum. The infection has reached the bone at the root tip.

A darkened tooth

Often after an old injury. The nerve died some time ago, sometimes without ever hurting.

What the appointment involves

Numb first

Properly numb. If you are still feeling it, say so — it means more anaesthetic, not gritted teeth.

Clean and shape

The dead or infected tissue is removed from inside the root canals and the space disinfected and shaped.

Seal, then crown

The canals are filled and sealed. A back tooth then needs a crown, because a root-treated tooth is brittle.

Questions

Asked often.

Does it hurt?

The tooth usually hurts more before than during or after. The treatment is done under local anaesthetic; afterwards it can be tender to bite on for a few days.

How many visits?

Often one, sometimes two if the tooth is infected and needs a dressing in between.

Would it be cheaper to just pull it?

In the short term, yes. Then you are choosing between a gap, a bridge or an implant, all of which cost more than the root canal would have. Keeping your own tooth is almost always the better value.

Can I be sedated for it?

Yes. Nitrous oxide or oral sedation are both available. More on sedation.