Question 1

What is root canal treatment and when is it needed?

Accepted Answer

It is the cleaning and filling of the inside of the tooth when the nerve is infected or badly inflamed. It is considered after a deep cavity, a knock or an abscess. Inside every tooth is the pulp, often called the nerve, made up of blood vessels and nerve fibres. When a deep cavity, a fracture or a knock reaches this pulp, it can become irreversibly inflamed or infected. Root canal treatment, also called endodontic treatment, consists of removing this pulp, cleaning and disinfecting the root canals, then filling them with a sealing material. The tooth stays in place and continues to do its job. Some signs can point to it: spontaneous pain or pain at night, sensitivity to heat that lingers, pain when chewing, a tooth that darkens, a swollen gum or a small spot on the gum. Sometimes there are no symptoms at all and the problem is revealed by an X-ray. Only a clinical examination with an X-ray allows the dentist to confirm whether root canal treatment is needed, or whether simpler treatment is enough.

Question 2

Is root canal treatment painful?

Accepted Answer

The treatment is carried out under local anaesthesia, so the tooth is numb. It often relieves the original pain. Sensitivity when chewing may persist for a few days afterwards. The painful reputation of root canal treatment comes mainly from the pain felt before treatment, when the nerve is inflamed or infected. The very purpose of the treatment is to remove this source of pain. During the session, local anaesthesia numbs the tooth and the area around it. When inflammation is very severe, the anaesthetic may take longer to work. The dentist can then add more until you are comfortable. After treatment, it is common for the tooth to stay tender to pressure for a few days, while the tissues around the root settle. Suitable pain relief is generally enough. It is advisable to avoid chewing on the treated side until the tooth has its final restoration. If the pain increases instead of easing, or if swelling appears, contact the practice for a check-up.

Question 3

How many sessions does root canal treatment take?

Accepted Answer

Depending on the case, one or more sessions. The number depends on the type of tooth, the number and shape of the canals, and whether or not there is an infection. A front tooth often has only one canal, whereas a molar generally has three or four, sometimes narrow or curved. The more complex the anatomy, the longer the treatment takes. When the tooth is infected, the dentist may choose to place a disinfecting product in the canals for a few days before filling them permanently. Treatment then takes two sessions or more. Each session generally takes a significant amount of time, because the canals are cleaned meticulously. Check X-rays are taken during treatment to verify the length and quality of the filling. Once the canals are filled, the tooth still needs to be restored, with a filling or a crown. This step is essential and is part of the treatment plan the dentist presents to you.

Question 4

Do I need a crown after root canal treatment?

Accepted Answer

Often, especially for molars and premolars. A root-treated tooth is more fragile and may fracture. A crown protects it; the dentist assesses what suits your tooth. A root-treated tooth is no longer nourished from the inside and has often lost a large part of its structure through decay and the treatment itself. It becomes more brittle, especially when it bears chewing forces. For back teeth, a crown is frequently recommended to encase the tooth and spread the forces. When the loss of tooth structure is limited, a partial restoration, such as an inlay or an onlay, may be enough. For front teeth, which bear less load, a simple filling is sometimes suitable. However, a root-treated tooth can darken over time, which may lead to considering a crown or a veneer for cosmetic reasons. It is better not to wait too long between the end of root canal treatment and the final restoration: a fracture during this period can jeopardise keeping the tooth.

Question 5

Is it better to have root canal treatment or to extract the tooth?

Accepted Answer

When possible, keeping your natural tooth is generally preferable. Extraction is discussed if the tooth is too damaged, fractured deep down or if its outlook is uncertain. A well-treated natural tooth is often the most comfortable solution: it keeps its sensations, its bone and its gum. Root canal treatment followed by a restoration allows it to stay in use for a long time in many cases. Extraction may seem simpler in the short term, but it leaves a gap that generally needs filling with an implant, a bridge or a denture. Without a replacement, the neighbouring teeth can tilt and chewing can become unbalanced. There are, however, situations where keeping the tooth is not reasonable: a vertical fracture of the root, very deep decay below the gum, significant bone loss or the failure of a previous treatment that is difficult to redo. The dentist examines the tooth, studies the X-ray and presents the options with their advantages, their limits and a written estimate for each. The decision is made together.

Root canal treatment

Root canal treatment

Other questions in this section