If the nerve in the centre of a tooth has died off or become infected, it may be may necessary to save a tooth with a root canal filling.

Contrary to popular belief root canal treatment does not cause pain – it relieves pain.

Root canals are tiny little tunnels and passageways in the centre of the tooth and roots that contain the tooth’s pulp tissues. The tooth pulp contains nerves, blood vessels and soft tissues that are important for the tooth’s development but it is not needed once the tooth is fully formed.

Deep decay or a crack in the tooth can cause an infection of the tooth’s pulpal tissues. This can cause severe toothache that people often associate with root canal problems. If the pain and infection is very severe, the nerves and pulpal tissues in the centre of the tooth can die off. At this stage the pain may go away but without treatment the infection remains and can spread down the root canals and into the surrounding jawbone to create an abscess.

X-rays may be taken to establish a clear picture of the root canals as well as the extent of the decay and infection. During root canal treatment a rubber sheet is placed around the tooth to keep it dry and make the procedure more comfortable. A small hole is drilled in the centre of the tooth to gain access to the root canals. Tiny instruments called files are used to remove the dead and diseased tissue in the root canals. The root canals are then thoroughly cleaned and disinfected. The canals are then filled to seal them and to prevent them from getting re-infected.

Is the procedure painful?

No. A local anaesthetic is given to numb the area so you should not feel any pain. The appointments for root canal treatments are generally longer than those for a filling but other than that it should not feel any different to a normal filling. It is normal to feel some soreness after the treatment, but this can be managed with over the counter painkillers such as paracetamol and ibuprofen. If the nerve of the tooth is dead or if it has been removed, an anaesthetic injection might not be needed.

How long does the treatment take?

It can take between 1-3 visits. Usually, at the initial appointment, the root canals are accessed and cleaned out. Medicine may be placed in the root canals to relieve the pain and clear the infection. A temporary filling is placed to seal the tooth between appointments. At subsequent appointments the root canals are cleaned, disinfected, shaped and filled. Once the root canals have been filled the tooth is rebuilt with filling material.

Will I need a crown?

Root-filled teeth are more fragile than healthy teeth which is why most teeth will require a crown after successful root canal treatment. This will help to protect the tooth and will help to minimise the risk of the tooth breaking in the future.

Do I need to see a specialist?

Root canal treatment is one of the more complex dental procedures. If the root canals are particularly curved, long or narrow then it may be necessary to refer you to a root canal specialist to carry out the root canal treatment. A dentist that specialises in root canal treatments is called an endodontist. It may also be necessary to refer you to a specialist if you have had root canal treatment in the past and if the roots of the tooth have become re-infected. The specialist may be able to remove the old root canal filling, clean out the root canals again and then re-fill them. Root canal specialists will often work with a microscope to help them find and clean out the narrow root canals.