Root Canal Treatment

Treatment is carried out by a specialist endodontist using a surgical operating microscope.

Treatment is done under local anaesthetic, and most patients compare it to having a filling.

If you are in pain, we can usually see you for an assessment within 48 hours. That appointment covers diagnosis, pain relief and a clear plan for treatment, with treatment scheduled from there.

Cavities that penetrate through enamel and dentin layers eventually reach the pulp chamber, introducing bacteria that cause infection.

Structural damage from biting hard objects, trauma, or natural tooth fractures can create pathways for bacteria to reach the pulp.

Impact injuries from sports or falls can damage pulp tissue even without visible external damage.

Teeth subjected to multiple fillings over time can develop pulp inflammation from the cumulative trauma of repeated procedures.

Natural tooth roots stimulate the jaw bone, preventing the bone deterioration that occurs after an extraction.

Natural teeth provide superior biting strength and sensation compared to bridges or dentures.

The cost of a root canal and crown is often lower than the long-term cost of an extraction followed by a high-quality replacement like a dental implant.

Your natural tooth maintains an appearance that even the best porcelain restorations struggle to replicate perfectly.

Your appointment begins with a thorough assessment. We perform a clinical examination, take digital X-rays, and in complex cases, use a 3D CBCT scan to see your root structure clearly. We then explain our findings, confirm the diagnosis, and discuss your treatment plan and all available options.

We make sure the tooth is numb before treatment starts, and check with you before we begin.

For anxious patients, we offer a range of sedation options:

• Nitrous Oxide (Happy Gas): Mild relaxation. You remain conscious and can drive home.
• Oral Sedation: A tablet taken before the appointment for deeper relaxation. You will need a driver.
• IV Sedation: Deep sedation (“twilight sleep”) administered by a dental sedationist for severe anxiety. You will need a driver.

Using a surgical operating microscope, we create a small, precise access opening in the tooth’s crown to reach the pulp chamber. This magnification allows us to preserve as much healthy tooth structure as possible.

This is the most critical phase of the treatment.

1. Remove Infected Pulp: The damaged pulp tissue is gently removed.
2. Precise Measurement: An electronic apex locator precisely measures the length of your root canals.
3. Advanced Cleaning: Flexible, rotary instruments clean and shape the canals. These are much faster and more comfortable than traditional manual files.
4. Thorough Disinfection: The canals are flushed with an antimicrobial solution. We use ultrasonic instruments and lasers to activate this solution, ensuring it reaches and disinfects every microscopic part of the canal system.

Technology showcase

• Surgical Operating Microscope: 25x magnification reveals canal anatomy invisible to the naked eye.
• Waterlase from Biolase: (Er,Cr:YSGG) for cleansing and disturbing tenacious bacterial biofilm.
  
• Ultrasonic Instruments: Enhanced cleaning effectiveness.
• Digital Apex Locator: Precise canal length measurement.
• Cone Beam CT (3D) Integration: A clear map for navigating complex anatomy.

Once spotlessly clean, the canals are filled. We use a biocompatible rubber-like material called gutta-percha. This material is heated and vertically compacted to create a complete, three-dimensional seal that locks out any future infection. A post-treatment X-ray checks the seal.

The access opening is sealed with a temporary or permanent filling.

For most back teeth, a dental crown is essential. The crown acts like a shield, protecting the weakened tooth structure from fracturing under biting forces. This step is critical for long-term success and is typically completed by your general dentist 2-4 weeks after the root canal.

The source of pain is the infection itself. This severe, throbbing pain is often what brings you to our practice.

With effective local anaesthetic, most patients feel pressure rather than pain. The procedure relieves the pain by removing the infection.

It is normal to feel mild to moderate soreness for 2-3 days as the surrounding tissues heal. This is easily managed with over-the-counter pain relief.

We ensure you are completely numb before starting. For infected teeth that can be difficult to numb, we use additional anaesthetic techniques to make sure the tooth is numb. We wait until the anaesthetic has taken full effect and verify you are numb before proceeding.

Our specialist equipment also improves comfort:

• Surgical Operating Microscope: This allows for extreme precision, minimising tissue trauma.
• Gentle Technique: Our specialist approach reduces post-operative inflammation.
• Quiet Instruments: We use quiet ultrasonic, laser and rotary instruments, which reduces the anxiety associated with traditional drill sounds.
• Patient Communication: You are in complete control. We use simple hand signals so you can tell us to pause or if you need anything at any time.

• Nitrous Oxide (Happy Gas): Mild relaxation. You remain conscious and can drive home.
• Oral Sedation: A tablet taken before your appointment for moderate relaxation. You will feel drowsy and need a driver.
• IV Sedation: Deep sedation (“twilight sleep”) administered by a dental sedationist. You will have minimal memory of the procedure.

• During the Injection: A brief pinch or sting for 2-3 seconds as the anaesthetic begins to work.
• During Treatment: Sensations of pressure, pushing, and water irrigation. Most patients feel pressure rather than pain.
• Post-Treatment (First 24-48 hours): Tenderness when biting, a dull ache (mild to moderate), and possible jaw stiffness. This is all normal, indicates healing, and is manageable with standard pain relief like Ibuprofen and Paracetamol.

Constant throbbing pain that worsens at night or radiates to your jaw or ear.

Sharp pain from hot or cold that lingers for more than 30 seconds after the source is removed.

A darkening or greyish appearance of a single tooth, indicating internal pulp damage.

A swollen area near the tooth or a persistent pimple-like bump on the gum (fistula), which may drain pus.

A recent trauma from a sports injury or accident, even without visible external signs, can damage the pulp.

A tooth with multiple or very large fillings can experience cumulative trauma to the pulp over time.

Visual inspection and gentle tapping (percussion) to assess inflammation.

Applying cold to the tooth to check the nerve’s response. A lingering, painful response often indicates irreversible inflammation.

Reveals infection, bone loss, and the root structure.

Used in complex cases to provide a detailed 3D view of the root anatomy.

When root canal is the better choice

Root canal treatment is the recommended choice when the tooth has adequate structure, healthy gum support, and no severe fractures.

Long-Term Benefits:

• Preserves Natural Tooth Function – No replacement performs as well as your natural tooth.
• Maintains Jaw Bone – The natural root stimulates the jaw bone, preventing the deterioration that follows extraction.
• Protects Adjacent Teeth – A root canal does not impact neighbouring teeth. A bridge, however, requires grinding down two adjacent healthy teeth.
• Cost-Effective Long-Term – Avoids the ongoing replacement costs of implants or bridges.

When the tooth is restored with a crown, root canal treatment is a reliable, long-lasting option.

• Numbness – The anaesthetic will wear off in 2-4 hours. Avoid eating until the numbness is gone to prevent biting your tongue or cheek.
• Pain Management – Over-the-counter pain relief, taken as directed on the packet, is usually enough. We will give you specific advice after your treatment.
• Eating – As for your post-treatment diet guidance, stick to soft, cool foods for the first 24 hours (e.g., yoghurt, smoothies, soup). Avoid hard, crunchy, or sticky foods. Chew on the opposite side.

• Day 2-3 – Discomfort typically peaks 24-48 hours post-treatment and then improves steadily. Continue pain medication as needed.
• Day 4-7 – Most discomfort should be minimal. You can resume a normal diet but continue to avoid chewing very hard foods directly on the treated tooth.
• Activities to Avoid – Do not smoke, as it delays healing. Avoid vigorous exercise for the first 24 hours.

The final step is the most important for long-term success: the permanent restoration.

Once your crown is placed, care for the tooth just as you would any other natural tooth: brush twice daily, floss daily, and attend regular 6-month checkups.

This is a specialist procedure to clean, disinfect, and re-seal a tooth that has failed to heal after a previous root canal treatment.

This is a microsurgical procedure that removes the infected tip of a tooth’s root to save the tooth.

This is an aesthetic treatment that whitens a discoloured or grey tooth from the inside out, often after the tooth has undergone root canal treatment.

This involves a specialist assessment to determine if a fracture in a tooth has reached the pulp.