Root Canal, Explained
How a tooth comes to need root canal treatment, what happens at each appointment, what each type of tooth costs, and how a root-filled tooth can be kept healthy for years afterwards.
What Happens During Root Canal Treatment, and What Does It Cost in Broughty Ferry?
Root canal treatment takes out infected or inflamed nerve tissue from within a tooth, then cleans, disinfects and seals the fine canals running down the root, which means the tooth stays rather than being taken out. It is carried out under local anaesthetic across one or two visits and feels much like having a lengthy filling. At Ferry Smile Studios the fee runs from £450 on a front tooth to £595 on a molar, and a first stage to settle a painful tooth is £150.
Why a Tooth Needs Root Canal Treatment
Inside every tooth sits a living core called the pulp: nerve fibres and tiny blood vessels that extend from the middle of the crown down one or more slender channels inside the root. Bacteria get in by way of a deep cavity, a crack, a large old filling that has begun to leak, or a hard knock. Because the pulp is sealed inside hard tooth with nowhere to swell, once it becomes inflamed or infected it cannot heal itself.
The usual warning signs are:
- A throbbing ache that disturbs your sleep or starts up with no obvious trigger
- Lingering pain after a hot drink, long after swallowing
- Tenderness when biting down
- A swelling or gum boil next to the tooth, occasionally with an unpleasant taste
- A front tooth that darkens to grey, months or even years after a knock
Now and then there is no pain whatsoever, and the first sign is a dark shadow at the root tip on a routine X-ray. It still has to be treated, since the infection gradually destroys the bone surrounding the root.
Save the Tooth or Take It Out?
When a tooth can be rebuilt, saving it is almost always the wiser course. Your own root stays, along with your natural bite and the gum and bone around it. An extraction is faster on the day, but you are then left with a gap to live with or fill, and a replacement tooth costs considerably more than keeping the original.
| Option | Typical fee | What it means |
|---|---|---|
| Molar root canal treatment with an onlay | £595 plus £750 | Your own tooth stays |
| Extraction, gap left | £125 | Adjacent teeth may drift into the space over the years |
| Having the tooth out, then an implant and crown | From £2,605 | Fixed, once several months of healing have passed |
| Having the tooth out, then a resin-retained bridge | From £675 for each unit | Fixed, glued to the neighbouring tooth |
If we believe a tooth has a poor outlook, say a crack running down the root or too little tooth left to build on, we will say so plainly and discuss the replacement options with you instead. 1
Told You Need Root Canal Treatment?
Come in and we will examine the tooth, take an X-ray and go through your options and the fees.
What Happens, Stage by Stage
- Assessment. The tooth is tested, X-rayed and judged worth saving. The fee is confirmed in writing before we begin.
- Numbing. Numbing gel goes on first, followed by the local anaesthetic. A tooth that is badly inflamed can be slower to numb, so we give it time and check before continuing.
- Isolation. A thin rubber sheet, known as a rubber dam, is placed over the tooth to keep saliva out and to stop tiny instruments or rinsing solutions reaching the rest of your mouth.
- Cleaning out. A small access hole is cut in the biting surface. The pulp is lifted out, and every canal is measured, then shaped using fine files and washed through repeatedly with disinfectant.
- A dressing, where needed. If infection is severe, a medicated paste is sealed in beneath a temporary filling for a fortnight or so.
- Sealing the canals. Once clean and dry, the canals are packed with a rubber-like material and sealer all the way to the tip of each root.
- Restoring the tooth. A front tooth normally needs only a filling. A back tooth usually needs a crown or onlay to prevent it fracturing.
Front teeth tend to have a single canal and can frequently be completed in one appointment. Molars may have three or four, often fine and curved, which is why they need more time.
Our Fees for Root Canal Treatment
| Treatment | Fee | Plan member |
|---|---|---|
| Pain-relief first stage | £150 | £135 |
| Incisor or canine (front tooth) | £450 | £405 |
| Premolar tooth | £525 | £473 |
| Molar tooth | £595 | £536 |
| Re-treating a previous root filling, from | £595 | £536 |
| Fibre post, where a core needs support | £160 | £144 |
| Onlay in ceramic | £750 | £675 |
| Back tooth ceramic crown, from | £675 | £608 |
Where pain brings you in for the first stage, that payment is knocked off the total fee at completion of the tooth. The crown or onlay is charged on top. A written plan sets everything out before treatment begins, and members of our dental plan pay 10% less. 1 The remaining fees are on our full price list.
Is It Painful?
Root canal treatment has a far worse reputation than it has earned. With the tooth fully numb, what most people notice is pressure, a little vibration and the occasional click; some even doze off. The pain people associate with it is usually the toothache beforehand, which the treatment takes away.
For a few days afterwards the tooth and gum will feel tender, particularly on biting. Ordinary painkillers, taken as directed on the packet, normally deal with it, and most people head straight back to work. If you are nervous, mention it when booking. We will agree a hand signal so you can stop us at any moment, and IV sedation is an option for longer appointments.
Caring for the Tooth After Treatment
- Treat the tooth gently until its permanent filling, onlay or crown is fitted; temporary fillings are not designed for crunching
- Keep brushing and cleaning between the teeth as usual, since clean margins are what keep fresh decay out
- Should the temporary filling drop out between appointments, phone us, because an open tooth allows bacteria to re-enter the canals
- Arrange your crown or onlay without delay. A root-filled back tooth left unprotected is the commonest reason such teeth are eventually lost, as they grow more brittle
- Get in touch if you notice swelling, or if the pain worsens rather than eases after three or four days
Beyond that, a root-filled tooth asks for nothing out of the ordinary. We will check it at your routine examinations and take an occasional X-ray to confirm the bone has healed around the root.
When Treatment Fails
The great majority of root-filled teeth settle and go on to give many years of healthy service, although not all of them do. An old root filling can break down if a canal was overlooked, the seal has leaked, or fresh decay has crept in beneath a crown. The tooth may start aching again, or a gum boil may develop. It can often be treated a second time; repeat treatment begins at £595.
If a tooth has unusual anatomy or has already been treated once, we may recommend a CT scan, £160, on the scanner we have here. It shows the canals and the bone around them in three dimensions and helps us judge whether retreatment is worth attempting. If it is not, we will walk you through the options for replacing the tooth, which our dental implant cost guide covers in detail.
Your dentist carries out root canal treatment here at the practice. Where a tooth is exceptionally complex, we will tell you and talk about referral.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.