root fillings (root canals)

Saving your natural teeth, if possible, is nearly always the best option. A root filling can be a cost-effective way to treat teeth with damaged pulp and is usually less expensive than extraction and placement of a bridge or an implant. Root treated teeth also have a very high success rate and can last a lifetime.

Root canal treatment, also known as endodontics, is carried out when the nerve or blood supply of the tooth (the pulp) becomes damaged, degenerates or becomes infected, usually due to decay or injury. The affected pulp is removed, the root canal is cleaned and then filled and sealed, to prevent any further infection occurring. Some front teeth have a single canal but many have two, three or more canals.

It is important to treat a damaged pulp because if left, it can become acutely infected, leading to an abscess, significant discomfort and if there is no drainage the tooth may need to be removed.

All dentists are trained to carry out endodontic work, but if it is a complex case, your dentist may prefer to refer you to a specialist endodontist.

Endodontics is a very skilled and detailed procedure. The first step is to treat any acute infection, which may involve antibiotics but should also include if possible, the extirpation or removal of the damaged pulp. Any abscess may also be drained at this time. A rubber dam or protective layer may be placed around the tooth to isolate it from the rest of the mouth. The dentist or endodontist then uses a powerful antiseptic irrigant and a selection of extremely fine instruments to clean out the root canal or canals, removing all traces of the infected pulp, and shaping it ready for the filling. X-rays will be needed to judge the length of the root canals accurately.

Often a temporary filling is placed and the tooth left to settle. At a further visit the tooth is checked and if the infection has cleared a permanent root filling is placed in the root canal to seal it up and prevent re-infection. Some endodontists prefer to do the root treatment at a single visit, especially if the pulp was damaged rather than infected.

If you don't want root canal treatment the tooth may need to be extracted. Once the pulp is destroyed it cannot recover and there is the risk of infection spreading. Most people would prefer not to have an extraction and root canal treatment is usually very effective.

No, a local anaesthetic is used.

Nowadays, modern techniques and materials mean that the tooth should not darken or discolour as was the case in the past. If discolouration should occur, the tooth can be treated to restore its natural appearance.

If carried out well, endodontic treatment should last indefinitely. If, however, infection does occur again, it may be re-treated to achieve a better seal or in some cases a surgical procedure called an apicectomy may be undertaken to try to resolve the infection. A root filled tooth dries out and becomes much more brittle and should be protected by a crown or an onlay that covers the cusps of the tooth.

Once the tooth is filled it can be cared for in just the same way as your other teeth. Clean at least twice daily with fluoride toothpaste, floss regularly and keep sugary snacks and drinks to a minimum. Visit your dentist for regular checkups to ensure that problems can be found and treated early. Chewing sugarfree gum for 20 minutes after meals has been shown to reduce tooth decay.