Added by Klaudia Grabowska on 13.01.2020 | Reviewed by Tomasz Lewandowski

What is root canal treatment?

Each tooth in a jaw has a root canal system located in the center of the tooth (in each root). Once it is infected by bacteria, root canal treatment is needed. So, what is a root canal? This treatment is also called endodontics or endodontic treatment. It allows a decayed or infected tooth to be repaired and saved by eliminating the bacteria from the infected root canals. Patients usually see the dentist when they feel pain in the teeth and, in the majority of cases, the reason for the excruciating pain is the infection. This can only be resolved by endodontic treatment or extraction. It should be noted that if patients visit a dentist regularly every year and maintain proper oral hygiene, root canal treatment could probably be avoided. Despite this, the American Association of Endodontics estimates that there are over 15 million root canal treatments performed every year and we hope that in this article, you will find all the important information regarding endodontic treatment.

What is the dental pulp?

The dental pulp is a term strongly linked to root canal treatment because this is the area where the treatment takes place. Generally, the dental pulp is the central part of a tooth structure, as illustrated below:Tooth structure

Pulp belongs to the endodontium, which is the dentin-pulp complex. The structure of pulp, as explained in an article for “News Medical” is developed from neural cells in the fetus. These cells concentrate and form dental papilla. The pulp is surrounded by a layer of protective cells. It has also a rich nerve structure and a large number of blood vessels. When root canal treatment is performed, the dental pulp is completely removed. The hard chamber that surrounds the pulp usually protects it from infections but when the tooth becomes decayed or the dentine and enamel are damaged by cracks, injury, dental caries, or fractures, this chamber erodes away and cavities or holes are formed, which exposes the pulp to microbes, some food or extreme temperatures and as a result, cause toothache. As the infection progresses, the pulp is at risk of becoming necrotic. In addition, the surrounding tissues and root structure may become infected as well, which causes jaw bone or root infections.

How many root canals do you have in a tooth?

The number of root canals varies depending on the tooth. The table  below shows the number of roots and canals for both upper and lower teeth:

Jaw


Tooth type

Tooth number

The usual number of roots

The usual number of canals for a tooth

Upper


Incisor


7, 8, 9, 10

1

1

Upper


Canine tooth


6, 11

1

1

Upper


1st Premolar


5, 12

2

2

Upper


2nd Premolar


4, 13

1 or 2

1 or 2

Upper


Molar

1, 2, 3, 14, 15, 16

3

3 or more (usually 3 or 4)

Lower

Incisor


23, 24, 25, 26

1

1 or 2

Lower


Canine tooth

22, 27

1

1

Lower

Premolar

20, 21, 28, 29

1

1 or 2

Lower

Molar

17, 18, 19, 30, 31, 32

2


3 or more (usually 3 or 4)

So, summarising the above, all the front teeth, that is upper and lower central and lateral incisors, as well as canines (called also cuspids or canine teeth), have only one root. On the back teeth, the upper 1st premolars have two roots, 2nd premolars have one or two roots and all lower premolar teeth have one root only. The upper molars usually have three roots and lower ones – two roots.

The above rules can vary and dentists are aware of this and always check before starting the treatment. The main variants are:

  • back lower molar teeth usually have at least three roots, but sometimes they have only two;
  • upper second premolars usually have a single root, but they can have two canals;
  • it is common that the front upper molar teeth (especially the 1st molars) have two canals;
  • central and lateral lower incisors may have two canals in one root.

The number of canals is not visible to the naked eye, so a dentist always performs an x-ray or RVG of the infected tooth to see how many canals it actually has. However, even these examinations do not guarantee the clear image of a tooth inside, and then specialists need to perform tomography or microscope treatment.

What Are the Signs That Root Canal Therapy Is Needed?

Generally, regular dental check-ups will allow the endodontist to identify any tooth decay or gum disease and treat it before the root system becomes infected. However, people often forget about their check-ups and only toothache reminds them of the necessity to visit a dentist. Below are the main conditions and signs that root canal treatment may be needed.

1. A tooth with irreversible pulpitis

Pulpitis refers to pulp tissue inflammation – a response to tissue irritation or injury. There are cases where the inflammation is so severe that it becomes irreversible. This means that the pulp tissue has been damaged to such an extent that it cannot be repaired or recovered. Problems leading to irreversible pulpitis, and consequently to root canal treatment, are:

  • traumatic accidents or events
  • advanced decay of a tooth
  • chronic clenching or grinding
  • trauma and irritation caused by dental work or restorations.

The most common sign of this problem is pain caused by an irritating stimulus, e.g. hot and cold (the problem of sensitive teeth) and/or postural change (for instance lying down or bending over). Such pain does not disappear when the stimulus is removed but rather endures for a longer time. There are also cases where the pain appears without any stimulus and is accompanied by gum infection.

2. A tooth has a necrotic dental pulp (a dead tooth)

The term “necrotic pulp” means that the pulp tissue has died. It is the final stage of tooth decay where a tooth is fully exposed to all bacteria and debris and is not protected by anything or it may appear regardless of the decay, as a result of some injury or trauma. The signs of this deterioration in the state of the tooth are:

  • discomfort – the tooth is very tender under pressure (e.g. while chewing) and acute pain is felt;
  • darkening – the tooth pulp degeneration causes dark byproducts to form, which make the tooth darken noticeably. It can be easily observed on the incisor teeth and canines;
  • a gum boil – this lesion often accompanies a necrotic tooth and literally a  drain for pus; it grows over weeks or months while the infection gets stronger;
  • the acute flare-up of an infection – this happens when the bacteria living in the necrotic pulp become active and causes severe pain, swelling, and throbbing

3. Badly fractured or cracked teeth

breaking tooth

One of the reasons that root canal treatment may be needed is when the tooth is broken or cracked. This may happen during eating solid food, an injury or teeth grinding and clenching

Root canal treatment may be needed when bad teeth have been broken or cracked in such a way that the area near the pulp tissue is also affected. The usual causes for this type of damage are eating solid food (e.g. hard candies), an injury (e.g. an accident), unforeseen items in meals (e.g. a bone), or teeth grinding and clenching. Teeth, post-dental treatment like dental fillings, are more vulnerable to such events. Once a tooth has been injured in a way described above, it is:

  • intensely painful while chewing and biting (when pressure is released or applied);
  • sensitive to acidic, sweet, hot and cold food;

This pain is very characteristic because it is almost impossible to attribute it to a single tooth to get toothache relief. It radiates to a greater area in the mouth.

4. Teeth whose pulp has been  “sacrificed” as a planned action

Sometimes, a dentist makes the decision to compromise the pulp when he performs a more serious treatment. It happens when a badly misaligned tooth is crowned, overdenture abutments are installed or there is a need for a root amputation. Then, root canal treatment precedes other dental treatments.

5. Teeth deeply sensitive to the changes in temperature

This problem can be very uncomfortable for people who do not always realize that it can be treated and do not know how to get rid of the toothache. Firstly, dentists try applying less invasive solutions such as fluoride or other compounds as a toothache cure, but if this does not work, root canal treatment is an effective solution that eliminates the problem of tooth sensitivity and sore gums (swollen gums).

6. A pulp exposure

It refers to the situations where the dental pulp is denuded (exposed) accidentally or as a result of tooth decay. It makes a tooth extremely sensitive even to the most gentle factors and causes a huge discomfort and pain. 

Root canal procedure

Root canal treatment involves four stages, which, on completion, can restore a heavily infected tooth. The root canal procedure time and the number of visits vary depending on the tooth type, its condition, and the number of root canals, but usually, there are one or two visits. A tooth x-ray will allow a dentist to give an estimated length of time the treatment may take, however, the exact number of visits is determined only after the dentist has opened the tooth and seen the roots. Generally, the front teeth are treated quicker than the back ones because their canals are straight and wide and it is relatively easy to access them. Below are the general root canal procedure steps.

x-ray root canal teeth

The root canal treatment time depends on the tooth type, condition and the number of root canals. Based on the x-ray the dentist estimates the length of time the treatment may take, however, the exact number of visits is determined after opening the tooth and seeing the roots by the doctor

Tooth preparation

Once a dentist takes the x-ray and has a general idea of what to expect in the tooth and how to plan the treatment, he administers a local anaesthetic which numbs the tooth as well as the surrounding tissue. Then, the tooth is isolated so that it has no direct contact with any teeth. For isolation, dentists may use various materials and forms. However, the British Endodontic Society recommends using a rubber dam (called a dental dam) which perfectly fits around a tooth protecting its interior from the bacteria in saliva but still permitting normal swallowing during the treatment. It is thought to have made a great contribution to the success of root canal treatment and every dentist should aim to use it. Moreover, if a tooth has been filled before, the filling must be removed and all pulpal walls need to be reconstructed. It might happen that a tooth is damaged so badly that even a root canal cannot save it and the extraction is necessary. 

Tooth opening

When the tooth is numbed and isolated, a dentist moves on to open it up. The so-called “access cavity” (a hole in a tooth), which is made with the use of a dental drill, permits access to the pulp chamber and the root system. Dentists need to locate all the canals, which are thin and curved, and make sure that the whole infected material is visible. Often, they have to use a special microscope and a very bright light to examine the tooth inside.

Cleaning the root canal

Teeth during the root canal treatment icon

When the tooth is open, a dentist starts to deep cleaning and disinfecting by removing the pulp tissue and all the contaminants, such as debris and bacteria

After opening a tooth, a dentist moves on to deep teeth cleaning and disinfecting them by removing the pulp tissue and all the contaminants, such as debris and bacteria. Firstly, the dentist measures the length of each root canal, usually using Xray and electronic devices. It is important to precisely clean the infected area and avoid irritating the healthy tissue. Then, the canals are cleaned, enlarged and shaped with the use of several little files (they look like pins). These files break up and separate the tissue and debris from the inside and the walls of a tooth. During the tooth-cleaning process, the dentists also irrigate the tooth using antibacterial liquid (such as physiological saline, sodium hypochlorite, citric acid, or chlorhexidine) to remove all the loose debris. Tooth irrigation is an extremely important part of tooth cleaning and is done many times at this stage. If the treatment is very complex and cannot be completed in one visit, the dentist fills the tooth roots with a medication (called a root canal temporary filling) that kills all the remaining bacteria and puts in a temporary filling material as protection between the tooth cleaning visits.

Root canal filling

The cleaned, shaped and widened canals are then prepared for the tooth filling. The dentist uses a gutta-percha material. It is a thermoplastic material, which, when heated, becomes soft and perfectly fits inside the chamber. It is extremely important that the entire cavity of the root canal is filled because otherwise, the tooth may get re-infected. When the material solidifies and the canals are filled, the root canal treatment is finished and restoration of the visible part of the tooth follows. Usually, the dentist fills and restores the rest of the tooth with a filling material. Nowadays, dentists advise restoring a tooth after a root canal with prosthetic works, such as crowns, denture adhesive, inlay, onlay or overlay. Of course, regular fillings are also used, but they are less and less popular. 

Crown after root canal treatment

A crown is a cover or tooth cap which replaces the tooth. It restores the shape, size, color, and function of the tooth. After root canal treatment, a tooth may be too fragile to function normally and could break or fracture very easily. Dental crowns eliminate these problems. They may be made from ceramic, metal, porcelain or powdered glass materials or a mix of metal and porcelain.

A dentist begins the procedure of dental crown after root canal treatment by taking impressions of the tooth to prepare a mold. This mold is then used to create a perfectly shaped and sized crown. In most places, it takes a few days to create a crown, however, there are dental surgeries/clinics where crowns are offered as a one-day procedure. When the crown is ready, it is glued to the crown-root inlay which is put after the root canal.

Root canal recovery

The main problem with the root canal recovery is the delayed root canal pain relief. Patients have usually experienced severe pain before they end up in the dentist’s office, so it is natural that they want it to disappear as soon as possible. The anaesthesia eases off a few hours after the procedure, and patients may feel slight pain and sensitivity after that. However, regular painkillers (like ibuprofen or paracetamol) should help. The discomfort improves within a few days. If it doesn’t, patients are advised to visit a dentist to check the cause of the pain. When patients decide to have a crown on a treated tooth, they are provided with a temporary filling, which requires special care, before the crown is created. Such a filling is quite fragile, so it is not recommended to bite hard and/or eat sticky food or to put too much pressure on the treated tooth. Of course, patients have to take proper care of their teeth to prevent any possible tooth damage. This includes brushing teeth at least twice a day, daily flossing, regular professional cleans in the dental surgery/clinic, and check-ups every year. 

Root canal aftercare

Root canal treatment aftercare is really important to achieve the best possible outcome as well as speed up the root canal recovery time.

We advise patients to:

  • reduce the stress on a treated tooth (before crowning, the tooth is unprotected and patients should avoid chewing on the treated side of the mouth)
  • choose soft food, at least at the beginning of recovery
  • brush teeth very gently
  • get the crown on a treated tooth attached as soon as possible
  • take pain relievers when needed
  • attend follow-up appointments and perform RVG or x-ray to check if the tooth is ok
  • tell your dentist about any concerns (e.g. if there is chronic pain, a fever, etc)
Ladybrushing teeth

Good aftercare like brushing the teeth, choosing soft food or follow up appointments is essential. If the patient ignores dentist suggestions regarding aftercare, it may lead up to a tooth loss

 

Root canal treatment is a routine procedure and in fact, every dentist can perform it. It is also very effective and means that the infected tooth can be saved. However, it does affect the tooth structure, so aftercare is vital. If patients ignore their dentists’ suggestions concerning aftercare, they could lose the tooth (if it subsequently splits or fractures). If it fractures below the gums, rebuilding it is impossible and the tooth will have to be extracted. In addition, it is strongly advised that patients quit smoking to improve their oral health and speed up the recovery after root canal therapy and crown placement. We hope everyone realises the destructive effects that smoking has on the health, appearance and general condition of the teeth, so root canal treatment may provide the motivation and drive to give it up. Finally, the treated tooth should not hurt or cause any discomfort at all, so if patients have a fever, feel that the filling has fallen out, feel pain when biting down or the tooth is cracked or broken, they should contact their dentist.

What to eat after a root canal?

Eating just after root canal treatment is a significant part of the recovery and deserves mentioning. The American Association of Endodontics (AAE) emphasizes that eating soft food after the treatment prevents accidentally biting the mouth inside or irritating the sensitive mouth area. 

The AAE suggests what to eat after the root canal. Patients recovering from root canal treatment are advised to eat the following soft food:

  • pasta or some other types of noodles
  • avocado
  • tofu
  • mashed bananas
  • scrambled eggs and omelettes
  • meatloaves
  • vegetable soup and soft or pureed vegetables
  • oatmeal or cream of milk and wheat

Some other food recommendations include: fruit smoothies, milkshakes, mangos, pears, peaches, mashed potatoes, rice pudding, sushi, pancakes, hummus, cheese, most Chinese, Thai and Indian food is also suggested.

Strawberries smoothie

Soft food like fruit smoothies, milkshakes, mangoes, pears, peaches, mashed potatoes, rice pudding, sushi, pancakes or pasta is recommended after a root canal treatment

Food that may cause the crown or filling to come off or crack should be avoided, of course. Chewing sticky food may dislodge a temporary crown, and eating hard candies or ice can chip even a porcelain crown. If there are some nerves left in the treated tooth, it will be particularly sensitive and tender so patients should be careful about the temperature of the food they eat. Foods that should be avoided include:

  • too hot or cold beverages
  • ice cubes
  • hot soups
  • hard food like nuts
  • chewy food like toffees, some sweets, and gums
  • crunchy food like corn, carrots, apples

The extreme temperature of food and drink may trigger the sensitivity around the restored area, so patients should always pay attention to this aspect. During recovery, patients should also avoid spicy food (which causes sensitivity and discomfort) and alcohol (which increases bleeding).

How successful is root canal treatment?

The root canal success rate and its effectiveness depend on such factors as diagnosis (the condition of the pulp just before the treatment), the anatomy of the root canal system (the success and effects are much more difficult to achieve where the canal system is very complex), proper tooth restoration (if a crown is placed after too long a time, there may be a leakage to the canals), maintaining oral hygiene, and the general condition of the other teeth (e.g. malocclusion, misalignment, or parafunction).

Root canal treatment belongs to the group of highly successful procedures. Almost 90% of treatments last for at least 9-10 years. Of course, a patient’s care and oral hygiene play a key role in the effectiveness and durability of the treatment. The effects may last longer, even for a lifetime, especially for those who do not smoke. Sometimes people have root canal problems with a treated tooth and it is necessary to perform secondary root canal treatment to save it or the dentist may suggest some alternatives like extraction or implantation. The specialist’s skills and expertise can also influence the effectiveness of the root canal treatment. We are not diminishing the services of regular dentists here, but it is indisputable that endodontists (certified specialists in root canal treatment) perform excellent root canal treatment with minimal instances of failure. Thus, if you are looking for the best specialist treatment, it would be best to choose an endodontist.

Root canal or extraction?

lady at the dentist

The dentist will take into consideration all facts and decide whatever to save the tooth or remove it. If there is a big crack or cavity that reaches far below the gum line and causing a serious weakness of the tooth, then extraction is recommended. If only the pulp is compromised the root canal treatment can help

Root canal treatment is a procedure aimed at repairing the infected and damaged tooth without extracting it completely. During the treatment, a dentist removes the damaged inside of the tooth, then thoroughly cleans and disinfects the remaining part and finally fills it with the material. So, in root canal treatment, only the damaged root is removed. On the other hand, extraction involves removing the entire tooth from its socket in the bone. Dentists do not extract a tooth if there are alternative treatments. Extraction is treated as a last resort. So, the dentist has to carefully evaluate the tooth and make the decision whether to save it or remove it. The common reason for extraction is the damaged tooth structure. If the crack or cavity in a tooth is so deep that it reaches far below the gum line thereby causing a  serious weakness of the tooth, then extraction is recommended. However, if it is only the pulp that is compromised, this can be removed without extracting the whole tooth thanks to root canal treatment. 

It is worth mentioning that extraction has two forms – simple and surgical. A simple extraction is performed under local anaesthetic. The dentist firstly uses a dental instrument called an elevator to loosen a tooth, and then removes the tooth with forceps. A surgical extraction takes place when a tooth is not visible because it has broken off, has not cut through the gum yet or is impacted. Such a tooth is extracted by an oral surgeon and the recovery takes a longer time. Regardless of the method, when a tooth has been extracted, a patient is left with a hole in their mouth which might cause some discomfort, especially if the tooth is in a visible place. Hence, dentists advise implantation as a solution. A dental implant replaces both a root and a crown of a tooth, and as a result, guarantees an aesthetic look and fulfills all the functions of a natural tooth.

Root canal complications

Complications after root canal treatment are rare, but it’s good to be aware of them. Properly identified, post-treatment problems are effectively solved by dentists. The most frequent ones are presented below.

Pain after root canal

Girl in toothache

The procedure as itself isn’t so painful due to local anaesthetic but there may be moderate post root canal pain lasting a few days after the treatment which is normal and should not be a worry but if it lasts longer the dentist should be informed

Root canal treatment requires a deep cleaning of the root canals, so the nearby gum area and surrounding nerves are often irritated. So, moderate post root canal pain lasting a few days after the procedure is normal and should not be a worry. The procedure itself is not painful thanks to a local anaesthetic. After this wears off (usually after several hours), patients may feel tooth sensitivity and a mild root canal pain in the treated area, so it is recommended to take painkillers. It is also important that patients do not expose themselves to any greater pain by e.g. eating hard food or smoking just after the treatment. Over time, the pain should wear off. If it doesn’t, it is necessary to visit a dentist again. Sometimes, pain is an indicator of the need for more cleaning appointments. Some teeth can be cleaned during one visit, but for some – up to two or three sessions are essential. Moreover, if the pain when breathing remains at the same level or intensifies, patients must visit a dentist who will either prescribe a stronger root canal pain remedy or perform an alternative treatment (or a revision root canal). Summing up the problem of pain, patients should remember that root canal treatment is performed to eliminate pain. The first few days are considered as recovery and throbbing pain may exist, however, it should be reasonably tolerable. So, if the pain returns, a patient should visit a dentist as soon as possible. 

Undetected Crack in the Root

A crack in a tooth which extends to the root of a tooth is easily reached and colonised by bacteria. While the root canals can be cleaned, the tiny spaces formed by any cracks cannot be cleaned. This means that if the bacteria reach these spaces, they cannot be completely removed and the tissues surrounding the roots are constantly irritated. Coping with the problem of cracks is difficult mainly because of two factors. Firstly, a dentist might not be aware of the existence of a crack or underestimate the cracks that are visible. Secondly, the cracks that are not treated often cause root canal treatment failure. In the majority of cases, the only way to solve the crack problem is a tooth extraction or a root amputation (for teeth with more than one root).

A defective or inadequate dental restoration

This refers to permanent restoration after root canal treatment, which is the last stage of this procedure. A defective or inadequate restoration will not fulfil its protective function and “invites” bacteria, germs and other contaminants to enter the inside of the tooth again. This malfunction is called a coronal leakage. It is estimated that it accounts for 13% of failed root canal treatments. Once the roots get re-infected, there is a need to perform a secondary root canal procedure in order to provide an adequate seal. Usually, the coronal leakage can be prevented when the permanent restoration is attached very shortly after root canal treatment. Whether it is in the form of a filling or crown, it needs to cover a tooth and block its interior tightly and thoroughly. So, patients should pay attention to the dentist’s skills and reviews when choosing their clinic/surgery and make sure that only high-quality materials used. 

A breakdown of the inner sealing material

The inner sealing material and its integrity inside a tooth play a major role in the success

of root canal treatment. It forms a barrier for the bacteria and contaminants, which protects the cleaned canals from being re-infected. This material fills the root canals and its amount has to perfectly fit the canal size. If there is too much or too little sealing material in a canal, the canal is not fully protected and bacteria can get inside easily. Also, it is possible that over time, the seal deteriorates. This happens, not because of an imprecise filling or uncovered cracks, but because the material simply wears out. It is estimated that root canal treatment lasts for 5-10 years (of course, it depends on the quality of work and a patient’s care), so patients must be aware that there may come a time for re-treatment.

More than one root causing problems

Usually, root canal treatment involves treating only one canal even if a tooth has a complex root canal system. If more than one canal is infected and a dentist overlooks this, it is certain that a patient will still feel root canal pain and the tooth will require further treatment soon. Root canal treatment on the same tooth is more complicated because a dentist has to remove the filling material and crown to get inside the tooth and fix the canal system. Such a problem appears mainly in molars because they tend to have more canals than roots. The most effective prevention of this complication comes down to the dentist and his/her skills. Once a tooth is opened correctly and there is clear access to the inside of the tooth and its canals, there is no chance that the dentist can overlook any canal. But, an inadequate tooth opening means that not everything inside is visible and the treatment will probably be incomplete and ineffective. 

Alternatives to root canal

Root canal treatment is performed for badly infected and damaged teeth. Its aim is to save a tooth. However, when the infection is so deep that it cannot be saved, the dentist will suggest some alternative treatments like tooth extraction and implantation. Sometimes, patients also choose to leave a tooth as it is without any treatment. 

Extraction

Both tooth extraction and root canal treatment are solutions for teeth which cannot be healed with a simple drill and fill because the damage and infection are too extensive. Root canal aims to save a tooth from extraction and is performed when the pulp is damaged and diseased to a great extent or when the pulp is even dead. However, the rest of the tooth must be in a relatively good condition and be worth saving, otherwise, the dentist might suggest removing a tooth, but this is always the last resort. It is safer to extract a tooth which is seriously damaged both inside and outside than to treat it with a root canal. Undoubtedly, the recovery after extraction (healing, bleeding and pain) lasts longer than after root canal because the treatment is more complex. However, a patient does have some solutions for replacing the tooth, so no-one should be left toothless. So, it is always good to listen to the dentist and his suggestions regarding the treatment type.  

Do nothing

Doing nothing is actually more of refraining from performing a dental treatment than leaving the problem as it is. There are many

Implant_retained_bridge_model

A dental implant is a solution for extracted tooth, it is a metal screw installed to the jawbone that becomes a part of it and holds an imitation of a tooth (the so-called dental crown)

supporters of the idea that food choices affect oral health. They believe that tooth infection can be healed through a proper diet. This means the elimination of sugar and all meals containing it as well as all grain products. However, although this solution will serve as a good preventative measure, it will not heal a deeply infected and damaged tooth. What is more, there are people who avoid dentists because of fear, shame about their teeth, or some other reasons and when they have a severe toothache, they opt for painkillers or root canal infection antibiotics and many people will even keep taking them for weeks or months. This will solve the effects of the infection i.e. the pain, but has no effect on the cause of the pain and will therefore never heal a tooth.

Dental Implant

Implantation is a follow-up treatment after tooth extraction. If a tooth is damaged too badly to be saved and a dentist decides to perform an extraction,  a patient may decide afterwards to have a dental implant as a tooth replacement. An implant replaces a whole tooth (root and crown) and is often recommended where complete teeth are missing. The implant not only fulfils an aesthetic function but also prevents gums from receding, enables proper chewing and biting and improves phonation and pronunciation. Once placed, dental implants last for years. For many people it is even a lifetime solution, so, without a doubt, it is worth considering this investment. A dentist can place an implant immediately after extraction (on the same visit). Often though, it is more common to wait at least 3 months before implantation so that the gums can heal properly after the tooth extraction.

Root canal cost - how much does a root canal cost?

Private root canal costs in the UK vary depending on several factors, such as:

  • the location of a dental office and its private rates
  • the complexity and extent of the tooth damage
  • the tooth position and its root canal system
  • the equipment and amenities of the dental office.

Of course, all clinics will list the cost of root canal treatment in their price lists. However, patients need to know that these prices are never final. The prices for root canal grow proportionately according to the number of root canals. A dentist will probably not give the patient the final price before examining the damaged tooth and taking an x-ray to assess its condition. So, patients, by all means, can obtain average prices in various clinics (by calling them or checking the price list on a website), but for their own final price, they need to visit physically visit a dentist. 

In the UK, the average prices for root canal treatment range from £100 to £350 for the front teeth and from £350 to £700 for the back teeth. Patients always need to check what this price includes because there are clinics where the initial consultation, x-rays and require are counted as extras and will require an additional payment. 

Prices may vary in different cities. Below you can find a cost comparison prepared by WhatClinic in 2016.

City

Price

Belfast

£213

London

£336

Reading

£368

Milton Keyneys

£349

Plymouth

£264

Bournemouth

£293

Brighton

£280

Cardiff

£256

Cheltenham

£333

Southampton

£357

Glasgow

£206

Manchester

£243

Leicester

£270

Liverpool

£334

Newcastle Upon Tyne

£196

Birmingham

£234

Leeds

£234

Cambridge

£376

Edinburgh

£199

York

£370

How much is root canal on NHS?

The NHS fees are grouped into 3 bands:

  • Band 1 – £22.70 – covers the consultation and examination, x-ray, scale and polish, treatment plans for further work
  • Band 2 – £62.10 – covers the treatments included in band 1, fillings, root canal treatment, teeth extractions
  • Band 3 – £269.30 – covers the treatments included in bands 1 and 2, and more complex treatments, like dental bridges, dentures, crowns.

So, the NHS cost for a root canal is £62.10 in England (in Wales it is £45.00). This price remains unchanged even if more than one tooth is treated and more than one visit is needed. It is also possible to get a crown on the NHS, however, this would be the band 3 price, which is £269.30 (£195 in Wales). Many dentists provide root canal NHS or private treatments, so it is important to ask whether NHS treatment is possible and make sure how much it would cost. 

Root canal abroad - how much root canal cost abroad?

For patients who cannot afford private root canal treatment in the UK and who are not qualified for NHS treatment (because there is no such dentist, the available dates are too remote, or the work needed is too extensive), there is an alternative, which is medical tourism – obtaining the treatment abroad. The top 3 countries for medical tourism are Poland, Hungary, and Turkey. The advantages of going abroad for treatment include:

  • significantly lower prices for all dental treatments (the cost differences stem from the lower costs of living in these countries)
  • high standard of treatment, modern and well-equipped clinics where dentists speak English fluently
  • easy access to these countries thanks to low-cost and direct flights
  • the option to book a full package (the treatment, airport pickup, hotel and transport)
  • opportunity to combine a treatment with a holiday

Patients can arrange treatment abroad either directly with the clinic they have found or with the help of medical travel agencies. In fact, there are many such agencies that offer clinics in a variety of countries and whose assistance is free. The advantage of the use of an agency over booking direct is that the agencies work with multiple clinics and can ask all of them for advice and a cost in order to choose the most affordable option for their customer as well as offering help with flight bookings and the organization of a hotel, transfers, etc. So, the patient needs to do nothing because everything is organized by the agency. 

Among patients from the UK (also from the USA, Germany and Scandinavian countries), the most popular are root canal treatment in Hungary, Poland, and Turkey.

Below is a price comparison for several countries:

 

Root canal in Poland

Turkish flag in the sea

Turkey is considered as one of the best medical tourist destinations due to great tourist facilities, many high-standard clinics and well-educated dentists

Usually, the prices for root canal treatment in Poland are about 75% lower than in the UK. Most clinics are equipped with modern microscopes (laser teeth cleaning), which means that the whole treatment can be performed in only one day. The biggest cities, such as Warsaw, Cracow, Gdansk, and Wroclaw, have direct flight connections with multiple cities in the UK, Norway, Sweden, Germany, and many more European countries and even with the USA. This means fast and cheap trave which usually lasts only 2-3 hours. Also, Poland is a beautiful, historically-rich country. Patients can get their root canal treatment in Poland in a city by the Baltic sea, near the Tatra mountains or in other beautiful regions. Regardless of the city, patients will have the opportunity to visit interesting places, see history, try the traditional Polish cuisine and simply relax. Poland is also a very safe country – the political situation is stable, there are no riots or conflicts and the people are open to tourists (there are over 18 million tourists visiting Poland every year).

Root canal in Turkey

Turkey is a country with the lowest prices for root canal treatment. There are many high-standard clinics with an excellent service, but there are also some questionable places, so patients must thoroughly check the clinic and dentist in Turkey so that they are not disappointed upon arrival. However, more and more clinics do meet European standards and offer as good a service as in Western European countries. Another great asset for Turkey is its location and tourism development. Turkey is one of the top countries for holidays, at the same time being one of the cheapest ones. Here, we would also advise customers to use medical tourism agency services. By using these services, patients are sure that they will go to a renowned clinic with a skilled specialist as well as being able to take advantage of additional services like accommodation and transfers. With regard to flights, the main Turkish cities have well-developed connections to European cities. The one aspect that might discourage people from visiting Turkey is its unstable political situation and earlier terrorist attacks. However, at present nothing worrying is happening and annually, the country welcomes millions of tourists, including those undertaking root canal treatment in Turkey.

Summary

Root canal treatment is one of the most popular dental treatments. It is needed when a nerve and blood supply (called a pulp) is badly infected. Usually, patients feel pain or notice that a tooth darkens at the final stage of damage, so only root canal treatment plus dental crown or tooth extraction plus implantation are the options. There is good news for those who cannot afford treatment, as there is the possibility of getting root canal work done on the NHS or to go abroad for the procedure (patients usually choose Poland, Hungary and Turkey as medical tourism destinations). Of course, whether a root canal treatment is required depends, most importantly, on how well a patient looks after their dental care. Following a healthy diet (avoiding sweets), maintaining proper oral hygiene and attending dental check-up visits (preferably twice a year) will allow you to keep a healthy, hygienic and aesthetic smile.

Sources

NHS Choices, NHS, https://www.nhs.uk/common-health-questions/dental-health/how-much-will-i-pay-for-nhs-dental-treatment/.

Mandal, Ananya. “What Is Dental Pulp?” News, 28 June 2019, https://www.news-medical.net/health/What-is-Dental-Pulp.aspx.

“Endodontists: the Root Canal Specialists.” American Association of Endodontists, 5 Dec. 2019, https://www.aae.org/specialty/.

Johnson, W.t. “Endodontic Treatment Outcomes in a Large Patient Population in the USA: An Epidemiological Study.” Yearbook of Dentistry, vol. 2006, 2006, pp. 263–265., doi:10.1016/s0084-3717(08)70208-3

Religioni, Urszula, and Mateusz Religioni. “Medical Tourism Trends in Poland.” Medical and Biological Sciences, vol. 29, no. 2, 2015, p. 63., doi:10.12775/mbs.2015.020.

Management Association, Information Resources. “Medical Tourism: Breakthroughs in Research and Practice.” IGI Global, 2018. 1-378. Web. 11 Dec 2019. doi:10.4018/978-1-5225-3920-9.

“WhatClinic • Healthcare & Beauty • Read Reviews & Compare Prices.” WhatClinic.com, https://www.whatclinic.com/.

Klaudia Grabowska

Klaudia started to work for Clinic Hunter many years ago, just after graduating from the John Paul II Catholic University of Lublin in Poland and since that time, this job has become her biggest passion and inspiration.

She has gained necessary expertise and experience by serving patients from all over the world (mainly the UK, Scandinavian countries, and the USA), taking an active part in numerous live and video trainings with clinics in Poland, Hungary and Turkey, participating in international medical tourism conferences and events, and completing internal Clinic Hunter courses. Now, Klaudia is an accomplished patient advisor specialising in such fields as dentistry, plastic and bariatric surgery and hair loss treatment. Her main idea is helping people nad making their lives better, that is why this job brings her so much satisfaction and joy.

In private, Klaudia is a bike-tour lover. She travelled to over 25 countries and many of them she visited by bike. However, now she spends every spare moment with her little son.

Send enquiry to the best doctors abroad

Agnieszka
Patient advisor
 

Contact us

Call us

Chat with us

Are you looking for treatment abroad?

Klaudia
Patient advisor