How Root Canal Works
What leads to a tooth needing root canal treatment, what we do at each appointment, the fee for each type of tooth, and how to keep a root-filled tooth healthy for the long term.
What Happens During Root Canal Treatment, and What Does It Cost in Lanark?
Root canal treatment removes inflamed or infected nerve tissue from inside a tooth, cleans and disinfects the fine canals that run through the root, then seals them, so the tooth can be kept rather than taken out. The tooth is numbed with local anaesthetic, the work takes one or two visits, and most people say it feels like having a longer filling. At Lanark Smile Studios the fee runs from £450 for a front tooth to £595 for a molar. If the tooth is painful now, a first stage to calm it down costs £150.
Why a Tooth Might Need Root Canal Treatment
At the heart of each tooth is the pulp, a soft, living tissue of nerves and fine blood vessels. It fills a chamber in the middle of the tooth and carries on down one or more slender canals inside the root. Bacteria can get in through deep decay, a crack, an old filling that's begun to leak, or a hard knock. Once the pulp becomes inflamed or infected, it can't heal, because it's enclosed in hard tooth and has no space to swell.
Common warning signs include:
- A throbbing ache, pain that wakes you at night, or pain that starts for no clear reason
- Sensitivity to hot drinks that lingers well after you've swallowed
- Tenderness when you bite on the tooth
- A swelling or gum boil beside the tooth, sometimes with a nasty taste
- A front tooth slowly darkening to grey in the months or years after a knock
Occasionally there are no symptoms at all, and the first sign is a dark area at the end of the root on a routine X-ray. It still needs treatment, as the infection gradually wears away the bone around the root.
Saving the Tooth or Taking It Out
If a tooth can be rebuilt, keeping it is almost always the better option. You hold on to your own root, the bone and gum that surround it, and your natural bite. An extraction is quicker on the day, but afterwards there's a gap to live with or to fill, and replacing a tooth costs considerably more than saving it.
| Choice | Typical fee | What it involves |
|---|---|---|
| Molar root canal treatment, then an onlay | £595 and £750 | Your own tooth stays |
| Extraction followed by an implant and crown | From £2,775 | A fixed tooth, fitted after a few months of healing |
| Extraction followed by a resin-retained bridge | From £675 per unit | A fixed tooth, bonded to the one beside the gap |
| Extraction with nothing to replace it | £125 | The teeth either side may drift into the space over time |
If we think a tooth has a poor outlook, perhaps because it's split down the root or there's too little of it left to rebuild, we'll tell you plainly and talk through ways of replacing it instead. 1
Told a Tooth Needs Root Canal?
Book an appointment and we'll examine the tooth, X-ray it, and go through your options and the costs.
What Happens, Stage by Stage
- Checking the tooth. We test it, take an X-ray and make sure it can be saved. The fee is given to you in writing before we start.
- Numbing. After a numbing gel, we give the local anaesthetic. A badly inflamed tooth can need extra, so we allow time and make sure it's completely numb before continuing.
- Rubber dam. A thin rubber sheet is placed around the tooth. It keeps the tooth dry and makes sure no tiny instruments or cleaning fluid end up in your mouth.
- Cleaning out the canals. We make a small opening in the top of the tooth and remove the pulp. Each canal is measured, shaped with very fine files and rinsed many times with a disinfecting liquid.
- Medicating, where needed. A badly infected tooth may have a medicated paste placed inside and a temporary filling on top for a week or two.
- Sealing the canals. When the canals are clean and dry, we fill them to the very end of each root with a rubber-like material and a sealer.
- Restoring the tooth. Front teeth generally only need a filling afterwards. Back teeth generally need an onlay or crown to protect them from cracking.
Most front teeth have a single canal and can often be finished in one visit. A molar may have three or four canals, which can be narrow and curved, so it takes longer.
Our Root Canal Fees
| Treatment | Fee | Plan member |
|---|---|---|
| Molar | £595 | £536 |
| Premolar | £525 | £473 |
| Incisor or canine (front tooth) | £450 | £405 |
| First stage to ease pain | £150 | £135 |
| Retreating a previous root filling, from | £595 | £536 |
| Fibre post to support a core, where needed | £160 | £144 |
| Onlay in ceramic | £750 | £675 |
| Crown in ceramic for a back tooth, from | £675 | £608 |
If we begin with the first stage because the tooth is painful, what you pay for it is taken off the full fee once the tooth is completed. The onlay or crown is charged separately. You'll have a written plan showing everything before we start, and members of our dental plans save 10%. 1 All our other fees are on the price list.
Will It Hurt?
Root canal treatment has a worse reputation than it deserves. Once the tooth is fully numb, most people notice pressure, some vibration and the occasional click, and a few even doze off. The pain people tend to remember is the toothache beforehand, and the treatment is what stops it.
The tooth and gum are likely to feel tender for a few days, particularly when you bite. Everyday painkillers, taken as directed on the pack, usually keep it under control, and most people return to work straight afterwards. If you're nervous, let us know when you book. We'll agree a signal you can use to stop us whenever you want, and IV sedation is available for longer appointments.
Caring for the Tooth Afterwards
- Be gentle with the tooth until the permanent filling, onlay or crown has been fitted. A temporary filling isn't made for hard or crunchy food
- Keep brushing and cleaning between your teeth as usual. Clean edges are what keep fresh decay out
- If the temporary filling comes out before your next visit, ring us. An open tooth lets bacteria get back into the canals
- Don't put off having the onlay or crown made. Root-filled back teeth become more brittle, and leaving one unprotected is the commonest reason they're lost
- Contact us if a swelling appears, or if after three or four days the pain is getting worse rather than better
From then on, a root-filled tooth doesn't need any special care. We'll check it at your dental examinations, with an X-ray now and again to confirm the bone around the root has healed.
When a Root Filling Fails
Most root-filled teeth settle down and stay healthy for many years, though not every one does. An older root filling can fail if a canal was missed, the seal has started leaking, or decay has crept in beneath an old crown. You might notice the tooth aching again, or a gum boil may appear. It can often be retreated, with repeat treatment starting at £595.
Where a tooth has an unusual root shape, or has been treated before, we may recommend a CT scan, £160, taken on the scanner here at the practice. It shows the canals and surrounding bone in three dimensions, which helps us judge whether retreatment is worth doing. If it isn't, we'll go over the ways the tooth could be replaced, which our guide to dental implant costs in Lanark explains.
Our general dentists, Dr Akça, Dr Flessas and Dr Gray, carry out root canal treatment at the practice. If a tooth turns out to be unusually complicated, we'll explain why and talk to you about a referral.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.