Root canal treatment

The root canal's reputation is decades out of date. For most people, the toothache that brings them in is the worst part of the whole story. The treatment itself is done with the tooth fully numbed, and what you feel in the chair is time and mild tedium, not pain. Afterwards the tooth may be tender for a few days, the way a bruise is tender. We won't promise you'll feel nothing, because no honest dentist promises that. But if you've been putting this off because of the name, the name is the scariest part.

What a root canal actually does: it removes the infected or dying nerve from inside the tooth so the tooth itself can stay. The alternative to a root canal is usually not "no treatment": it's losing the tooth.

What happens during treatment

Inside every tooth is a soft core of nerves and blood vessels. When deep decay or a crack lets bacteria reach it, the nerve becomes inflamed and then infected. That's the throbbing, sleep-wrecking toothache, and the reason the tooth may feel worse at night or with heat.

The treatment, step by step: the dentist numbs the tooth thoroughly and checks the numbness before starting. A small opening is made in the top of the tooth. The infected nerve tissue is removed from the fine canals inside the roots, the canals are cleaned, shaped and disinfected, and then sealed with a filling material so bacteria can't return. The opening is closed with a filling.

Depending on the tooth (a front tooth usually has one canal, a molar three or more) and how bad the infection is, this happens in one visit or is split over two, with a dressing in the tooth between them. Many root canals are done in one visit; infected or complex teeth are split over two. Either way, you'll know the plan and the full cost before the first visit starts.

After treatment

Tenderness for a few days is normal. The tissue around the root has been working hard, and it settles. Ordinary painkillers handle it. Chew on the other side until the tooth has its final restoration.

That restoration matters as much as the root canal itself. A tooth that needed a root canal has usually already lost a lot of its structure, and without its nerve it becomes more brittle over time. A back tooth almost always needs a crown afterwards to stop it cracking under chewing forces; a front tooth can sometimes get away with a strong filling. Budget for the crown from the start: a root canal followed by a fractured, uncrowned molar is money spent twice.

Phone us if pain gets worse instead of better after a few days, or if swelling appears. That's not the normal course, and we want to see it.

Root canal or extraction

Sometimes pulling the tooth is the sensible choice, and we'll say so when it is. Extraction makes sense when the tooth is too broken down to rebuild, when the crack runs below the gum, when gum disease has already loosened it, or when the honest arithmetic of root canal plus crown doesn't fit your budget and a gap in that position won't harm your bite.

Keeping your own tooth is usually worth fighting for: nothing artificial chews quite like it, and a gap has consequences of its own: neighbouring teeth drift, and replacing the tooth later with a bridge or an implant costs more than the root canal would have. But it's your mouth and your budget. We'll give you both options with real numbers and let you decide without pressure.

If you wait

An infected nerve doesn't heal on its own. Sometimes the pain fades because the nerve has died. The infection is still there, working quietly. Left long enough it becomes an abscess at the root tip, which can flare suddenly into swelling and serious pain, and each stage makes the tooth harder and more expensive to save. If your toothache has conveniently disappeared, that's the moment to book, not to relax. Severe swelling needs same-day help. See our emergency page.

What it costs

Cost depends mostly on which tooth it is (molars have more canals and take longer than front teeth) and on whether a crown is needed afterwards. We'll quote the whole path in writing before starting, root canal and recommended restoration together, so there's no surprise second bill. Medical aid cover for root canals varies by plan; we'll help you check yours first.

Frequently asked questions

Does a root canal hurt?

The treatment is done fully numbed. Most patients feel pressure and vibration, not pain. The days before treatment, when the nerve is inflamed, are usually far worse than anything in the chair. Expect bruise-like tenderness for a few days afterwards.

How long does the appointment take?

Longer than a filling: the canals are fine and the cleaning is meticulous. Set aside a good part of an hour, sometimes more for a molar. You can drive yourself home afterwards.

Is the tooth dead afterwards?

The nerve is gone, so the tooth no longer feels hot and cold, but it's still held by the same root and gum and still works. It does become more brittle, which is why back teeth need a crown.

Can the infection come back?

It can, though sealing the canals is designed to prevent exactly that. If a treated tooth flares up years later, it can often be retreated. Come in rather than assuming it's lost.

Why is a root canal more expensive than pulling the tooth?

It's slower, finer work: cleaning and sealing canals thinner than a pin, checked against X-rays as we go. Extraction is cheaper on the day; add the cost of filling the gap later and the comparison usually narrows or reverses.