Root canal treatment under the microscope
Saving a tooth whose nerve is inflamed or infected: cleaning the canals under the microscope, so we see what we treat, and sealing them.
Root canal treatment (endodontics) saves a tooth whose nerve has become inflamed or infected, usually after deep decay, a crack or a knock. The canals inside the root are cleaned, disinfected and sealed, and the tooth stays where it is.
We work under the microscope: the canals are very narrow, and magnification shows openings, curves and cracks that can't be seen with the naked eye. In short, we see what we treat.
Suitable if
- Pain that comes on its own or wakes you at night.
- Sensitivity to heat that lingers long after the hot drink is gone.
- An abscess or swelling on the gum next to a tooth.
- A tooth that has darkened after a knock.
- An older root canal treatment that has become reinfected.
Not suitable if
- Teeth with a vertical fracture down into the root.
- Teeth so broken down that they can't be rebuilt after treatment.
Your alternatives
For a tooth with an affected nerve there are really two options:
- Root canal treatment keeps your own tooth, with its root. Afterwards the tooth usually needs a build-up or a crown so it doesn't fracture.
- Extraction removes the tooth, and the gap is then replaced with an implant, a bridge or a denture.
When the tooth can be saved, we usually recommend keeping it: nothing replaces a natural tooth perfectly. We also tell you honestly when it no longer makes sense.
How it goes
Consultation and plan
We examine the tooth, test how the nerve responds and take an X-ray. When the roots are complex or the treatment is a redo, a CBCT scan shows the canals in three dimensions.
Preparation
Local anaesthetic, then we isolate the tooth with a thin rubber sheet (rubber dam), so we work clean and dry and the disinfecting solutions don't reach your mouth.
The treatment itself
Under the microscope we open the tooth and find every canal. We clean and shape them with instruments driven by a Kavo endomotor, which controls speed and force, and disinfect them with irrigating solutions. Finally we seal them, usually in the same visit or over two.
Check-ups and maintenance
The tooth is then rebuilt with a build-up or, for back teeth, most often a crown. We check healing around the root on X-rays at your check-ups.
How long it takes overall
- Consultation and X-ray
- one visit
- Canal treatment
- 1–2 visits
- Build-up or crown
- after treatment, 1–3 visits
- Follow-up X-ray
- after a few months
What the cost depends on
The cost depends on the tooth and the number of canals: a front tooth usually has one canal, a molar three or four. It also matters whether it's a first treatment or a redo, which means removing the old material, and what restoration follows.
You get the estimate after the consultation, with the root canal and the rebuilding of the tooth as separate stages. Details in the guide to treatment cost.
Costs
How the cost of a treatment is set →What you will feel
Root canal treatment has a worse reputation than it deserves. Under local anaesthetic it doesn't hurt: you feel pressure and vibration, and most patients say it was easier than they expected. The pain before, from the inflamed nerve, is usually worse than the treatment.
Afterwards, the tooth may be tender to bite on for a few days as the tissues around the root settle. The painkiller the dentist recommends is usually enough.
Risks and limits
A root-treated tooth is more fragile and can crack if it isn't protected in time with a build-up or a crown. That's why rebuilding it is part of the plan.
Sometimes the infection persists or returns, especially when canals are very curved or calcified; the treatment can then be redone or, rarely, the tooth has to come out. The microscope and CBCT reduce this risk but don't remove it.
After treatment
Don't chew on the treated tooth until it has its final restoration: the temporary filling isn't made for force. Pain that grows after the third day, swelling or a fever is worth a call.
Common questions
- How long does treatment take?
- Usually one or two visits for the canals, then the tooth is rebuilt. A redo may need an extra visit.
- Does it hurt?
- No. We work under local anaesthetic. Afterwards, the tooth may be tender to bite on for a few days.
- How often do I come back for check-ups?
- At your usual six-monthly check-ups, and we check healing around the root on an X-ray after a few months.
- Why under the microscope?
- Canals are very narrow and sometimes hidden. The microscope magnifies them and shows openings, curves and cracks that would otherwise be missed: we see what we treat.
- Is the tooth dead after root canal treatment?
- The nerve is removed, but the tooth stays in the bone, supported by the tissues around it, and can work for many years, especially with a crown.
- What happens if I don't have the treatment?
- The infection doesn't go away on its own. It can cause abscesses, spread into the bone and, in the end, the tooth is lost.