Root canal treatment

The treatment is done under local anaesthetic and is generally no worse than having a filling. Most of the pain people associate with root canals is the pulpitis or abscess pain that comes before it, which the treatment relieves. Tenderness for a few days afterwards is normal and usually settles with paracetamol or ibuprofen.

A cohort of 598 endodontically treated teeth followed for 5 to 37 years reported cumulative tooth survival of 97% at 10 years, 81% at 20, 76% at 30 and 68% at 37. Survival means the tooth is still in the mouth, not that it was never symptomatic or never redone. How long yours lasts depends more on how much sound tooth structure remains, the quality of the final restoration and your periodontal health than on the root filling itself.

Back teeth almost always do. CADTH's review found cumulative survival of 94% at 5 years for crowned root-filled teeth against 63% for direct restorations, and Ng and colleagues reported odds of survival 3.9 times higher (95% CI 3.5–4.3) with a crown. No guideline mandates a crown in every case — a molar that has lost 2 or more walls is a far clearer indication than an intact front tooth — so ask which category your tooth is in and make us justify the answer.

The root filling itself takes one or two appointments of 60 to 120 minutes. If you are having the crown as well, plan on 4 appointments across 7 days, because the laboratory needs 3 to 5 working days. A Cochrane review of single- versus multiple-visit treatment found no difference in radiographic failure at one year, so compressing the endodontics into one trip does not compromise the result.

Not the same day. Felkai and colleagues (British Dental Journal, 2023) set 72 hours as the minimum interval between non-surgical endodontic treatment and flying, because cabin pressure acting on trapped gas and residual inflammation can produce barodontalgia on ascent and descent. 5 days is more comfortable, and if you stay for the crown you are flying 7 days out anyway. This is not a clotting question — there is no admission, no general anaesthetic and no immobility involved.

Where the tooth is restorable, keeping it preserves the natural periodontal attachment and avoids surgery and bone grafting, and long-term survival for the two options is broadly comparable. Extraction is the better answer when the tooth is unrestorable, has a vertical root fracture, or has advanced periodontal attachment loss. It is a decision about one specific tooth, made on that tooth — not on averages.

€300 to €750 per tooth with us, all-in: consultation, radiographs and cone-beam CT where indicated, anaesthetic, rubber dam, cleaning and filling of every canal, a fibre post and core where the tooth needs one, and a definitive ceramic or zirconia crown with the laboratory work. The low end is a single-canal front tooth; the top end is a molar with 3 or 4 canals, a post and core and a zirconia crown, or a retreatment. Endodontics is quoted per tooth, never per arch — any 'full arch' figure you are shown is a bundle of unrelated procedures.

Mild tenderness on biting can persist for a couple of weeks while inflammation at the root tip resolves, particularly where the pre-treatment lesion was large. Pain that runs past that, or that returns after settling, can indicate a missed canal, incomplete disinfection, a high restoration, a cracked root or a periodontal problem, and needs reassessing with radiographs. Retreatment and apical surgery are recognised next steps, not accidents.

Very few. The work is chairside under local anaesthetic — no incision, no general anaesthetic — and anticoagulants are not stopped for non-surgical endodontics. If you take bisphosphonates or other antiresorptive drugs, keeping the tooth this way is the preferred option, because it avoids the extraction that carries the jaw-osteonecrosis risk those drugs are known for. A prosthetic heart valve or previous infective endocarditis does not rule you out either; it means a single dose of prophylactic antibiotics before we start, per current guidance. Pregnancy is not a reason to leave an infected tooth untreated — treatment for pain or infection is considered safe with lidocaine local anaesthetic, the second trimester is simply the more comfortable window for elective timing, and the flight is the bigger question than the dentistry. The real exclusions are tooth-level, not patient-level: a vertical root fracture, too little sound structure to restore, or advanced periodontal attachment loss — in which case we will say so and talk about extraction instead.

Tenderness on biting for a few days — sometimes a couple of weeks — is normal and settles with paracetamol or ibuprofen. What is not normal: swelling that spreads towards the eye or down under the jaw into the neck, difficulty swallowing or breathing — that one is emergency care immediately, not a message and a wait — fever or feeling generally unwell, or severe pain with rapid swelling and bruising within hours of the appointment, which can signal irrigant forced past the root tip and needs same-day review. Two mechanical problems are worth a message rather than a wait: a bite that hits the treated tooth first, which takes minutes to adjust and days of pain to ignore, and a temporary filling that has cracked or come out between visits, because the canal system is only clean for as long as it stays sealed.

No. The claim descends from the 'focal infection theory' of the early 1900s and the work of Weston Price, whose experiments lacked the controls modern research requires and whose conclusions mainstream dentistry abandoned decades ago. There is no valid scientific evidence linking root-canal-treated teeth to cancer, heart disease or any other systemic illness — the American Association of Endodontists maintains a standing rebuttal precisely because the claim keeps resurfacing online. The logic is also backwards: the treatment removes infected tissue and seals the canal system against reinfection. The thing that genuinely does seed bacteria into the bloodstream and the surrounding bone is what the treatment takes away — an untreated abscess.