Root Canal Explained
Why a tooth ends up needing root canal treatment, what we actually do at each visit, how much it costs by tooth type, and what keeps a root-filled tooth going for years.
What Does Root Canal Treatment Involve, and How Much Does It Cost in Hamilton?
Root canal treatment clears infected or inflamed nerve tissue out of the inside of a tooth, disinfects the narrow canals in the root and seals them, so you keep the tooth instead of losing it. It's done with local anaesthetic over one or two appointments and feels much like a long filling. At Hamilton Smile Studios it ranges from £450 for a front tooth to £595 for a molar, and if you're in pain a first stage to settle it is £150.
When a Tooth Needs Root Canal Treatment
Every tooth has a living core, the pulp, made of nerve fibres and tiny blood vessels. It runs from the centre of the crown down through one or more narrow channels in the root. Bacteria can reach it through a deep cavity, a crack, a big old filling that's started to leak, or a heavy knock. Once the pulp is inflamed or infected it can't recover, because it's boxed in by hard tooth with no room to swell.
Typical signs are:
- An ache that throbs, wakes you up or arrives for no obvious reason
- Pain from a hot drink that hangs around long after you've swallowed
- Soreness when you bite down on that tooth
- A gum boil or swelling next to the tooth, sometimes with a bad taste
- A front tooth turning greyish months or years after an injury
Sometimes there's no pain at all, and we spot a dark shadow at the tip of the root on a routine X-ray. That still needs treating, because the infection slowly eats into the bone around the root.
Root Canal or Extraction?
If the tooth can be restored, keeping it is nearly always the better choice. You keep your own root, the gum and bone around it, and your natural bite. Taking a tooth out is quicker on the day, but the gap then has to be lived with or filled, and replacing a tooth costs a good deal more than saving one.
| Option | Typical fee | What it means |
|---|---|---|
| Root canal treatment on a molar, plus an onlay | £595 plus £750 | You keep your own tooth |
| Extraction, leaving a gap | £125 | Neighbouring teeth can tip into the space over time |
| Extraction, then an implant and crown | From £2,605 | A fixed replacement, after several months of healing |
| Extraction, then a resin-retained bridge | From £675 per unit | A fixed replacement bonded to the tooth next door |
We'll be straight with you if we think a tooth's chances are poor, for example if it's cracked down the root or there's too little left to rebuild. In that case we'll talk through the replacement options instead. 1
Been Told You Need a Root Canal?
Book in and we'll check the tooth, take an X-ray and talk through the options and fees.
Step by Step: What Happens
- Assessment. We test the tooth, take an X-ray and confirm it's worth saving. You'll get the fee in writing before anything starts.
- Numbing. Local anaesthetic is given after a numbing gel. A very inflamed tooth can take more to numb, so we wait and check it's fully numb before going on.
- Isolating the tooth. A thin sheet of rubber, called a rubber dam, goes over the tooth. It keeps saliva out and stops small instruments or rinses getting into your mouth.
- Cleaning. A small opening is made through the top of the tooth. The pulp is removed, and each canal is measured, shaped with fine files and flushed repeatedly with a disinfecting solution.
- Dressing, if needed. If the tooth is badly infected, a medicated paste is left inside and the tooth sealed with a temporary filling for a week or two.
- Filling the canals. Once the canals are clean and dry, they're filled with a rubbery material and a sealer, right to the tip of each root.
- Rebuilding the tooth. A front tooth usually just needs a filling. A back tooth usually needs an onlay or crown to stop it cracking.
Front teeth usually have one canal and can often be done in a single visit. Molars can have three or four, sometimes curved and very fine, which is why they take longer.
Fees at Hamilton Smile Studios
| Treatment | Fee | Plan member |
|---|---|---|
| First stage, to relieve pain | £150 | £135 |
| Front tooth (incisor or canine) | £450 | £405 |
| Premolar | £525 | £473 |
| Molar | £595 | £536 |
| Redoing an old root filling, from | £595 | £536 |
| Fibre post, if needed to hold a core | £160 | £144 |
| Ceramic onlay | £750 | £675 |
| Ceramic crown, back tooth, from | £675 | £608 |
If you start with the first stage because you're in pain, that amount counts towards the full fee when the tooth is finished. The onlay or crown is a separate fee. Everything is set out in a written plan before we begin, and dental plan members save 10%. 1 Our full price list has the rest.
Does It Hurt?
The reputation is worse than the reality. With the tooth properly numb, most people feel pressure, a bit of vibration and the odd click, and some nod off. The pain people remember is usually the toothache that came before, which the treatment ends.
Expect the tooth and gum to be tender for a few days afterwards, especially when you bite. Ordinary painkillers, taken as the packet says, normally handle it, and most people go straight back to work. If you're anxious, tell us when you book. We'll agree a signal for you to stop us at any point, and for longer appointments IV sedation is available.
Looking After the Tooth Afterwards
- Go easy on the tooth until the permanent filling, onlay or crown is in. Temporary fillings aren't built for crunching
- Brush and clean between your teeth as normal. Keeping the edges clean is what stops new decay getting in
- If the temporary filling falls out between visits, call us. An open tooth lets bacteria back into the canals
- Book your onlay or crown promptly. A root-filled back tooth left without one is the most common way these teeth are lost, because they become more brittle
- Call us if swelling appears, or the pain gets worse instead of better after three or four days
After that, a root-filled tooth needs nothing special. We'll keep an eye on it at your dental examinations and take an X-ray every so often to make sure the bone around the root has healed.
If Treatment Doesn't Work
Most root-filled teeth settle and stay healthy for many years, but not all. A root filling done years ago can fail if a canal was missed, the seal has leaked, or new decay has got in under an old crown. The tooth may ache again or a gum boil may appear. Often it can be treated again; repeat treatment starts at £595.
For a tooth with unusual anatomy, or one that's been treated before, we may suggest a CT scan, £160, on our scanner at the practice. It shows the canals and the bone in 3D, which helps us decide whether retreatment is worthwhile. If it isn't, we'll explain the options for replacing the tooth, which are covered in our dental implant cost guide.
Root canal treatment at the practice is carried out by Dr Karanveer Singh and Dr Lee Min Ning. If a tooth is exceptionally complex, we'll tell you and discuss referral.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.