Root Canal Treatment

Root canal treatment — also called endodontic treatment — is the procedure that saves a tooth when the nerve inside it becomes inflamed or infected, usually through deep decay, a crack, or a large or repeatedly replaced filling. The infected tissue is removed, the fine canals inside the roots are cleaned and disinfected, and the space is sealed to help prevent reinfection. It is one of the most valuable treatments in dentistry, and it is carried out routinely at our Wimpole Street practice.

You may need root canal treatment if you have a persistent toothache, lingering sensitivity to hot or cold, pain on biting, a darkened tooth, or a swelling or gum boil near a tooth. Sometimes there are no symptoms at all and the problem is picked up on a routine X-ray. Whatever brings you to us, diagnosis comes first: your dentist will examine and test the tooth, take a digital X-ray, and explain exactly what is happening before any treatment is proposed.

The treatment itself is far more comfortable than its reputation suggests. The tooth is fully numbed with local anaesthetic, and with modern anaesthesia most patients report little discomfort — many compare the experience to having a large filling. In fact, much of the pain people associate with root canals is the toothache before treatment; the procedure is what relieves it.

Here is what happens step by step. A small opening is made in the top of the tooth to reach the canals. Using modern rotary nickel-titanium instruments and electronic length measurement, each canal is carefully shaped and cleaned, then irrigated with disinfecting solutions to remove bacteria. A rubber dam — a small protective sheet — isolates the tooth to keep it clean and dry throughout. Finally, the canals are filled with a biocompatible material called gutta-percha and sealed, and the tooth is restored with a filling or, frequently, prepared for a crown.

Front teeth can often be completed in a single visit of around 60–90 minutes. Molars, which typically have three or four canals, may need one to two visits depending on the anatomy and the extent of infection. Mild tenderness for a few days afterwards is normal as the tissues around the root settle, and is usually manageable with over-the-counter pain relief.

Fees start from £695 for a front tooth and from £895 for a molar — transparent pricing that compares well for endodontic care in central London — reflecting the additional canals and time molars require. The final cost depends on the tooth, the complexity of its anatomy, whether treatment is a first-time procedure or a re-treatment of earlier root canal work, and the restoration needed afterwards. You receive a written, itemised quote before treatment begins, including the cost of any recommended crown.

The honest comparison is root canal versus extraction. Removing the tooth may seem simpler, but a gap brings its own consequences: drifting neighbouring teeth, bone shrinkage, and the cost of replacement with an implant, bridge or denture — which over time usually exceeds the cost of saving the tooth. Keeping your natural tooth preserves your bite, your bone and your smile. That said, some teeth are too damaged to save, and where extraction is genuinely the better option, we will tell you so plainly.

It is important to be realistic about outcomes. Success rates for modern root canal treatment are typically high, but no treatment can be guaranteed. Occasionally an infection persists or returns, in which case options include re-treatment, a small surgical procedure called an apicectomy, or referral to a specialist endodontist for complex anatomy. Root-treated teeth are also somewhat more brittle over time, which is why back teeth usually benefit from a crown afterwards to protect them from fracture.

Aftercare is straightforward. Avoid chewing hard foods on the tooth until it is definitively restored, keep the area clean with normal brushing and interdental cleaning, and attend your review appointments so we can confirm healing on follow-up X-rays. A well-executed root canal on a well-restored tooth can last many years — often decades — though longevity varies with the tooth, the final restoration and your ongoing oral care.

If you are anxious — and root canal treatment carries more unearned fear than almost any other procedure — please tell us when you book. We allow generous appointment times, explain each stage before it happens, agree a stop signal, and check your comfort throughout. Many of our most nervous patients are surprised to find themselves relaxed enough to listen to music or a podcast during treatment, and relieved that the toothache that brought them in is finally gone.

Prompt assessment also protects your options. An inflamed nerve caught early is often simpler to treat than a long-standing infection that has spread to the bone around the root, and delaying can occasionally turn a saveable tooth into one that must be extracted. If you have a toothache, sensitivity that lingers after hot or cold, or a swelling near a tooth, an early appointment gives you the widest range of choices — and if no root canal is needed, we will happily tell you so.

If you are searching for root canal treatment in London, our Marylebone practice near Harley Street offers modern rotary endodontics, digital imaging and genuinely unhurried appointments — with nervous patients made especially welcome. From your first assessment at our Wimpole Street practice to your final restoration, everything is explained in plain English and priced in writing before it begins.

In the days after treatment, a few simple measures help the tooth settle: chew on the other side until the definitive filling or crown is placed, keep the area clean with gentle brushing and interdental cleaning, and take over-the-counter pain relief as advised if the tooth feels tender to bite on — that tenderness usually fades within a few days as the tissues around the root calm down. Contact the practice if pain worsens rather than eases, if swelling develops, or if the temporary filling comes out, as these are worth checking promptly. A short review visit and a follow-up X-ray in due course let us confirm the bone around the root is healing as expected.