Root canal treatment is a procedure in which inflamed or exposed nerve tissue (pulp) is removed from the root canals of a tooth, and the canals are cleaned with antibacterial and disinfecting solutions and then sealed. Its aim is to keep a tooth that can no longer be saved with a filling, rather than extract it. At our clinic in Denizli, Turkey, root canal treatment is planned and carried out with the support of digital X-rays and an apex locator.
- Aims to keep the natural tooth instead of extracting it
- Fast, low-dose imaging with digital radiography (RVG)
- An apex locator to identify the position of the root tip
- Canal cleaning and shaping with rotary (engine-driven) files
Treatment process
Diagnosis and digital X-ray
The tooth is assessed clinically and with a digital X-ray, checking the number of roots, their curvature and whether the canals are open.
Removing the nerve
Under local anaesthetic, the tooth is accessed and the inflamed pulp is removed from the root canals.
Cleaning and shaping
The canals are enlarged with rotary files and irrigated with disinfecting and antibacterial solutions; the working length is set with an apex locator.
Interim medication if needed
If it cannot be confirmed that the canals are free of microorganisms, an antibacterial medicine is left inside for 1–2 weeks under a temporary filling.
Canal filling and restoration
The cleaned canals are sealed, and the crown of the tooth is restored with a filling or a crown depending on how much tooth remains.
What is root canal treatment?
Inside the enamel and dentine layers, every tooth contains living tissue called the pulp, which holds nerves and blood vessels. Once decay reaches this tissue, or the pulp is exposed by trauma such as a fracture, the tooth can no longer be saved with a filling.
At that point there are two options: extraction or root canal treatment. With root canal treatment the tooth stays in place; only the inflamed pulp is removed, and the canals are enlarged, irrigated with disinfecting and antibacterial solutions, and then filled.
When is root canal treatment needed?
- When decay has progressed through the layers of the tooth and reached the pulp (nerve)
- When the pulp has been exposed by a fracture or by excessive biting forces (occlusal trauma)
- When a previous root canal treatment has failed and infection has developed at the root tip
Spontaneous, throbbing pain that often worsens at night and does not respond to painkillers, and lingering sensitivity to hot and cold, suggest that decay has reached the nerve. The final decision is made after an examination and an X-ray.
How is root canal treatment carried out?
Treatment is performed under local anaesthetic. The nerve is removed, and the canals are enlarged and irrigated until they are free of microorganisms.
If the canals can be confirmed to be clean, they can be filled on the same day and treatment completed in a single visit. When necessary, antibacterial medication is left in the canals for 1–2 weeks and the canal filling is completed at the next visit.
Once root canal treatment is finished, the top of the tooth must be permanently restored. Leaving a temporary filling in place for too long can allow leakage and reinfection.
Technology used in modern endodontics
Digital radiography (RVG)
Radiovisiography is a digital X-ray system that displays the image on screen in about a second. The radiation dose is considerably lower than with conventional X-ray film, and fast imaging makes diagnosis and treatment more comfortable for both patient and dentist.
Apex locator
This device electronically indicates the position of the root tip (apex), helping the canals to be cleaned and filled to the correct length, which affects the soundness and lifespan of the treatment.
Rotary files
Used with endodontic handpieces, rotary files clean and shape the canal walls effectively. They are faster and more practical than hand instruments.
Cone beam CT
In certain cases, a CBCT scan may be used to see the root tip and canal anatomy more clearly.
Rubber dam
When needed, a thin rubber sheet (rubber dam) is placed around the tooth to prevent saliva and other contaminants from entering the disinfected canals.
Factors that affect the outcome
Root canal treatment has a high success rate, but the outcome for each tooth depends on several factors:
- Root anatomy: the number of canals, how curved the roots are, and whether the canals are blocked for any reason
- Accurate diagnosis and an appropriate treatment plan
- The patient’s cooperation during treatment
- Keeping appointments; wearing a temporary filling for a long time increases the risk of leakage and reinfection
Root canal treatment or extraction and an implant?
As a rule, it is healthier to preserve the natural tooth wherever possible. A bridge to replace an extracted tooth requires the neighbouring teeth to be prepared as well and has more drawbacks than a tooth saved with root canal treatment. A single-tooth implant is a more costly option than root canal treatment.
Advances in both endodontics and implant dentistry mean that, for some doubtful teeth, more than one route is reasonable: in some cases extraction and an implant may be more appropriate, in others extending the life of the tooth with root canal treatment. The dentist and patient weigh all the options and decide together.
Frequently asked questions
How many visits does root canal treatment take?
If the canals can be confirmed free of microorganisms, treatment can be completed on the same day. When needed, antibacterial medication is left in the canals for 1–2 weeks and the canal filling is done at a second visit.
Does root canal treatment hurt?
Treatment is carried out under local anaesthetic. Mild tenderness for a few days afterwards is possible and usually settles quickly. If you notice severe pain or swelling, contact your dentist.
Will my tooth need a crown afterwards?
That depends on how much sound tooth structure remains. Teeth with limited loss can be restored with a filling, while a crown may be recommended for teeth with extensive loss. This is decided at the examination after treatment.
Is it a problem to keep a temporary filling for a long time?
Yes. Temporary fillings are not designed for long-term use and can leak over time, allowing the canals to become reinfected. Attending your appointments on time is important for the success of treatment. International patients should plan their stay with this in mind.
Is extraction and an implant better than root canal treatment?
The general approach is to keep the natural tooth. However, where the root or bone support is doubtful, an implant may be the more suitable option. The right route is decided together by the dentist and patient after an examination and X-rays.
My tooth is still sensitive after root canal treatment. What could be the reason?
After root canal treatment it is normal to feel temporary tenderness when touching or biting on the tooth for one week to fifteen days. This is due to swelling in the surrounding tissues and settles with time. If it lasts longer than this, the root canal treatment should be re-evaluated.
The information on this website is for general information only and does not replace an examination, diagnosis or treatment plan by a dentist. Treatment and outcomes vary from person to person.