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Dentistry Being told that you need root canal treatment can be confusing – particularly if your tooth doesn’t hurt very much.
What exactly is wrong with it? Why can’t you just have a filling? And what happens if you leave it alone?
Root canal treatment is generally considered when the soft tissue inside a tooth, known as the dental pulp, has become inflamed, infected or damaged and simply repairing the outside of the tooth will not address the problem.
The aim of treatment is to deal with the problem inside the tooth and, where appropriate, allow the natural tooth to remain in your mouth.
Although the part of a tooth you can see looks solid, there is a space inside it containing dental pulp.
The pulp contains nerves and blood vessels and plays an important role while your tooth develops.
The pulp can become inflamed, infected or damaged.
Possible causes include:
Once the pulp has been significantly affected, treating the outside of the tooth alone may not resolve the problem.
This is why your dentist might recommend root canal treatment.
Root canal treatment is also known as endodontic treatment.
During treatment, the clinician accesses the inside of the tooth, removes inflamed or infected pulp tissue and carefully cleans, shapes and fills the root canal system.
The NHS describes root canal treatment as treatment used to remove infection from inside a tooth before the root canal is cleaned and filled.
Importantly, the tooth itself isn’t removed.
Where the tooth is suitable for treatment, the aim is to treat the problem within it so that your natural tooth can remain.
There isn’t a single symptom that means you definitely need a root canal.
Possible symptoms can include:
But these symptoms can have other causes.
That’s why an examination is important.
This surprises many people.
A tooth does not necessarily have to be painful for root canal treatment to be recommended.
Sometimes symptoms change as the condition of the pulp changes. In other cases, a problem is identified during a dental examination or on an X-ray.
So:
“It doesn’t hurt” doesn’t necessarily mean “there’s nothing wrong”.
Equally:
“It hurts” doesn’t necessarily mean “I need a root canal”.
The diagnosis matters more than one symptom.
Your dentist will build a picture from several pieces of information rather than relying on one test.
This may include:
What have you noticed?
When did it begin?
What makes it better or worse?
Has the tooth previously had a large filling, crown, trauma or other treatment?
Your dentist will look carefully at the tooth and surrounding tissues.
Different tests can help your dentist understand how the tooth is responding.
X-rays can provide useful information about the tooth, roots and surrounding area.
In selected cases, three-dimensional CBCT imaging may provide additional useful information.
A CBCT scan isn’t automatically necessary simply because you may need root canal treatment.
This depends on how far the problem has progressed.
If decay or damage affects the outside of a tooth but the pulp remains sufficiently healthy, repairing the tooth with a filling or another restoration may be appropriate.
But once the pulp itself has become significantly inflamed, infected or damaged, simply placing a filling over the tooth does not treat what is happening inside it.
Your dentist should be able to explain why a filling is or isn’t an appropriate option for your particular tooth.
This depends on the diagnosis.
If the pulp is infected and the source of the problem isn’t treated, it won’t necessarily resolve by itself.
The NHS advises that if an infected tooth is not treated, it may eventually need to be removed.
But that doesn’t mean every patient who is advised to have a root canal must immediately agree to treatment.
You should understand:
That allows you to make an informed decision.
No.
This is an important distinction.
Root canal treatment is often considered because retaining the natural tooth may be possible.
But the root canals are only one part of the picture.
Your clinician also needs to consider things such as:
There are circumstances where root canal treatment may not be considered appropriate and extraction may instead be discussed.
Related: Root canal treatment or extraction – how do I decide?
Not necessarily.
Dentists provide root canal treatment as part of general dental care.
Sometimes a dentist may recommend specialist assessment or treatment because a case is particularly complex, a tooth has been previously treated or another aspect of the case would benefit from specialist endodontic assessment.
At Evolve, specialist endodontic care is provided by:
Dr Alex Brett – Specialist Endodontist, GDC no. 244328.
Alex accepts referrals from dentists as well as patients who choose to self-refer.
Related: What is an endodontist and why might I need to see one?
Reality: Some problems are identified even when symptoms are mild or absent. Diagnosis is based on your examination and relevant investigations, not pain alone.
Reality: Root canal treatment treats the inside of the tooth. Where appropriate, its purpose is to allow the natural tooth to remain.
Reality: Many root canal treatments can be provided by general dentists. Specialist assessment may be recommended or chosen in particular circumstances.
Antibiotics are not a substitute for treating the underlying problem within the tooth.
Whether antibiotics are appropriate depends on your clinical circumstances. Your dentist will decide whether they are indicated.
That depends on the diagnosis.
Symptoms can sometimes change without the underlying problem being resolved. Ask your dentist what they believe will happen if treatment is delayed.
Extraction may be one of the alternatives in some cases.
However, removing a tooth has its own implications, including whether the resulting space needs to be replaced.
Read: Root canal treatment or extraction – how do I decide?
Our complete patient resource explains root canal treatment, what happens during treatment, when specialist care might be appropriate and what to expect afterwards.
What it means, what to expect and understanding your options
If you’ve been told you need root canal treatment and would like specialist advice, you can see Dr Alex Brett, Specialist Endodontist, at Evolve.
Your dentist can refer you, or you can contact us directly.
Speak to our team about an endodontic assessment
For independent information, read the NHS guide to root canal treatment.
If you’ve been told you may need root canal treatment, understanding why it’s been recommended is an important first step.
At Evolve Dentistry in Portishead, we offer both general root canal treatment and specialist endodontic care with Dr Alex Brett. You can contact us directly for a specialist assessment, even if you’re registered with another dental practice.
Explore root canal treatment at Evolve Dentistry
You can also read Evolve Dentistry’s CQC report.
💚 WE’RE HIRING! Join our award-winning team! 💚
Patient Care Advisor | Evolve Dentistry, Portishead
We’re not just looking for someone to answer the phone and book appointments.
We’re looking for someone who LOVES people, takes pride in making others feel welcome and believes that exceptional customer service is all about the little things. ✨
At Evolve Dentistry, our Patient Care Advisors are at the heart of everything we do. From the first friendly hello to helping patients feel comfortable and cared for, you’ll play a huge part in creating the experience we’re so proud of.
And the best bit? You don’t need dental experience!
If you’ve worked in hospitality, customer service, reception or another people-focused role, we’d love to hear from you.
💚 What we’re offering:
✨ £14.50–£17.50 per hour, depending on experience
✨ A supportive, award-winning team
✨ A beautiful, modern working environment
✨ Training and development opportunities
✨ Staff dental discounts
✨ Team socials and celebrations
✨ A workplace where you’re genuinely valued
📅 Working hours:
Tuesday afternoons, Wednesdays, Thursdays and one Saturday per month.
We’re looking for someone who’s warm, organised, confident, positive and passionate about making a difference to people’s day.
Sound like you? We’d love to meet you!
📩 Email hello@evolve-dentistry.co.uk to request an application pack.
⏰ Applications close Friday 30 October 2026.
💚 Know someone who’d be perfect for our team? Tag them below or share this post with them!
#EvolveDentistry #WereHiring #PortisheadJobs #NorthSomersetJobs #DentalCareers #PatientCare #JoinOurTeam
If you’re considering replacing an amalgam filling, you may have come across the term SMART.
SMART stands for Safe Mercury Amalgam Removal Technique. It is a protocol designed to reduce exposure to mercury vapour and particles while an amalgam filling is being removed.
At Evolve, SMART amalgam removal is available for adults who have made an informed decision to replace their amalgam fillings.
Importantly, we don’t suggest that everyone should have their amalgam fillings removed, and we don’t make claims that removing them will improve your general health.
Swipe through for a simple explanation of what the SMART approach involves.
#SMARTAmalgamRemoval #AmalgamFillings #DentalCare #EvolveDentistry
If you’ve never visited Evolve before, here’s a little look around.
We know that walking into a new dental practice can feel daunting, particularly if it’s been a while since your last appointment.
We’ve designed Evolve to feel calm, welcoming and a little different from what you might expect from a dental practice.
But the most important part isn’t the building. It’s how you’re made to feel when you’re here.
Come in, make yourself comfortable in our patient lounge and let us look after you.
#EvolveDentistry #Portishead #PortisheadDentist #DentalCare
Gum disease can be surprisingly easy to overlook.
Bleeding when you brush, red or swollen gums, persistent bad breath or gums that seem to be receding are all things worth paying attention to.
The important thing is not to wait until something hurts. Gum disease can develop without causing pain, which is one reason regular dental and hygiene appointments matter.
In this short video, Yasmin explains some of the signs to look out for.
If you’ve noticed a change in your gums, mention it at your next appointment or get in touch with the team.
#GumHealth #DentalHealth #PreventiveDentistry #EvolveDentistry
🦷 Day one, first clinic!
Carol has sent us the first photos from her trip — and what a first day it’s been!
Working alongside five other dentists, the team saw an incredible 197 patients in just one day. ❤️
In Carol’s words:
“I’ve taken out more teeth today than I have in the past year!”
A very different day in dentistry from the ones Carol is used to back home at Evolve, and a reminder of just how much need there is for the care the team is providing.
We’re so proud of her — and we’ll be sharing more updates and photos from Carol’s trip as they come in. 🌍🦷
#EvolveDentistry #DentalOutreach #Dentistry #MakingADifference
Ever run your tongue over your teeth and wonder why they suddenly feel rough?
There are a few possible reasons, from plaque build-up to changes in the surface of a tooth.
In this short video, Yasmin explains some of the common causes and when it’s worth mentioning it to your dentist.
Noticing small changes in your mouth is useful. You don’t need to diagnose them yourself, but do tell us if something feels different.
#DentalHealth #OralHealth #Portishead #EvolveDentistry
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