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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.
You can also read Evolve Dentistry’s CQC report.
Electric or manual toothbrush - which is better?
It`s one of those dental questions where almost everyone has an opinion.
But does buying an electric toothbrush automatically mean you`re doing a better job?
Richard tackles the question.
Whichever toothbrush you use, how you brush matters enormously - so don`t panic if there`s nothing rechargeable sitting beside your bathroom sink.
Now we`re curious...
Clear aligners or fixed braces - which is better?
Which is better - clear aligners or fixed braces?
Neither.
At least, not until we know more about you.
The right orthodontic treatment depends on your teeth, what you`d like to change, your lifestyle and a number of clinical considerations.
For some people, clear aligners can be a great option. For others, fixed braces may be more appropriate.
So rather than starting with:
“Which braces do you want?”
We`d much rather start with:
“What would you like to change about your smile?”
Swipe through to understand some of the differences.
💚 £338 raised for Macmillan Cancer Support! 💚
We had such a lovely time at our Macmillan Coffee Morning last week. ☕🍰
A huge thank you to everyone who popped into the practice, enjoyed a slice of cake, had a chat and made a donation. It was wonderful to see so many of our patients, friends and members of the local community getting involved, and we were genuinely touched by everyone’s generosity.
Together, you helped us raise an amazing £169.
And we’re delighted to share that Carol has very generously matched every pound raised, bringing our final total to…
🥁 £338 for Macmillan Cancer Support! 💚
Thank you to our brilliant team for baking, organising and keeping the cake table well stocked, and to every single person who helped make the day such an enjoyable one.
Days like this remind us just how lovely the community around Evolve really is. 💚
#MacmillanCoffeeMorning #MacmillanCancerSupport #Portishead #EvolveDentistry #PortisheadCommunity
Being shortlisted for Team of the Year means a lot to us, but not because of the trophy.
It’s because dentistry is never the work of one person.
It’s the nurse who notices you’re nervous before you’ve said a word. The reception team member who remembers the conversation you had last time. The clinician who takes time to explain something again. The person behind the scenes making sure your visit runs smoothly.
Those small things happen every day at Evolve, and they only happen because people care about the experience we create together.
So being a finalist gives us a lovely excuse to say something we probably don’t say often enough: we’re incredibly proud of this team.
#PrivateDentistryAwards #TeamOfTheYear #DentalTeam #EvolveDentistry
You might notice a familiar face missing from Evolve for a little while… 💚
Carol is heading to Zambia with SmileStar, a dental charity providing free dental care to communities with limited access to treatment.
In this video, Carol shares a little more about where she’s going, what she’ll be doing while she’s there and why she wanted to be part of the trip.
It’s going to be a very different couple of weeks away from the practice, and we’re incredibly proud to see Carol giving her time and skills to support SmileStar’s work.
We’ll be sharing a little more from her trip when we can, but for now, we’ll let Carol tell you all about it in her own words. 💚
Safe travels, Carol. We can’t wait to hear all about it when you’re home!
#EvolveDentistry #SmileStar #Zambia #Dentistry #Portishead
🍰 Come and join us today! 💚
Our Macmillan Coffee Morning is in full swing at Evolve Dentistry, and we’d love to see you!
We’ve got plenty of delicious homemade cakes waiting for you, so pop in, say hello, grab a slice (or two!) and help us raise money for Macmillan Cancer Support.
We’ll be serving cakes right through until 5pm today, so there’s still plenty of time to come down.
📍 Evolve Dentistry, Portishead
🍰 Cakes until 5pm
💚 Everyone is welcome
Come hungry! 😋
#MacmillanCoffeeMorning #MacmillanCancerSupport #Portishead #PortisheadCommunity #EvolveDentistry
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