Mish Sachdev

Everything you need to know about root canal treatment

Root canal is a very common procedure that removes infection from the root system of a tooth. Let’s first start by explaining how the tooth gets infected and what signs this show.

It takes a long time for this to happen so that’s why it’s so important to have regular check-ups and to visit your dentist as soon as you experience any symptoms.

Step One

The first step involves early enamel decay in your tooth. This is caused by have an excessive amount of refined sugar in your diet. The frequency makes more of a difference than the amount of sugar you have and therefore you should reduce the number of times/week you are consuming sugary foodstuffs.

The solution at this stage is very simple – reduce the consumption of sugars, use fluoride substances (ie mouthwashes and professionally applied varnishes) to help combat against the decay as monitor the lesion. Often it is not needed to fill these cavities at this stage.

Step Two

If left, the decaying lesion advances further into the tooth. The bacteria use the sugar to feed and they release acid as a by-product. This acid damages the tooth and decays it. This is the process of tooth decay. As the lesion advances, the bacteria are able to shield themselves off from the toothbrush and toothpaste so it’s pretty much impossible for you to remedy this at home. This type of lesion always requires a filling.

The solution – Remove the decay/bacteria and then fill the tooth. Again, at this stage it’s fairly simple and depending on how much tooth has decayed, the tooth can be treated very successfully and will survive for a long time.

Step Three


Step 3

If you leave the decay, once again it advances further down into the tooth towards the root canal system. The root canal system is a complex bundle of nerves and blood vessels that are contained in a hollow portion of the tooth. Once the bacteria enter this system it is easy for them to spread, as it’s soft tissue rather than the harder tissue (dentine/enamel). You may experience pain once this happens.

The solution – the solution now is to perform root canal treatment. This involves the following steps:

  1. Remove the decay
  2. Remove all of the soft tissues in the root canal system as this will contain large amount of bacteria
  3. Disinfect the entire root canal system with disinfectant. This is actually very simple (although it does takes a while) – you just wash the area with disinfectant.
  4. Fill the root canal system with a filling material
  5. Provide a good seal – this stops bacteria from re-entering
  6. Crown the tooth or put a filling to restore the cavity. Crowns are generally a good idea because they help to seal the tooth very well and they help to prevent against tooth fractures

Step Four


Step 4

If left, once again the issue gets worse. The bacteria destroy the root canal tissue and cause an infection. When this happens you can get an abscess and/or severe pain.

The solution – The solution, again, is to perform root canal system in exactly the same way as before. The success rate may be slightly lower as the number and severity of the bacteria has increased and the time it takes to do root canal treatment may increase as well.

How long does it take to do root canal treatment?

Typically it takes between 1-2hours to do root canal treatment. Front teeth are quicker to do as they only have one canal. Back teeth are harder as they have 3 or 4 canals to clean.

If you have a very large infection, or a difficult tooth, it may take longer or you may need multiple visits.

Does root canal treatment hurt?

No, root canal treatment should be pain free. The majority of my patients come in worried as they have heard bad things but once it’s all finished, they confess that it wasn’t that bad and it didn’t hurt at all. The worst part of it is that you keep your mouth open for longer periods of time and if that’s an issue we can have shorter appointments. I think you must always remember when a friend is telling a story about how the treatment went, it’s boring to say things like “It didn’t hurt at all”. What people do is exaggerate things and makes things up so their story sounds more entertaining that it actually is.

After the procedure, the tooth can be a little sore for the next few days. It’s nothing that Ibuprofen/Paracetamol can’t fix and after 3 days the tooth is completely back to normal.

How do I know if I need a root canal?

There are a few signs and symptoms to watch out for:

  1. Severe pain
  2. Constant pain
  3. Pain affecting sleep
  4. Pain that lingers
  5. Pain that arrives spontaneously (ie out of the blue)
  6. Abscess on the side of the gum
  7. A bad taste in the mouth

If you experience any of these signs then call your dentist immediately.

Can you eat after root canal treatment?

Yes, although we would recommend a soft ish diet for the next few days after root canal treatment. Also, as mentioned before it may be a good idea to crown the tooth after as it protects it from cracking. The reason the tooth may crack is that it is considerable weaker after root canal treatment as we have had to remove some of the tooth to actually do the procedure and also because once the nerve has been removed, the tooth no longer has the feedback it used to have. The nerves play a vital role in feeding back to the brain how hard we must bite down onto something (ie food). Once the nerves are taking out you don’t get this feedback and you might bite a little harder and hence be more likely to fracture. So in the time between the root canal has finished, and the before the final crown has been fitted the tooth may be at risk of fracturing. Therefore, it’s advisable to eat a softish diet and perhaps eat on the other time.

How long does it take for a root canal to heal?

This depends on how severe the bacterial infection was and how long it was left for.

If you reach step 3, as described above, then the tooth will pretty much heal very soon after the root canal has been done.

If the lesion was advanced and you had a big infection, this leaks out from the tip of the root to infect the surrounding bone. Once again, if you leave this for a longer time, more bone is destroyed. It’s the bacteria from the tooth that initiates it. Once it has been removed the bone should heal by itself, however the bigger the bone lesion the longer it will take. You should expect some the bone to grow back after 3-6months