Endodontics

Root canal treatment is the most common procedure performed within the field of endodontics. Endodontics is the dental speciality as a whole, encompassing not just root canal treatment but a range of procedures focused on diagnosing and treating conditions affecting the dental pulp and surrounding tissues. A general dentist can perform straightforward root canal treatments, but an endodontist has undertaken additional years of specialist training to manage more complex cases — including teeth with unusual root anatomy, situations where a previous root canal has failed, and more advanced surgical procedures to save the natural tooth.

The number of appointments required depends on the complexity of the case and the type of procedure being performed. A straightforward root canal on a single-rooted tooth can sometimes be completed in a single appointment. However cases involving multi-rooted teeth, severe infection, or more complex anatomy often require two or more visits — this allows any infection to be properly controlled between sessions and ensures the canals are fully cleaned and sealed. Re-root canal treatments, where a previously treated tooth requires further intervention, typically require additional appointments. Your endodontist at Etwall Dental Practice will discuss the treatment plan and expected number of visits at your initial consultation.

Endodontic procedures are carried out under local anaesthetic, which thoroughly numbs the affected tooth and surrounding tissue. Most patients report that the procedure itself is comfortable, with little more than a sensation of pressure. The reputation for root canal and endodontic treatment being extremely painful largely stems from the discomfort caused by the infection that made treatment necessary in the first place, rather than from the procedure itself. After treatment, some tenderness or mild discomfort for a few days is normal, particularly if the surrounding tissue was inflamed beforehand, and can be managed with over-the-counter pain relief.

An apicectomy is a minor surgical procedure performed when conventional root canal treatment has not been successful in clearing an infection at the root tip of a tooth. It involves making a small incision in the gum to gain access to the very tip of the tooth root. The tip of the root, along with any infected tissue surrounding it, is removed, and the end of the root canal is sealed with a small filling to prevent bacteria from re-entering. An apicectomy is typically considered when retreatment of the root canal itself is not possible or would carry too high a risk of further complications. It is performed under local anaesthetic and most patients recover well within a few days.

While endodontic treatment has a high long-term success rate, a small percentage of treated teeth can become reinfected over time. This can occur if bacteria find a new pathway into the sealed tooth, such as through a new crack, the breakdown of the sealing material, or new decay that penetrates to the root-filled area. It can also occur if the original treatment did not fully clear all infected tissue due to unusually complex canal anatomy. If reinfection occurs retreatment may be possible, or an apicectomy may be recommended. Regular dental check-ups at Etwall Dental Practice, including X-rays, allow us to monitor treated teeth and identify any signs of reinfection early.

Your general dentist will typically refer you to an endodontist when a case is particularly complex. This might include teeth with unusual or curved root anatomy, situations where a previous root canal treatment has not resolved an infection, or cases requiring specialist surgical intervention such as an apicectomy. You may also be referred if your tooth has a very fine or calcified canal that requires specialist instruments and expertise to treat safely. At Etwall Dental Practice our team includes specialists in endodontics who can handle the full range of root-related dental problems, from routine root canal treatment through to complex retreatment and surgical cases.