Root canal treatment — also called endodontic treatment — is one of the most misunderstood procedures in dentistry. Patients often arrive expecting significant pain, only to find that the treatment is much closer in experience to having a filling. The pain associated with root canal in popular imagination usually refers to the untreated infection that makes root canal necessary, not the treatment itself. Understanding what actually happens makes the whole process considerably less daunting.
Why root canal treatment is needed
Inside each tooth, beneath the enamel and dentine, is a soft tissue called the pulp. This contains nerves and blood vessels that helped the tooth develop. If the pulp becomes infected or inflamed — usually because of deep decay, a cracked tooth, or trauma — it cannot heal itself. Left untreated, the infection can spread to the bone surrounding the tooth and cause an abscess. Root canal treatment removes the infected pulp, cleans and shapes the canals inside the root, and seals them to prevent reinfection.
Signs you might need root canal treatment
Persistent, severe toothache — especially pain that throbs or wakes you at night.
Prolonged sensitivity to heat or cold that lingers after the stimulus is removed.
A darkened tooth (indicating the pulp is dying or dead).
Swelling or tenderness in the gum near a tooth.
A persistent spot or pimple on the gum (a sinus tract — the infection draining).
Pain when biting or chewing.
Sometimes a tooth with a dying pulp causes no pain at all — the problem is found on an X-ray at a routine check-up. This is another reason regular dental check-ups matter.
What does root canal treatment involve?
The procedure is carried out under local anaesthetic, so the tooth and surrounding area are numb throughout. Most patients describe mild pressure or vibration rather than pain. The steps are broadly as follows:
An X-ray confirms the extent of infection and shows the shape of the root canals.
Local anaesthetic is administered. Once numb, a rubber dam (a thin sheet) is placed around the tooth to keep it dry and prevent contamination.
An opening is made through the top of the tooth to access the pulp chamber.
Specialist instruments are used to remove the pulp and shape the canals.
The canals are cleaned with an antibacterial irrigation solution.
The canals are filled with a rubber-like material called gutta-percha and sealed.
A temporary or permanent filling is placed. Most teeth treated with root canal then have a crown fitted to protect the tooth from fracture.
How long does root canal treatment take?
A single-rooted tooth (such as a front incisor) can often be treated in one appointment of 60 to 90 minutes. Molar teeth at the back of the mouth have multiple roots and more complex canal systems; these usually require two appointments, each lasting 60 to 90 minutes. Between appointments, a medicated dressing is placed in the canals and the tooth is sealed with a temporary filling.
In cases where infection is significant, your dentist may defer the final seal until the infection has settled. This is normal and does not mean the treatment has gone wrong.
What does root canal treatment cost?
On the NHS, root canal treatment falls under Band 2 (£73.50 in 2025/26), which covers the root canal itself alongside any other treatment needed in that course of care. If a crown is then required, that triggers a Band 3 charge (£319.10), which covers the crown and any other treatment in the course. NHS availability for root canal can vary — not all NHS practices offer it for all teeth, and waiting times apply.
Private root canal treatment in Nottingham typically costs £400 to £900 per tooth, depending on the number of roots and complexity. A crown placed afterwards adds £500 to £1,200. Private treatment offers more predictable access and appointment timing, and may include the use of an operating microscope, which improves precision in complex cases.
After root canal treatment: what to expect
Some tenderness in the area for a few days after each appointment is normal, particularly if there was infection present before treatment. Over-the-counter ibuprofen or paracetamol typically manages this well. Avoid chewing hard foods on the treated tooth until it has been permanently restored. Most people return to normal activities the same day.
The tooth itself is no longer 'alive' once the pulp is removed, which can make it slightly more brittle over time. A crown is usually recommended to protect it. Root canal-treated teeth can last as long as natural teeth with good care and regular reviews.
Root canal treatment at Pear Tree Dental, Nottingham
If you have toothache or have been told you need root canal treatment, we can assess your tooth and discuss your options clearly before any treatment begins. Book an appointment or call us on 0115 931 2935. You can also explore our dental services for more information.
FAQ
Q: Is root canal treatment painful? A: The treatment itself is carried out under local anaesthetic and is not typically painful. Discomfort in the days before treatment — from the infection — is usually what patients remember. Most people are surprised by how straightforward the procedure feels.
Q: What happens if I do not have root canal treatment? A: The infection will not clear on its own. It will usually worsen, spreading to the surrounding bone. Eventually the tooth may need to be extracted. Antibiotics can reduce acute infection temporarily but do not resolve the underlying problem.
Q: Can a tooth that had root canal treatment get infected again? A: Yes, though it is uncommon. Reinfection can occur if the seal breaks down, if a canal was missed during treatment, or if decay reaches the root again. This is why a crown and regular check-ups are important after treatment.
Q: How do I know if I need root canal or just a filling? A: An X-ray and clinical examination are needed to determine this — there is no reliable way to tell from symptoms alone. Book an assessment at Pear Tree Dental in Nottingham or call 0115 931 2935 to discuss your symptoms.