Root canal treatment in Stamford Hill, London

If you are experiencing tooth ache, or your dentist has recommended a root canal procedure, contact us to see our Specialist Endodontist (Rahul Bose).

What is a root canal treatment?

Root canal (endodontic) treatment is required when there is an infection of the root and the nerve (pulp) is severely damaged or inflamed. The pulp is a tissue made up of nerves, connective tissue, and blood vessels.

Root canal treatment aims to clean, disinfect and seal the inside of the infected root. This allows for restoring health of the tooth and the surrounding tissues. 

Root canal treatment is a reliable and successful method of preserving natural teeth, where possible, that would otherwise be removed.

At Northfield Dental Clinic, we understand how much impact tooth loss can have on your quality of life and self-confidence, which is the reason we offer a specialist root canal treatment service to help save your tooth and maintain your smile.

There are numerous reasons why you may require root canal treatment, including:

  • Severe tooth sensitivity to hot and cold that lingers
  • Discomfort when chewing
  • Spontaneous, throbbing dull toothache that keeps you awake at night
  • Swelling around the tooth


However, in many cases, there may be no obvious pain or issues associated with an infected tooth.  An infection of the roots may be commonly identified by a dentist after a clinical or X-ray examination. 

In these situations, you may be still referred to see our Specialist in Endodontics.

Root canal retreatment

In some cases, root canal retreatment may be required to treat a tooth with an infection associated with a previous root canal treatment.

This involves removing the entirety of the existing root filling, recleaning the root canal system to ensure they are adequately disinfected and then resealing the roots.

Endodontic microsurgery (Apicectomy)

In certain situations, even after a good quality root treatment, the tooth may not heal as expected. Such cases include large pre-existing infections, cystic lesions, and complex cases where it is not possible to reach and clean the end of the root of the tooth.

Endodontic surgery involves directly accessing and removing the inflamed and infected tissue as well as the very tip of the root. The gum then has a few stitches placed to help the tissue heal properly. Over time the bone will grow back to replace the removed infected tissue.

What causes a tooth infection and the need for root canal treatment?

The most common cause of a tooth infection is tooth decay, cracks, tooth trauma, or an ill-fitting leaking dental restoration such as a filling or a crown.

These conditions can cause bacteria to enter the pulp (nerve) of the tooth. The blood vessels also reside in the pulp of the tooth. 

The pulp can become inflamed and begins to die. The space the pulp inhabits (the root canal) rapidly becomes infected with bacteria. This may cause pain and swelling in the supporting tissues (abscess) or the tooth may remain symptom-free.

A specialist in root canal treatment is required to remove the infection and prevent tooth loss.

Why have I been referred to a Specialist Endodontist?

The root canal system, especially in back (molar) teeth, is often complex and difficult to clean well. This is why many general dentists prefer to refer these cases to a specialist who has the training, latest state-of-the-art equipment, material, and experience to deal with any root canal related problem.

Specialist Endodontists undergo further postgraduate training and they are formally recognised by the General Dental Council.

As a result, Specialist Endodontists are highly skilled and experienced in diagnosing and managing any problems related to the pulp (nerve) and/or roots of the tooth.

Several well-controlled clinical studies, have demonstrated more predictable treatment outcomes and higher success rates for root canal procedures when performed by a Specialist Endodontist.

How successful is root canal treatment?

The success of endodontic treatment can vary depending on the complexity of the case and predictability of treatment is dependent upon the condition of the tooth prior to treatment.

Several clinical studies have shown high survival rates of root treated teeth which is similar and, in some cases, better than dental implants.

At Northfield Dental clinic, our specialist (Mr Bose) always uses a surgical microscope during treatment, to magnify the tooth, and strict infection control protocols to enhance success rates.

The number of appointments required to perform root canal treatment and restore a natural tooth with a crown, if required, are far fewer than for artificial dental implant prosthesis and crown placement. The overall cost of the root canal treatment is also lower than the dental implant option.

However, as with any medical procedure, success can never be guaranteed no matter how well the treatment has been performed. This is because healing is heavily reliant on the response of each individual patient to the performed treatment. 

Root canal treatment generally fails in the long term due to structural problems within the tooth. This occurs usually due to an existing or a new crack which has developed in the tooth as a result of daily wear and tear, which can be made worse due to clenching habits, eating hard foods or parafunctional subconscious activity such as grinding at night. 

Gum disease can also lead to the loss of the tooth in the long term, hence it is vital to maintain good oral hygiene and seek any necessary periodontal (gum) care as recommended by the dentist.

Can all teeth undergo root canal treatment?

Although retaining natural teeth is generally accepted as the best treatment outcome, in some cases, root canal treatment may not be possible.

Broadly, this includes, if the tooth has a pre-existing crack/fracture of significant size, insufficient sound remaining tooth structure to retain a filling or crown or a lack of support from the surrounding bone and gum tissue. There is a possibility that this could be identified during the course of treatment, in which case, removal of the tooth may be indicated.

If a tooth has already been root treated, revision of treatment may not always be possible.

If the tooth cannot be saved,  dental implants are usually the best option to replace natural teeth, if feasible. For further information regarding dental implants, please seek advice from our Implantologist.

Frequently Asked Questions

At the consultation appointment, we will take a full history of the tooth in question followed by a clinical examination of the tooth and surrounding supporting structures.

Appropriate special investigations and X-rays will be conducted, in order to diagnose your dental problem and plan your treatment accurately.

In certain instances, a 3D Cone Beam CT (CBCT) scan may be recommended to gain further detailed information about the tooth and/or health condition and to carry out root canal treatment more efficiently and predictably.

The overall prognosis of root treatment will be discussed and a bespoke treatment plan formulated.

The tooth in question will be numbed with local anaesthetic.

The existing dental filling and/or crown may need removal to investigate the tooth prior to root canal treatment. If there is sufficient remaining tooth structure, the tooth will be isolated with a rubber dam, in order to perform root canal treatment. This step is absolutely imperative as it provides a clean working environment but also keeps you safe throughout the procedure.

A small access cavity (hole) will be made in the tooth.   Once the canals have been cleaned and shaped, the root filling will be placed, followed by a permanent tooth coloured filling to seal the access cavity.

During the treatment, 2 to 3 x-rays will normally be taken.

Once root canal treatment has been completed, a permanent tooth coloured filling will be placed to definitively seal the tooth.

In certain situations, i.e., a front tooth, no further dental treatment is required other than good oral hygiene, including brushing, flossing, and regular check-ups.

The back (chewing) teeth, however, are more prone to fracture following root canal treatment. These teeth may require further protection, to enhance longevity, often with an onlay or a crown.

At the assessment stage, advice will be provided if it is likely that an onlay or a crown will be required following root canal treatment.

We will send a letter to your dentist explaining what treatment has been performed and advice on any further restorative work, if required. Leaving the root treated tooth without the recommended restoration can result in tooth fracture and reduced survival of the tooth.

We invite all our patients to return for a one year review appointment (no extra fee) or the tooth can be checked with their own dentist as part of a routine check up. In complex cases, we may ask you to come back for a review sooner.

The time taken to complete the root treatment depends upon the complexity of the case.

Generally, treatment can be completed in one (60-90 minute) appointment. 

Occasionally, more than one appointment may be required.

You should not usually experience any pain or discomfort during the procedure.

It is not uncommon to have some discomfort in the jaw. The tooth may feel tender as the anaesthetic wears off.

Occasionally, a very small number of patients may experience an increased degree of discomfort and swelling for 1-2 weeks following completion of treatment. This problem is transient and has no bearing on the long term prognosis.

Any post-operative discomfort can be effectively managed with over the counter medications.

Detailed aftercare information will be provided at the end of the appointment.

We offer an Intravenous (IV) conscious sedation service for patients who find treatment difficult to cope with. 

More information can be provided at the consultation appointment.

The alternative to root canal treatment is removal of the tooth. Generally, the options to replace missing teeth are dental implants, a fixed bridge or a removable denture. It is also an option to accept the gap.

If removal of the tooth is being considered, it is recommended to discuss these options with your dentist prior to removing your tooth.

If a tooth infection is left untreated, the surrounding bone will be affected and lost. A small infection may develop into an abscess or even a swelling of the face that may, in rare cases, need urgent care in a hospital setting.

A tooth infection can only be predictably treated by root canal treatment or removal of the tooth.

Antibiotics do not eliminate the source of infection and repeated doses can lead to resistance.

Not sure which treatment is right for you?

Contact us today to find out how we can help you improve your smile.

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