Root canal treatment saves a tooth whose inner nerve has become infected or damaged. At Sydney Smile Centre on Maroubra Road, the appointment involves cleaning and shaping the canals under local anaesthetic, then sealing them. Modern techniques are designed to keep you comfortable throughout. To discuss a painful tooth with our Maroubra team, call us on 02 9349 2387.
Few dental words worry people more than “root canal”. Most of that worry comes from stories passed down from an era of slower instruments and weaker anaesthetic. What the treatment actually does is simple: it removes infection from inside a tooth so the tooth can stay in your mouth instead of coming out. Here is what genuinely happens, start to finish.
What is actually going on inside the tooth
Every tooth has a hollow centre containing soft tissue called the pulp, made up of nerve and blood vessels. That pulp runs from the crown of the tooth down through narrow channels, the root canals, to the tip of each root. While the tooth is sealed, the pulp is protected. Once bacteria get in, they have nowhere to be flushed out to, and the immune system cannot reach them.
Bacteria usually arrive by one of a few routes:
- Deep decay: a cavity that has worked through enamel and dentine until it reaches the pulp chamber.
- A crack or fracture: often from biting something hard, or from years of grinding, opening a pathway straight to the nerve.
- Trauma: a knock to a front tooth can kill the pulp even when the tooth looks intact, sometimes months or years later.
- A failing old restoration: a large filling that has leaked at the margins, letting bacteria seep underneath.
Once the pulp is infected it does not recover on its own. The two realistic options are to clean the inside of the tooth out, or to remove the tooth.
Signs that may point to an infected nerve
Symptoms vary a lot, which is why self-diagnosis is unreliable. Things worth having looked at include lingering sensitivity to hot that keeps aching after the stimulus has gone, pain that wakes you at night or worsens when you lie flat, tenderness when you bite on one specific tooth, a tooth that has darkened compared with its neighbours, or a small pimple-like swelling on the gum that may drain and then return.
Just as importantly, some infected teeth give no symptoms at all. A dying nerve can go quiet once it has fully deteriorated, and the problem is then found on a routine radiograph as a shadow at the root tip. That is one of the practical arguments for keeping up regular check-ups rather than only attending when something hurts. If you are in pain right now, our guide on easing dental pain covers what helps in the meantime.
Step by step: what the appointment involves
Knowing the sequence removes most of the anxiety. A typical course of treatment runs like this:
- Diagnosis: we test the tooth, check how it responds to cold and to pressure, and take radiographs to see the root anatomy and any infection at the root tip.
- Anaesthetic: the tooth and surrounding tissue are numbed thoroughly. We check the numbness is working before anything else begins, and we can top it up at any point.
- Isolation: a rubber dam, a small sheet that isolates the tooth, keeps the working area dry and stops anything reaching the back of your throat.
- Access: a small opening is made through the biting surface, or through the back of a front tooth, to reach the pulp chamber.
- Cleaning and shaping: fine files remove the infected tissue from each canal, and the canals are irrigated with a disinfecting solution. Measurements confirm we have worked to the correct length of each root.
- Sealing: the cleaned canals are filled with a rubber-like material and sealer so bacteria cannot recolonise them, and the access opening is closed.
Sometimes this is completed in a single longer visit. Often it is split across two, with a medicated dressing left inside the tooth in between to settle a stubborn infection. A back tooth with three or four canals naturally takes longer than a single-canal front tooth.
Why the old reputation no longer fits
We are careful never to promise a painless procedure, because nobody can guarantee how an individual will respond. What we can say is that contemporary root canal treatment is designed around comfort. Local anaesthetic techniques are more reliable than they were, rotary instruments shape canals in a fraction of the time older hand filing took, and radiographs give a much clearer picture of the root anatomy before we start.
It also helps to separate two things people tend to merge. The severe pain associated with root canals is usually the pain of the infection that led to treatment, not the treatment itself. Removing that infected tissue is what relieves it. For patients who find dental treatment difficult regardless, we take a slower, more explained approach, and our page for anxious patients sets out what that looks like.
Root canal or extraction: weighing it up
Taking the tooth out is quicker and, on the day, simpler. The trade-offs show up later. A gap in the arch lets neighbouring teeth drift and the opposing tooth over-erupt, which can change your bite. Replacing the tooth afterwards with an implant or a bridge is generally a longer process than root canal treatment would have been, and every replacement has its own maintenance.
Keeping your own tooth is usually preferable where the tooth is restorable, meaning there is enough sound structure left to rebuild and the supporting bone is healthy. Extraction becomes the more sensible option when a tooth is split vertically, when decay has run well below the gum line, or when the tooth cannot be predictably restored. If you are weighing up replacement options, our comparison of implants, dentures and bridges is a good next read. Costs vary depending on your individual needs, so see our fees page or book a consultation for an exact quote.
Why a crown usually follows
A root-treated tooth is no longer supplied with blood and moisture from within, and it has had material removed from the middle to create access. Back teeth in particular become more brittle and are at real risk of fracturing under chewing forces. A crown covers and splints the remaining tooth structure so those forces are spread rather than concentrated on a weakened cusp.
The crown is normally placed a short time after the canals are sealed, once we are satisfied the tooth is settled and comfortable. Front teeth with minimal loss of structure can sometimes be restored with a bonded filling instead. This staging is one reason a nearby practice is worth having. Being on Maroubra Road, a few minutes from Maroubra Junction, means the two or three visits involved do not turn into a trip across the city each time.
Recovery and looking after the tooth long term
Expect the tooth to feel tender to bite on for a few days while the ligament around the root settles. Over-the-counter pain relief is usually enough, and most people go back to work the same day or the next. Stick to softer foods and chew on the other side until the final restoration is fitted, since a temporary filling is not built for heavy loads.
Contact us if pain increases sharply after the first couple of days, if swelling develops, or if the temporary filling comes out. Longer term, a root-treated tooth still needs brushing, cleaning between the teeth and regular check-ups. It cannot decay in the treated nerve space, but the rest of the tooth and the gum around it can still develop problems, and we monitor the root tip with a radiograph periodically to confirm healing.
Frequently asked questions
How do I book, and what are your hours?
Call Sydney Smile Centre on 02 9349 2387 or request an appointment through our online form. We are open Monday to Friday 9am to 5pm and Saturday 9am to 1pm. New and emergency patients are welcome. If you are in significant pain, say so when you call so we can look at the soonest available time rather than a standard booking slot.
How do I get to you from Maroubra?
We are at Shop 1, 16 Maroubra Road, Pagewood, right on the Maroubra and Pagewood border and only a few minutes from Maroubra Junction and Pacific Square. There is free parking available via Glanfield Street, and the Anzac Parade bus routes drop you within a short walk. For a treatment that may take two visits, that proximity makes a real difference.
How long does root canal treatment take?
A single appointment commonly runs between 60 and 90 minutes, depending on which tooth is involved and how many canals it has. Front teeth are usually quicker than molars. Some cases are completed in one visit, while others are split across two appointments with a dressing left in the tooth in between to help settle the infection.
Will I be numb, and can I drive afterwards?
The tooth and surrounding area are numbed with local anaesthetic before treatment starts, and we confirm it has taken effect before proceeding. Local anaesthetic does not affect your ability to drive, so you can take yourself home. Numbness in the lip, cheek or tongue typically wears off over the following two to three hours.
Can I just take antibiotics instead?
Antibiotics can settle swelling that has spread into the surrounding tissue, but they cannot reach the bacteria inside the canal system because there is no blood supply left in there to carry them. That is why antibiotics alone do not resolve the underlying problem, and symptoms tend to return once the course finishes. The source of the infection still needs to be treated.
How long will the tooth last afterwards?
Many root-treated teeth serve for many years, particularly when they are protected with a crown and looked after with good daily cleaning and regular check-ups. We cannot guarantee an outcome for any individual tooth, as it depends on how much sound structure remains, your bite forces and habits such as grinding. We will discuss the outlook for your specific tooth at the consultation.
