Root canal therapy in London, ON

When a root canal is needed

Inside every tooth, under the hard outer layers, is a soft core of nerve and blood vessel called the pulp. Deep decay, a crack, a lost filling or a knock to the mouth can let bacteria reach it. Once the pulp is inflamed or infected it cannot heal on its own, and because it is sealed inside a rigid tooth, the swelling has nowhere to go. That pressure is the throb.

Signs worth getting looked at:

• Pain that lingers rather than passing in a second or two — particularly if it wakes you at night
• Sensitivity to hot or cold that won’t fade after the drink is finished
• Pain when you bite down on that tooth specifically
• Swelling or tenderness in the gum near the tooth, or a small pimple-like spot on the gum
• A tooth that has darkened compared with its neighbours

Two things worth knowing. First, not every tooth that needs treatment hurts — an infection can be quietly present on an X-ray with no symptoms at all, which is one of the reasons regular checkups matter. Second, if the pain stops suddenly on its own, that is not necessarily good news: it can mean the nerve has died, and the infection usually continues without it.

What the treatment actually involves

Nothing about it is dramatic. Step by step, this is the whole of it:

• Numbing. Local anaesthetic first, and we wait until you tell us the tooth is properly numb — not until we think it should be.
• Isolating the tooth. A thin sheet called a dam is placed around it. It keeps the tooth dry and clean, and it stops anything reaching the back of your throat, which most people find reassuring rather than otherwise.
• Opening the top. A small access hole through the biting surface, much like preparing a filling.
• Cleaning and shaping. The inflamed or infected pulp is removed and each canal is cleaned along its full length and disinfected. This is the part that takes the time, and it is why a molar with several canals takes longer than a front tooth with one.
• Sealing. The cleaned canals are filled so that bacteria cannot get back in.
• Restoring the tooth. A filling closes the access hole, and most back teeth then need a crown to hold everything together — see the questions below for why.

Set aside a longer appointment than you would for a filling. Often the whole thing is done in one visit; sometimes, particularly where there is a lot of infection, we place a temporary filling and finish at a second appointment. We will tell you which after we have looked and taken an X-ray, not once we have already started.

Afterwards

The freezing takes a few hours to wear off. Until it does, be careful with hot drinks and try not to chew on that side — it is easy to bite a numb cheek without noticing.

Expect the tooth to feel tender for a few days, especially when you bite. That is normal: the tooth is fine, but the ligament holding it has been through something. Ordinary over-the-counter pain relief, taken as directed on the packet, is almost always enough. The deep, throbbing ache that brought you in should be gone.

If you have a temporary filling, chew on the other side and avoid anything sticky until the permanent restoration is in. Call us if the pain gets worse rather than better after two or three days, if swelling appears or increases, or if the temporary filling comes out.

Our gentle approach

We know this is the appointment people fear most, so we take extra care: clear explanations before each step, regular check-ins, and breaks whenever you need them. Raise a hand and we stop — you are not trapped in the chair.

If dental anxiety is a real barrier for you, say so when you book rather than on the day. It costs nothing to tell us and it changes how we plan the appointment — see dental anxiety and sedation for what else we can offer.

Cost and insurance

The cost depends on the tooth. A front tooth with a single canal is a shorter, simpler procedure than a back molar with three or four, and the crown that a back tooth usually needs afterwards is a separate cost from the root canal itself. We will set out both parts in writing before you agree to anything, so there is no surprise at the desk.

Most insurance plans contribute toward root canal treatment. We direct-bill where we can, and we are a participating Canadian Dental Care Plan provider.

Common questions

Does a root canal hurt?

This is the question we get most, and the honest answer surprises people: the pain you are worried about is the pain you already have. An inflamed nerve is what makes a tooth throb. The treatment removes it. You are numbed first, and most patients tell us afterwards that it felt much like having a filling done — longer, but no worse.

How many appointments will it take?

Often one, sometimes two. It depends on which tooth it is and how much infection is present — a front tooth has a single canal, a back molar can have three or four. We will tell you which after we have looked and taken an X-ray, not after we have started.

Can I go back to work afterwards?

Usually yes. The freezing takes a few hours to wear off, so you may want to avoid an important meeting or a lunch you were looking forward to. Some tenderness for a few days afterwards is normal and usually settles with ordinary over-the-counter pain relief.

Why do I need a crown as well?

Because a treated tooth is more brittle than a living one. To reach the canal we have to open the top of the tooth, and that hollows it out. A back tooth doing the work of chewing usually needs a crown to hold it together — without one it can crack, and a cracked tooth often cannot be saved. Front teeth carry less load and can sometimes be restored with a filling instead. We will tell you which applies to your tooth, and the cost of both parts, before you agree to anything.

Would it be simpler to just have the tooth pulled?

It is quicker on the day, and occasionally it is genuinely the better option — some teeth are too broken or too decayed to save. But an extraction leaves a gap, and gaps do not stay still: neighbouring teeth drift, the opposing tooth drops down, and the bone that held the root gradually shrinks. Replacing the tooth later with an implant or a bridge usually costs more than saving it now. We will give you an honest assessment either way, including when we think saving it is not worth your money.