Root Canal Treatment

Root canal treatment

 

When people ask us, ‘what is a root canal’ we usually tell them “it’s how we’re going to save your tooth”Root canal treatment is sometimes the best and only way of saving a damaged tooth.  And here at Smileworks we love teeth and don’t like extracting them if we can help it.  The proper name for these types of treatments is endodontics – and you may hear them described this way or as root fillings or root treatment.

 

 

 

But sometimes your teeth get damaged by trauma or infected by decay.  This can be as a result of poor oral hygiene. Bacteria gets through cracks in the enamel and deep down into the tooth root.  This is the part of the tooth that is ‘alive’ and is susceptible to infection just like any part of your body.  It’s also the part that can cause you pain.

 

Root canal pain

 

Most people who need root canals come to see us because they’re in pain.  The infection inside the tooth can cause swelling and pain and build up pressure.  This can manifest as either ‘hot pulp’ which feels like painful toothache, extreme sensitivity or an abscess.  Sometimes patients will come in with dreadful pain and swelling in that side of their face.  This is different to the pain caused by cavities and failing fillings.  We can replace old fillings for you and remove the painful tooth root sometimes without the need for a root canal.

 

If you are experiencing pain then you can make an emergency appointment by visiting our emergency dentist page here. We can get you out of pain pretty quickly and have you on the road to recovery in record time.  So don’t be shy about making an emergency appointment if you have swelling or pain.  Here’s a video explaining the procedure:

 

 

 

 

So does a root canal hurt?

Not usually.  At Smileworks our dentists will make sure you are completely numb before going anywhere near the hot pulp or anything that’s causing you pain.  Local anesthesia is a wonderful thing.   And we make sure people are the numbest they can possibly be.

 

 

Sometimes acute pulpitis can be very difficult to get numb where the tooth is innervated by one or more nerves.  Your dentist will be creative about where they put the anaesthetic to make absolutely sure you will not feel pain.  There are potentially 6 nerves that innovate the first molar and we have a multitude of creative and effectual ways of getting them all numb.  So the procedure is rarely painful.  A hot tooth can be hard to get numb no matter how talented your dentist is.  And that is why time is something you need to get this procedure right.

 

Causes of infection

 

So how does the root of the tooth become infected when it’s below the gum line?  Here’s the structure of a tooth and the process of root canal treatment:

 

 

Pulpitis and root canal therapy

 

 

Tooth decay, broken or failing crowns or even fillings that have failed or fallen out can cause you to need endodontic treatment.  Bacteria gets in the little cracks and fissures causes painful infections. Recently placed fillings can cause the nerve of the tooth to flare up.  You are more likely to need root canal treatment or get an abscess if you:

 

 

 

Here at Smileworks we are conservative dentists.  This means that we don’t like drilling or filing your teeth if we can help it.  The reason for this is that as soon as we touch your tooth with the dentists drill, the chances of it failing and requiring subsequent treatment or even removal are dramatically increased.

 

 

This is why Braces and adult orthodontics are a better idea than traditional veneers if have the choice and composite bonding is better than porcelain veneers where appropriate as the damage to the individual tooth or teeth is likely to be less.

 

Had an appointment with Patri for a painful wisdom tooth. I was terrified of the extraction but she was absolutely amazing. Fantastic job! Also, if you think Smileworks might be a bit pricey, think again. I ended up paying considerably less than what another dentist would have charged me. A super happy customer 🙂read more
Minodora Zidaru
Minodora Z.
22:05 22 Mar 19
Susan (dentist) and Eva did my composite bonding and Susan is excellent at her work! I am in love with my new smile and can't recommend her enough! The staff at Smileworks are so professional and friendly. Thank you!read more
Sophie Siu
Sophie S.
11:40 10 Mar 19
Went to Smileworks for lip fillers and had a wonderful experience! I had Susan doing my fillers and she is absolutely amazing at what she does.. She is so so lovely and easy to get on with and answered all my questions and worries before I even asked and made sure she discussed exactly the outcome I wanted. She made me feel completely safe and at ease which is what I was hoping for as it was my first time. I cant recommend Susan enough, she is an absolute gem and is truly amazing at what she does, I love my new lips! Also the girls at reception were lovely and very helpful, I even had a call from Davina the day after (who was really really lovely) to see how I was and if i had any questions. It is obvious that they care about their patients and the work that they do for them.read more
Maddie Dooley
Maddie D.
17:30 08 Mar 19
I had semi-permanent makeup (eyebrows) done by Hannah. What can I say? I LOVE them. They have changed my face and my confidence! Hannah is lovely and takes her time to talk you through everything. I felt at ease with her-she's friendly and approachable and doesn't make you feel silly for asking questions. She goes through the design process and makes sure you are 100% happy before continuing. She spent hours designing my brows with me until they were perfect. Seems nothing is too much trouble for her!! Would definitely recommend and I shall most definitely be back in the future! (Should also note everyone I have come into contact with at Smileworks has also been lovely!!) 😁😁read more
Ellie Roberts
Ellie R.
20:35 04 Mar 19
I had semi-permanent eyeliner with Hannah. it was a great experience I came back 3 times in all for all the top ups.(included in the price ) She made sure that I was 100 percent happy with the look and pain free. She took the time, and was extremely friendly and welcoming as well as totally professional .I will definitely come back as it fades It's amazing to not put eyeliner on and know you look good at 6.30 am at the gym!read more
J Lo
J L.
19:31 12 Feb 19
Visited here today staff were so warm and friendly! I had an aesthetic appointment with MJ she made me feel so relaxed and at ease. I would highly recommend Smileworks!read more
E Bailey
E B.
17:08 12 Feb 19
Great place with professional staff and nice atmosphere. My appointment was with Louise and Eva who were very helpful, friendly and knowledgeable. They have explained everything clearly and made me feel relaxed. Would highly recommend.read more
Denise Colley
Denise C.
22:42 27 Jan 19
I had my lips done here in November and a quick check up in December... I was amazed at how professional it was and I love the aesthetic of the office too. MJ made me feel a home, as did the rest of the team, and I will definitely be returning when I need to!read more
Danielle Piper
Danielle P.
20:12 20 Jan 19
Been coming here for the past few months, teeth are so much better since coming here, teeth whitening under way and look boss. Thanks to Zoe for sorting my pegs out and for the laughs. See ya soon gorj xxxxxread more
James Selsby
James S.
09:39 16 Jan 19
Probably the best visit to the dentist's ever! I would recommend without ant second thought! Keep up the good work!!!
Σοφια Αλεξιαδου
Σοφια Α.
15:17 05 Jan 19
Refreshing new look of the "dentist". I found Smileworks quick with no hassle. They know what they're doing and not stuffy. Would definitely recommend.read more
Carolyn Wagstaff
Carolyn W.
20:07 27 Dec 18
I find myself recommending more people to these guys every day at work, I wouldn’t go anywhere else now! Amazing service delivered in a friendly and welcoming environment.read more
Jared & Co Barbers
Jared & Co B.
19:28 11 Dec 18
I absolutely love this place. Staff are amazing. And what can I say about the wonderful MJ....Try it yourself, I guarantee you wont disappointed.read more
pamela Bretland
pamela B.
18:46 11 Dec 18
First time for lip fillers, so obviously a little nervous on the outcome but I am over the moon. A natural yet full look could not recommend smileworks anymore. MJ is unreal at what she does and puts you at ease within a few seconds of the consultation whilst also giving all the right info and questions. Excited for another ml already!read more
Rosa Horsley
Rosa H.
12:13 26 Nov 18
Great experience. Very happy with my new smile. All the staff are faultless and so welcoming!!
Jessica Hudson
Jessica H.
16:13 14 Nov 18
Can't recommend smileworks enough amazing service! Really helpful over the phone and booking my first visit was so easy. Laurence and Georgie were so friendly and discussed the different options and treatment plan in detail. Nothing was too much trouble 🙂 Thanks guys!read more
Sam Abbott
Sam A.
16:06 07 Nov 18
I feel 5 star is not enough and those guys deserve an infinite number of stars and a unicorn on top of that! I have a severe phobia if it comes to my teeth, I'm a survivor of Polish public dentist care and let me tell you that's something straight from nightmares and torture chambers. As a results my teeth are not in a great way (those that did survive), to add to the "fun" I also have major orthodontic issues. I knew I needed help and it took me about a year and a half (this is not an exaggeration) to make my way to Smileworks. In the meantime I tried two other 5-star rated places and I wasn't convinced enough to stick around. The second I called Smileworks I had a warm fuzzy feeling in my belly that this place is the right place finally, It took a few months and multiple appointment before the right treatment plan could be created, since my case is complicated to say the least. I feel that there was a LOT of thoughts put into finding a solution, which made me feel at ease and gain enough trust to go ahead with the treatment. Every time I come to visit everyone is just brilliant. All the ladies and gents are nice and bubbly, which definitely helps to relax. Their approach is very gentle, a lot of attention is given to the patients and you just get the feeling that this guys really know what they do. I feel spoiled and I stopped fearing every dentist visit as I used to in the past. I know it sounds odd, but if anyone is able to make dentist appointments as pleasurable as possible, that's the people at Smileworks! As to address the money, things like that cost a lot, that's the unfortunate reality and there's no way to avoid that. For what I've been offered i think that's worth every penny. If it comes to the plane theme, I think it's amazing and I absolutely love it, especially because of all the little details. Finally a place with a sense of humor! I get how people scared of dentist AND flying can find it disturbing, but I think that's just an edge case.I will preach the genius of this place forever and share it with anyone who is eager to listen (or is not eager to listen at all but just haven't ran fast enough from me).read more
Joanna Skorupa
Joanna S.
10:24 26 Oct 18
Had my first appointment today with Paula and Jess. It was very nice, friendly and professional! I was talked through a plan for future treatments that I wanted and given a price estimate, so helpful! Appointment was also 2 days after I phoned them, so seen very quickly!read more
Laura Johnston
Laura J.
14:22 19 Oct 18
Had bad experiences with other dentists. Went to smileworks. I could not have been treated better. The staff are amazing and my dentist Susan is fantastic. She put me completely at ease. I've never said this before but I now enjoy going to see her and get work done on my teeth. Would highly recommend smileworksread more
Karen Wells
Karen W.
04:22 11 Oct 18
I went to smileworks last week for a new retainer. The service I received was great, from meeting the receptionists to when I was receiving treatment from Paula and the dental nurse. Everyone was very smiley, friendly and helpful. Paula especially took the time to explain whitening treatments to me (as I mentioned I would like whiter teeth on my patient details form) and also explained treatments such as composite bonding which could help me achieve the perfect smile I was looking for. The dental nurse helping was also very calming and patient. I would definitely recommend to others and would really like to compliment their great customer service. Thanks smileworks and all their lovely staff.read more
Victoria Thomas-Hui
Victoria T.
20:33 10 Oct 18
Went to smileworks to have my eyebrows done by Hannah! From the moment you walk in everyone is super friendly and Hannah greets you like an old friend! This was my second visit as it was a top up! My eyebrows are really not easy as they pretty much non existent and what was there was super wonky! Hannah was amazing! She was so patient and spent a ridiculously long time making sure I went home happy! Would 100% recommend to everyone!! Xread more
Bethany Sheldon
Bethany S.
16:31 06 Oct 18
I couldn’t recommend Smileworks more! All staff are so friendly and make you feel welcome. Hannah is absolutely amazing! An absolute perfectionist in semi-permanent makeup. Anyone who is considering having eyebrows/eyeliner/lips done should 100% have Hannah do them, you won’t regret it!read more
Abby Cowdell
Abby C.
16:26 17 Sep 18
Very pleased with the dermal fillers administered by MJ and the semi permanent makeup from Hannah. Both took the time and effort to ensure I received the best options for treatment. In addition, the reception staff were very polite and welcoming which added to my positive experience. Would definitely recommend.read more
Rose
Rose
21:59 10 Sep 18
I unfortunately lost a tooth a few years ago due to a nasty abscess that too many root canal treatments could not cure. I decided at the beginning of the year that it was time to fix my smile and went for a consultation for a dental implant. I visited a couple of dental practices and decided on smileworks due to the friendliness of staff and their ability to answer all of my questions and put my mind at ease. Plus an added benefit was that they offered credit to help finance the treatment. I could not be more happy with my decision and my results. I have a perfect smile once more and dealing with the team was an absolute pleasure! I cannot recommend their services highly enough.read more
Grainne Mulholland
Grainne M.
12:34 05 Sep 18
One of the best dental practice I have ever seen. Thank you all for your helping me during my emergency visit. للأخوة العرب المقيمين أو الزائرين إلى ليفربول، هذه العيادة من أفضل عيادات الأسنان التي رأيتها في حياتي بدء من الاستقبال وحتى الطبيب المعالج. اذا احتجت الى زيارة طبيب الاسنان اجعل هذي العيادة خيارك الأول!read more
Ali Alsolme
Ali A.
14:19 01 Sep 18

 

What is a root canal? 

 

The root canal procedure involves completely numbing the area and then making a tiny hole in the tooth.  A special file is used to carefully removing the infected material from inside the tooth.  This is the nerve or ‘pulp’ that is causing you the pain.  Because of the numbing you will not feel a thing.  Many people complain that their root canals hurt and this makes here at Smileworks feel very sad.  The only reason a root canal should hurt is if it’s rushed.  And what we have plenty of here at Smileworks is time.  Some molars are innovated by up to six different nerves and our dentists get seriously creative about making sure you won’t feel a thing.

 

 

Once you’re numb we can get all the infected material cleaned out the space and then irrigate it or flush it out with a cleaning solution.  This is typically a chemical called chlorhexidine (contained in some mouthwash) or a weak hypochlorite solution.  And what do we know about hypochlorite?  It kills all known germs, dead.  So this will give your tissue a good chance of recovering.

 

 

The space is then filled in with a special material and the hole is filled in and your tooth is restored to it’s healthy, pain-free and functional old self.  The reason the space is filled in is because any space is liable to fill back up with bacteria.  So we use a rubber-like material to fill the space so nothing can get in and cause you any more problems.

 

 

Root canal cost

Here's the 2019 Root Canal Prices at Smileworks for Root canals and re-root treatments

 
 

Here are the costs for your root canal treatment in 2019. Remember the reason you are paying is because here at Smileworks we will make sure we take the time to get you numb and do the work using the most advanced materials and machinery available. Dr Rowland-Warmann likens root fillings to cleaning out the cupboard under the stairs through the keyhole, in the dark. Root canal treatments require attention, skill and are often complex treatments so they need to be planned and managed accordingly. So microscopes, special lights, CBCT scanners and apex locators are all a good idea. And then there’s time. Often the difference-maker between pain and failure and happiness and success.

 
 

  • Anterior (front) Tooth | £400
  • Incisor Tooth | £400
  • Premolar Tooth | £425
  • Molar Root Canal | £475
  • Re-root Anterior (front) Tooth | £450
  • Re-root Incisor Tooth | £450
  • Re-root Premolar Tooth | £500
  • Re-root Molar Root Canal | £500

 
 
If you require more than one tooth then just multiply these prices by the amount of root fillings you need or want. Remember that doing nothing is always an option, as is extraction and other less expensive things. So come in to see us and get the full picture.
 
 
These are guide prices – if the root canal is particularly complex (such as extremely curved roots, fractured instruments or other complex pathology), fees may vary or you may require a referral to specialist endodontist where the fees will be substantially more. To be clear MJ is a dentist with a special interest in endodontics and not a specialist endodontist.
 
 
Fees are quoted at your consultation – here at Smileworks we don’t like surprises so you will know precisely how much you’ll be paying before any work is undertaken.


 
 

If you're concerned about the affordability of treatment then take a look at our patient finance calculator here:
 
 



 
 

Private vs NHS Root Canals

 

The NHS is a wonderful and noble service and we absolutely love and respect it here at Smileworks.  Take a look at your root canal options here.  It’s much, much cheaper than us. Many of our Smileworks dentists here have worked in the NHS and have done root canals but they (and any conscientious dentist will tell you) they’d rather work in an environment where they can spend twice the time, use a microscope, have tools like apex-locators on hand and be able to diagnose using a CT scanner if necessary.  Most of which, you’ll not find at your local NHS practice.  So the decision is yours.

 

We take root canal safety very seriously at Smileworks and if you’ve ever had a root canal without a piece of safety apparatus called a ‘rubber dam’ then you need to change dentist.  Here’s a picture of a Smileworks patient wearing a rubber dam.  It basically stops anything nasty getting swallowed or inhaled during the procedure.  The disco shades are an optional extra along with the Tom Jones root canal playlist…

 

 

Root canal safety Rubber dam

 

 

 

Root canal risks & complications

 

Once you get home the tissue can get re infected.  The most common cause for this is a leaky dental crown.  This is where a crown is required on top of the canal because the tooth is too damaged. Bacteria can get in and cause a flare-up.  Come and see us and we can get this fixed.  To read all about leakage and crowns in general see or main page here: Dental Crowns Liverpool.

 

Pain

 

There can be residual pain after a root canal.  This can be a type of ‘bruising feeling’ from the local anaesthetic injection sites or it can be tenderness from the treatment.  Use painkillers you’d normally use for a headache and if it hasn’t resolved in a few days or if they don’t even take the edge off, come in to see us again.

 

Failure

 

Root canals are complex.  There is no such think as a routine root canal and there is a great deal of rubbish on the internet about how your root canal is going to be a happy experience with rainbows and sunshine and 100% success rate.  This is not realistic ands here at Smileworks we tell you how it is not what you want to hear.  The success rate of any dentist is around 80-85% and in more complex cases this may be reduced further depending on the tooth and the associated.  Sometimes root canals fail even with the best treatment for reasons we are not entirely clear about.  But if you come to us for treatment we will fix anything that needs fixing quickly and effectively.

Swelling

 

As with any dental treatment there can be swelling but it should subside. IF it is getting worse or more painful then come back in and we will take a look.  If you are experiencing pain worrying in nature, or it is affecting your ability to breathe or swallow, you should proceed straight to A&E.

 

Root canal alternatives

Extraction

 

If the tooth is unrestorable or if the caries (tooth decay) is too deep or extends down to the bone then an extraction is likely indicated.  Sometimes decay extends so far down that we simply can’t put a crown on because the crown will be beneath the gum margin and it just won’t be a success.  This is when you’ll need an extraction. For extractions you can see our wonderful oral surgeon, Dr Anca Antoniu who will be able to take your tooth out for you painlessly.

 

Referral

 

We are not endodontic specialists here at Smileworks but we do know a thing or two about root canals. If the anatomy is really complex, or a previous root canal has had complications that are super-difficult to manage, then we’d rather refer you to one of our trusted partners who will be able to give you the standard of care commensurate with an extremely difficult, specialist case.  We love referring patients on because we don’t ever put our patients at risk. There is no ‘hero-dontics’ at Smileworks and our cases are reviewed by a multidisciplinary team – something that sets us apart from many practices in Liverpool.

 

Do nothing

 

Sometimes people want to just leave it because they want to have a think.  Not having treatment is always an option.  This may risk the tooth flaring up and you being in pain again.  All we can do is advise you regarding your treatment options.

Root canals for children

 

Kids sometimes have root canals.  One of the most common causes or children needing root canals is trauma to the front teeth. We don’t want to be extracting the central incisors of children, so if your child is happy and motivated and they understand the treatment then that’s fine and we will typically get excellent results.  The intended outcomes and benefits need to be carefully explained to both parents and the children to make sure everyone is on the same page.

 

Root Canal Myths

 

I can control the pain with strong painkillers:

Strong painkillers will help in the short term but they will not fix the underlying issue and there is a strong likelihood that you may become addicted to some painkillers that will, in the end, cause you far more pain and suffering than even the worst visit to the dentist.

 

 

It’s ok, I’m going to ask to be sedated:

If you are an extremely anxious patient and concerned about your treatment, you may elect to be sedated for your root canal procedure.  We can arrange this for you; we can discuss the fees involved in this at your consultation.  Usually the scariest part of your root canal is listening to Tom Jones for the duration of your appointment (if it’s Dr Rowland-Warmann treating you.  Read some of our reviews and see what people usually feel after their treatments with us. You’re in safe hands and we will make sure you are calm and comfortable throughout your appointment.

 

 

I don’t want my nerve taking out or damaging:

By the time you need a root canal, the nerve is past saving and needs to be removed along with the bacteria and inflamed material.  So ‘saving the nerve’ is impossible.

 

For more myths see the FAQ section below.

 

 

Root Canal FAQ

Here are the most commonly asked questions about this treatment by our patients.

  • How do I know if I need a root canal?
  • You’ll be in pain and have swelling and your tooth might feel hot or ache or just be downright excruciatingly painful. Your dentist may have recommended you need a root canal also.
  • Are root canals safe?
  • When all the correct procedure are followed and everything is in place, root canal treatment is relatively safe. The only real risk is practices not using an instrument called a ‘rubber dam’. If your dentist has never used this when you’ve had a root canal then you should change dentist, because they are not taking safety seriously and do not care about you. If a file gets accidentally dropped down your throat and you start coughing, can be aspirated (breathed in) and get lodged within your lung, requiring surgery for its removal in extreme cases. So rubber dams are a big deal around here and mandatory in the completion of root canals.
  • Can it fail?
  • Root canal treatments can fail for a number of reasons: - Bacteria remaining in the system - Fractured instruments - Inadequate previous root filling - Perforations of the previous root canal system - Resorption due to trauma – or for no apparent reason - Leaking coronal restorations or leaking crowns leading to reinfection
  • Root canals and crowns
  • If an abscess is big enough and causes facial swelling then it can make you systemically unwell (so cause a fever). If a tooth is throbbing it can cause a headache. Lower teeth can make you seem like you’ve got toothache in your upper teeth and the nerves radiate in all directions causing confusing and often worrying ‘referred pain’.
  • What if I have pain after root canal?
  • Initially there may be some mild discomfort after the procedure. This might feel like a bruise (from the anesthetic) and the area will feel tender. This is fairly common and can be managed with the same painkillers you’d take for a headache and will subside after a day or two. Severe pain and associated swelling a couple of days after the procedure may occur. This can be a flare-up from bugs that lived inside the tooth that have been jiggled about by the treatment. This is called a phoenix abscess. It’s best to make an appointment to see us. The third post-treatment pain type is very severe pain and rapid swelling. Hypersensivity to some of the chemicals used to clean the inside of the tooth can cause this and you must visit A&E or go straight back to your dentist (or Smileworks). Dr Rowland-Warmann has extensively studied the pathology and incidence of such occurrences and you can read about them here. But be aware they are extremely uncommon.
  • How long does a root canal take?
  • At Smileworks a root canal appointment 90 minutes and if it’s more complex, You may need further appointments, which are included in your cost quoted at the start.
  • Are antibiotics a substitute for a root canal?
  • Antibiotics are not a substitute for root canal treatment. They do not make an abscess go away they suppress it and put it to sleep. Then it will reappear at a later date. Antibiotics will reduce the acute phase of an abscess but will not remove the bacteria from the inside of a tooth.
  • Root canal NHS vs Private
  • This is always a tricky subject and one that’s been covered already. Root canals can be clinically challenging to treat and complex in nature. So the thing that is of paramount significance is time. Practitioners in private practice are not necessarily better than those in the NHS. However, many NHS practitioners feel that due to the constraints placed on them by the NHS (including time constraints and the need to hit targets) that they would sometimes not able to allocate the kind of time to complete a root canal in the same way a private practitioner might be able to. The other factor is budgets and equipment. In private practice we have a CBCT scanner for the diagnosis of complex and difficult cases. Private practices may have more ready access to gadgets that make the endodontic procedure more streamlined. We have made significant investments to get you in fast and treated effectively. Pain management In endodontics is a huge deal - and that takes time. And truly conscientious dentists will agree with this sentiment.
  • What happens to my nerve?
  • The nerve is removed. Your nerve lives in the tooth which is like a little hard tube. If the nerve or pulp dies or becomes infected it will increase in size and swell. This is what produces the pain and throbbing. The nerve doesn’t always have to be dead to be infected. It’s usually an acute bacterial infection that causes the pain. The inside of the tooth is cleaned with specialized instruments and made bigger and cleaned out with a cleaning solution and filed with a rubber-like compound that is biocompatible and is called gutta percha. The principle is that a hollow tube can store bacteria but a filled one cant. This has the effect of eradicating bacteria.