Key takeaways can be found at the bottom of the page.

Root canal treatments have long had a reputation for being daunting! But is that still accurate today? To help us better understand the process, we spoke with Chief Dental Officer, Dr Gina Kilfeather, who shared her perspective on how root canals have evolved, why they’re often the best option for saving a tooth, and what patients can expect before, during and after treatment.

Common reasons for root canal treatment

The most frequent reason for root canal treatment is an abscess − often presenting as persistent pain that painkillers can’t relieve. You may or may not have visible swelling, but that deep, throbbing pain is usually a sign of infection.

In other cases, your dentist might recommend an elective root canal. This is often done when a tooth has a large filling, and the plan is to place a crown over it. If your dentist suspects the nerve might die in the coming years, it’s better to perform the root canal first rather than risk drilling through a €900 crown later on! This preventative approach is especially common for patients in their 60s and 70s upward, where older dental work may be starting to fail.

During a root canal procedure, your dentist removes the damaged part of the tooth (called the pulp), carefully cleans and disinfects the area, and then seals it to protect the tooth and help it heal.

The number of root canal sessions needed

Root canal procedures have come a long way. The instruments we use today are more advanced and allow dentists to do a lot of the procedure (particularly cleaning and widening the canals of the tooth) much more efficiently. It still takes time to disinfect the area thoroughly, but the mechanical part of the process is now quicker.

The number of appointments you’ll need − whether one, two or three − depends on the clinical scenario. For example:

• If there’s a significant infection, two visits are usually required.
• If the nerve is inflamed but not infected, a single visit might be enough.
• Most molar root canals are done over two visits due to the complexity and number of tooth canals involved.

Ultimately, the goal is to ensure the infection is fully cleared, which sometimes means placing antibacterial medication between visits to allow the tooth to heal properly.

How long does a root canal take?

The duration of treatment depends on the tooth:

• Front teeth (incisors) have fewer canals, so each visit could take around 30-45 minutes.
• Molars often with three to five canals, these require more time − often 90 minutes per visit.

It’s not that the procedure itself takes longer, it’s the thorough cleaning and disinfection that needs extra care and time.

Is an extraction easier than a root canal?

If you’re faced with the choice between a root canal and extraction, your dentist will almost always advocate for keeping your own tooth. While dental implants are a brilliant option, and we’ll discuss those in a moment − nothing beats your natural teeth.

Removing a tooth may seem like a quick fix, especially when you're in severe pain. But long-term, it can lead to complications. If you take out a molar, for instance, the surrounding teeth can tilt or drift into the gap. The tooth above might over-erupt, and the ones beside it can begin to bite at awkward angles. This increases your risk of tooth fractures and would cause any future treatment to be more difficult.

In general, the health and longevity of your nearby teeth can be compromised. And if another abscess develops in one of those teeth, you may find yourself facing further extractions − leading to larger gaps and more complex dental issues.

Planning for the long term

Dentists will always try to help patients plan ahead. For instance, losing a back molar (known as number seven) may not be as critical as losing the tooth sitting before it (known as number six), which is a key tooth for chewing. If you can save the number six tooth, it’s worth doing. If the number seven fails down the line, extraction might be considered then.

Cost is often a factor, and your dental team understand that. It’s worth considering that while an extraction seems cheaper upfront, the long-term costs (both financial and functional) can be higher if any surrounding teeth begin to fail in ways like I mentioned above. You can discuss all these factors with your dentist when deciding on a plan.

What to expect after your root canal

Recovery from a root canal is usually straightforward and fairly similar to having a large filling done. Most patients can return to work the next day. You might experience mild tenderness or a headache-like sensation in the tooth for a few days. I always advise:

• Chewing on the opposite side if the tooth is sore.
• Taking over-the-counter painkillers (or prescribed painkillers if you’ve been given them) if needed.
• Avoiding hard foods for a few days.

If you’re going to be doing things like giving a presentation at work or if you’re a teacher, you might prefer to schedule your treatment around those commitments − but generally, recovery is quick and manageable.

Do you need a crown after a root canal?

For molars and premolars, yes, absolutely. A root canal-treated tooth is no longer ‘alive’ and loses its blood supply, making it brittle and prone to fracture. Placing a crown acts like a helmet by protecting the tooth from breaking under pressure. A crown significantly reduces the risk of vertical fractures and helps preserve the tooth long-term. For other teeth, it’s best to discuss with your dentist and see.

Are root canals safe?

Yes, root canals are safe. Despite some recent attention on social media, there’s no research to suggest that root canals or the materials used in them are unsafe. If you have concerns, speak with your dentist. Every patient has unique clinical needs, and your dental team will help you make the best decision for your health.

Key takeaways

1. Root canals are often the best way to save a tooth

• The most common reason for a root canal is abscess.
• Elective root canals may be recommended before placing a crown on a tooth, as a preventative approach.
• During the procedure, your dentist removes the damaged part of the tooth, disinfects the area, and then seals it to protect the tooth and help it heal.

2. The procedure is more efficient than it used to be

• Modern tools allow quicker cleaning and shaping of canals.
• Most treatments require 1–2 visits depending on the individual’s clinical circumstances.

3. Keeping your natural tooth is usually better than extraction

• Extractions can cause bite issues, teeth to shift, and future complications.
• Dental implants are an option, but preserving your own tooth is ideal.

4. Treatment time varies by tooth type

• Front teeth: 30–45 minutes per visit.
• Molars: Around 90 minutes per visit due to the multiple canals in these teeth.

5. Recovery is quick and manageable

• Mild tenderness is normal; most patients return to work the next day.
• Avoid hard foods and chew on the opposite side for a few days.

6. A crown is essential for long-term protection

• Crowns act like helmets, protecting teeth after root canal treatment.

7. Root canals are safe and backed by research

• There is no reputable evidence that links root canals/the material used to health risks.

8. Cost vs value: think long-term

• While extractions may seem cheaper, they can lead to more expensive issues down the line.
• Strategic planning (e.g. saving your key chewing teeth) helps preserve oral health.

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately.