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Endodontics, or root canal treatment, aims to clean the inside of an infected tooth and save it from extraction. With treatment, we can prevent further infection and breakdown of the tooth. Success rates are high, however the more extensive the infection the more likely a repeat treatment may be needed.

Advanced gum diseases or decay can progress to irreversibly damage the nerves of the teeth and cause an infection which will not go away with antibiotics or a simple filling.

Unfortunately, in this instance, a little more has to be done to remove the decay in the roots of the tooth, and this is where modern endodontics comes in.

Whatever the cause of your pain and infection, you must seek advice to have the area drained and relieve the swelling. We will normally try to drain the swelling from inside the tooth or occasionally, if extensive, we will make a small incision into the affected area and drain the swelling directly. Once drained and the pressure relieved, the pain associated will reside as well.

Advanced Endodontics at Pimlico Dental

Dr Anish Patel has a special interest in Endodontics, having completed further training in advanced endodontics related to general practice.

He routinely works under a dental microscope, allowing him to practise minimally invasive dentistry, conserve tooth structure and reduce postoperative complications. Dr Patel pursues perfection in dentistry and strives to ensure all his patients are relaxed and comfortable in his care.


What does the treatment involve?

Even though it may sound scary, root canal treatment actually involves many of the steps used in a normal filling. You will be completely numb and will not feel a thing apart from small amounts of pressure. It is done at the practice many times a week and is a perfected routine procedure. Root canal treatment can be done over one longer visit or two separate appointments.

1st Visit – around 30-45 minutes

  • Firstly, we use local anaesthetic in the affected area to minimise any pain or discomfort. We then wait a minimum of 10 minutes for it to work.
  • While we wait, we may be busy around you getting the rubber guard ready to place over your tooth. This protects you from swallowing any materials we use and makes for a clean, infection free environment for us to work in.
  • When you feel ready, we proceed with the treatment. We check you feel numb by asking you and checking that one side of your tongue and lower lip have lost sensation.
  • We begin removing the decay from the top part of the tooth and the root canal. We then use small instruments to clean right down to the bottom of the roots, and wash the tooth out with disinfectant.
  • We then fill the roots with an antibiotic and anti-inflammatory paste and place a temporary filling on top, which will last around a week until your second appointment.

2nd Visit – around 30-45 minutes

  • We may be able to carry out all your root canal treatment in one visit, or ask you to return for a second appointment.
  • After administering local anaesthetic, we remove the temporary filling and the paste placed inside the tooth, and clean it thoroughly again.
  • We shape and clean the root canals with special instruments, before drying them and filling with rubber material to prevent any further infection.
  • We then fill the tooth with a simple metal or composite filling, or place a crown if necessary for structure and aesthetic reasons.

What should I expect after my treatment?

After treatment, your lips and gums may remain numb for a few hours until the anaesthetic wears off. Later you may experience some pain and discomfort, which you can treat with pain medicines, such as ibuprofen, paracetamol, or a stronger prescription painkiller with supplemental antibiotics. This usually lasts only a day or two, but the relief from the pain of an infected tooth will be great.

Are there any risks associated with the treatment?

The major risk of not having treatment is progression of the swelling and infection to areas that may restrict swallowing and breathing. Therefore, no matter how large or small, it is important you have a medical professional check and treat your tooth urgently.

With any root canal procedure there are associated risks. They are small and unlikely, but it is something everyone should know. They include prolonged numbness and altered sensation, fracture of the tooth or instruments, recurrent infections despite treatment, jaw ache (due to keeping mouth open for a long time), and extraction of tooth if root canal fails.

Are there any alternatives to treatment?

Once the swelling and infection is controlled with antibiotics or draining, you can have the tooth extracted if you wish. Removing the source of infection (the tooth) will have the same effect as root treatment. We try to do all we can to save your natural tooth, as extraction can cause added treatment and costs. The obvious difference is the lack of tooth to chew with, as well as the remaining teeth tilting, shifting and moving into the space left, causing alignment issues.

Frequently asked questions

  • Is the treatment painful?

    Endodontic treatment has a reputation for being painful, but many patients do not find it painful, and liken it to having a standard filling. We use local anaesthetic to reduce any discomfort. You will likely be in pain from an infected tooth, so the relief felt when treatment is started far outweighs any discomfort that may be felt.
  • Is endodontics safe?

    Yes, when performed by a dental professional, endodontics is a completely safe and effective treatment. We have many years of experience and have undertaken courses in advanced endodontics so you are in safe hands.
  • Why do you use a microscope?

    Endodontics is a high detail treatment, where we need to see fine details in order to produce the best results. Using a microscope enables us to perform highly accurate, controlled and precise dentistry, with far fewer complications.
  • Can the treatment fail?

    Endodontic treatment can occasionally fail, sometimes a long time after it was completed. The failure is usually due to a fracture, new decay or the crown becoming loose or damaged. Treatment can be repeated on the same tooth if necessary, however most treated teeth will last for years without issue.

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