What is root canal treatment?

What is a root canal treatment?

Everything you wanted to know about root canal procedure

As a specialist in Endodontics, my expertise and work focuses entirely on root canal treatments.


For many, the term ‘root canal treatment’ is enough to instil deep fear and conjure images of painful, extended dental treatments. The truth is however, far less gruesome.

You might be surprised to find out, when done properly, the root canal treatment itself should not cause you any pain. Yes, it is possible not to experience any root canal treatment pain.


So, is root canal painful?

Dr. Adi Moran, root canal specialist and endodontist London:

“Once you are in the dental chair and undergoing a root canal treatment, it’s my job to make sure the experience is painless, start to finish. This is usually not that difficult to achieve.
Getting you to believe this fact before starting treatment is not that simple and sometimes not even possible.

Most realize that a root canal treatment can be painless only after having experienced the procedure, and that’s OK.”

Let’s dig deeper and explore what root canal treatments are all about.

Endodontic treatments, the professional term for the various types of root canal related treatments, are focused at one of two things:

  1. Preserving the existing health of your tooth and thus preserving the existing health of the adjacent soft tissues and bone, which support the tooth in place (treatment for preventing future complications in the jaw and other root canal complications).


  1. Healing the tooth’s supporting soft tissues and surrounding bone, if these are already inflamed as a result of infection attacking your tooth’s root canal system (root canal infection).



If you are in pain and need a root canal treatment, the aim is to get you out of pain, not to cause you pain. This is a huge misconception about root canal treatment pain.


Endodontic treatments belong to the ‘inflammation category’, due to root canal infections.

Simply put, in a hypothetical completely sterile world, root canal treatments would not be needed.

Broadly speaking, you need a root canal treatment if you have a root canal infection – i.e. infection has gotten into your root canal system. Depending on the severity of the situation, your tooth could still be considered “alive” or already “dead”.

Some common routes for root canal infection taking hold of your root canal system are through tooth caries (known as tooth decays or cavities) or through tooth fractures.

In root canal treatments we try to treat or even sometimes reverse an attack on your tooth’s immune system or on the immune system of your tooth supporting tissues, via an infection.


An infection may challenge your tooth’s immune system before it physically gets inside the tooth (for example at the “younger” stage of your tooth caries/cavity). If your tooth is still “alive”/vital before infection gets in, the inflammation in your root canal system or supporting tissues may still be there as a ‘sterile inflammation’, not yet an ‘infected inflammation’.


Breaking it down further, sometimes the ‘sterile inflammation’ inside the tooth may even still be in a “reversible stage”. The implication is that theoretically you may possibly get away with just a filling or a crown without doing a root canal treatment first.

Dr Adi Moran, root canal specialist:

“Humbly and with the highest respect to my referring dentists, on rare occasions a patient is referred for root canal treatment and my treating decision is to ‘not treat’. Rather, I refer back to the referring dentist for a crown/filling with close monitoring and follow-ups.”

You can see how much a correct diagnosis or differential diagnosis of your unique dental situation is so crucial when it comes to root canal treatment procedure.

The key is to make a correct diagnosis and proceed with the right root canal treatment for your particular unique situation.

“Is root canal painful? Will I feel root canal treatment pain?”

Many patients mistakenly think that if they are not feeling any pain in their teeth, than they probably don’t currently suffer from a situation requiring a root canal treatment. Others believe that pain necessarily means a root canal treatment is in the cards.

Neither is necessarily right and this is exactly where the in depth knowledge of a root canal specialist, an endodontist can prove helpful.

The art of correctly diagnosing a problem in the tooth’s root canal sometime requires complex multifactorial thinking and analysis. There is a lot of current, advanced academic knowledge in the specialized field of Endodontics, which those specializing in the field, root canal specialists, make sure to keep current about.

There is a good reason why specialists training in a narrow field of dentistry like endodontists, take years of studies to complete. Some of these studies are focused at learning to efficiently and correctly identify your exiting root canal related problem.

Understanding the root canal treatment procedure:

If you do find yourself needing a root canal treatment, this is the root canal procedure you can expect:


  • We first decide if your tooth is still vital or ”alive”. If this is the case we consider the root canal system to still be infection free or partially infection free.


We will then replace the damaged root canal tissue with a root filling, while making sure to keep your root canal system infection free during the procedure and afterwards.


  • If your tooth needs a root canal treatment (or root canal retreatment) but is already non-vital, we work under the assumption that your root canal system is infected.


The procedure will then be aimed at disinfecting your root canal system to the highest level attainable prior to performing the root canal filling itself.

The technical aspect of the procedure requires great expertise, delicate hand movements (which when done correctly can also aid to the patient’s comfort) and an understanding of “what step to do next” in a correct manner, which may vary and be tooth or case specific.


Each tooth is a little different and each comes with different pre-treatment conditions to consider.


Treatment mishaps (unlucky accidents) may occur during every step of the treatment, and happen more when performed by a less qualified dentist. The vast majority of those mishaps can usually be avoided in the first place. When they do occur, some of these may then not be so easy to fix and might also require a comprehensive analysis taking into account of different factors before deciding on how to best manage the situation.


Broadly speaking, treating an ‘inflamed but sterile/partially sterile’ root canal system has higher long-term success rates compared to a treatment of an infected root canal system when an inflammation has already extended out of the tooth and into the underlying supporting soft tissues and bone.


However, this is only true when the root canal treatment was done correctly, and all the rules and guidelines of root canal treatments were strictly followed.


It is crucial for a root canal treating dentist to treat the canal system in as strict aseptic manner as possible (and also to provide proper post-treatment conditions to prevent new post-treatment root canal infection from getting in).


Some non-specialist dentists often give too much emphasis to techniques and the technical final canal shape and root filling on the post-treatment radiograph, without incorporating consideration to other crucial factors or disregarding microbiology and effective disinfection procedures.


Having your teeth treated by an Endodontist, “root canal specialist”, will raise the chances that these guidelines and techniques are strictly adhered to.

Learn more about how we manage your root canal treatment pain