During a check-up, we examine the teeth, mouth, and gums to determine if any underlying conditions impact your smile. If you’re a new patient to our practice, you’ll need to book a comprehensive new-patient exam for £95, which includes two x-rays. If you’re an existing patient, you can book a Continuing Care Exam for £50.
Root canals are small channels at the base of a tooth that contains nerves, connective tissues, and blood vessels, collectively known as dental pulp.
If a tooth becomes cracked or decayed, bacteria can penetrate the tooth’s surface and infect the pulp.
If a tooth’s pulp becomes infected or is at risk of infection, your dentist may need to remove it and replace it with a filling, known as a root canal treatment.
In some cases, depending on how decayed the tooth is, the dentist may also need to fit a crown to your tooth following the endodontic treatment.
An infected tooth can become significantly inflamed. Several symptoms indicate you might need endodontic treatment, including:
However, sometimes, dental pulp infection can be asymptomatic.
In this case, your dentist will usually spot the issue on an x-ray.
The dental pulp becomes infected when bacteria penetrate the centre of a tooth after it becomes compromised because of a large cavity or breakage incurred through injury, among other things.
A few things can lead to a dental infection requiring endodontic treatment.
These include:
Leaving an infected tooth alone and not receiving proper, timely treatment for it can have potentially serious consequences, including:
There are four basic steps to endodontic treatment. First, the dentist will remove any infected tissue from the tooth’s centre.
Next, they will shape the root canals, smooth them out, and disinfect them to ensure they have removed all the bacteria from the tooth. Depending on the severity of the infection, it may take more than one round of treatment before the area is spotless and free from bacteria.
They will fill and seal the root canals to make sure no bacteria can re-enter the canals.
Some dentists may wait a week to ensure the infection is gone before sealing your tooth. If your dentist does not complete the procedure on the same day, the hole in your tooth will be covered with a temporary filling to keep food particles and other debris out of your freshly cleaned tooth.
To seal the tooth, your dentist will use a compound called gutta-percha — a biocompatible material similar to rubber — to fix it with adhesive cement.
Finally, the dentist may fit a crown to restore the function and appearance of the tooth and protect it from reinfection.
Most root canals are carried out perfectly well by general dentists. Some cases genuinely benefit from someone who does little else, and it helps to know which is which before you start ringing round.
An endodontist is a dentist on the General Dental Council’s Specialist List for endodontics, having completed several years of additional postgraduate training in root canal treatment alone. It is a protected title in the UK, so anyone using it must be on that register.
A Specialist Endodontist has completed substantial further training, often to master’s level, without holding the specialist registration. In practice they handle the large majority of root canals, including plenty of difficult ones.
Root canal treatment at our practice is led by Dr Amar-Lal Sarin, a Specialist Endodontist on the GDC Specialist List for endodontics. He qualified from the University of Birmingham in 2011 and completed his MClinDent in Endodontology at the UCL Eastman Dental Institute. He also holds the Membership in Endodontics (M.Endo) from both the Royal College of Surgeons of Edinburgh and the Royal College of Surgeons of England. GDC number 210134.
As a registered Specialist Endodontist, Dr Sarin can treat complex cases in-house, so most patients won’t need to be referred elsewhere.
Two honest points. Referral usually costs more, often considerably, and specialist waiting times can be weeks. And a referral is not a sign anything has gone wrong. It means the case needs equipment or experience beyond routine, which is exactly when you want someone to say so rather than attempt it.
People often assume the pain level decides the difficulty. It does not. Anatomy does.
Usually straightforward: front teeth and canines, which typically have a single, fairly straight canal. Often one appointment.
Moderate: premolars, with one or two canals.
More involved: molars, which commonly have three or four canals, sometimes more, and often curved. Lower molars in particular can hide an extra canal that is easy to miss, and a missed canal is the most common reason a root canal fails later.
Genuinely complex: any tooth being retreated, any tooth with calcified canals, and teeth in patients who cannot open wide or who gag readily.
This is why quotes vary so much between teeth. A front tooth and a lower molar are different procedures sharing a name.
Success rates for well-executed first-time root canal treatment are high, commonly quoted at around 85 to 95 per cent over the longer term. That leaves a real minority that do not settle, and knowing the reasons helps.
A missed canal. The most frequent cause. Bacteria remain in a canal that was never found and cleaned.
Reinfection through the crown. A root-treated tooth left without proper coverage lets bacteria back in from above. This is why crowning a root-treated back tooth is recommended rather than optional.
A crack in the root, which no amount of cleaning inside the tooth can fix.
Delayed restoration. A temporary filling left in place for months instead of weeks eventually leaks.
If a root canal fails there are three routes: retreatment, meaning reopening and re-cleaning the canals; surgery at the root tip; or extraction and replacement. Which is right depends on how much sound tooth is left, and it is a genuine decision rather than an obvious one.
The first few days. Tenderness when biting is normal and expected, because the ligament around the root has been irritated. It usually settles within a week. Over-the-counter pain relief as directed on the packet is generally enough.
Do not chew on it until it is permanently restored. A tooth with a temporary filling is weak, and this is the point at which teeth crack. If it does, our page on cracked teeth explains the outcomes.
Get the permanent restoration done on time. This is the single most important thing you control. A root-treated tooth is more brittle because its internal blood supply has gone, and a back tooth without a crown is considerably more likely to split. Weeks is fine. Months is how teeth get lost after successful treatment.
What is not normal: increasing pain after three or four days, swelling, a return of the original throbbing, or a bad taste. Ring us rather than waiting it out.
Long term, a well-restored root-treated tooth can last decades. It will not respond to cold, because there is no nerve left, which also means you cannot rely on pain to warn you if decay starts underneath a crown. Regular check-ups matter more, not less.
Worth thinking about properly rather than defaulting either way.
Keeping the tooth preserves the root, which preserves the bone around it. Nothing artificial matches your own root for maintaining jaw shape, and there is no gap for neighbouring teeth to drift into.
Extraction is cheaper immediately and finishes the problem in one appointment. It also commits you to replacing the tooth, or to living with a gap, and both have consequences.
Comparing honestly across a decade: root canal at £425 plus a crown from £995 is more than an extraction at £195. But extraction plus an implant costs substantially more than either, and doing nothing lets the teeth either side move. Our guide to replacing a missing tooth sets out what follows.
Our general position: if the tooth has enough sound structure left to restore, keeping it is usually the better long-term decision. If it is largely broken down, cracked, or has already failed treatment twice, extraction stops you spending money on a tooth that is going to be lost anyway.
Usually not. Most root canals are done well by general dentists, and by dentists with additional endodontic training. Specialist referral is worth it for retreatment, unusual anatomy, or surgical cases.
An endodontist is on the GDC Specialist List for endodontics after several years of additional training in root canals alone. A dentist with a special interest has substantial further training without that registration. Both do root canals routinely.
Ours starts from £425, with the exact fee depending on which tooth and how many canals. Molars cost more than front teeth because there is more to clean. Budget for a crown afterwards on back teeth.
The treatment itself is done under local anaesthetic, so you feel pressure rather than pain. Most people find it far less unpleasant than the toothache that brought them in. Tenderness on biting for a few days afterwards is normal.
One appointment of 60 to 90 minutes for a front tooth. Molars often take longer or need two visits, because there are more canals to clean and shape.
Mild tenderness for a few days is expected. Pain that increases after three or four days, or swelling, or a returning throb, needs checking. It can mean a missed canal or persistent infection.
On back teeth, yes, in almost all cases. The tooth is more brittle afterwards and crowning it substantially reduces the risk of it splitting. Front teeth sometimes manage with a filling if enough tooth remains.
Yes. Retreatment involves removing the previous filling material and re-cleaning the canals. It is more demanding than first-time treatment and is often where a specialist referral makes sense.
Decades, when it is properly cleaned and promptly restored. The two things that shorten it are a delayed permanent restoration and a missed canal.
If a tooth is throbbing, keeping you awake, or has swollen up, we hold emergency slots each day and opening a tooth to release pressure often brings relief within minutes.
Call 020 7928 4474 or book online. We are in Elephant and Castle, minutes from Waterloo, Borough, London Bridge and Southwark. If you need seeing today, our emergency dentist page covers what we treat, and stopping severe tooth pain covers the next few hours. If antibiotics have been suggested to you, this page explains why they do not fix the tooth.
Clinician credentials are as published on our team page and the GDC register. Fees start from the figures quoted and are confirmed before treatment. Success rate figures are indicative ranges from published clinical literature. This page is general information, not a diagnosis. Last reviewed August 2026.
