General — 6 min read
Root Canals
The procedure has a reputation built on how it felt in 1975. Under a microscope with modern instrumentation, it is routine — and it is how you keep your own tooth.
Screened and introduced free, usually within a few hours. Sunny Isles Beach, Florida and the surrounding corridor.
Indications
A root canal is usually indicated when
Root canal treatment removes infected or inflamed pulp from inside the tooth, disinfects the canal system and seals it. The tooth stays; only the nerve tissue inside it is removed.
- Pain that lingers for more than thirty seconds after something hot or cold
- Spontaneous, throbbing pain that wakes you at night
- Pain on biting down on one specific tooth
- A tooth that has darkened compared with its neighbours
- A pimple or bump on the gum near a tooth root that comes and goes
- Swelling of the face or jaw — which is urgent, not routine
Good candidate if
- The pulp is inflamed or infected but the tooth is restorable
- Enough sound tooth structure remains for a crown to grip
- No vertical root fracture on imaging
- You would rather keep the tooth than replace it
No cost, no obligation, no lead list.
The detail
Why the operator matters more than the procedure
The procedure has a reputation built on how it felt in 1975. Under a microscope with modern instrumentation, it is routine — and it is how you keep your own tooth.
Molar canal anatomy is not a set of straight tubes. Upper first molars have a second canal in the mesiobuccal root in the large majority of cases, and it is fine, curved and easily missed without magnification. Missed canals are the leading cause of root canal failure. An endodontist working under a surgical microscope with rubber dam isolation, and often a CBCT for complex anatomy, finds and treats what is actually there. Published success rates for specialist-performed treatment sit around 90 to 95 percent, meaningfully above general practice averages.
The other decision is what goes on top. A back tooth that has had a root canal has lost structural integrity and a significant proportion of its remaining strength — it needs cuspal coverage, meaning a crown or an onlay, usually within weeks. Root-canal-treated molars left with only a filling fracture at a much higher rate, and a vertical root fracture is unrestorable. Delaying the crown is the single most common way a technically successful root canal ends in extraction.
The sequence
What actually happens, in order.
Timings vary between practices and cases. The order does not — and a plan that skips a step is worth asking about.
Diagnosis
Cold and electric pulp testing, percussion, radiographs and CBCT where anatomy or a suspected fracture demands it.
Isolation
Local anaesthetic and a rubber dam. Treatment without a dam is contaminated treatment — this is not optional.
Cleaning and shaping
Canals located under the microscope, instrumented to length with rotary files, and irrigated with sodium hypochlorite.
Sealing
Canals filled with gutta-percha and sealer, then a well-sealed core placed to prevent recontamination.
Crown
Cuspal coverage on any back tooth, within weeks. This is part of the treatment, not an upsell.
Getting the right hands
Who should be doing your root canals.
This is the variable that decides your result, and it is the one you have least ability to assess from the outside.
Not years in dentistry. How many of these they do in a month, and what the difficult ones looked like.
Anyone can photograph a result on delivery day. We want to see it after it has been used.
CBCT, microscope, scanner, printer — whichever this case genuinely requires, on site rather than referred out.
For anything ceramic, the technician is half the result. A dentist who cannot name theirs is outsourcing blind.
Root Canals FAQ
What people ask us about root canals.
Including the cost question, answered with a real range rather than a request to call.
The treatment itself is done under local anaesthetic and is usually comparable to having a filling. The pain people associate with root canals is the abscess that precedes it, which the treatment relieves. Expect mild tenderness on biting for a few days afterwards.
A front tooth typically runs $800 to $1,200, premolars $900 to $1,400, and molars $1,200 to $1,900 with a specialist. Retreatment of a previously treated tooth costs more. The crown afterwards is a separate $1,200 to $2,500 and should be budgeted with it.
Compare the total costs honestly. Root canal plus crown often lands near $2,500 to $3,500; extraction plus implant and crown is usually $4,000 to $6,500 and takes months longer. A natural tooth also retains its ligament and proprioception, which no implant reproduces. Extraction wins only when the tooth is genuinely unrestorable.
Decades, routinely, when it is properly sealed and promptly crowned. Failures cluster around missed canals, delayed crowns and coronal leakage from a temporary filling left in place too long.
Front teeth with simple anatomy are handled well by many general dentists. For molars, retreatments, curved or calcified canals and anything already symptomatic after previous treatment, a specialist with a microscope has materially better outcomes. Ask whether they use a microscope and a rubber dam — the answer is diagnostic.