Root canals, done right the first time

What a root canal is actually treating

Inside every tooth is a chamber of soft tissue called the pulp, made up of nerve and blood vessels. Deep decay, a crack, repeated dental work or a knock to the tooth can let bacteria reach it. Once the pulp is infected or dying it cannot heal on its own, and the infection works its way down the canals toward the tip of the root and into the bone around it.

A root canal removes that tissue, disinfects and shapes the canal system, then seals it so bacteria cannot re-colonize the space. The tooth stays in your mouth and keeps doing its job. Nothing is taken out of your jaw.

The alternative is usually extraction, and that starts a longer chain. The gap needs an implant or a bridge, and the bone in that spot begins to shrink once the root is gone. Keeping your own tooth, when it can be kept predictably, is the more conservative choice and usually the cheaper one over time.

Signs to watch for, and how we work out what is wrong

Common signals include lingering pain to hot or cold that does not fade after a few seconds, pain on biting, a dull ache that wakes you at night, a pimple-like bump on the gum, or a tooth that has darkened. Some teeth give no warning at all and show up only as a shadow at the root tip on an X-ray.

Diagnosis is the part that gets rushed. We use cold testing, tap and bite tests, and check each tooth individually, because pain refers easily and the tooth that hurts is not always the tooth that is sick. When a standard X-ray does not settle it, CBCT 3D imaging shows root anatomy, extra canals and bone changes that flat images hide.

Cracked teeth are their own puzzle. A crack can look like a straightforward infection while carrying a very different outlook. Cracked tooth diagnosis is free with treatment, because knowing whether a tooth is worth saving comes before deciding how to save it.

What the appointment is actually like

You are numbed first, and we confirm you are fully numb before starting. If dental anxiety is the reason you have put this off, sedation options are available and worth asking about when you book.

A small sheet called a rubber dam isolates the tooth. It keeps saliva and bacteria out of the canal and keeps rinsing solutions out of your mouth. Our endodontists work under a surgical microscope, which is the difference between seeing a canal and guessing where one should be. Molars often have four canals and sometimes more, and missed anatomy is a common reason treatment does not settle down.

The canals are cleaned, shaped and disinfected, then filled and sealed. Many teeth are finished in a single visit, while heavily infected or complex teeth may need two. If a tooth turns out not to be savable, our oral surgeons and implant team are in the same Midtown building, so you are not starting over with a referral across town.

Afterwards, and why the crown matters as much as the root canal

Expect the tooth to feel tender to bite on for a few days while the ligament around the root calms down. Over-the-counter anti-inflammatories usually handle it. Pain that builds, swelling that grows, or a fever is not part of normal healing and is a reason to call us rather than wait it out.

The single biggest thing you can do to protect the work is to get the tooth properly restored, and soon. A treated back tooth has lost internal structure and has an access opening through its biting surface. Left with only a temporary filling, it can crack under ordinary chewing, and a vertical root fracture is the one problem a root canal cannot fix. Most back teeth need a crown or onlay after treatment. Front teeth sometimes need only a bonded filling.

Chew on the other side until the final restoration is on. After that, the tooth is brushed and flossed like any other and still needs regular checkups.

Cost, insurance and financing

Root canal treatment starts at $900. Retreatment of a tooth treated previously starts at $1,200, since old filling material has to be removed before the canals can be cleaned and sealed again. An apicoectomy, a small surgical procedure at the root tip used when a conventional approach cannot reach the problem, starts at $1,400. Cracked tooth diagnosis is free with treatment. The crown or filling that restores the tooth afterwards is a separate cost, and we quote it at the same time so nothing appears later.

Most dental plans cover endodontic treatment at a meaningful percentage, often more than they contribute toward an implant to replace the same tooth. We verify your benefits for free before you decide, and you get the full figure in writing.

If there is a gap, financing is available through Cherry, Affirm and Sunbit. There is also an in-house membership plan if you do not carry dental insurance, and HSA and FSA funds generally apply.

Treatments & pricing

Prices are estimates for self-pay patients before insurance. Insurance reduces costs significantly. Financing available - most patients qualify in minutes via Cherry or Sunbit.

Frequently asked

Learn more about this

• Is Root Canal Painful?
• Things to Know Before Root Canal Treatment
• Failed Root Canal Symptoms
• Is There an Alternative to Root Canal?
• Root Canal Cost in Houston
• Root Canal Treatment for Kids