Last Updated on 15/09/2026 by Dr Chetan Kaher
Root canal has a reputation it doesn’t really deserve. The point of the procedure isn’t to cause pain, it’s to remove infection or inflammation from inside a tooth so the tooth itself can stay put.
Modern techniques let dentists clean and seal the canals while holding onto as much natural tooth structure as they can. If you’ve been told you need endodontic treatment, knowing what actually happens step by step can take a lot of the fear out of it. If you’re looking for treatment in Finchley, understanding the process can also help you know what to expect.
What Is Endodontics Treatment?
Endodontics deals with the inside of the tooth, specifically the pulp and the root canals running through it.
The pulp holds nerves and blood vessels. Deep decay, a crack, a knock, any of it can let bacteria in, and once the pulp’s infected or badly inflamed, you’re looking at persistent pain or an abscess forming.
Root canal treats that from the inside, rather than taking the tooth out altogether. At Smile Cliniq, our associate dentist Dr Krishen Shah, who has a special interest in endodontics, describes it as treatment for infection or inflammation of the pulp, completed in either one or two stages depending on the case.
Step 1: Examination and Diagnosis
Nobody opens the tooth up first. It starts with a look and a conversation.
The dentist examines the tooth, asks about your symptoms, and may take an X-ray to check the roots and the bone around them. That’s how they work out whether the pulp’s actually infected or inflamed, and whether root canal is really the answer.
Symptoms that tend to point this way:
- Persistent toothache
- Sensitivity to hot or cold
- Pain when biting down
- Swelling around the tooth
- A recurring gum boil or abscess
- Darkening of the tooth
Not every toothache needs a root canal, which is exactly why the diagnosis step isn’t skipped.
Step 2: Numbing the Tooth
Local anaesthetic goes in first, numbing the tooth and the area around it before anything else happens.
A dental dam often gets used too, isolating the tooth and keeping things dry, it stops saliva or bacteria getting into the tooth mid-procedure.
If you’re nervous about any of this, say so beforehand. Most dentists would rather talk you through what’s coming and how anxiety can be managed than have you sit through it worrying silently.
Step 3: Creating Access to the Tooth
A small opening is made through the top of the tooth, down to the pulp, giving access to the canal system underneath.
Where exactly that opening goes, and how big it needs to be, depends entirely on the tooth. Front teeth, premolars and molars all have different root shapes, so this step looks a bit different every time.
Step 4: Removing the Infected Pulp
The damaged pulp comes out first. Then the dentist locates the canals and starts cleaning. This is really the heart of the procedure, the part that’s actually dealing with the infection.
Our process involves removing the decay and pulp, then smoothing and shaping the canal walls with files.
Every canal has to be cleaned along its whole length. Miss a section and bacteria can just sit there.
Step 5: Cleaning and Disinfecting the Canals
There’s more to this step than clearing out what’s visible.
The canals get shaped so they can be properly disinfected and later filled, with irrigating solutions flushing out bacteria and debris as the dentist works. At Smile Cliniq, we use irrigants like sodium hypochlorite or iodine for this.
Sometimes medication gets placed inside the tooth and a temporary filling goes on top, with the final treatment finished at a later visit, useful when a tooth needs a bit of time to settle first.
Step 6: Filling the Root Canals
Once everything’s clean and the tooth’s ready, the canal spaces get filled and sealed so bacteria can’t get back in.
If it’s a two-stage treatment, you’ll likely get a temporary filling first, with the permanent one placed once the tooth’s settled. Whether you need one appointment or several comes down to how the individual tooth is doing.
Step 7: Restoring the Tooth
The infection’s dealt with at this point, but the tooth itself often isn’t quite finished.
A tooth that’s been through root canal treatment tends to be more fracture-prone, especially if a fair amount of structure was already lost to decay or old fillings. Depending on what’s left, your dentist might suggest a permanent filling, an onlay, or a crown to keep it protected long-term.
This part isn’t optional extra polish, cleaning the canals is only half the job. Sealing and restoring the tooth properly is what makes the treatment actually hold.
What Does Root Canal Treatment Feel Like Afterwards?
Some tenderness around the tooth is normal, especially when biting down. Usually that’s just inflammation settling, not a sign the infection’s still there.
Your dentist can suggest pain relief and aftercare that fits your situation. If swelling gets worse, or the pain doesn’t ease off, or something just feels off, call the practice rather than waiting to see.
How Much Does Endodontic Treatment Cost in the UK?
Figures for endodontic treatment cost in the UK floating around online can be misleading, because the price genuinely varies a lot case to case.
It comes down to which tooth’s involved, how complicated the root canal anatomy is, whether you need a specialist, and whether restoration work is needed after. Our published fees are described as guides rather than fixed prices, with more complex cases costing more, patients get a personalised plan and estimate once they’ve been assessed.
When Should You Seek Treatment?
Don’t sit on persistent tooth pain hoping it settles on its own. An infected pulp generally doesn’t fix itself without treatment.
If you’ve been told you need endodontic treatment in Finchley, our practice is at 138 Ballards Lane, Finchley, London N3 2PA. We handle root canal treatment and specialist endodontic care, with the plan built around the specific tooth and what it needs. Call 020 8343 1133.
Once you know what each stage actually involves, root canal stops feeling like a mystery. It’s really just this: clear out the damaged tissue, clean and disinfect the canals, seal them up, and restore the tooth so it keeps doing its job.
Frequently asked questions
Is root canal treatment painful?
The tooth is numbed with local anaesthetic before anything happens, so the procedure itself shouldn’t hurt. Some tenderness while biting down is normal for a few days afterwards as inflammation settles.
How many visits does root canal treatment take?
It depends on the tooth. Some cases finish in one appointment, others are done in two stages with a temporary filling in between while the tooth settles.
Does a tooth need a crown after root canal treatment?
Often, yes. A treated tooth is more fracture-prone, especially if a lot of structure was already lost to decay, so a filling, onlay or crown is usually needed to protect it long-term.
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