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Advanced dentistry · Microscope
Root canal treatment removes an infected or inflamed nerve from inside a tooth, cleans and seals the root canals, and lets you keep the tooth. At Sardinia House it is done by Dr Spencer Richman, who works only in endodontics and treats every tooth under a microscope. Most teeth are treated in one or two visits. Guide fee from £1,200; consultation £150.
Guide fee
From £1,200
Visits
One or two
Consultation
£150, including imaging
With
Dr Spencer Richman, under the microscope
Who it is for
A deep, throbbing ache, pain that lingers long after something hot or cold, or a tooth that hurts when you lie down are signs the nerve inside is inflamed beyond recovery. Treating the canal removes the source of the pain.
A swelling in the gum, a small pimple that comes and goes, or a bad taste suggests infection has spread from the root into the bone. Antibiotics may calm it for a while, but only treating the root canal clears it.
A tooth that has slowly turned grey, often years after a knock, usually has a nerve that has died quietly. It may not hurt at all, but it can be found on an X-ray and is still worth treating.
A root-treated tooth can pick up infection again if a canal was overlooked, the seal leaked, or the crown was left too long. Re-treatment under the microscope often finds what was missed the first time around.
The difference
Root canals are fine, curved and often branched. Dr Richman works under a Zeiss or CJ-Optik operating microscope throughout, so he can see the canal openings, cracks and debris that are invisible to the naked eye.
Where an X-ray leaves doubt, a CBCT scan on site shows the number and shape of the canals and the extent of any infection around the root. The treatment is planned against that picture rather than discovered as we go.
Dr Spencer Richman treats root canals and little else. His day is spent on exactly this kind of work, including the complex, curved and calcified cases that general practice refers on to him.
A root-treated back tooth should be crowned soon afterwards to stop it fracturing. Because the CEREC mill is on site, the root canal and a crown can be finished in a single day when that suits the tooth.
The process
We examine the tooth, test the nerve and take digital X-rays, with a CBCT scan where it is needed. The consultation fee of £150 includes this imaging, and you leave with a written plan and fee.
The tooth is numbed thoroughly and isolated behind a thin rubber sheet, which keeps it dry and keeps the cleaning solutions away from the rest of your mouth. Many people find this the most reassuring part.
Through a small opening in the biting surface, each canal is found under the microscope, then cleaned, shaped and disinfected to its tip. This is the painstaking part, and it is where the time goes.
The canals are filled with a rubber-like material and sealed. If a second visit is needed, an antibacterial dressing is placed inside the tooth and a secure temporary filling closes it in between.
The tooth is then rebuilt, usually with a crown for a back tooth or a filling for a front one. With the same-day crown option, this can happen before you leave the building.
Afterwards
The tooth and the surrounding gum are often tender for a few days as the inflammation settles, and ordinary painkillers usually manage it. Avoid chewing hard food on the tooth until it has its final filling or crown, as a root-treated tooth is more brittle until it is sealed. Keep brushing and flossing as normal, and contact us if swelling appears.
Guide fees
Guide fees. Nothing is started until your plan, with every fee written down, is in your hands. See all fees
Who provides it
Good to know
The treatment itself should not. The tooth is fully numbed and, because the inflamed nerve is being removed, the source of the pain goes with it. Afterwards the tooth can be tender to bite on for a few days, and this settles with ordinary painkillers.
Allow one to two hours per visit, depending on the tooth and the number of canals. Many teeth are finished in one visit. A tooth with a large infection may be dressed and completed at a second appointment a few weeks later.
Our guide fee is from £1,200; difficult cases start at £1,250 and surgical cases at £1,300. The £150 consultation includes imaging. A crown afterwards is quoted separately, and everything is confirmed in writing beforehand.
A root-treated tooth keeps the bone around it and your bite as it was. Taking the tooth out is faster on the day, but an implant or bridge to fill the gap tends to cost more and take longer overall. Where the tooth is worth saving, saving it is usually the better route.
For most back teeth, yes. A root-treated molar has lost structure and becomes more likely to fracture. A crown protects it, and here it can be made and fitted the same day. Front teeth can often be restored with a filling.
Root canal treatment can be expected to succeed in most cases when it is done thoroughly and the tooth is sealed promptly. Outcomes vary with the condition of the tooth and the extent of infection, which is why we examine and image carefully before quoting.
Often, yes. Under the microscope the old filling is removed, missed canals are found and the tooth is cleaned again. Where re-treatment through the crown is not possible, a small surgical procedure at the root tip is an alternative.
Often, yes. Dr Spencer Richman completes most root canals in a single appointment under the microscope, and sometimes two visits are needed where an infection should settle first. Because we mill crowns on site, the tooth can be root-filled and crowned on the same day when the case allows.
A root-filled tooth has no nerve, but it is not dead in any useful sense: it is still anchored in the bone, still works for chewing and is usually protected with a crown. A well-sealed root filling removes the source of infection, and there is no good evidence that a sound root-filled tooth harms your general health.
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