The process
From consultation to restored tooth
Dr Spencer Richman at the dental operating microscope.
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Advanced dentistry · Microscope
Root canal treatment, under the microscope
Root canal treatment removes infected or inflamed pulp from inside a tooth, then cleans, shapes and seals the canals so the tooth can stay. Dr Spencer Richman, whose practice is limited to endodontics, carries it out under a dental operating microscope, with CBCT 3D imaging where needed. Most teeth take one or two visits. Consultation £150 including imaging; treatment from £1,200.
Guide fee
From £1,200
Consultation
£150, imaging included
Visits
Usually one or two
With
Dr Spencer Richman
Who it is for
Signs a tooth may need root canal treatment
Pain that lingers after hot or cold
A healthy tooth settles within seconds of a hot or cold drink. Pain that lingers for minutes afterwards suggests the pulp, the soft tissue inside the tooth, is inflamed and unlikely to recover on its own.
Pain that starts on its own or wakes you
Spontaneous throbbing, or an ache that wakes you at night, usually means the pulp is badly inflamed or infected. It tends to worsen with time, so it is worth being seen promptly.
Swelling or tenderness when you bite
A tooth that is sore to bite on, a swelling in the gum beside it or a small spot that keeps reappearing can all point to infection at the tip of the root.
No symptoms at all
Some teeth lose their nerve quietly. The first sign may be a dark area on a routine X-ray or a tooth that has changed colour. We show you the image and explain what it means.
The difference
What changes the result
A practice limited to endodontics
Dr Spencer Richman's practice is limited to endodontics. He holds an MSc in Endodontology and is a member of the British Endodontic Society. Root canal treatment and the diagnosis of cracked teeth are the whole of his clinical work.
More about Spencer's root canal work at spencerrichman.co.uk.
The operating microscope
Root canals can be finer than a pin, and many teeth have more of them than expected. High magnification and bright, focused light let us find extra and narrow canals that are easily missed with the naked eye.
CBCT 3D imaging
A standard X-ray flattens a tooth into two dimensions. Where the anatomy is complex, a CBCT scan taken on site shows the roots, canals and surrounding bone in 3D, so treatment is planned before it begins.
Rubber dam and rotary instruments
A rubber dam isolates the tooth, keeping saliva and bacteria out and the cleaning solutions in. Modern, flexible rotary instruments then shape each canal smoothly and efficiently, following its natural curve.
01
Consultation and imaging
We examine the tooth, test how it responds and take the images needed, including a CBCT scan where it helps. You leave with a clear diagnosis, your options and a written fee. The consultation is £150.
02
Numb and isolate
The tooth is numbed with local anaesthetic and we wait until it is fully comfortable. A rubber dam is then placed around it. Most people compare the experience to having a filling.
03
Clean and shape
Working under the microscope, we locate each canal, measure its length and clean it with fine rotary instruments and disinfecting solutions. This is the careful part, and it is given the time it needs.
04
Fill and seal
The canals are filled and sealed to stop bacteria returning. Some teeth are completed in one visit. Others are dressed and finished at a second appointment, depending on the infection and the anatomy.
05
Restore the tooth
A root-filled tooth needs a sound restoration over the top to protect it. For back teeth that is often a crown, which can frequently be made and fitted in one visit with CEREC on site.
Afterwards
Aftercare
The tooth and the gum around it can feel tender for a few days, particularly on biting. This usually settles with ordinary painkillers, if they are suitable for you. Avoid chewing hard foods on the tooth until its final restoration is in place. Contact us if you notice swelling, or pain that is getting worse instead of easing.
Guide fees
Root canal consultation, including imaging£150
Root canal treatmentfrom £1,200
Complex root canal treatmentfrom £1,250
Surgical root canal treatmentfrom £1,300
Same-day CEREC crown afterwardsfrom £1,250
Guide fees. You receive a written plan with exact costs before treatment starts. See all fees
Common questions
Questions, answered
Does root canal treatment hurt?+
It is carried out under local anaesthetic, and most people compare it to having a filling. You should feel pressure and vibration, not pain. Some tenderness for a few days afterwards is normal and usually settles with ordinary painkillers.
How long does root canal treatment take?+
Most teeth are completed in one or two visits. Back teeth with several canals, and teeth being re-treated, take longer than front teeth. We tell you how many appointments to expect at your consultation.
How much does root canal treatment cost?+
The consultation is £150 and includes imaging. Treatment is from £1,200, complex cases from £1,250 and surgical treatment from £1,300. You receive a written plan with the exact fee before anything starts.
Can a tooth that has already had root canal treatment be treated again?+
Often, yes. A root-filled tooth can become reinfected if a canal was missed or the seal has broken down. Re-treatment means removing the old filling material, cleaning the canals again under the microscope and resealing them. We assess the tooth with imaging first and tell you plainly what its outlook is.
Why is a microscope used for root canal treatment?+
Canals are tiny, often curved and sometimes hidden. Magnification and bright light let us see inside the tooth in detail, find extra canals and check each one is clean before it is sealed.
Is it better to have the tooth taken out instead?+
Keeping your own tooth is usually preferable where it can be restored predictably. An extraction leaves a gap that may then need an implant, a bridge or a denture. Where a tooth has a poor outlook we will say so, and explain the alternatives.
Will I need a crown after root canal treatment?+
Back teeth usually do. Root-filled molars and premolars are more prone to fracture, and a crown holds them together. Front teeth can often be restored with a filling instead.