Root Canal and Crown: What to Expect, Step by Step

What is root canal treatment?

Inside every tooth is soft tissue called the pulp. When decay, a crack or a gum problem lets bacteria reach the pulp, it can become infected. Root canal treatment removes the infected pulp, cleans the inside of the tooth and seals it to stop the infection coming back. Without treatment, an infected tooth may need to be taken out (NHS).

Signs a tooth may need a root canal

Cleveland Clinic lists these signs (Cleveland Clinic):

• Pain when chewing or touching the tooth
• Pain that spreads to the jaw, face or nearby teeth
• Tender or swollen gums, or a pimple on the gum that may ooze pus
• A swollen jaw
• A tooth that has turned darker
• A loose tooth

If you have pain with swelling, see a dentist without waiting. Only an examination and an X-ray can show whether a root canal is needed.

How root canal treatment is done, step by step

1. X-ray and examination. The dentist checks the tooth and the shape of its roots.
2. Numbing. A local anaesthetic numbs the tooth and the area around it.
3. Keeping the tooth dry. A thin rubber sheet (dental dam) or cotton keeps the tooth clean and dry.
4. Opening the tooth. A small opening is made in the top of the tooth to reach the pulp.
5. Cleaning and shaping. The infected pulp is removed and the canals are cleaned, disinfected and shaped.
6. Filling the canals. The canals are filled with a rubber-like material and sealed.
7. Temporary filling. A temporary filling closes the tooth until the permanent filling or crown is placed.

(NHS; Cleveland Clinic)

How many sessions does a root canal take?

It depends on the tooth and the infection. The NHS says treatment usually takes two or more appointments, each lasting one to two hours or sometimes longer. Cleveland Clinic says the root canal itself takes about 60 to 90 minutes, with some cases needing more than one visit. Back teeth have more roots and canals, so they often take longer than front teeth. If you need a crown, plan for usually two more appointments: one to prepare the tooth and one to fit the crown.

Does a root canal hurt?

Treatment is done under local anaesthetic, so the tooth is numb. You may feel pressure or movement while the dentist works. Afterwards, mild tenderness for about three to five days is common, and over-the-counter pain relief usually helps (AAE). Most people recover in less than a week (Cleveland Clinic). Call your dentist if the pain is severe, gets worse, or lasts more than a few days, or if your face swells.

Do you need a crown after a root canal?

Often, yes, but not always. A crown is a cap that covers the whole visible part of the tooth. After a root canal, a tooth can be weaker, especially if a lot of it was lost to decay or old fillings.

• Back teeth (molars and premolars) usually need a crown, because they take the force of chewing.
• Front teeth may be fine with a filling, depending on how much of the tooth is left.
• Teeth with large old fillings or a lot of damage are more likely to need a crown.

(Colgate; NHS)

The American Association of Endodontists (AAE) advises having the final crown or filling placed as soon as the root canal is finished, and not chewing on the tooth until then (AAE).

How a crown is fitted after a root canal

1. Preparing the tooth. The dentist shapes the tooth so the crown can fit over it.
2. Impression or scan. A mould, or in some clinics a digital scan, records the shape of the tooth and your bite.
3. Temporary crown. A temporary crown protects the tooth while the permanent one is made.
4. Fitting. The permanent crown is fitted, the bite is checked and the crown is cemented in place.

Crowns are made from different materials, chosen for strength at the back of the mouth and for a natural look at the front.

Recovery and aftercare

• Your mouth may stay numb for several hours. Wait for the numbness to wear off before eating.
• Eat soft food for a few days and chew on the other side until the crown is fitted.
• Keep brushing and flossing gently around the tooth.
• Avoid smoking, which can slow healing.
• Go to your follow-up appointments.

(NHS; AAE; Cleveland Clinic)

Call your dentist if the temporary filling or crown falls out, your bite feels uneven, or the swelling or pain comes back. A tooth that has been treated and restored properly can last as long as your other natural teeth (AAE).

Can you have a root canal while pregnant?

Yes, when it is needed. The American Dental Association (ADA) says dental care, including X-rays and local anaesthetic, is safe at any point during pregnancy, and that delaying needed treatment can lead to more complex problems. It cites the American College of Obstetricians and Gynecologists (ACOG), which says root canal problems can be treated at any time during pregnancy (ADA). Tell your dentist that you are pregnant, and ask your doctor or dentist before taking any pain medicine.

Root canal or extraction?

Taking the tooth out is the other option. A root canal keeps your own tooth. If a tooth is removed, the gap usually needs to be filled with an implant or a bridge so the neighbouring teeth don't move. When a tooth is too damaged to save, the dentist may recommend removing it and replacing it (Cleveland Clinic).

Does insurance cover root canal and crowns in the UAE?

Basic plans such as Dubai's Essential Benefits Plan don't cover routine dental treatment (DHA table of benefits). Plans with dental benefits usually cover root canal treatment, up to an annual limit and after a co-payment. Crowns are covered on some plans, for example only after a root canal, and excluded on others. Many plans need the insurer's approval before treatment, so check your table of benefits or ask your insurer. Read more in our guide Does health insurance cover dental in the UAE?

At Ibn Al Haitham Medical Centre, our team checks your coverage with your insurer before your visit. The clinic works with Daman, Enaya, Dubai Police, Neuron, Almadallah, Nextcare, RTA and Aetna, and accepts more insurers than these. See our insurance page.

Root canal and crown treatment at Ibn Al Haitham Medical Centre

Ibn Al Haitham Medical Centre, a dental clinic on Umm Hurrair Road in Dubai since 2000, offers root canal treatment and crowns and bridges. Treatment starts with an examination and X-rays, and finishes with a permanent filling or crown and a follow-up review of the tooth. Both of our dentists, Dr. Aamra Alsarraj (General Dentist) and Dr. Rim Akrama (Implantology & Cosmetic Dentistry), carry out root canal treatment and crowns, and crowns are made from moulds of your teeth. Our dentists speak Arabic and English. The clinic is open Saturday to Thursday, 10:00 to 19:00.

Frequently asked questions

Book a check at our Dubai clinic

If a tooth hurts or you've been told you need a root canal, book a visit at Ibn Al Haitham Medical Centre in Umm Hurrair, Dubai. Call or WhatsApp +971 55 172 5757, or call +971 4 396 3332.

Sources

• Root canal treatment — NHS
• Root canal treatment: what happens — NHS
• Root canal — Cleveland Clinic
• Root canal pain: what to expect — American Association of Endodontists
• Post-treatment care — American Association of Endodontists
• Is a crown necessary after a root canal? — Colgate
• Pregnancy — American Dental Association
• Essential Benefits Plan table of benefits — Dubai Health Authority (ISAHD)