Root Canal Treatment

Several situations can lead to inflammation or infection of the dental pulp. The most common causes include:

• deep decay
• old leaking restorations
• repeated restorations on the same tooth
• a tooth fracture or crack
• trauma
• severe tooth wear
• an infection already established around the root

If the condition is not treated in time, pain, swelling, persistent tenderness, an abscess or bone loss around the root may develop.

Treatment begins with a careful clinical and radiographic assessment. Once the indication has been confirmed, local anaesthesia is administered to ensure comfort during the procedure.

The tooth is isolated with a rubber dam to keep the treatment area clean and protected. An access opening is then made to reach the inside of the tooth and the root canals. Inflamed or infected tissue is removed, and the canals are cleaned, disinfected and shaped using dedicated instruments.

The root canal system is then sealed with biocompatible materials to prevent renewed contamination. The tooth should subsequently be restored appropriately, with a definitive restoration or crown depending on the case, to restore strength, seal and function.

If you would like to understand the procedure in more detail, see how root canal treatment is performed step by step.

Root canal treatment requires in-depth knowledge of the internal anatomy of teeth and the ability to manage situations that can vary greatly in complexity. Complex anatomy, calcified or difficult-to-locate canals, unclear diagnoses and other demanding situations can particularly benefit from a specialist approach.

At the Portuguese Institute of Endodontics, Prof. Rui Pereira da Costa has dedicated his clinical practice exclusively to Endodontics since 2004, with more than 20 years of experience in the diagnosis and treatment of endodontic cases, including highly complex situations.

This clinical experience is complemented by operating microscopy, digital radiography and, when clinically indicated, cone beam computed tomography (CBCT), allowing each case to be studied in greater detail and the most precise and conservative approach possible to be planned.

You can also learn what distinguishes an endodontist from a general dentist.

After treatment, the tooth may remain sensitive for a few days. Until it has been definitively restored, it is advisable to avoid chewing hard foods on that side, particularly if the tooth has lost a significant amount of structure.

It is essential to complete the restorative phase recommended by your dentist, because a good coronal seal is an important part of medium- and long-term success.

With appropriate follow-up and good oral hygiene, many root canal-treated teeth can remain functional for many years.

You can also read about care and recovery after root canal treatment.

Whenever clinically possible, preserving the natural tooth is usually the best option.

A well-treated natural tooth allows comfortable chewing, helps maintain the correct position of neighbouring teeth, and preserves function and aesthetics in a more biological and conservative way. In many cases, avoiding extraction also means avoiding additional treatment that may be more complex, time-consuming and costly.

Nothing completely replaces the structure, functional sensation and integration of a natural tooth. Therefore, when a predictable option exists to retain it, that possibility should be carefully considered.

When the decision is between preserving and replacing the tooth, we explain the differences between root canal treatment and a dental implant in more detail.

If extraction has been recommended and there is still uncertainty about whether the tooth can be preserved, it may be useful to seek an endodontic second opinion before making an irreversible decision.