Root Canal Treatment

When root canal treatment may be needed

• When decay has reached the nerve of the tooth and the inflammation in the nerve has become irreversible. Pain that starts on its own, wakes you at night or lasts a long time can point to this. The diagnosis is made with an examination and an X-ray.
• When the nerve of the tooth has died. This can happen after a knock to the tooth, or under deep decay and large fillings. Sometimes it causes no symptoms at all. It is then picked up only when the examination, nerve tests and X-rays are assessed together.
• When infection from inside the tooth has caused an abscess, or inflammation at the tip of the root.
• The nerve can also lose its vitality over time in teeth that have had a crown. One review pooled 37 studies of teeth that were vital at the start. The teeth received a crown or a partial restoration, or served as a bridge support. Of every 100 of these teeth, about 5 lost the vitality of their nerve². The studies followed the teeth for different lengths of time, and the share was higher in those with longer follow-up. The certainty of the evidence is low.

Before an examination, no one can say for certain that a tooth will need root canal treatment. A 2026 European guideline on deep decay notes that in very deep decay, the risk of exposing the nerve is high. It says this risk should be anticipated³. Whether the nerve needs treatment is sometimes clear only while the decay is being removed.

When another option is considered first

• Deep decay without symptoms. This covers teeth with no pain, or only brief sensitivity triggered by something hot, cold or sweet. For these teeth, the European guideline recommends selective or stepwise removal³. In these approaches, not all of the softened decay next to the nerve is removed at one sitting. This is a weak recommendation and the certainty of the evidence is very low.
• Teeth whose nerve is exposed while decay is removed, and which do not ache on their own. Removing only part of the nerve (pulpotomy) appears to be as effective as root canal treatment³. However, this rests on a single study and the certainty of the evidence is low. The guideline also recommends³ partial or full pulpotomy for some teeth with signs of irreversible inflammation of the nerve. This is a weak recommendation and the certainty of the evidence is low. The studies behind this recommendation compared partial with full pulpotomy. They did not compare pulpotomy with root canal treatment. Whether it suits a particular tooth is decided by the examination findings and your dentist. The guideline notes that not every dentist may be able to carry out this procedure on adult teeth.
• Teeth that cannot be saved. Root canal treatment will not save a tooth with too little sound tooth left to restore, or with a root fracture that cannot be repaired. In that case, extraction and what will replace the missing tooth are discussed.
• Antibiotics do not replace treatment. Antibiotics do not take the place of root canal treatment or an extraction. In some cases they may be needed in addition (see "Pain and abscess" below). Antibiotics are not recommended for the pain of an inflamed nerve; there is not enough evidence⁴ that they reduce it. The only trial on this included 40 people.

• Doing nothing. A dental abscess does not go away on its own⁵ and needs treating by a dentist. If there is inflammation at the tip of a root that causes no symptoms, talk to your dentist about what to do.
• Root canal treatment. Your own tooth stays in the mouth and the neighbouring teeth are not touched. After treatment, the top of the tooth is restored with a filling, an onlay or a crown.
• Extraction and an implant. The tooth is taken out, an implant is placed in the jawbone in its place, and a crown is made on top. This is a surgical procedure, and there is a wait while the bone heals, so it usually needs more than one trip. A review of 46 studies looked at single missing teeth. Of every 100 implants, about 97 were still in the mouth after five years and about 95 after ten⁶. These rates are for the implant itself. In the same review, of every 100 crowns on top, about 96 were in use after five years and about 89 after ten⁶. Even among implants that stayed in the mouth, complications such as screw loosening, gum problems and bone loss were reported often⁶. These figures come from published studies, not from our own records. Details are on the dental implants page.
• Extraction and a bridge. The missing tooth is replaced with a bridge attached to the teeth on either side. For a conventional bridge, these teeth also have to be reduced.
• Extraction and a partial denture, or leaving the gap. A partial denture can be taken in and out. For some gaps at the back of the mouth, leaving the gap is also discussed; your dentist assesses how this would affect chewing.

A review of 143 studies found that root-filled teeth and single implant crowns stay in the mouth at similar rates¹ over the long term. Studies comparing the two treatments directly are extremely rare. The studies also defined success so differently that their success rates could not be compared¹. So it is not accurate to say either that "a natural tooth always lasts longer" or that "an implant always lasts longer".

The steps below are for a first root canal treatment on a permanent tooth. According to the NHS website for England, treatment usually takes 2 or more appointments; appointments can take 1 to 2 hours, sometimes longer⁷. This describes practice; we did not find a review that measured appointment length.

Some studies compared treatment completed in one visit with treatment spread over several. They found no clear difference in failure on X-rays at one year and beyond (13 studies, 1,505 teeth)⁸. This is not evidence that the two approaches are equivalent. Your dentist will tell you after the examination how many visits your tooth needs. How the appointments fit a stay in Antalya is covered in "Treatment in Antalya, follow-up in the UK".

If you feel anxious about treatment, tell your dentist. Ask whether sedation is available and whether it would suit you.

Risks and disadvantages

The figures below come from published studies, not from our own records.

• Pain after treatment. Pain is common before root canal treatment and eases after it. One review gives the average share of people reporting pain: 81 in every 100 before treatment, 40 after 24 hours and 11 after one week⁹. These rates were calculated from 30, 11 and 12 studies respectively. They are averages across studies, not the chance for any one patient.
• More pain in the first week after a single visit. More people reported pain in the first week after single-visit treatment than after the first of several visits (5 studies, 638 teeth, moderate-certainty evidence⁸). In the first three days after the canals were filled, no difference in the intensity of pain was found (12 studies, 1,258 teeth, low-certainty evidence)⁸.
• Flare-up. A flare-up is severe pain or swelling after treatment that needs an unplanned appointment. It is uncommon. It occurred in 688 of 24,320 cases in 15 studies, that is, in about 3 in every 100 cases¹⁰. It was reported more often in teeth that ached on their own, or hurt when tapped, before treatment. Each of these findings rests on 3 non-randomised studies, and the certainty of the evidence is low or very low.
• The tip of the root does not heal fully in every tooth. One review combined studies published between 1922 and 2002, with at least one year of follow-up. In it, the success rate measured as complete healing on X-rays was between 68 and 85 per cent¹¹. For teeth that do not heal, repeat root canal treatment, surgery at the tip of the root or extraction is discussed. We do not give a source for the success rates of these options on this page. Ask your dentist what can be expected for your tooth.
• The tooth can break. Decay, earlier fillings and the opening made for treatment may have reduced the sound tissue in the tooth. This raises the risk of it breaking. This is why the top of the tooth needs a permanent restoration.
• Discolouration. A tooth whose nerve has died can darken over time. Such a tooth can be lightened by bleaching from the inside. In rare cases this procedure has been linked to resorption of the root surface¹². The source gives no rate for this side effect.

Benefits

• Root canal treatment aims to keep your own tooth in the mouth without reducing the neighbouring teeth.
• Most root-filled teeth stay in place for years (see "How long does it last?" below).

• Painkillers. Until you see a dentist, a 2024 guideline from the American Dental Association recommends ibuprofen if it is suitable for you. It can be taken on its own or together with paracetamol. This evidence comes from studies of pain after tooth extraction, not directly from toothache, and its certainty is low¹³. Follow the instructions on the pack and do not exceed the recommended daily dose. If there is bleeding in the mouth, do not take aspirin or ibuprofen. This self-care advice applies for 24 hours only¹⁴. If the pain continues or you need more painkillers, talk to a pharmacist or dentist where you are. If you are pregnant, take regular medication, or have a stomach, kidney or bleeding problem, ask a pharmacist before choosing a painkiller.
• Do not put a tablet next to the tooth. Placing a painkiller next to the aching tooth or on the gum can damage the tissue¹⁴. Swallow tablets.
• Antibiotics do not replace root canal treatment. One review looked at adults having root canal treatment for inflammation at the tip of the root or an abscess. Antibiotics added to the treatment have not been shown to reduce pain or swelling (3 trials, 134 people)¹⁵. The certainty of the evidence is low or very low. Antibiotics may be needed¹⁶ if the infection is spreading or causes a fever. The same applies if the pus cannot be drained straight away. Your dentist decides.
• Do not squeeze an abscess at home. An abscess is treated by a dentist draining the pus under local anaesthetic and removing the cause⁵. If the cause is in the tooth, this usually means root canal treatment or having the tooth out.

The anaesthetic can take a few hours to wear off. Do not eat until the numbness has gone, and take care not to bite your cheek or tongue. The same NHS page says the area may feel swollen and sore after treatment, but it should get better in a couple of weeks⁷.

Daily care

• Until the top of the tooth has been restored permanently, do not chew hard or sticky food on that side. The temporary filling may fall out or the tooth may break.
• Take painkillers as directed on the pack or as your dentist advises.
• Brush your teeth twice a day with a fluoride toothpaste. Clean between your teeth every day with interdental brushes or floss.
• Do not put off the appointment for the permanent restoration, whether it is in Antalya or with your own dentist in the UK.

Studies do not give a lifespan in years. They report how many root-filled teeth are still in the mouth after a period of time. Staying in the mouth does not mean there were no problems during that time. These figures come from published studies, not from our own records.

One review pooled the results of 14 studies. Of every 100 root-filled teeth, about 86 were in place at 2–3 years, 93 at 4–5 years and 87 at 8–10 years¹⁷. The results of different studies were pooled for each period; these rates do not follow the same teeth over time. Most of the studies were retrospective. The rates are per tooth and do not predict the outcome for any single tooth.

The same review found four factors¹⁷ linked with the tooth staying in place. These were a crown after treatment, a neighbouring tooth on both sides, not serving as a bridge support, and not being a molar. The review notes that the evidence on these factors is weak.

The tooth staying in place and the tip of the root healing completely on X-rays are different things. The rate of complete healing is given above, under risks.

A root-filled back tooth can be restored with a filling, with an onlay that covers the chewing cusps of the tooth, or with a crown. The choice depends on how much sound tooth is left.

• Teeth with a crown have been reported in observational studies¹⁷ to stay in the mouth longer.
• The 2012 Cochrane review found only one randomised trial comparing a crown with a filling. It covers only premolars with a carbon-fibre post (117 participants, high risk of bias) and showed no difference at 3 years¹⁸. Finding no difference does not mean the two are equivalent. According to the review, the evidence is not enough to decide¹⁸ whether a filling or a crown works better.
• A 2015 update found no study¹⁹ up to that date comparing an inlay or onlay with a crown.

So it has not been shown that every root-filled tooth needs a crown. For crowns, see the dental crowns page.

A meta-analysis pooling bonded onlays and overlays on root-filled teeth has no comparison group. Failures were about 4 in every 100 restorations at 2 to 4 years, and about 11 to 21 at 7 years or more²⁰. These figures are not a survival curve and do not predict the outcome for any one tooth. The authors state that most failures appeared repairable. Whether repairs were done, and how they turned out, was not measured. Like the other figures on this page, these come from published studies, not from our own records.

For front teeth, one retrospective study followed 196 direct composite veneers placed in a university clinic for an average of 3.5 years. The annual failure rate was about 5 in every 100 veneers on vital teeth and about 10 on root-filled teeth²¹. This higher failure rate does not rule out a composite veneer on a root-filled tooth.

Contact a dentist if any of the following happens:

• Toothache that starts on its own, wakes you at night or keeps getting worse
• A lingering ache after something hot or cold
• Pain when you bite or touch the tooth
• A pimple-like swelling or discharge on the gum
• A tooth that changes colour after a knock
• Pain or swelling that does not ease, or gets worse, after root canal treatment; a temporary filling that falls out
• Pain, swelling or discharge from the gum around a root-filled tooth, even years later

If you think you have an abscess, see a dentist without delay, even if you have no fever or swelling. A dental abscess does not go away on its own and needs urgent dental treatment⁵. If you have swelling in your face or jaw, or a fever, get seen by a dentist the same day. The NHS website for England advises an urgent dentist appointment, or help from NHS 111⁵, if you think you have a dental abscess. If you do not have a dentist or cannot get an emergency appointment, it says to call 111 or use 111 online⁵.

Emergencies. The following need urgent medical help⁵. Do not wait for a dental appointment or for the clinic's reply. In the UK, call 999 or go to A&E. In Turkey, the emergency number is 112.

• Swelling that makes it hard to breathe, speak or swallow
• Swelling of the eye or the neck²², a painful eye, or sudden problems with your eyesight
• A lot of swelling inside your mouth
• Finding it hard to open your mouth

Before you fly home

Know which stage your tooth has reached: canals filled or not, and a temporary or a permanent restoration on top. If the treatment is not finished, know who will finish it, where and when. Make sure you have written care instructions, your treatment record with copies of the X-rays, and a way to reach the clinic.

Once you are back in the UK

If a problem comes up that is not urgent, write to the clinic and send photographs. For anything that needs someone to look at the tooth, see your own dentist in the UK. Take your treatment record and X-rays with you. If you think you have an abscess, follow the NHS advice above. In the emergencies above, do not wait for a reply.

Your treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists.

In Turkey, as in the UK, a dentist does not have to be a specialist to carry out root canal treatment. Turkish law authorises every dentist²³ to diagnose and treat the teeth, the gums and the tissues of the mouth and jaw. It ties the specialist title to a specialist certificate²³, issued and registered by the Ministry of Health²⁴. Endodontics is the branch of dentistry that deals with the pulp and the root canals. It is one of the nine dental specialties set by law in Turkey²³. In the UK, dentists do not have to join a specialist list²⁵ to practise a specialty. They may use the title "specialist" only if they are on the GDC's list.

Ask who will examine your tooth, carry out the root canal treatment and fit the permanent restoration. Ask what their title is, where they qualified, and whether they hold a Ministry-registered specialist certificate in endodontics. Ask for the answers in writing. On this page, "your own dentist in the UK" means the dentist you see at home.

Root canal treatment on one tooth can be finished in one visit or spread over several. Between visits, the tooth carries a temporary filling. The top of the tooth then needs a permanent restoration: a filling, an onlay or a crown. An onlay or a crown made in a laboratory adds appointments. Healing at the tip of the root is checked with X-rays over time, so the follow-up continues after you are home.

The usual sequence

1. Examination and X-ray in Antalya. Whether the tooth can be kept, and whether root canal treatment suits it, is decided at this stage.
2. Cleaning and filling the canals. This may take one visit or more. Between visits, the tooth has a temporary filling.
3. The permanent restoration. A filling, an onlay or a crown goes on once the canals are filled. Ask whether this will be done in Antalya on the same trip, on a return visit, or by your own dentist in the UK.
4. Review. Healing at the tip of the root is checked with X-rays at intervals your dentist sets. If you live in the UK, this is likely to be done by your own dentist there.

If the treatment is not finished when you fly home

Your trip may end before the canals are filled, or before the top of the tooth is permanently restored. If so, agree in writing who will finish the treatment, where and when. A temporary filling does not mean the treatment is complete. Until the tooth is permanently restored, do not chew hard food on that side. Ask your own dentist before you travel whether they would finish the treatment or fit the restoration.

What to agree in writing before you start

Before you book, you receive a written preliminary plan based on the photographs and any X-rays you send. It sets out the appointments and how many days they need. It is not a diagnosis or a final treatment plan. The examination and X-rays in Antalya confirm or change it, and with it the days and the cost. If it changes, you receive the revised plan in writing before treatment starts. You can take time to decide, and you can say no, or ask to stop, at any stage. Once treatment has started, ask what would happen to the tooth if it stopped at that point. You can also have the assessment, and any treatment, with a dentist in the UK. The General Dental Council says you should always be assessed by a qualified dentist before being given a treatment plan and cost estimate²⁶.

Whether a tooth needs root canal treatment is sometimes clear only after the examination and an X-ray, or while decay is being removed. So ask the plan to say which teeth might need it, and what would change for your trip if they do. How many days you need in Antalya depends on how many teeth are treated and whether a tooth has been treated before. It also depends on how each tooth will be restored, and on whether other treatment is planned in the same trip.

Ask for the plan to answer these questions:

1. Which teeth need root canal treatment, and which might need it?
2. How many visits is each tooth expected to need, and will the canals be filled before you fly home?
3. How will each tooth be restored, and will that be done in Antalya, on a return visit or by your own dentist in the UK?
4. If the treatment is not finished on this trip, who finishes it, where and when?
5. Which records will you take home for your own dentist?

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment, and about a week after most dental procedures²⁷. Ask your dentist how long to wait after your own treatment. The authors note that the research is limited and comes mainly from military aviation. Treat it as a starting point for your dentist's advice, not as a rule.

Your own dentist

The General Dental Council suggests talking to your own dentist²⁶ before you go. They need to know the plan in case problems come up later. They may also be the one who checks the tooth or fits the permanent restoration. Ask them before you travel whether they will take this on. If you do not have a dentist in the UK, it helps to find one before you travel. Once you are home, a problem with a root-filled tooth is usually first seen by your own dentist. National guidance in England (NICE) says the interval between check-ups should be set for each person according to their risk²⁸ and discussed with them.

Your records

Ask the clinic for a written record of the treatment to take back to your own dentist. For each tooth, it should say:

• which tooth was treated, and whether it had been root-treated before
• whether the canals were filled, and the materials used
• what is on top: a temporary filling, or a permanent filling, onlay or crown, and any post
• what still needs to be done, and by when

Ask for copies of the X-rays taken before and after treatment, in a form your own dentist can open. In Turkey, the health tourism regulation entitles international patients to an itemised bill. On request, they also get free copies of the records of the materials used, the tests and the imaging²⁹. The NHS lists exchanging medical records and arranging aftercare back home³⁰ among the things to consider before treatment abroad.

What the NHS does and does not do

If you later need NHS dental care in England or Wales, having been treated abroad does not by itself shut you out of it. An NHS dental practice may accept you for a course of treatment, not only an urgent appointment. If it does, it provides clinically necessary treatment, with your consent³¹. This means the treatment that every NHS dental contract must offer. However, the NHS free-repair and replacement provisions do not apply³¹ to work done by another provider. These are the free repair or replacement an NHS practice can give for its own work. The NHS website for England also states that the NHS is not liable for negligence or failure of treatment³⁰ when you have treatment abroad. On the NHS England routes that fund planned treatment abroad, you cannot get reimbursement for dental treatment³².

The NHS guidance quoted here is for England, and for England and Wales where stated. Scotland and Northern Ireland have their own NHS rules, and we hold no source for them. If you live there, check the arrangements where you live.

Travel insurance

The NHS website for England says that most travel insurance policies will not cover you for planned treatment abroad, so you may need specialist cover³⁰. Tell your insurer about your plans. Ask before you book whether anything linked to the treatment is covered, such as a complication or an extra trip.

The General Dental Council lists questions to ask before treatment abroad²⁶. Below are most of them, with what this page can tell you today and what to ask for in writing.

1. Who will carry out my treatment, and what are their qualifications? The treatment is provided by our clinic in Antalya, Turkey. Ask for the name of the dentist who will carry out the root canal treatment and fit the restoration. Ask where they qualified and what their title is (see who carries out the treatment, above).
2. Are you regulated by a professional body and registered with it? In Turkey, a health facility needs an authorisation certificate²⁹ from the Ministry of Health to treat international patients. Authorised facilities appear in a register the Ministry publishes³³, so you can check it yourself. The authorisation belongs to the facility, not to the dentist, and it says nothing about the result of your treatment. Ask for the treating dentist's own registration details as well. See health tourism authorisation.
3. Is the work guaranteed, are the terms in writing, and for how long do they apply? The tip of the root does not heal fully in every tooth (see "Risks and benefits"). This page makes no guarantee. Ask what the clinic's written terms cover, for example repeat treatment if the tooth does not heal. Ask too whether care by your own dentist in the UK changes those terms.
4. What aftercare do you provide, and who can I contact after the treatment? For a problem that is not urgent, you write to the clinic and send photographs. Check-ups, review X-rays and problems that need someone to look at the tooth are usually with your own dentist in the UK. Ask whom to contact at the clinic, how, and in which language.
5. If there are complications, who pays for further treatment, extra flights and the hotel? Ask for the answer in writing before you commit. Ask too who pays if the treatment has to be finished in the UK.
6. Do you have a complaints system, and can I see a copy? Ask for it before treatment. The GDC says it cannot resolve complaints or help with refunds³⁴; its investigations concern the dentists on its own register. Turkey's health tourism regulation makes the facility responsible for complications and medical malpractice arising after the health service it provided²⁹.
7. Will the dental team speak English, or will you provide a translator? Ask who will explain your plan and your consent form to you, and in which language.
8. How many times have you carried out this treatment, and what are your rates of success and complications? We publish no figures of our own yet: the figures on this page come from published studies, not from our own records. Ask for the clinic's own figures in writing, and ask how they were measured.
9. Do you have insurance to cover this treatment? In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre²⁹. That does not by itself tell you whether your treatment is covered, so ask which procedures in your plan, if any, fall under it. Ask too, in writing, whether the clinic or the treating dentist holds insurance for complications or errors, what it covers and whom it protects.
10. What happens if the examination shows the treatment is not suitable? Sometimes a tooth cannot be saved, and extraction is discussed instead. Ask before you book what you pay for the examination and X-rays in that case, and what happens to the rest of your plan.

The NHS names warning signs to think about before booking any treatment abroad. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare³². Apply them to this clinic too.

This page does not show prices. A treatment plan is prepared for you after an examination. The main factors that shape it are:

• The type of tooth and the number of canals (molars usually have more canals)
• The state of the canals: narrow, curved or previously filled canals
• Whether it is a first treatment or a repeat root canal treatment
• How many visits are needed, and how many trips
• Whether the tooth is restored afterwards with a filling, an onlay or a crown; a post, if needed
• Whether the permanent restoration is made in Antalya or by your own dentist in the UK

Ask for the plan in writing. It should say what is included, and whether the permanent restoration of the tooth (and a post, if needed) is included or charged separately. Ask too who pays for further treatment and extra travel if there is a complication.

If you are comparing with a quote from a UK practice, compare what each one includes, item by item.