What Happens During a Root Canal Procedure at StormDental?

Walking into a dental appointment with a clear understanding of what is about to happen makes a genuine difference to how relaxed you feel in the chair. For patients facing root canal treatment in Dreghorn, knowing the sequence of events — from the first injection of anaesthetic through to the final placement of a filling or crown — removes much of the uncertainty that fuels anxiety. Root canal treatment is a well-established, carefully structured procedure, and every step has a specific purpose. This guide walks you through each stage in plain language.

It is worth noting at the outset that root canal treatment is not a single, uniform experience. The precise steps, the number of visits required, and the time taken all vary depending on which tooth is being treated, how many canals it contains, how complex the anatomy is, and how extensive the infection has become. What follows reflects the typical approach taken at StormDental, where we treat each case individually and adapt our technique to your specific needs.

Step 1: Local Anaesthesia

Before any work begins, your dentist will thoroughly numb the affected tooth and the surrounding gum tissue using a local anaesthetic injection. A topical anaesthetic gel is usually applied to the gum first to reduce the sensation of the injection itself. The most commonly used agent for root canal work is lidocaine, which is highly effective and fast-acting. Once the anaesthetic has been administered, your dentist will wait a few minutes and then test the tooth to confirm it is fully numb before proceeding. You may feel pressure, movement, and vibration throughout the procedure, but you should not experience sharp pain. If at any point during treatment you feel discomfort beyond what you would consider pressure, raise your hand immediately — your dentist can always administer additional anaesthetic.

Step 2: Rubber Dam Placement

Once the tooth is numb, a small sheet of latex or latex-free rubber called a rubber dam is fitted around the tooth. The dam is held in place with a small clamp and creates a clean, isolated working environment. This step is essential for several reasons. It keeps the tooth dry and free from saliva, which contains bacteria that could recontaminate the canals during treatment. It also protects you by preventing any small instruments or irrigation fluids from reaching the back of your throat. The rubber dam may feel unusual at first, but most patients quickly stop noticing it.

Step 3: Access Opening

With the tooth isolated and numb, the dentist uses a dental drill to create a small opening through the crown of the tooth — through the enamel and dentine — to reach the pulp chamber beneath. For front teeth (incisors and canines), this access hole is made through the back surface of the tooth. For premolars and molars, the opening is made through the biting surface. The size and position of the opening are carefully planned to give direct access to all the canals without removing more tooth structure than necessary. Once the pulp chamber is reached, the infected or dead pulp tissue is visible and accessible.

Step 4: Canal Measurement and Mapping

Before the canals can be cleaned, your dentist needs to establish the working length — the precise measurement from the opening of the canal to its tip (the apex of the root). This is done using an electronic apex locator, a small device that sends a signal through a fine file placed in the canal and measures the exact point at the root tip. X-rays taken at this stage confirm the measurement and allow your dentist to map the shape and any curvature of each canal. Accurate measurement is crucial: cleaning too short leaves infected tissue behind, while going beyond the apex can cause unnecessary damage to the surrounding bone.

Step 5: Cleaning and Shaping the Canals

This is the central and most time-consuming part of the procedure. Using a series of fine, flexible instruments called endodontic files — often rotary (motorised) files made from nickel-titanium — your dentist systematically removes all the infected pulp tissue from within the canals and shapes them into a smooth, tapering form that can be thoroughly disinfected and sealed. The files are used in a specific sequence, gradually increasing in size to clean the full width of each canal. Modern rotary instruments have significantly reduced both the time required for this step and the level of discomfort associated with it compared to older manual techniques.

Throughout the cleaning and shaping process, the canals are repeatedly irrigated with antimicrobial solutions, most commonly sodium hypochlorite (a safe, dilute form of bleach) and sometimes EDTA (a chelating agent that removes the smear layer from canal walls). This irrigation is vital for dissolving organic debris, killing bacteria deep within the canal system, and preparing the canal walls to receive the final filling material. Your dentist will use a fine needle to deliver the irrigant safely within the canal without forcing any solution beyond the root tip.

Step 6: Temporary Filling Between Appointments

In many cases — particularly where there was significant infection or a dental abscess — your dentist will place a medicated temporary filling inside the canals between appointments rather than completing the treatment in a single visit. This medication, often calcium hydroxide, continues to disinfect the canal system over the following days or weeks. A temporary filling is then placed in the access hole to seal the tooth between visits. It is important to avoid chewing heavily on the side of the temporary filling, as it is not designed to withstand the same forces as a permanent restoration. You should also contact your dental practice if the temporary filling comes out before your next appointment.

Step 7: Filling with Gutta-Percha and Sealing

At the final treatment appointment — or at the end of a single-visit procedure — once the dentist is satisfied that the canals are clean and dry, they are filled with a biocompatible material called gutta-percha. Gutta-percha is a natural polymer derived from the latex of the percha tree. It has been used in dentistry for over 150 years and remains the gold standard filling material for root canals because it is inert, dimensionally stable, easy to shape, and radio-opaque (meaning it shows clearly on X-rays, allowing verification that the canals have been filled completely to the apex). The gutta-percha cones are placed into the canals along with a sealing cement that fills any gaps and bonds the material to the canal walls. A final X-ray confirms the quality of the fill before the access cavity is sealed with a permanent filling.

Step 8: Crown or Permanent Restoration

The final stage of root canal treatment is placing a suitable permanent restoration to protect the tooth. For front teeth with minimal structural loss, a tooth-coloured composite filling placed in the access cavity is often sufficient. For back teeth — particularly molars and premolars — a dental crown is strongly recommended. Root-canal-treated teeth lose some of their moisture content over time and can become slightly more brittle than vital teeth, making them more susceptible to fracture under the heavy biting forces of the back of the mouth. A crown encases the entire visible portion of the tooth, distributing biting forces evenly and protecting the underlying structure. Fitting the crown may require a separate appointment and in some cases the involvement of a dental laboratory to fabricate a custom restoration.

According to Wikipedia’s overview of root canal treatment, a properly restored tooth following root canal therapy yields long-term success rates near 97%, with studies showing that the overwhelming majority of treated teeth are retained eight years after the procedure. This makes root canal treatment one of the most reliably successful interventions in modern dentistry.

We hope this detailed walkthrough has given you a clearer picture of exactly what root canal treatment involves. At StormDental, we are committed to making the experience as comfortable and straightforward as possible, with clear communication at every step so you always know what is happening and why. If you have questions ahead of your appointment, or if you are experiencing symptoms and would like an assessment, please call us on 01294 218 733 — our friendly team will be glad to help.