Root Canal Treatment in Rawalpindi

The nerve inside a tooth can only be inflamed so far before the damage becomes irreversible. Past that point the tissue dies, bacteria colonise the empty canal, and infection spreads out through the root tip into the bone. At that stage there are two options: root canal, or extraction.

A tooth that has been aching severely for days and then suddenly goes quiet has not healed. In most cases the nerve has finished dying. There is no longer live tissue to generate pain, but the canal is now an undisturbed space for bacteria, and the infection continues outward into the bone.

Patients regularly take this silence as recovery and return six months later with facial swelling and a tooth that is no longer savable. If a severe toothache resolves on its own without treatment, that is a reason to be seen, not a reason to relax.

The tooth is thoroughly numbed and isolated with a rubber dam, which keeps the field clean and stops anything reaching the back of your throat. An opening is made through the top of the tooth, the dead tissue is removed, and the canal system is cleaned, disinfected and shaped with fine instruments.

Once clean and dry, the canals are sealed with an inert filling material and the access opening is closed. If the infection is significant, medication may be placed inside and the tooth sealed temporarily for a week or two before completing. This is normal practice, not a complication.

This is the part patients most often decline and most often regret. A root-treated back tooth has had its blood supply removed and a cavity cut through its biting surface. It is structurally weaker and it is brittle. Under normal chewing force, an uncrowned root-treated molar has a significant chance of fracturing, often below the gum, at which point it cannot be saved and the entire root canal has been wasted.

A crown distributes the biting force around the tooth instead of through it. It is the difference between a treatment that lasts decades and one that lasts a couple of years. Front teeth with minimal structure loss are sometimes an exception; back teeth essentially never are. When we recommend a crown, this is the reason.

The numbness lasts two to four hours, and you should not eat on that side until it has fully gone — it is easy to bite your own cheek without feeling it. Mild tenderness on biting for two or three days is normal, and settles with ordinary painkillers.

Chew on the other side until the permanent restoration is placed, especially if the tooth has a temporary filling. Contact us if pain increases rather than decreases after the first few days, or if there is swelling.

Extraction is cheaper on the day and considerably more expensive over a lifetime. A missing back tooth lets the neighbouring teeth tilt into the space and the opposing tooth drift down, which changes the bite. Replacing it properly with an implant or a bridge costs several times what saving the original tooth would have.

There are teeth that genuinely cannot be saved — vertical root fractures, severe decay below the gum, insufficient remaining structure — and where that is the case we will tell you plainly rather than performing a treatment that will fail. But where a tooth is savable, saving it is almost always the better decision, clinically and financially.