When the teeth just started to be decayed, we didn't take it seriously, as it didn't hurt. We believed it was no big deal. Later the decay became more and more serious, and there came the toothache which we could no longer ignore. But even then we still didn’t want to go to the hospital, instead we ate some painkillers and went to work the next day. Later, the toothache became so unbearable that we could barely eat any food. So we reluctantly went to the dental hospital for check up, but the doctor told us it was too late that we had to receive root canal treatment. Root canal treatment sounds terrible because it means some nerves may be killed.

The tooth nerves are inside the pulp. Pulling those nerves out is just one step of root canal treatment. When the tooth decay goes through the pulp causing tooth sensitivity, a root canal treatment is required. But it doesn’t mean the nerves are to be removed surely, unless the tooth is rotten with only root left. Normally, it depends on the severity of the tooth decay. If the oral bacteria only damage the dentin, a resin composition filling is enough.

1. Is it painful to remove tooth nerves?

In general, the doctor will remove the dead pulp at the root under local anesthesia, and it won’t be so painful after the removal of tooth nerves. However, if the tooth has crooked root, it will be more difficult to remove the nerves, and the anesthetic effect won’t be strong. The number of root canals to be cleaned depends on the specific location of the tooth, for example, that of the front teeth is 1-2, while the molars is 3-4. The more root canals in the tooth, the more difficult the treatment will be.

2. Why is the removal of tooth nerves so expensive?

Usually, the cost is determined by the number of root canals to be cleaned and the difficulty of the treatment, as well as the tooth’s location. The more anterior the tooth is, the easier the treatment will be, thus the cost will be low, and vice versa. The treatment for back teeth is difficult, as the doctor needs not only to remove the tooth nerves but also to check the condition of cavities. Such treatment always requires 2-4 subsequent visits.

3. Is there a case that patient suffers from more pain after treatment?

In such case, the doctor might have not removed the pulp completely, causing the result of inflammation. At that time, the filling material should be taken out and a new root canal treatment should be done. After that, a porcelain crown should be placed to protect the original tooth, as the tooth without the nutrition from the pulp will become black and vulnerable like a dead tooth which is susceptible to break when chewing food.

If the tooth is decayed but causes no pain, it is not too late to fill the tooth. But once the tooth nerves become painful, it will be unbearable to average people.

Severe pain in the teeth means the loss of opportunity for tooth filling, then another treatment plan – root canal treatment should be applied.

4. Conventional root canal treatment can be divided into the following steps:

(1) Remove the decayed tissues of the tooth, expose the pulp chamber, and pull out the infected pulp with nerve broach;

(2) Measure the length of the root canal. That must be done with certain instrument (currently it’s the root canal length measurement device) as the teeth are opaque;

(3) Prepare the root canal with a metal file, that is, eliminate the substances in the canal. As the technology advances, the traditional hand-operated devices have been replaced by the mechanical devices, which can, on one hand, refine the procedure of root canal preparation, and on the other hand shorten the treatment time, and improve the experience of both patients and doctors;

(4) When the root canal preparation is applied, the canal must be rinsed simultaneously without stop. More and more doctors clean the canal with ultrasonic instrument to ensure the work can be done perfectly;

(5) After preparation, it is necessary to seal the root canal with disinfection medication according to the state of disease. Subsequent visit is required after a certain period of time;

(6) The subsequent visit is for taking out the original medication, sealing the root canal with a permanent material, restoring the contour of the tooth, and fixing the restoration if necessary.

The cost of root canal treatment is much higher than that of tooth filling. If a tooth is decayed but causes no pain, it can be filled, and the cost is about a few hundred yuan (inlays excluded).

However, if the root canal treatment is required, the cost will rise up to a few thousand yuan. Why is it so expensive?

First, the cost differs by the location of the tooth. The full-mouth teeth are divided into three types: anterior teeth, premolars (bicuspids) and molars. The treatment for the anterior teeth is simple, so the cost is relatively low, followed by the premolars. The treatment for molars is the most expensive because the molars’ roots are complicated and the treatment is difficult;

In addition, molars usually have 3-4 roots, and each root may have multiple nerves. Normally the cost of root canal treatment refers to the cost of treating 3 nerves. If the tooth has more than 3 nerves, then each additional nerve will cause an extra fee;

If a tooth becomes inflamed due to incomplete root canal treatment, then the cost of a second root canal treatment will be much more expensive than the first one, mainly because the second treatment is more difficult.

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