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Endodontics · UK

Root canal treatment, by a specialist endodontist.

Save the tooth. A GDC-registered endodontist with a dental operating microscope, apex locator and rotary NiTi files, in a practice that will finish the job with a proper crown within 3 months.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private root canal treatment costs in the UK.

Indicative ranges for specialist endodontic treatment in London and across the UK.

Procedure Indicative range
Consultation, vitality testing and periapical radiograph £150 to £300
CBCT for complex or retreatment cases £250 to £450
Anterior or premolar root canal (single canal) £800 to £1,200
Molar root canal (3 to 4 canals) £1,200 to £1,800
Retreatment (removal of old gutta-percha and re-obturation) £1,400 to £2,000
Apicectomy (surgical endodontics) £900 to £1,400
Definitive crown or cuspal-coverage onlay £950 to £1,600

Total for a molar: root canal £1,200 to £1,800 plus a crown £950 to £1,600, or £2,150 to £3,400 all in. Extraction plus implant is typically £3,500 to £4,500.

The journey

From referral to the definitive crown.

One team from first message to the crown that finishes the job. Everything is booked before you consent.

  1. 03

    Before

    Vitality testing and imaging

    Cold and electric pulp tests, periapical films, and CBCT for calcified canals, resorption, missed MB2 canals or suspected perforation.

  2. 04

    On the day

    Local anaesthetic and rubber dam

    Every specialist root canal is done under LA with rubber dam isolation. No dam, no root canal. It is not optional.

  3. 05

    On the day

    The root canal itself

    60 to 90 minutes per visit, one or two visits. Access cavity, canal location under the microscope, working length by apex locator, chemomechanical debridement with sodium hypochlorite and EDTA.

  4. 06

    On the day

    Obturation and provisional seal

    Gutta-percha and AH Plus sealer to the working length, then an immediate coronal seal. Mild tenderness for 2 to 5 days, ibuprofen usually enough.

  5. 07

    After

    The definitive crown within 3 months

    A crown or cuspal-coverage onlay is booked for molars and premolars within 3 months. This is the single biggest determinant of long-term survival.

When it helps

The indications we see, and when to extract instead.

Root canal treatment saves natural teeth. Where prognosis is favourable we retain the tooth. Where it is not, we say so.

  • Irreversible pulpitis

    Spontaneous pain, thermal hypersensitivity that lingers more than 30 seconds after removing the stimulus, throbbing at night.

  • Pulp necrosis with periapical abscess

    A dead pulp with a visible radiolucency at the apex, tenderness to percussion, sometimes a draining sinus in the gum.

  • Deep caries into the pulp

    A cavity that has reached the pulp chamber. Pulp cap is unpredictable once frank exposure has occurred with symptoms.

  • Trauma with pulp exposure

    A fractured incisor or crown with visible pulp. Vital pulp therapy in the young, root canal treatment in the mature tooth.

  • Internal or external resorption

    A resorptive defect on radiograph or CBCT. Early root canal treatment can arrest internal resorption and stabilise the tooth.

  • Extreme tooth wear

    Attrition or erosion so severe that restorative build-up will encroach on the pulp. Elective root canal treatment before crown work.

  • Prophylactic before a crown

    A tooth with a large existing restoration and borderline pulp that will not tolerate crown preparation and cementation.

  • Not always the answer

    A vertical root fracture, an unrestorable tooth or a hopeless periodontal prognosis is an extraction, not a root canal.

Procedure options

Primary, retreatment, apicectomy or implant.

Four routes, one honest recommendation. We do not push root canal treatment on teeth that will not survive.

  • Primary root canal treatment

    First-time endodontic treatment on a tooth with irreversible pulpitis or pulp necrosis. Highest success rate, 90 to 95% with a specialist.

  • Retreatment

    Removal of old gutta-percha, re-cleaning, re-shaping and re-obturation of a failed root canal. Success 60 to 75%. Often a missed MB2 canal in an upper molar.

  • Apicectomy

    Surgical endodontics through the gum to remove the root tip and a small periapical granuloma. Reserved for cases where orthograde retreatment has failed or is not possible.

  • Extraction plus implant

    For unrestorable or fractured teeth: extraction, bone graft if needed, and an implant. Typically £3,500 to £4,500 versus £1,600 to £2,800 for root canal plus crown.

Safety and recovery

What to expect afterwards, honestly.

Modern specialist endodontics is a common, safe procedure. The things worth planning are your definitive crown, post-operative tenderness, and the 1-year radiographic review.

  • Mild tenderness for 2 to 5 days

    Post-operative tenderness to biting for a few days is normal. Ibuprofen 400mg three times daily is usually enough. Severe swelling is not normal, call the practice.

  • The definitive crown within 3 months

    A provisional restoration is not enough. Molars and premolars need a crown or cuspal-coverage onlay within 3 months to prevent cracking and coronal leakage.

  • Flare-up rate around 5%

    A minority of teeth flare up with pain and swelling 24 to 48 hours after the first visit. Antibiotics are rarely helpful. Return to the endodontist for drainage.

  • Instrument separation

    A rotary file can occasionally separate in a canal. In experienced hands with a microscope, this rarely affects prognosis if the canal is otherwise well cleaned.

  • Realistic 5-year survival

    90% or better with an adequate crown, around 70% without one. Root canal treatment is a crown-completion project, not just endo.

  • When to extract instead

    A vertical root fracture, an unrestorable tooth or a hopeless periodontal prognosis is an extraction plus implant, not a heroic root canal.

Related treatments

FAQs

The questions patients ask us most.

  • Does root canal treatment hurt?

    No. Under local anaesthetic and rubber dam, the procedure itself is painless. The pain you feel beforehand, from irreversible pulpitis or an abscess, usually settles within 24 to 48 hours of the first visit. Mild tenderness to biting for 2 to 5 days afterwards is normal and settles with ibuprofen.

  • What is the difference between a specialist endodontist and my general dentist?

    A specialist endodontist is on the GDC specialist list, has completed 3 years of postgraduate endodontic training, and uses a dental operating microscope, apex locator and rotary NiTi files as standard. Molar success rates rise from 65 to 85% with a GDP to 90 to 95% with a specialist. Complex cases (retreatments, calcified canals, missed MB2 canals, curved roots) should go to a specialist.

  • How much does a private root canal cost in the UK?

    With a specialist endodontist: £800 to £1,200 for an anterior or premolar single-canal tooth, £1,200 to £1,800 for a molar with 3 to 4 canals, £1,400 to £2,000 for retreatment, and £900 to £1,400 for apicectomy. Add £950 to £1,600 for the definitive crown, which is essential for long-term survival.

  • Root canal treatment or extraction plus implant?

    A restorable tooth with a favourable prognosis is retained: root canal plus crown at £1,600 to £2,800 is cheaper than extraction plus implant at £3,500 to £4,500, and keeps your natural tooth. Unrestorable teeth, vertical root fractures and hopeless periodontal prognosis go to extraction plus implant.

  • Why does my endodontist insist on rubber dam?

    Rubber dam isolates the tooth from saliva and bacteria, protects the airway from small instruments, and lets the endodontist irrigate with sodium hypochlorite safely. No dam, no root canal. It is a standard of care, not optional.

  • What happens if the root canal fails?

    The failure rate is 10 to 15% at 5 years. Options are retreatment (removal of old gutta-percha and re-obturation, success 60 to 75%), apicectomy for small persistent periapical lesions, or extraction plus implant.

Sources

Last reviewed 2026-09-05. Editorial by Pulse Atlas Editorial. Reading time about 7 minutes.