Dental & Skin Clinic, Royal Tunbridge Wells
Root Canal Treatment in Tunbridge Wells — Stop the Pain, and Keep the Tooth
If a tooth is throbbing, keeping you awake or painful to bite on, root canal treatment clears the infection at the source and saves the tooth.
- Painful teeth assessed and treated
- Local anaesthetic — the tooth is fully numb before we start
- Saves the tooth rather than removing it
- Treated by Dr Simon Azimi, GDC 81382
- Opposite Tunbridge Wells station
The kind of pain that reorganises your day around it
It started as sensitivity to something cold. Then it began lasting after the cold had gone. Now it's a deep, throbbing ache that comes in waves, and it's worse when you lie down, which is why you've been sitting up on the sofa at two in the morning.
You've been counting hours between painkillers. You're chewing entirely on the other side. Hot drinks have become impossible, and there was a moment yesterday when the pain seemed to move to your ear or your jaw and you genuinely couldn't tell which tooth it was coming from.
Or perhaps there's no pain at all any more — it stopped a few weeks ago and you were relieved. Then a small pimple appeared on the gum, and the tooth has gone slightly grey, and it's tender to press.
That last one matters. When a badly infected nerve dies, the pain often stops. The infection doesn't. It just moves quietly out of the end of the root and into the bone.
Whatever stage you're at: ring us on 01892 547286. Painful teeth are assessed properly rather than fitted in around the edges, and the first thing anyone needs is a straight answer about what's going on.
When to seek urgent care immediately: if you have swelling in your face that is spreading, swelling that closes your eye or reaches your neck, difficulty swallowing or breathing, or you feel generally unwell with a fever — do not wait for a dental appointment. Go to A&E or ring 111. Dental infections are usually straightforward, but they must not be left when they spread.
The pain stops, and the tooth stays
Those are the two things people want from this appointment, and they're what the treatment is for.
Root canal treatment removes the infected nerve tissue from inside the tooth — the thing that is generating the pain — cleans and disinfects the empty canals, and seals them so bacteria can't get back in. The source is gone, so the pain goes with it.
And the tooth stays in your mouth. That's the part people don't expect, because so many arrive assuming this tooth is a write-off. A root-treated tooth, protected properly afterwards, can go on chewing for many years. You keep your own root in your own jaw, the neighbouring teeth stay where they are, and you don't face the gap, the bridge or the implant that follows an extraction.
Most people sleep properly the night after treatment for the first time in a week. That's usually the moment it registers that it's over.
Why patients come to us with a painful tooth
We take the pain seriously.
Toothache is exhausting and it makes people frightened. You'll be listened to, examined, X-rayed and told what's actually happening, rather than handed antibiotics and a follow-up in a fortnight.
The tooth is fully numb before anything starts.
Effective local anaesthetic is used, and it's given time to work. An acutely infected tooth can be harder to numb than a healthy one — that's a known thing, we plan for it, and if you're not numb you say so and we deal with it before continuing.
You can stop at any point.
Agree a hand signal at the start. It's respected. For a lot of people that single arrangement is what makes a long appointment manageable.
Honest about the alternative.
Root canal treatment isn't always the right answer. Some teeth are too broken down or too badly cracked to be worth saving, and you'll be told that plainly, with the cost of each route, rather than being taken down a treatment path that ends in an extraction anyway.
One dentist, start to finish.
Dr Simon Azimi assesses, treats and restores the tooth. Where a case is genuinely complex — unusual anatomy, a calcified canal, a retreatment — you'd be referred to a clinician on the GDC specialist list in endodontics rather than have it attempted regardless.
Two minutes from the station.
At the entrance to Calverley Park, opposite Tunbridge Wells railway station, which is a real advantage when you're travelling in for a longer appointment or coming back for the crown.
Get seen about a painful tooth
If you're in pain, ringing is faster. Call 01892 547286.
What is root canal treatment?
Root canal treatment — also called endodontics — is the removal of infected or dying nerve tissue from inside a tooth, followed by cleaning, disinfecting and sealing the space it leaves behind.
Its purpose is to save a tooth that would otherwise have to be taken out.
Inside every tooth is a soft core called the pulp, which contains the nerve and blood supply, running down through narrow channels called root canals. When bacteria reach the pulp — through deep decay, a leaking filling, a crack, or a knock to the tooth — it becomes inflamed and then infected. The pulp is sealed inside hard tissue with nowhere to swell, which is exactly why it hurts as much as it does.
Once the pulp is infected it does not recover. The choice at that point is to clear it out and keep the tooth, or to remove the tooth.
What are the signs I need root canal treatment?
The common ones:
- Lingering sensitivity to hot or cold — pain that carries on for seconds or minutes after the drink has gone, rather than a quick zing
- Pain that wakes you at night or is worse when you lie down
- Throbbing, spontaneous pain that arrives without anything triggering it
- Pain when biting or when the tooth is tapped
- Tenderness or swelling in the gum near the tooth, sometimes with a small pimple that discharges and then returns
- A tooth that has darkened compared with its neighbours
- A tooth that feels loose or slightly raised, as if it's meeting the opposite tooth first
- Pain that stopped on its own and left tenderness or a bad taste behind
You don't need all of these. One or two are enough to warrant an X-ray, which is the only way to be certain — a decayed tooth and an infected nerve can look identical from the outside.
Let's deal with the reputation
Root canal treatment has the worst name in dentistry, and most of what it's based on is decades out of date.
The reputation was earned in an era of less effective anaesthesia, hand-only instruments and appointments that ran for hours. Techniques, materials and anaesthetics have all moved on considerably since then.
The bigger reason for the reputation is more human. People come for root canal treatment when they are already in severe pain — often days into it, exhausted and dreading everything. The pain they arrive with gets attached, in memory, to the treatment that ended it. The treatment is what stopped the pain, not what caused it.
Does root canal treatment hurt?
During treatment, the tooth is numbed with local anaesthetic and you shouldn't feel pain. Most people report pressure, vibration and the tedium of keeping their mouth open, and nothing sharper than that.
Two honest caveats. First, a tooth with an active infection can be more difficult to numb completely, because inflamed tissue resists anaesthetic — this is well recognised, it's planned for, and there are additional techniques for it. Tell us straight away if you feel anything; that is not a complaint, it's information we need.
Second, afterwards the tooth is usually tender to bite on for a few days, sometimes up to a week or so, as the tissue around the root settles. Ordinary over-the-counter painkillers manage this for most people. A smaller number get a flare-up of more significant pain in the first day or two, which we'd want to know about.
Read more: five root canal myths, answered honestly
How many appointments does root canal treatment take?
Usually one or two, depending on the tooth and how infected it is.
Front teeth generally have a single canal and are quicker. Back molars can have three or four canals, sometimes with awkward curves, and take longer. Some teeth are cleaned and sealed in one visit; others are cleaned, dressed with an antibacterial medicament and sealed at a second appointment a week or two later, which can be the better approach when there's a lot of infection.
What actually happens during the treatment?
- Numbing. Local anaesthetic, given time to work fully.
- Opening the tooth. A small access hole is made through the biting surface or the back of a front tooth.
- Cleaning the canals. The infected pulp tissue is removed and each canal is cleaned and shaped along its full length with fine instruments, flushed with disinfecting solution as the work goes on.
- Measuring. The length of each root is measured — with an electronic apex locator and X-rays — so the canal is cleaned and filled right to the tip, no further and no shorter.
- Sealing. The canals are filled with a rubber-like material called gutta-percha and a sealer, which stops bacteria re-entering the space.
- Rebuilding the tooth. A filling closes the access hole. In most cases a crown is then recommended to protect the tooth long term.
Will I need a crown afterwards?
Usually, on a back tooth — and it matters more than people expect.
A tooth that needs root canal treatment has generally already lost a lot of structure to decay or fracture, and the access hole removes more. A root-treated tooth also no longer has its internal blood supply, which makes it more brittle over time. The single most common way a successfully root-treated tooth is eventually lost is not reinfection — it's the tooth splitting under normal chewing force.
A crown wraps the tooth and holds it together, which is why it's recommended for most back teeth after root canal treatment. Front teeth with modest damage can sometimes be restored with a filling alone. You'll be told what your tooth needs and what it costs before treatment starts, so the crown isn't a surprise at the end.
Won't antibiotics clear it up?
Not on their own. This is one of the most useful things to understand about an infected tooth.
Antibiotics travel in the bloodstream. The pulp inside an infected tooth has lost its blood supply, so antibiotics cannot reach the bacteria living in there. They may reduce swelling and settle things temporarily if the infection has spread into the surrounding tissue, which is sometimes necessary before treatment — but they do not treat the source, and the pain returns once the course finishes.
The only ways to remove the source are root canal treatment or extraction.
What happens if I do nothing?
The infection doesn't resolve by itself. It progresses out of the end of the root into the surrounding bone, forming an abscess. That can mean recurrent flare-ups, facial swelling, bone loss around the root, and eventually losing the tooth anyway — often as an urgent extraction at a worse moment, and sometimes with more of the tooth gone than would have allowed it to be saved.
Spread beyond the tooth is uncommon but it is serious when it happens. That's why facial swelling is treated as urgent rather than something to see how it goes with.
How successful is root canal treatment, and what are the risks?
The risks worth knowing about:
- The tooth remains tender for a few days, sometimes longer, and a small number of people get a short-lived flare-up.
- Treatment can fail to settle the infection. If that happens, options are retreatment, a small surgical procedure at the root tip, or extraction.
- Canals can be difficult or impossible to negotiate. Some are very curved, very narrow or calcified with age. This may mean referral to a clinician on the GDC specialist list in endodontics.
- Instruments can occasionally separate inside a canal, or a root can be perforated. Both are uncommon, and both would be explained to you if they occurred.
- The tooth becomes more brittle, which is why a crown is usually recommended.
- A root-treated front tooth can darken over time. That's treatable — internal whitening or a crown or veneer.
Step by step
From the first phone call to a tooth you've stopped thinking about
Assessment
An examination and an X-ray to confirm the nerve is involved and to see how far the infection has travelled. The tooth may be tested with cold or a small electrical pulp tester to check whether the nerve is alive. You'll be shown the X-ray.
The options and the cost, in writing
Root canal treatment and a crown, or extraction and the ways of replacing the tooth. Both costed, both explained, with an honest view on whether the tooth is worth saving.
Getting you out of pain
Where the tooth is acutely painful, the first priority is settling it. That often means starting the treatment — opening the tooth and removing the infected pulp relieves the pressure — rather than sending you away with tablets.
Cleaning and sealing
One or two appointments, as above. Between visits, if two are needed, the tooth is dressed and sealed with a temporary filling. Ring us if the temporary comes out.
Protecting the tooth
A permanent filling and, in most cases, a crown. This part shouldn't be postponed indefinitely — an unprotected root-treated back tooth is at real risk of fracturing.
Afterwards
Eat on the other side until the tenderness settles and the tooth is fully restored. Then it's an ordinary tooth again: brush it, clean between it, and have it checked at your routine appointments.
Fees
How much does root canal treatment cost in Tunbridge Wells?
Root canal treatment costs more than an extraction on the day. It costs considerably less than replacing the tooth afterwards — a bridge or an implant is a larger undertaking in both time and money, and neither is as good as the tooth you already have. When you're comparing the two, compare the whole route rather than the first appointment.
Ask for the cost of the crown at the same time as the root canal treatment, so you know the full figure before you begin. We'd rather you had it upfront.
In pain right now? Call 01892 547286
Root canal treatment vs extraction
| Root canal treatment | Extraction | |
|---|---|---|
| Keeps your own tooth | Yes | No |
| Appointments | Usually 1–2, plus a crown visit | Usually 1 |
| Cost on the day | Higher | Lower |
| Cost over the following years | Crown, then routine care | Bridge, implant or denture — or living with the gap |
| Effect on neighbouring teeth | None | They can drift into the gap, and the bite changes over time |
| Effect on the jawbone | Bone is preserved by the root | Bone in the socket shrinks after the tooth is removed |
| Recovery | Tender for a few days | Socket heals over one to two weeks |
| Chewing | Normal once restored | Reduced until the tooth is replaced |
| When it's the right choice | The tooth has enough sound structure left to restore | The tooth is split, badly broken down, or has severe bone loss around it |
Is it always better to save the tooth?
Usually, but not always. Nothing replaces a natural tooth as well as the natural tooth, and keeping it avoids the whole sequence that follows a gap. That's why root canal treatment is normally the first option offered.
But a tooth that is cracked below the gumline, broken down so far there's nothing left to hold a crown, or loose from advanced gum disease may not be restorable — and spending money on saving it can mean spending it twice. You'll be given a candid assessment of which of these your tooth is, including when the honest answer is that it's borderline.
What if I have the tooth out instead?
Then the gap needs a decision, not necessarily today. Back molars at the very end of the arch are sometimes left as a gap without much consequence. Anywhere else, leaving a space allows the neighbouring teeth to tip and the opposing tooth to over-erupt, which causes bite problems in the years that follow.
The replacement options are a bridge, a denture, or an implant, each with its own cost, timescale and trade-offs.
Questions
Frequently asked questions
Does root canal treatment hurt?
The tooth is numbed with local anaesthetic first, and during treatment most people feel pressure rather than pain — many describe it as similar to having a large filling. An acutely infected tooth can be harder to numb, so tell us immediately if you feel anything. Afterwards the tooth is usually tender to bite on for a few days.
Will I need a crown after root canal treatment?
On back teeth, usually. Root-treated teeth become more brittle and the most common reason one is eventually lost is fracture rather than reinfection. A crown wraps and protects it. Some front teeth can be restored with a filling alone.
Can antibiotics cure an infected tooth?
No. The pulp inside the tooth has no blood supply, so antibiotics can't reach the bacteria living there. They may settle swelling temporarily, but the pain returns when the course ends. The source is only removed by root canal treatment or extraction.
How long does a root-treated tooth last?
Many years, in most cases, provided it's properly restored and looked after. The tooth still needs cleaning and check-ups like any other — a root-treated tooth can't feel decay starting, which is one reason not to skip appointments.
Can I go to work afterwards?
Usually yes. You'll be numb for a few hours and the tooth will likely be tender for a few days, but most people carry on as normal. Take care not to bite your lip or cheek while numb, and eat on the other side until it settles.
What if the pain has stopped on its own?
That often means the nerve has died, not that the problem has resolved. The infection continues out of the root end into the bone. A tooth that hurt badly and then went quiet still needs assessing.
Is root canal treatment safe? I've read things online.
Yes. Root canal treatment is a long-established, evidence-based procedure carried out routinely across the world. Claims circulating online linking it to systemic illness derive from research from the early twentieth century that has been thoroughly reviewed and is not supported by current evidence.
What if the treatment doesn't work?
It's uncommon, but it happens. The options then are retreatment, a small surgical procedure at the root tip, or extraction. If a case looks complex from the outset, you'd be referred to a clinician on the GDC specialist list in endodontics.
My face is swollen. What should I do?
Ring us on 01892 547286 straight away. If the swelling is spreading, closing your eye, reaching your neck, or you're having any difficulty swallowing or breathing, or you feel unwell with a fever, go to A&E or call 111 without waiting for a dental appointment.
Can I have root canal treatment if I'm pregnant?
Usually yes, and an untreated dental infection carries its own risks. Tell us you're pregnant and how far along, and treatment and any X-rays will be planned accordingly.
Will the tooth go dark?
A root-treated front tooth can darken over the years. It's treatable — internal whitening, a veneer or a crown, depending on the tooth. Mention it if it matters to you, because it's easier to plan for at the start.
Getting here
Root canal treatment for Tunbridge Wells and the surrounding area
When a tooth is causing this much trouble, how far you have to travel matters. We're at the entrance to Calverley Park, directly opposite Tunbridge Wells railway station.
Patients reach us from Tonbridge in around fifteen minutes by road or a few minutes by train, from Pembury and Southborough more quickly still, and from Groombridge and Frant on the roads into town from the south. If you're travelling in for a longer appointment, being a short walk from the platform is a genuine help.
If you're in pain, ring 01892 547286 before you set off, and we'll tell you what to do next.
Don't sit up with it another night
A painful tooth doesn't settle on its own, and the longer an infected nerve is left, the fewer options there are for saving the tooth.
Or request a call back and we'll ring you as soon as we can.
Mon–Fri 8:30am–5:15pm · Sat 10am–4:30pm1 The Lodge, Mount Pleasant Avenue, Royal Tunbridge Wells, Kent TN1 1QY
Reviewed by Dr Simon Azimi, GDC 81382