Root Canal Treatment in Singapore

What is root canal treatment?

Root canal treatment, also known as endodontic therapy, is a dental procedure performed to treat an infection or inflammation within the pulp (innermost of a tooth).

Root canal therapy is recommended as a way to save a tooth that might otherwise need to be extracted. The procedure involves removing the infected or damaged pulp, cleaning and disinfecting the root canals, and sealing the space with a filling material. The tooth is then often restored with a dental crown to provide strength and protection.

What is a tooth pulp?

The pulp is the innermost part of the tooth, containing nerves, blood vessels, and connective tissue. When the pulp becomes infected or inflamed, it can cause severe pain and may lead to the formation of an abscess if not treated promptly.

When do you need root canal treatment?

Root canal treatment is typically recommended when the pulp becomes infected or inflamed.

There are several reasons why a dentist might recommend root canal treatment:

1. Decay: 

   • Tooth decay can progress to the pulp of the tooth if left untreated. Bacteria from the decay can cause infection and inflammation within the pulp chamber.

2. Trauma: 

   • Physical trauma to a tooth, such as a severe blow or injury, can damage the pulp even if there is no visible external damage to the tooth.

3. Deep fillings:

   • Large or deep cavities that extend into the pulp chamber may expose the pulp to bacteria, leading to infection and inflammation.

4. Repeated dental procedures: 

   • Teeth that have undergone multiple dental procedures, such as extensive fillings or repeated restorations, may develop complications over time, necessitating a root canal.

5. Abscess: 

   • If a dental infection is left untreated, it can lead to the formation of an abscess. An abscess is a collection of pus within the body. This may occur within the jaw bone or spread outward to the surrounding area. This is a painful condition and may be potentially life-threatening if the abscess spreads to vital parts of the body such as the area surrounding the throat, the brain, or downwards towards the heart, requiring prompt attention.

How do you know if you need a root canal?

The need for a root canal treatment is often indicated by specific signs and symptoms. If you experience any of the following, it's important to consult with a dentist for a proper evaluation:

1. Severe toothache: 

   • Persistent and severe tooth pain, especially when chewing or applying pressure, can be a sign of pulp inflammation or infection.

2. Prolonged sensitivity:

   • Increased sensitivity to hot or cold temperatures that lingers after the stimulus is removed may indicate pulp damage.

3. Swelling and tenderness: 

   • Swelling and tenderness in the gums, especially near a specific tooth, may suggest an infection that requires attention.

4. Discolouration of the tooth: 

   • A tooth that has become discoloured (darkening) may indicate damage or death of the pulp inside.

5. Painful chewing:

   • Pain or discomfort while chewing or biting down on a specific tooth may indicate underlying issues with the pulp.

6. Tender or swollen lymph nodes: 

   • In some cases, infection in the tooth can lead to tender or swollen lymph nodes in the neck or jaw area.

Root canal procedure

What are the stages of treatment?

1. Diagnosis: The dentist examines the tooth and takes X-rays to determine the extent of the infection or damage.
2. Access opening: The dentist creates an opening in the crown of the tooth to access the pulp chamber and root canals.

3. Cleaning and shaping: The dentist removes the infected or inflamed pulp tissue from the pulp chamber and the root canals. The canals are then cleaned, shaped, and disinfected to remove any remaining bacteria.

4. Filling: After cleaning and shaping, the dentist fills the empty space inside the tooth with a biocompatible material, usually a rubber-like substance called gutta-percha. This seals the canals and prevents bacteria from re-entering.

5. Restoration: In many cases, a tooth that has undergone a root canal treatment may need a dental crown to provide additional support and restore its function and appearance.

6. Follow-up: Patients are advised to follow proper oral hygiene practices and attend regular dental check-ups to ensure the success of the root canal treatment.

How long are the procedures?

Root canal treatment for a front tooth normally takes 1 to 2 visits depending on the case. Each visit normally takes less than 1 hour. However, root canal treatment for a back tooth might take 2 -3 visits. Each visit might take about 1 hour or more depending on the complexity of the case.

What are the pros and cons?

Here are some pros and cons associated with root canal treatment:

Pros

1. Saves the tooth: 

   • Root canal treatment can save a tooth that would otherwise require extraction. This helps maintain your teeth and prevents the need for further dental work like bridges or implants.

2. Relieves pain: 

   • One of the main reasons for undergoing a root canal is to alleviate severe tooth pain caused by infection or inflammation of the pulp. The procedure removes the source of the pain, providing relief.

3. Restores function: 

   • After a root canal, the tooth can still function normally for biting and chewing. With proper care, such as regular brushing, flossing, and dental check-ups, the restored tooth can last a lifetime.

Cons

1. Requires multiple visits: 

   • Root canal treatment typically involves multiple appointments, especially if the infection is severe or complications arise. This can be inconvenient for some patients who may need to take time off work or rearrange their schedules.

2. Potential discomfort: 

   • While root canal treatment is performed under local anesthesia to minimise discomfort, some patients may experience mild discomfort or sensitivity during or after the procedure. This discomfort is usually temporary and can be managed with over-the-counter pain medication.

3. Risk of reinfection: 

   • Although root canal treatment is highly effective in eliminating infection, there is a small risk of reinfection if bacteria are not completely removed from the root canal system or if the tooth is not properly restored. Regular dental check-ups and good oral hygiene are essential to minimise this risk.

4. Cost: 

   • Root canal treatment can be expensive, especially if additional procedures such as crown placement are required to restore the tooth's strength and appearance. However, compared to the cost of tooth extraction followed by tooth replacement options like implants or bridges, root canal treatment may be more cost-effective in the long run.

Overall, while root canal treatment has its drawbacks, the benefits of preserving natural teeth and relieving pain often outweigh the potential disadvantages for many patients.

What to do after root canal treatment?

After a root canal treatment, it's important to follow your dentist's instructions for post-operative care to ensure proper healing and to prevent complications. Here are some general guidelines:

1. Follow your dentist's instructions: 

   • Your dentist will provide specific post-operative instructions based on your individual case. Make sure to follow them carefully.

2. Pain management: 

   • It's common to experience some discomfort after a root canal procedure. Your dentist may recommend painkillers or prescribe medication. Take them as directed.

3. Avoid chewing on the treated tooth: 

   • Give the treated tooth some time to heal. Avoid chewing on that side of your mouth until your dentist gives you the green light.

4. Maintain good oral hygiene:

   • Continue with your regular oral hygiene routine, but be gentle around the treated area. Brush and floss carefully

5. Attend follow-up appointments: 

   • Your dentist may schedule follow-up appointments to monitor the healing process. Attend these appointments to ensure everything is progressing as expected.

6. Watch for signs of infection: 

   • Keep an eye out for any signs of infection, such as increasing pain, swelling, or discharge. If you notice any concerning symptoms, contact your dentist promptly.

7. Avoid hard and sticky food: 

   • While the tooth is healing, it's advisable to avoid hard and sticky food that could potentially cause damage or discomfort.

How much will the root canal procedure cost?

The cost can range from SGD 350 to SGD 1500 per tooth or more, depending on various factors. This cost excludes dental crowns. Public institutions like National Dental Centre of Singapore may charge less, but private clinics often have shorter waiting times.

Can I use MediSave/CHAS to pay for root canal treatment?

For root canal treatment, CHAS subsidies are available, limited to 2 root canal treatments per calendar year. Additional details on CHAS subsidies can be found here.

MediSave typically does not cover general dental treatments, such as root canal treatment, unless they involve surgical procedures deemed medically necessary. Non-surgical dental treatments, including routine check-ups and root canal treatment, are not eligible for claims under the MediSave scheme. 

Is there an alternative to a root canal?

It is important to note that the alternatives may not be as effective in certain cases, and the decision should be made in consultation with your dentist. Here are a few other options:

1. Extraction: 

   • Removing the tooth is an alternative to root canal treatment. However, losing a natural tooth can lead to various issues, including difficulties with chewing, changes in bite, and the potential for neighbouring teeth to shift. It is important to replace a tooth after extraction. Treatment options after extraction can be a denture, dental bridge, or implant.

2. Apicoectomy: 

   • This is a surgical procedure in which the tip of the tooth's root is removed along with any infected tissue. While it can be an option, it is typically considered when a traditional root canal has failed.

3. Medication: 

   • Antibiotics and painkillers may be prescribed to manage the infection and symptoms temporarily. However, this doesn't address the underlying issue and is not a definitive treatment.

4. Watchful waiting: 

   • In some cases, especially with teeth that do not exhibit any signs and symptoms such as pain, the dentist may choose to monitor the situation and intervene only if the condition worsens.

FAQ

Is root canal treatment painful?

Typically, a root canal procedure is not painful or may cause very minimal pain, as local anaesthesia is administered during the procedure.

Is it better to have a root canal treatment or extraction?

Whether it's better to have a root canal or extraction depends on various factors, including the condition of the affected tooth, your overall oral health, personal preferences, and financial considerations. 

Generally, a root canal treatment allows you to preserve your natural tooth and restores function of that tooth. However, it has the downside of requiring multiple visits, a potentially higher upfront cost, and a small chance of treatment failure. 

An extraction on the other hand is an immediate solution for the pain, has lower upfront cost and could potentially be a less complex procedure. However, this comes at a cost of losing your natural tooth and potentially requiring a replacement. 

That being said, if the tooth is too badly decayed, then an extraction followed by a replacement could be the only treatment option available to you. 

Are there any side effects of root canal treatment?

Root canal treatment is generally considered a safe and effective procedure for treating infected or damaged teeth. However, like any medical or dental procedure, there can be potential side effects or complications, though they are relatively rare. Here are some possible side effects associated with root canal treatment:

1. Discomfort or pain:

   • It's common to experience some discomfort or mild pain following a root canal procedure. This discomfort is usually temporary and can be managed with over-the-counter pain medication. Severe or persistent pain may indicate an underlying issue and should be reported to your dentist.

2. Swelling or inflammation: 

   • Some swelling or inflammation around the treated tooth and surrounding gum tissue may occur after a root canal. This is typically temporary and should resolve on its own within a few days. Applying ice packs and taking anti-inflammatory medication can help alleviate swelling and discomfort.

3. Infection: 

   • While root canal treatment is performed to eliminate infection from the tooth, there is a small risk of infection occurring or reoccurring after the procedure. This may manifest as swelling, pain, or discharge from the affected tooth and should be promptly evaluated and treated by your dentist.

4. Complications with restoration: 

   • After the root canal procedure, the tooth will typically need to be restored with a filling or crown to restore its strength and appearance. Occasionally, complications such as a loose filling or crown, fracture of the restored tooth, or improper fit of the restoration may occur and require additional treatment.

It's essential to follow your dentist's post-operative instructions carefully and attend follow-up appointments to monitor your recovery and address any concerns or complications that may arise. Most side effects associated with root canal treatment are minor and temporary, and the benefits of preserving your natural tooth typically outweigh the risks.

How long does it take to recover from a root canal treatment?

The recovery time after a root canal procedure can vary depending on several factors, including the complexity of the procedure, the severity of the infection or inflammation, and individual healing factors. In general, here's what you can expect in terms of recovery timeline:

1. Immediate post-procedure: 

   • After the root canal procedure, you may experience some numbness in the treated area due to the local anesthesia used during the procedure. It's normal to feel a bit groggy immediately afterward, especially if you were sedated for the procedure.

2. First few days: 

   • During the first few days following the root canal, you may experience some discomfort or mild pain around the treated tooth and surrounding gum tissue. This is normal and can usually be managed with over-the-counter pain medication, such as ibuprofen or acetaminophen. You may also notice some swelling or tenderness in the area.

3. One to two weeks: 

   • Most patients experience improvement in symptoms within the first week after a root canal procedure. Any initial discomfort or pain should gradually diminish, and swelling should begin to subside. However, it's essential to continue practicing good oral hygiene and follow any post-operative instructions provided by your dentist to aid in the healing process.

4. Long-term: 

   • In the weeks and months following the root canal, you should continue to monitor the treated tooth for any signs of persistent pain, swelling, or other unusual symptoms. Attend follow-up appointments with your dentist as recommended to ensure that the tooth is healing properly and to address any concerns or complications that may arise.

Overall, most patients can expect to fully recover from a root canal procedure within a few days to a couple of weeks. However, individual experiences may vary, and it's essential to listen to your body and seek prompt dental care if you experience any prolonged or severe symptoms. With proper care and maintenance, a tooth that has undergone root canal treatment can function normally and provide years of reliable service.

How long does a root canal last?

A root canal is a restorative dental procedure with the potential for long-term success. The durability of the results depends on the way you take care of your teeth, just like caring for your other teeth.

How many visits for root canal treatment?

Complex cases of root canal treatment may require 2 to 3 visits, while simpler cases can often be completed in a single visit. However, each case is unique and should be assessed by the dentist to determine the appropriate treatment plan.

Can I eat normally after root canal treatment?

Yes, you can resume a normal diet following root canal treatment. While most foods are fine, it's advisable to avoid hard food that may exert excessive pressure on the treated tooth.

What happens if root canal treatment fails?

Although root canal treatment typically has a high success rate, there is a possibility of failure. If the treatment is unsuccessful, you might have to extract the tooth.