FAQ: Root canal treatment

A root canal treatment is a dental procedure in which infected or dead nerve tissue is removed from inside the tooth. The root canals are then cleaned, disinfected, shaped, and finally sealed.
The main goal is to save the natural tooth and eliminate infection.

Steps, outlook and costs at a glance: Root canal treatment in Singen.

• It removes harmful bacteria and prevents the infection from spreading.

• It helps prevent abscesses and infections of the jawbone.

• It allows you to keep your own tooth instead of replacing it.

• Keeping your own tooth maintains proper chewing function and jaw stability.

• Removes a source of inflammation: an infection in the jaw can affect the body as a whole.

• Protects against chronic inflammation: untreated dental infections can contribute to other conditions over time.

• Better quality of life: no more pain, normal chewing and often no need for an implant or bridge.

1. Examination and X-ray

2. Local anaesthesia

3. Opening of the tooth

4. Removal of infected nerve tissue

5. Mechanical and chemical cleaning of the canals

6. Drying and sealing the canals

7. Final restoration, often with a crown for long-term stability

During a root canal treatment, we determine the length of the root canal as precisely as possible. There are two ways to do this: conventionally with an X-ray, or very precisely with electronic length measurement.

Electronic length measurement can reduce complications and improve the chances of success. However, statutory health insurance usually does not pay for it.

Special disinfecting solutions (e.g. sodium hypochlorite, EDTA, chlorhexidine) are used to reduce bacteria deep inside the canals. Many practices also use ultrasonic or sonic activation, which can improve cleaning.

These upgraded solutions and activation techniques are not covered by insurance and require private payment.

Statutory health insurance only covers what is considered “sufficient, appropriate, and economical”.
Modern endodontic methods count as a quality improvement, but they are considered optional upgrades, not basic care.

Common non-covered private services include:

• Electronic length measurement

• Machine-assisted canal preparation

• Activated or specialised irrigation techniques

• High-end bioceramic filling materials

• Dental microscope use (frequently a private service)

Insurance covers only the basic root canal treatment, and only if the tooth is classified as worth preserving (e.g. a key tooth for chewing stability).
The basic cleaning and filling of the canals is included.

Depending on the tooth and the work involved, additional services may include:

• Electronic length measurement

• Antibacterial / activated irrigation

• Machine-assisted canal preparation

• Work with magnification aids

• Often also: the permanent crown (usually partly private)

We discuss the costs of additional services with you before treatment and set them out in a treatment and cost plan.

How good the outlook is depends mainly on the condition of the tooth and on whether the canals can be cleaned completely and sealed tightly. We give you an assessment for your tooth after the examination.

Careful aftercare helps the tooth last.

With modern anaesthesia, treatment is largely pain-free.
Temporary sensitivity afterwards is normal and usually resolves within a few days.

If the treatment is carried out well and the tooth is properly restored – often with a crown – a root-treated tooth can last many years, often decades.

Often yes.
After treatment, the tooth becomes more fragile. A crown protects it from fractures and increases long-term success.

Yes, if bacteria get into the tooth again. In that case, a retreatment (a second root canal treatment) or an apicoectomy (root tip surgery) may be an option. Only rarely does the tooth have to be extracted because it can no longer be saved.

A root canal treatment is a proven way to save a natural tooth.
Statutory health insurance covers only the basic version.
Important modern techniques – such as electronic length measurement, activated disinfection, and treatment under magnification – are not covered, but they can improve the chances of keeping the tooth for a long time.

A retreatment (also called revision) is a second root canal procedure performed on a tooth that has previously undergone root canal therapy but still shows symptoms or signs of infection on the X-ray.
During retreatment, the old root filling material is removed, the canals are re-cleaned and disinfected, and then filled again.

Common reasons why a retreatment becomes necessary:

• One or more canals were not located or fully cleaned during the first treatment

• Bacteria re-entered the tooth (e.g. through leaking fillings or crowns)

• Complex canal anatomy was missed

• The original treatment used outdated techniques or materials

• Persistent or recurring infection at the root tip

A retreatment requires more time, experience and equipment than the first root canal treatment:

• The old root filling material has to be removed completely – often with very fine instruments, ultrasound and under magnification.

• Complex or blocked canals have to be made accessible again, sometimes with special files or solvents.

• Because there is already a chronic inflammation, more cleaning and disinfection is needed.

• The work is done with magnification aids. This is usually a private service.

• Several sessions are often needed, especially if the inflammation is severe.

Statutory health insurance only covers basic care. Many essential steps of a careful retreatment are therefore private services, and the costs are usually higher than for the first treatment.

The costs depend on the tooth, the number of canals and the work involved; molars with three or four canals take more work.
We discuss the costs with you before treatment and set them out in a treatment and cost plan.

The prognosis depends mainly on the condition of the tooth and on whether the canals can be cleaned completely and sealed tightly. We give you an assessment for your tooth after the examination.

A successful retreatment can preserve the tooth for many years or decades. It prevents renewed inflammation and pain and can avoid surgery such as an apicoectomy, as well as tooth loss and complex replacement.

A retreatment tackles the actual cause – the bacteria in the root canal. An apicoectomy, on the other hand, only treats the consequences at the inflamed root tip. According to current endodontic standards, retreatment therefore comes first, and an apicoectomy only afterwards.

Root canal retreatment is a more demanding procedure than initial root canal therapy, which is why it is more costly.
If it succeeds, however, the prognosis for the tooth is good, and your own tooth can often be kept.