When the pulp cannot be saved
A tooth after root canal treatment loses sensation, but it stays in the arch and keeps carrying bite forces, so it is usually worth treating before we consider removing it. Success depends on a tight seal at every stage: from isolation during the procedure to the final restoration of the tooth.
Who is this treatment for?
- Pain appears on its own, wakes you at night or comes back when the painkiller wears off.
- A hot drink causes pain that lasts long after you swallow, and cold brings brief relief.
- A painful swelling or a fistula has appeared on the gum next to the tooth.
- The tooth has darkened after an old injury, even though nothing hurts.
- A tooth treated with a root canal before is causing symptoms again or has a lesion visible on the X-ray.
What to expect
- We start with an endodontic consultation: we check how the tooth responds and review an X-ray if it is needed for the diagnosis. This decides whether the canals need opening.
- We give local anaesthesia before we start and check that it has worked before we reach for the instruments.
- We isolate the tooth with a rubber dam and work in a dry field, cut off from saliva, throughout the visit.
- Under the microscope we locate the canal openings, shape the canals with instruments and rinse them with disinfecting solutions.
- We confirm the canal length with a check X-ray, and then fill the canals with gutta-percha or leave a dressing for the next stage.
The first days after the visit
- After the anaesthesia it is worth waiting to eat until feeling returns to your lip and tongue.
- Until the final restoration it is better to spare the treated tooth; chew hard food on the other side.
- A temporary filling is meant to last until the next visit, not several months, so do not put off the appointment.
- Increasing pain, a swollen cheek or a fever are a reason to call the same day.
- The bone around the root tip rebuilds over months, so we assess its condition on an X-ray only at the check-up.
Why it is worth saving the tooth
Your own root stays
Keeping the tooth in the bone means the gap does not need filling: the neighbouring teeth stay untouched and the ridge keeps working.
Working under magnification
Under a microscope you can see anatomy that cannot be made out with the naked eye: narrow and calcified canals or remnants of earlier treatment.
Anaesthesia and breaks
We shape the canals under local anaesthesia, and during a long visit we take breaks whenever you ask for them.
Restoration in the same plan
We set the extent of the restoration and when we will do it together with the root canal treatment plan, because it decides how long the treated tooth will last.
From the first conversation to aftercare
Four steps to a healthy, beautiful smile.
01
Diagnostic consultation
An examination, intraoral and extraoral photos and, if needed, an intraoral scan and 3D CT.
02
Treatment plan
You receive it in writing, with stages, costs and alternatives. No pressure, no “offer that ends today”.
03
Treatment
The treatment is carried out by the doctor who planned your care. For specialist procedures, by a doctor from the team whom you meet before treatment starts.
04
Aftercare
A follow-up visit included in the price and written aftercare instructions. After treatment you contact the studio, which puts you in touch with your lead doctor.
Frequently asked questions
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At Smile Bonding Studio treatment of a single-canal tooth under a microscope in a single-visit procedure starts from 799 PLN. The amount depends on the number of canals, whether the treatment is primary or a retreatment, and the number of visits. Payment can be spread into instalments of up to 48 months, and you receive the final quote in the treatment plan by email.
We carry out the procedure under infiltration or nerve block anaesthesia and check that it has worked before we start. With acute inflammation full anaesthesia can be harder to achieve and needs an extra dose. For a few days after the visit the tooth is often tender when you bite.
It will not replace opening the canals: for irreversible pulpitis European guidelines recommend treating the tooth, not a systemic antibiotic. A Cochrane review found no evidence that penicillin reduces this pain, but it is based on one trial with 40 patients and low certainty of evidence. Relief comes from removing the pulp from the affected tooth.
Some teeth yes, some need two stages; the condition of the pulp, the anatomy of the canals and whether there is active inflammation decide. A Cochrane review found no difference in effectiveness between one and several visits, but pain in the first week is more common after single-visit treatment.
For adults, the Polish National Health Fund (NFZ) covers root canal treatment of the front teeth, from canine to canine. Children and young people up to 18 and women who are pregnant or postpartum have wider coverage. You can confirm the current terms at a practice with an NFZ contract.
Eat beforehand: the visit lasts 60–120 minutes, and after the anaesthesia you need to wait to eat until feeling returns to your lip and tongue. Bring a list of the medicines you take and any X-rays you have from another practice. Also plan the date of the next visit, because a temporary filling is not a solution for months.
Our satisfied patients
A tooth that wakes you at night, or a dentist who looks at the X-ray and says “the canals need opening”: this is usually how the story starts. The questions are then the same: will it hurt, how long will it take, will the tooth hold up and how much will it cost. We carry out root canal treatment in Gdańsk under a microscope and with rubber dam isolation. Below we explain what price lists do not say: how the procedure goes, what the prognosis depends on, what affects the cost and what you can check yourself before your visit.
What root canal treatment is and why there are so many misconceptions about endodontics
Root canal treatment, in medical terms endodontic treatment, or endodontics, means removing irreversibly inflamed or necrotic pulp from the pulp chamber and root canals, shaping the canals, disinfecting them and sealing them tightly with gutta-percha. The tooth then loses sensation, but it stays in the bone and keeps carrying bite forces; that is the point of the procedure. The misconception starts with the word “dead”: we are talking about a root that still keeps the bite complete.
Endodontics, retreatment, periapical lesion: a glossary from the practice
The same words keep coming up in root canal treatment plans:
- retreatment, or re-endodontics (re-endo): requires removing the earlier canal filling;
- rubber dam: isolation that cuts the tooth off from saliva;
- apex locator: a device for measuring canal length;
- periapical lesion: an inflammatory focus in the bone at the end of the root.
Three beliefs worth setting aside before your visit
The first: that a tooth after endodontics “poisons the body”. The second: that an antibiotic will deal with it without opening the canals; for irreversible pulpitis the guidelines of the European Society of Endodontology recommend pulp treatment or root canal treatment, not a systemic antibiotic. A Cochrane review found no evidence that penicillin reduces pain in this condition, but it is based on one trial with 40 patients, and the certainty of evidence was rated low; this means there is too little evidence, not that a lack of effect has been shown. Removing the pulp from the affected tooth remains the standard approach. The third: that no pain means no treatment is needed; pulp necrosis can be symptomless and show up on an X-ray.
Who root canal treatment in Gdańsk is for, and who it is not for
The decision is preceded by an endodontic consultation: we check how the tooth responds to stimuli and review an X-ray. When the anatomy of the canals or a lesion in the bone raises doubts, the guidelines of the European Society of Endodontology allow a CBCT scan, not routinely, only when the diagnosis is unclear.
Symptoms worth coming in with straight away
- pain appears on its own, wakes you at night or comes back after a painkiller;
- a hot drink causes pain that lasts after you swallow, and cold brings relief;
- a painful swelling or a fistula has appeared on the gum next to the tooth;
- the tooth has darkened after an old injury, even though nothing hurts;
- a tooth treated with a root canal before is causing symptoms again.
The limits of the method: when a tooth cannot be kept
Not every tooth can be saved, and we say so at the consultation. A vertical root fracture ends the matter. So do a lack of tissue for a restoration, advanced gum disease around that tooth or an impassable obstruction in the canal. In that case we talk about removing the tooth instead of treating it at any cost.
How the procedure works, step by step
One visit lasts 60–120 minutes, depending on the number of canals and whether the tooth has been treated before. We take breaks whenever you ask for them.
Stage 1: endodontic consultation and diagnosis
An examination, tests of the tooth’s response, a review of the X-ray, a diagnosis. On this basis a plan with the scope of work and a quote is made; you receive it by email, broken down into stages.
Stage 2: local anaesthesia and rubber dam isolation
We give infiltration or nerve block anaesthesia before we start and check that it has worked before we reach for the instruments. Then we isolate the tooth with a rubber dam and work in a dry field throughout the visit. This is not an add-on to the price list: the American Association of Endodontists regards isolation as an integral part of every non-surgical endodontic procedure, and the guidelines of the European Society of Endodontology recommend meticulous aseptic technique and an optimal working field. The reason is simple: saliva carries bacteria, and a shaped and rinsed canal loses its point if oral flora gets back into it during the procedure. Isolation also protects the mucosa from disinfecting solutions and the airway from small instruments.
Stage 3: shaping and disinfecting the canals under a microscope
Under the microscope we locate the canal openings, shape the canals with instruments and rinse them with disinfecting solutions. Magnification makes the biggest difference where the anatomy cannot be made out with the naked eye: in narrow and calcified canals, in molars, with a broken instrument. Working under magnification is recommended by the European guidelines.
Stage 4: filling the canals and a check X-ray
We confirm the canal length with a check X-ray, and then fill the canals with gutta-percha or leave a dressing for the next stage; whether sealing moves to another visit depends on the condition of the canal at the end of the work. The X-ray after filling stays in your records; you can ask us to go through it with you.
One visit or two: what really decides
A single-visit procedure is sometimes presented as a mark of quality, and the evidence does not support this. A Cochrane review comparing one visit with several, thirteen trials and over 1 500 teeth, found no difference in the rate of failures assessed on X-ray; it did indicate, however, that pain in the first week is probably more common after a single-visit procedure. The available trials therefore do not show that either approach gives better results; that is not proof, however, that the two are equivalent. A second stage is usually required by exudate in the canal, acute inflammation or incomplete disinfection.
How many years a tooth lasts after root canal treatment and what it depends on
A systematic review by Ng, Mann and Gulabivala collected the proportions of teeth retained after treatment: about 86 per cent at 2–3 years, 93 per cent at 4–5 years and 87 per cent at 8–10 years. Over a decade we therefore lose roughly one tooth in seven to eight, even with correctly performed work. It is not a lifelong solution and no one can honestly promise that.
Restoring the tooth: a decision that weighs more than filling the canals
In the same review the number one factor for tooth survival is a prosthetic restoration of the crown after treatment is completed, and number two is contact with the neighbouring teeth. Not the material in the canal and not the brand of instruments. That is why we set the extent of the restoration and its timing together with the plan, not “sometime later”; we describe the details on the crowns and bridges page.
What shortens the life of a treated tooth
A temporary filling is meant to last until the next visit, not several months; putting off the appointment wastes well-shaped canals. Until it is restored it is worth sparing the treated tooth and chewing hard food on the other side. And one more thing: no pain does not mean “healed”. The bone around the root tip rebuilds over months and is assessed on an X-ray at the check-up.
Primary treatment, retreatment, apicoectomy or extraction
When a tooth causes symptoms, there are in practice four paths:
- primary treatment: the canals are opened for the first time;
- retreatment: we remove the earlier canal filling, shape the canals again and seal them; it costs more;
- microsurgical apicoectomy: when an obstruction in the canal cannot be passed from the crown side;
- tooth extraction with the gap filled later; we write about it on the extractions, implants and dentures pages.
Root canal treatment in Gdańsk: price and what affects the cost
At Smile Bonding Studio endodontic treatment of a single-canal tooth under a microscope, in a single-visit procedure, costs from 799 PLN. This is a starting price; we give the final amount in the treatment plan after the consultation. The quote depends on the number of canals in the tooth, from one to four, whether the treatment is primary or a retreatment, and the number of visits. As a rough guide, on practice comparison sites prices for root canal treatment in Gdańsk range from about 250 PLN to about 2 400 PLN, with an average of around 870 PLN; these are market data, not our price list.
Two things are worth counting from the start. First: the final restoration is added to the cost of endodontics, so comparing the price of canal treatment alone with the price of an implant is misleading. Second: payment can be spread into instalments of up to 48 months (the credit decision is made by the lender) or paid in stages, after each visit, not in advance for everything.
Root canal treatment on the NFZ: what public coverage for adults does not include
The services guaranteed for adults by the Polish National Health Fund (NFZ) include root canal treatment of the front teeth, from canine to canine. Children and young people up to 18 and women who are pregnant or postpartum have wider coverage. For a molar the choice comes down to private treatment or extraction; you can confirm the terms at a practice with an NFZ contract.
What to look for when choosing a practice in Gdańsk
Five things you can check by phone or at the consultation:
- whether the tooth will be isolated with a rubber dam throughout the visit;
- whether the work in the canals is done under magnification;
- whether the canal length is confirmed by measurement and an X-ray;
- whether the extent and timing of the restoration are in the plan from the start, with the cost;
- whether a check-up with an X-ray has been scheduled.
At our clinic endodontics is led by Patryk Kononowicz, DDS. We see patients at ul. Obrońców Westerplatte 32B in Gdańsk (Oliwa), Monday to Friday between 9:00 and 20:00. If after the procedure the pain grows, your cheek swells or you get a fever, call the same day.
Key takeaways
- Endodontics lets you keep your own root in the bone; the tooth loses sensation but keeps working.
- Rubber dam isolation is the standard of care, not an add-on; this is how the American Association of Endodontists and the European guidelines describe it.
- The available reviews found no difference in effectiveness between one and several visits, and pain in the first week after a single-visit procedure is more common.
- For irreversible pulpitis the European guidelines recommend treating the tooth, not a systemic antibiotic.
- After 8–10 years about 87 per cent of teeth are retained, so we lose some despite correctly performed work.
- Tooth survival depends more on the final restoration than on the canal filling itself.
- The price rises with the number of canals and for retreatment; with us from 799 PLN, with instalments of up to 48 months.
Summary
Endodontics is neither a cosmetic procedure nor an emergency patch. It is a way of keeping your own root in the bone when the pulp can no longer be saved, and of avoiding a gap that then has to be filled with something. The fate of the tooth is decided by a tight seal at every stage and by what happens after the canals are sealed, not by the number of visits or the name of the equipment listed on the practice website.
Not every tooth can be kept, and the procedure does not give lifelong certainty. With a vertical root fracture or a lack of tissue for a restoration, removing the tooth can be the more sensible choice. We lose some teeth despite correctly performed work; that is why instead of a guarantee you get a prognosis given in ranges, a scheduled check-up with an X-ray and a plan made after the examination, individually for your tooth, not for the statistics.
If you are considering root canal treatment in Gdańsk, start with an endodontic consultation: an examination, a review of the X-ray and a written plan with the scope, stages, cost of the restoration and alternatives, including extraction. You receive the plan by email, so you make the decision calmly at home, not in the chair. And if the tooth hurts right now, call: spontaneous pain is not worth riding out on painkillers, because the source stays in the canal.
