Root canal treatment in Küsnacht: gentle and precise

Root canal treatment is necessary when the inside of a tooth, the dental pulp, is inflamed or has died. The diseased tissue is removed from the root canals, and the canals are cleaned, disinfected and tightly filled. The aim is to save your own tooth rather than having to extract it. Thanks to local anaesthesia, the treatment is usually no more painful than a larger filling.

At our dental practice in Küsnacht near Zurich, we use the machine-driven Reciproc system and, where necessary, 3D X-rays. On this page, you can find out how to tell whether you may need root canal treatment, how it works, what to bear in mind afterwards and what alternatives there are.

When is root canal treatment necessary?

Inside every tooth is the dental pulp, with nerves and blood vessels. The most common cause of inflammation is deep tooth decay: if the dentine – the layer beneath the enamel – is badly damaged, bacteria reach the nerve. Deep fillings, cracks in the tooth or an accident can also damage the pulp.

Typical symptoms include:

• severe or throbbing toothache, often at night as well
• pain when chewing or biting down
• persistent sensitivity to heat or cold
• a feeling of pressure in the tooth or jaw
• swelling of the gum or cheek
• discolouration of the tooth

An affected tooth does not always hurt. A dead nerve can remain symptom-free and only show up on an X-ray. Conversely, not every toothache means root canal treatment. Only an examination can provide clarity.

How root canal treatment works

Depending on the situation, treatment takes place in one or more sessions. The main steps:

1. Diagnosis: Examination and X-ray to assess the condition and course of the root canals.
2. Anaesthesia: The tooth is numbed with a local anaesthetic.
3. Access and cleaning: The tooth is opened, the inflamed tissue is removed, and the canals are widened with fine instruments and rinsed.
4. Filling: The cleaned canals are tightly sealed with gutta-percha, a rubber-like material.
5. Sealing and build-up: The tooth receives a filling. Depending on how much tooth structure remains, a post and later a crown may be needed.

If the tissue around the root tip is already badly inflamed, an antibiotic may also be needed. We decide this on a case-by-case basis.

Reciproc system and 3D X-rays

We use the Reciproc system to prepare the root canals. The instruments are machine-driven in a back-and-forth reciprocating motion. This allows thorough cleaning, adapts well to the course of the canal and requires only a few instruments. For you, this usually means less time with your mouth open.

Root canals are often curved or branched. Where a standard X-ray is not enough, we use cone beam computed tomography (CBCT), a three-dimensional X-ray. This allows the canals to be located more precisely and inflammation at the root tip to be assessed better. You can read about the equipment we use on the page on X-ray technology at our practice.

Risks and limitations

Like any procedure, root canal treatment carries risks. We discuss these with you beforehand. They may include:

• discomfort in the treated tooth or at the injection site of the anaesthetic in the days afterwards
• pain if filling material passes beyond the root tip
• renewed inflammation, for example if bacteria remain in hard-to-reach lateral canals
• a fracture of the tooth, because root-filled teeth become more brittle

Root canal treatment increases the chance of saving a tooth, but cannot guarantee it. Sometimes a second treatment (re-treatment) is needed, and in some cases the tooth has to be removed nonetheless.

The alternative to root canal treatment is extracting the tooth. The gap is then usually closed with a bridge or a dental implant. This is more involved and does not fully replace your own tooth. That is why trying to save the tooth is worthwhile in many cases, but not in all: if a tooth is too badly damaged, we will honestly advise against it.

After treatment: care and crown

Mild discomfort when chewing is normal in the first few days and usually subsides on its own. You can support healing:

• cool the cheek from the outside if needed
• only eat once the anaesthetic has worn off, and spare that side at first
• avoid smoking and be careful with irritating foods
• continue to brush your teeth thoroughly, including around the treated tooth

If the pain increases, your cheek swells or the discomfort lasts longer than a few days, please get in touch with us.

A root-filled tooth no longer has a blood supply and becomes more brittle over time. Molars with significant loss of tooth structure in particular therefore often need a crown to protect the tooth from breaking. We discuss whether this is necessary in your case after the treatment.

How we work at our practice

First, we examine the tooth and use an X-ray to determine whether root canal treatment makes sense or whether another solution would be better. We explain the steps, the risks and the alternatives before we begin. The costs depend on the tooth, the number of root canals and the effort involved. On request, we can provide a cost estimate in advance. We carry out root canal treatments ourselves at our practice.

If you are anxious about the treatment, let us know. We take time for a preliminary conversation and only begin when you are ready. On request, treatment is also possible under nitrous oxide sedation. Find out more on our page Fear of the dentist.

Frequently asked questions

Does root canal treatment hurt?

During treatment, the tooth is numbed with a local anaesthetic, so you usually only feel pressure and vibration. The treatment often even relieves the pain that the inflamed nerve was causing beforehand. If the surrounding area is badly inflamed, the anaesthetic sometimes works less well. Let us know if this happens so that we can top up the anaesthetic.

How long does pain last after root canal treatment?

Pain from pressure or biting is normal in the first few days and usually eases gradually. Standard painkillers generally help. If the pain gets worse instead of better, or swelling develops, contact us. In an emergency, you can reach us on +41 77 480 94 45.

How long does root canal treatment take?

That depends on the tooth and the inflammation. Front teeth usually have one canal, molars several. Some treatments are completed in one session; if the inflammation is more severe, several appointments are needed, with a medicated dressing placed in between.

Can’t I just have the tooth pulled?

That is possible, but the gap should generally be closed so that the neighbouring teeth do not shift. A bridge or implant involves more effort than saving your own tooth. We show you both options and advise you on what makes sense in your situation.

Does a root-filled tooth last?

With good restoration and care, a root-filled tooth can last for many years. There is no guarantee. A tight seal, a crown if needed and regular check-ups are important.

Do you have toothache or questions about root canal treatment? Book an appointment at our practice in Küsnacht here – we will be happy to advise you.