What is a root canal treatment?
A root canal treatment is a procedure in which the dentist removes the inflamed or dead tissue from inside a tooth or molar, cleans and disinfects the canal, and then seals it. In everyday English it is often called a nerve treatment; the clinical field is endodontics.
Every tooth contains a chamber of living tissue: the pulp. It holds the nerve and the blood vessels that feed the tooth. When that tissue becomes inflamed — through a cavity that has grown too deep, a leaking or ageing filling, a crack, or a blow to the tooth — bacteria reach the pulp.
The problem is that this infection cannot resolve itself. The pulp is sealed inside hard tooth tissue, where your immune system and antibiotics can barely reach. So there is only one way to stop it: remove the tissue. What remains is your own tooth, still in place and still doing its share of the chewing.
Do I really need it? What happens if you don’t
A root canal infection never clears up on its own, because the inflamed tissue is sealed inside hard tooth tissue where the immune system and antibiotics cannot reach it. Postponing almost always makes the situation worse.
Left untreated, it progresses in stages. The infection finds its way out through the root tip and reaches the jawbone. There it forms a focus of inflammation that can grow into an abscess: a painful swelling, sometimes with a swollen cheek, a bad taste or fever. That is an infection in your jaw that needs prompt treatment.
What misleads many people: the pain can disappear along the way. That feels like good news, but it usually means the nerve has died — the infection continues, just without a warning signal.
The longer you wait, the less healthy tooth tissue remains to build on. At some point saving the tooth is no longer an option and only extraction is left. In pain, or unsure? Call us — looking costs nothing.
Root canal treatment or extraction?
A root canal treatment keeps your own tooth; extraction removes it permanently. Pulling is faster and cheaper at that moment, but the consequences continue. This is a real trade-off, and a fair one to weigh out loud.
| Root canal treatment | Extraction | |
|---|---|---|
| Your own tooth | kept | gone permanently |
| Jawbone | the root keeps the bone active | recedes over time |
| Neighbouring teeth | stay in place | can drift; the opposing molar over-erupts |
| Appointments | 1 to 2, of 45 to 90 minutes | usually 1 |
| Needed afterwards | a filling or crown as build-up | bridge, implant or denture — almost always costlier and more invasive |
| Best choice when | the tooth can be saved | cracked root, too little healthy tissue |
When extraction is the wiser choice
Extraction is preferable when the tooth can no longer be saved — in that case a root canal treatment is wasted money and lost time. That applies when:
- The tooth is badly broken, with too little healthy tissue to build on.
- The root is cracked or split.
- The tooth sits so far back that it barely contributes to chewing, such as a wisdom tooth.
- A previous root canal treatment has failed, with no realistic prospect of retreatment.
We will say so honestly if that is your situation. But in most cases keeping your own tooth is the better outcome — and that is what we aim for.
Does a root canal treatment hurt?
A root canal treatment causes virtually no pain during the procedure, because it is carried out under local anaesthetic. This treatment’s reputation dates from an era of different techniques and different anaesthetics; today’s practice is another matter.
What people call “root canal pain” is almost always the pain of the infection itself: that throbbing, nagging ache that worsens when you lie down or drink something hot. That pain is the reason you came in — and it is exactly what the treatment takes away.
Here is how we do it: we only anaesthetise once you say you are ready, we wait until it has fully taken effect, and we agree a stop signal in advance. Raise your hand and we stop — not at the end of the step we are on, but immediately.
After-pain: what’s normal and when to call us
After-pain following a root canal treatment is normal and usually settles within about a week. The tissue around the root tip was irritated during the procedure and needs time to calm down.
What is normal:
- A tender tooth for the first few days, especially when biting or chewing on that side.
- A nagging or lightly throbbing feeling that eases day by day.
- Symptoms manageable with an ordinary painkiller (paracetamol or ibuprofen).
- Largely gone after about a week. If the infection was severe beforehand, it takes a little longer.
When to call us:
- The pain gets worse after a few days instead of easing.
- Your cheek swells, or you develop a fever.
- You can barely open your jaw.
- The temporary filling has come out.
- After two weeks the pain is still unchanged.
- Months or years later the pain returns — retreatment is sometimes needed.
You are always welcome to call, even if you are unsure whether it is “bad enough”.
How long does it take, and why sometimes two appointments?
A root canal treatment takes roughly 45 to 90 minutes per appointment and is completed in one or two visits. The number of canals drives the time: a front tooth usually has one, a premolar two, a large molar three to four.
In one appointment if the tooth is relatively calm and the infection limited.
In two appointments if the infection is severe or the tooth is very painful. At the first visit we remove the inflamed tissue, clean the canals and place a disinfecting medicine under a temporary filling. That medicine works for one to two weeks. At the second visit we fill the canals permanently.
So a second appointment is not a sign that something went wrong. Sealing a canal permanently while bacteria are still inside is asking for trouble later. A little patience gives a better result — and you will usually notice the worst pain is gone after that first visit.
What does it cost, and what does insurance cover?
Dental tariffs in the Netherlands are set by law by the Dutch Healthcare Authority (NZa) and are the same at every dentist. No practice may deviate from them, so you pay no more and no less here than elsewhere.
If you have recently moved to the Netherlands, the system works differently from many other countries:
- Basic insurance (basisverzekering) — for adults, dental care is in principle not covered. For children under 18, a root canal treatment normally is covered.
- Supplementary insurance (aanvullende tandartsverzekering) — an optional add-on that reimburses part of the cost, depending on your policy.
- The number of root canals — a front tooth with one canal falls under a different tariff than a molar with four.
- The build-up afterwards — a treated tooth often needs a crown, which is a separate tariff.
For anything above €250 you receive a written estimate in advance. No surprises afterwards: you know the cost before we begin.
Front tooth or molar: does it matter?
Yes — the number of root canals differs per tooth type, and that determines both the duration and the tariff of a root canal treatment.
| Tooth type | Root canals | Effect on treatment |
|---|---|---|
| Front tooth or canine | usually 1, straight | quickest; lowest tariff |
| Premolar (small molar) | typically 2 | medium |
| Molar (large molar) | 3 to 4, often curved | longest session; most precision work |
With a front tooth there is something extra: the result is visible. A treated front tooth can darken over time, because the tissue inside has been removed. There are ways to address that — internal bleaching or a veneer — but it is better to know in advance than to discover it later. If a visible tooth is involved, we discuss the aesthetic side straight away.
Anxious about the dentist? That’s welcome here
Dental anxiety is not a reason to stay away, but a reason to tell us in advance. We know that “root canal” is, for many people, the most frightening phrase in dentistry.
Dentist Ghafari has practised in the Netherlands for over twenty years and has increasingly focused on treating anxious patients and children. She specialises in carefully guiding patients through treatment — and her particular affinity is endodontics. That is no coincidence: this is precisely the treatment where calm and explanation make the most difference.
What that means in practice:
- Talk first, treat later. You are welcome to come and meet us without anything happening that day.
- Everything is explained — what we do, what you will feel, how long it takes. Unknown is scarier than unpleasant.
- You set the pace. We agree a stop signal: hand up means stop, no discussion.
- Generous scheduling. For an anxious patient we allow more time. Haste is the enemy of calm.
Infection: recognising the signs and when it’s urgent
A root canal infection usually causes a persistent, throbbing pain that does not fade once the trigger is gone — and that is what distinguishes it from an ordinary sensitive tooth. Recognisable signals:
- Throbbing pain that worsens when you lie down or bend forward.
- Lingering pain from hot or cold, long after the glass or cup is gone.
- Pain when biting down or tapping on the tooth.
- A tooth that is darkening.
- A small bump on the gum near the root, sometimes with a bad taste.
- Pain that disappeared on its own — the nerve may have died; the infection continues.
When it is urgent: a swollen cheek, fever, a jaw you can barely open, or pain that painkillers no longer control. Do not wait until Monday — see our emergency page for what to do.
Root canal treatment in Voorschoten — in English
Tandartspraktijk Voorschoten carries out root canal treatments in the centre of Voorschoten, and treats patients in English as well as Dutch. We are easily reached from Wassenaar, Leiden, Leidschendam and the wider Den Haag area — which matters if you would rather discuss a treatment like this in your own language.
In pain, or referred by your dentist for a root canal treatment? Call us — we will first look calmly at where the pain is coming from and discuss what is needed, including the honest trade-off between treating and extracting.
Not registered with us yet? We are accepting new patients. You can register online, and if you are in pain we will always see what is possible at short notice.
