Root canal treatment: duration, expiry – costs

Root canal treatment: duration, course & costs

Many people only go to the dentist when they have severe toothache. Thanks to modern technology and highly qualified medical professionals, the fear of treatment is unfounded. Surgical operations on the tooth root today even make it possible to preserve teeth that were immediately extracted in the past.

What is a root canal?

Root canal treatment (also root canal treatment) is a dental method with which dead or inflamed teeth are preserved. The bacteria are removed with special instruments and the function of the tooth is restored. It therefore does not have to be pulled. Successful root canal treatment can preserve the tooth for many years or even decades.

Root canal treatment: when it is needed

Root canal treatment is often the last option to save a sick or injured tooth. The result can usually be seen for many years. Nobody has to be afraid of the intervention anymore.

Root canal treatment – when it is really necessary:

  1. In case of tooth root infection
    If bacteria attack the tooth substance and are not stopped in time, they reach the inside of the tooth and the tooth root. The undetected or untreated caries often leads to inflammation of the tooth root. Root canal treatment can save the diseased tooth.
  2. Root canal treatment for dentures
    A root canal may also precede the insertion of a crown or dental bridge. If the dentist has to remove a lot of the tooth substance, the dental pulp is partially or even completely exposed. Bacteria could now easily penetrate and cause inflammation of the tooth root. To prevent this possible tooth root infection, the dentist often completely removes the dental pulp. The crown or dental bridge are then secured longer.

How long does a root canal treatment last at the dentist??

A session lasts an average of 60 minutes, but can also take more or less time. The actual duration of treatment depends on the individual case. First of all, it depends on whether an initial or revision treatment is carried out. In the case of revision treatment, teeth with root canal treatment with insufficient root filling are already available. The duration also depends on which treatment technique and which instruments are used. Additional factors are the degree of inflammation and destruction of the tooth as well as the care of the attending doctor.

In most cases, one session is not enough to remove the caries, clean the root canals, and fill the hollow tooth with plastic or cement. On average, two treatment appointments (without diagnostics) are necessary.

Root canal treatment: procedure

The root canal treatment aims to preserve a sick or damaged tooth
(Fig. 1).

Before the dentist undertakes the procedure, he usually clarifies the possible risks and consequences. If the dental nerve (pulp) is still active, i.e. not yet dead, local anesthesia is initiated. The patient does not feel any pain during the root canal treatment. The tooth is now drilled out to the tooth nerve, the nerve is removed and the individual channels are rinsed with a disinfectant solution. In this way, bacteria that have nested in the walls are removed. The doctor clears the inside of the tooth with small files (Fig. 2 and 3).

X-ray images are taken during root canal treatment to assess tooth length and treatment status. If the inflammation has not progressed too far, the tooth can be closed with dense filling material in the first treatment session (Fig. 4). In the case of resistant infections, treatment can extend over several appointments. In such cases, the tooth is treated with medication between appointments.

After completing this procedure, the root-treated tooth is usually crowned so that long-term preservation is guaranteed despite the loss of substance (Fig. 5).

How long the healing phase lasts depends on the condition of the tooth before treatment. The duration of the root canal treatment itself can take up to three hours.

Benefits of root canal treatment

  • The natural tooth is preserved and sits firmly in the jaw.
  • Visually different >After the root canal treatment, the tooth is usually painless. Since it is no longer supplied with blood, it has also become more unstable. In most cases, the treated tooth is then crowned. In the follow-up treatment of the root canal, the doctor and patient discuss exactly how to proceed.

Pain doesn’t have to be

A tooth root treatment does not necessarily have to be painful. The progress in modern dentistry today enables a largely painless root canal treatment. The local anesthetic, which is tailored to the patient, ensures that the sensitive tooth area does not trigger any painful sensations right from the start. For anxiety patients, nitrous oxide can also be used for relaxation. Should a patient still feel pain during the treatment, the dentist will stop immediately and adjust the anesthesia accordingly.

Pain after tooth root treatment is no longer necessary. If all areas of the tooth up to the root tip have been thoroughly cleaned of bacteria and the tooth has been closed well afterwards, no complaints should follow.

What should I avoid after root canal treatment? >Avoid hot food and drinks while the anesthetic is still working. Under the influence of anesthesia, temperatures are easily misjudged and there is a risk of scalding. As soon as the anesthetic wears off, you can eat and drink everything as usual.

If you are otherwise healthy and normally do sports, there is no reason not to be active after a tooth root treatment. Sauna, solarium and direct sunlight should be avoided at first.

After the treatment has been completed, the affected tooth is sealed bacteria-proof by a filling and can be carefully loaded again. However, it is not as stable as healthy teeth, which is why you rely on hard foods such as Nuts should be avoided.

What happens if the treatment fails?

Root canal treatment is a complicated procedure that does not always work due to the finely branched root canals. If canals were not adequately or not cleaned at all in the first session or if bacteria have penetrated the root canal system through the filling, revision treatment (renewed treatment) is necessary. This is similar to the initial treatment, but is more time-consuming. The old filling material is taken out and bacteria in the channels are combated with a medication if necessary. The success rate for revision is lower than for initial treatment.

Root canal treatment: alternative treatment options

Root canal treatment or tooth extraction? Nobody has to make this decision alone. Talking to the dentist will clarify what makes more medical sense.

Pull out the tooth and insert the implant

Some dentists advocate replacing the dead tooth with a ceramic implant. This alternative procedure is chosen when someone does not want a dead tooth in their mouth. In this way, tooth root treatment can be avoided and the tooth is removed. The subsequently inserted implant is veneered in your own tooth shade and is then completely unremarkable.

It is also worth asking if lasers are used for root canal treatment. In conjunction with a special disinfection program and nickel-titanium root instruments, there are positive reports about the increase in healing success.


Root tip resection (WSR) is a surgical procedure for tooth preservation. The root tip is removed and the inflamed tissue is removed. Infections are eliminated by the bacteria-tight closure of the root canal. The prerequisite for the intervention is that the tooth is worth preserving and can therefore be permanently filled with a filling or crown after the operation.

healing anesthesia

Despite the success of treatment, curative anesthesia is one of the most scientifically controversial methods in dentistry, because the therapy does not work equally well for everyone. On the one hand, this is because each patient differs anatomically and biochemically from others. On the other hand, each tooth has an individual history and has a certain starting situation – individual causes of complaint play an important role in the prognosis and the success of a curative anesthesia. In addition, the time of the start of treatment is decisive for the success of the curative anesthesia. If the diseased tooth is still in the reversible, watery inflammatory phase, the alternative method is promising to prevent root canal treatment. A liquid anesthetic (curative anesthesia) is injected onto the affected tooth using a syringe. The pain stimuli are suppressed, the tooth is supplied with nutrients at the same time. The treatment can be repeated up to 3 times, with 2 to 3 days between the individual treatments. However, if the affected tooth is already in the second inflammatory phase, curative anesthesia is excluded, since the tooth nerve (pulp) can no longer heal.

Root canal treatment: risks and complications

Even with the greatest possible care, the following risks and complications may occur:

  • infections
  • bleeding
  • Pain and swelling
  • Instrument breakage in the root canal
  • Injuries to the maxillary sinus or nerves
  • Damage to surrounding teeth
  • Loss of the operated tooth
  • Discoloration of the tooth (due to various metabolic products or iron deposits from the blood, the tooth can turn dark. This is harmless to health, but can be cosmetically disruptive. The dentist can, however, then whiten the tooth.)

Root canal treatment: cost

Root canal treatment is complex and its costs are correspondingly high. They range from around 200 to 1,000 euros. The amount depends on how complex the treatment is and which special procedures are used. But the price of the surgical procedure also varies from dentist to dentist. Patients usually receive an overview of the costs incurred before treatment. You can also see how high a possible own contribution is.

Root canal treatment: Pay the health insurance?

The health insurance company pays an upcoming treatment only under certain conditions. It is not a question of what a root canal treatment may cost, but rather clearly defined restrictions: The expenses are borne when a tooth is classified as worth preserving. The probability that the tooth can actually be preserved through the procedure should therefore be foreseeable. This means that the root canals can be cleaned up to or close to the root tips and then filled. The following additional conditions apply to the root canal treatment of the molars: a closed row of teeth should be maintained. From the middle of the jaw to the treated tooth. In addition, one-sided shortening of the row of teeth to the rear should be avoided with the intervention. If the tooth to be treated has a functional denture, it is also worth preserving.

If these conditions do not apply, the health insurance does not cover the costs of the treatment. In this case, only an extraction, i.e. the removal of the tooth, is provided as cash benefit.

Case study of a root canal treatment in which the SHI contributes to the costs because the tooth is considered worthy of treatment.

To increase the success of the treatment, the dentist uses the following – widely used – special procedures: electrometric length measurement or application of the electro-physical-chemical method

Root canal treatment costs € 609.29
Service billable via SHI € 279.50
Own contribution without additional insurance € 329.79
Reimbursement by DFV ZahnSchutz Exclusive € 329.79
Remaining own contribution € 0.00

How much is my own share for a root canal treatment??

Even if the health insurance covers the costs of the treatment, patients have to factor in an additional payment for root canal treatment. The average fixed grant from the statutory health insurance usually amounts to around 300 euros. The patient’s own contribution or additional payment for root canal treatment can amount to up to EUR 500. Although the root canal treatment is a cash benefit, dentists can also offer private benefits. These are, for example, electrophysical-chemical methods for cleaning and disinfecting the channels or their electrometric length determination. If an operating microscope is used, this is also billed according to the private fee schedule for dentists (GOZ). You must then bear the costs yourself.

Case study of a root canal treatment in which the SHI refuses to cover the costs for the following reasons:

  • Root revision (re-treatment after failed treatment),
  • unclear chances of success of the treatment (e.g. if the tip of the root is difficult to reach and can therefore only be treated to a limited extent),
  • Posterior teeth neither in complete row of teeth nor one-sided free end situation nor preservation of existing, usable dentures
Root canal treatment costs € 834.94
Service billable via SHI € 0.00
Own contribution without additional insurance € 834.94
Reimbursement by DFV ZahnSchutz Exclusive € 834.94
Remaining own contribution € 0.00

Supplementary dental insurance for root canal treatment: What does the DFV do??

Patients also have to pay their own share if they pay for root canal treatment through their health insurance. If the statutory health insurance company refuses the treatment because the tooth to be treated is classified as “not worth preserving”, patients remain at the entire cost.

With the Stiftung Warentest TESTSIEGER DFV-ZahnSchutz Exklusiv (VERY GOOD 0.5) you save up to 100% of your own contribution to root canal treatments. You will receive up to 100% reimbursement for all dental and orthodontic treatments.

FAQs about root canal treatment

How do I know that a root canal treatment is necessary?

Possible signs of inflammation are:

  • Hot and cold sensitivity
  • Spontaneous pain (especially at night)
  • Bite discomfort
  • Knock sensitivity to throbbing pain
  • Swelling of the surrounding soft tissue

Sometimes headache or jaw pain can indicate the need for root canal treatment. In many cases, however, there are no symptoms at all and the inflammation in the bone from the tooth (apical ostitis) only appears on the X-ray image.

When is repeat treatment (revision) necessary??

Revision treatment is necessary if, during root canal treatment, bacteria remain in the canal system or have subsequently resettled. In such cases, the root filling is completely removed and the complete canal system, including any previously overlooked canals, is cleaned thoroughly. Then, as with the initial treatment, filling and closure.

I have no complaints, why do I need root canal treatment?

A chronic infection often runs without complaints and the consequences can only be seen on the x-ray. The bone around the tooth root dissolves and develops into an acute inflammation with pain, swelling and pus formation.

Every tooth can be saved by a root canal treatment?

No, not every tooth can be saved by root canal treatment. If the tooth is severely destroyed or there is a fracture of the root, it can no longer be restored.

How good is the prognosis for my root-treated tooth?

The chances of success for a root canal treatment are very high if the tooth is only inflamed, but the tooth holder and bone are healthy. If the inflammation has already spread and has led to bone disintegration (otitis apicalis) or if the tooth has not been adequately restored (partial crown, crown) after successful treatment, the chances of success decrease significantly.

How can I ensure the health and maintenance of my tooth after treatment??

To ensure long-term success, the tooth must be provided with a suitable, fixed restoration (overlay, partial crown, crown). In this way, the weakened tooth regains full chewing power and is protected from a fracture. To ensure the life of the tooth, patients should pay attention to good oral hygiene, flossing, regular visits to the dentist and professional tooth cleaning.

I need a check-up?

To document the healing process, x-rays of the root-treated tooth are taken at intervals of 3, 6 and 12 months and then annually up to four years after the treatment.

I am an anxiety patient?

Anxiety patients have the option of receiving root canal treatment under sedation or general anesthesia.

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Christina Cherry
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