You can avoid a root canal

Root canal treatment: duration, procedure & costs

What is a root canal treatment?

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

The health insurance company only covers the costs proportionally and under certain conditions. With our dental insurance you will receive up to 100% reimbursement for root canal treatments.

Root canal treatment: when it is needed

Root canal treatment, also called root canal treatment, is often the last resort to save a sick or injured tooth. The result can usually be seen over many years. Nobody needs to be afraid of the procedure these days.

Root canal treatment - when it is really necessary:

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

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

A session lasts an average of 60 minutes, but it 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 that have already been root canal treated with inadequate root fillings are present. Furthermore, the duration 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 physician.

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

Root canal treatment: procedure

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

Before the dentist undertakes the procedure, he usually explains the possible risks and consequences. If the tooth 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 then drilled open to the tooth nerve, the nerve is removed and the individual canals are rinsed with a disinfecting solution. This will eliminate bacteria that have lodged in the walls. The doctor clears out the inside of the tooth with small files (Fig. 2 and 3).

During the root canal treatment, x-rays are taken 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, the treatment can extend over several appointments. In such cases, the tooth is provided with a medicated insert between appointments.

After completing this procedure, the root canal-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 the treatment. The duration of the root canal treatment itself can take up to three hours.

Benefits of root canal treatment

  • The natural tooth is retained and sits firmly in the jaw.
  • Visually, a root-treated tooth does not differ from other natural teeth.
  • Complicated dentures are not necessary.
  • The treated tooth is ideally suited as a support if a bridge over neighboring tooth gaps is necessary at a later point in time.

After the root canal treatment

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. How exactly to proceed further is discussed by the doctor and patient in the post-root canal treatment.

Pain doesn't have to be

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

Pain after a root treatment does not have to be any more. If all areas of the tooth up to the tip of the root have been thoroughly cleaned of bacteria and the tooth is then well sealed, no complaints should follow.

What should I avoid after a root canal treatment?

Avoid hot food and drinks as long as the anesthesia is still effective. Under the influence of anesthesia, it is easy to misjudge temperatures and run the risk of scalding. As soon as the anesthesia wears off, you can eat and drink everything again as usual.

If you are otherwise healthy and normally exercise, there is nothing to prevent you from exercising after a root canal treatment. Sauna, solarium and direct sunlight should initially be avoided.

After the treatment is completed, the affected tooth is sealed against bacteria with a filling and can be carefully loaded again. However, it is not as stable as healthy teeth, which is why you should avoid hard foods such as nuts.

What if the treatment fails?

Root canal treatment is a complicated procedure that is not always successful due to the finely branched root canals. If canals were not cleaned sufficiently or not at all in the first session or if bacteria 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 removed and bacteria in the canals are fought with a drug, if necessary. The success rate for the revision is lower than for an 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.

Extract 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, root treatment can be avoided and the tooth is removed. The implant that is then inserted is veneered in your own tooth color and is then completely inconspicuous.

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


The root tip resection (ESC) is a surgical procedure to preserve teeth. The tip of the root is removed and the inflamed tissue is removed. The bacteria-proof closure of the root canal eliminates infections. The prerequisite for the intervention is that the tooth is worth preserving and can therefore be permanently restored with a filling or crown after the operation.

Medical anesthesia

Despite the success of the treatment, therapeutic 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 due to the fact that every patient is anatomically and biochemically different from others. On the other hand, every tooth has an individual history and a certain initial situation - the individual causes of complaints play an essential role in the prognosis and the success of therapeutic 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 (medical anesthesia) is injected into the affected tooth with a syringe. The pain stimuli are suppressed and 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, as 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 arise:

  • Infections
  • Bleeding
  • Pain and swelling
  • Broken instrument 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 disturbing. The dentist can then whiten the tooth.)

Root canal treatment: costs

Root canal treatment is complex and its costs are correspondingly high. They range from around 200 to 1,000 euros. The respective amount depends on how complex the treatment is and what 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 prior to treatment. You can also see from it how high a possible co-payment will be.

Root canal treatment: does the health insurance pay?

The health insurance company only pays for an upcoming treatment under certain conditions. It is not a question of what a root canal treatment may cost, but rather clearly defined restrictions: the expenses are paid if a tooth is classified as worthy of preservation. The likelihood that the tooth can actually be preserved by 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 preserved. From the middle of the jaw to the treated tooth. In addition, the intervention should avoid a one-sided shortening of the row of teeth to the rear. If the tooth to be treated has a functional denture, it is also worthy of preservation.

If these requirements are not met, the health insurance company will not cover the costs of the treatment. Only an extraction, i.e. the removal of the tooth, is then provided as a health insurance benefit.

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

To increase the success of the treatment, the dentist uses the following - widespread - special procedures: electrometric length measurement or use of electrophysical-chemical methods

Root canal treatment costs609,29 €
Service billable via GKV279,50 €
Own contribution without additional insurance329,79 €
Reimbursement of costs by DFV ZahnSchutz Exclusive329,79 €
Remaining co-payment0,00 €

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

Even if the health insurance company bears the costs of the treatment, patients must take into account an additional payment for root canal treatment. The average fixed subsidy from statutory health insurance is usually around 300 euros. The patient's own contribution or additional payment for root canal treatment can amount to up to 500 euros. Although the root canal treatment is a health insurance benefit, dentists can also offer private services. These are, for example, electrophysical-chemical methods for cleaning and disinfecting the channels or their electrometric length determination. If a surgical microscope is used, this will also be billed according to the private fee schedule for dentists (GOZ). You then have to pay the costs yourself.

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

  • Root revision (re-treatment after unsuccessful treatment),
  • Unclear prospects of success of the treatment (e.g. if the tip of the root is difficult to reach and therefore only treatable to a limited extent),
  • Posterior tooth neither in a complete row of teeth nor unilateral free-end situation nor preservation of existing, usable dentures
Root canal treatment costs834,94 €
Service billable via GKV0,00 €
Own contribution without additional insurance834,94 €
Reimbursement of costs by DFV ZahnSchutz Exclusive834,94 €
Remaining co-payment0,00 €

Additional dental insurance for root canal treatment: what does the DFV do?

Patients also have to pay their own contribution if their health insurance covers the costs of the root canal treatment. If the statutory health insurance company rejects the treatment because the tooth to be treated is classified as “not worth preserving”, the patient is left with the entire cost.

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

Best test winner services for all dental treatments!

The five-time Stiftung Warentest test winner DFV-ZahnSchutz reimburses up to 100% of the costs for your root canal treatment!

  • Up to 100% reimbursement for dental treatment
  • Including measures to eliminate pain
  • Without a health issue
  • Without waiting
Take out additional dental insurance

FAQs on root canal treatment

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

Possible signs of inflammation are:

  • Sensitivity to hot and cold
  • Spontaneous pain (especially at night)
  • Discomfort when biting
  • Sensitivity from knocking to throbbing pain
  • Swelling of the surrounding soft tissue

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

When is a repeat treatment (revision) necessary?

A revision treatment is necessary if bacteria have remained in the canal system during a root canal treatment or have subsequently settled. In such cases, the root filling is completely removed and the entire canal system, including previously overlooked canals, is thoroughly cleaned. Then, as with the initial treatment, filling and sealing take place.

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

A chronic infection often runs smoothly and the consequences only become apparent on the X-ray. The bone around the tooth root dissolves and develops into an acute inflammation with pain, swelling, and pus formation.

Can every tooth be saved with a root canal treatment?

No, not every tooth can be saved with a root canal treatment. If the tooth is severely damaged or if the root is fractured, it can no longer be restored.

How good is the prognosis for my endodontic tooth?

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

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

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

Do I need a check-up?

In order to document the healing process, x-rays of the root-treated tooth are made every 3, 6 and 12 months and then annually up to four years after the treatment.

I am an anxiety patient?

For anxious patients there is the option of having a root canal treatment under sedation or general anesthesia.

All statements without guarantee.