Root canal treatment in Malta: stop the pain and keep the tooth
Root canals have a worse reputation than they deserve. The tooth is fully numbed for it, and most people walk out saying it was nothing like as bad as they had braced themselves for.
What a root canal is, and why a tooth needs one
Inside every tooth, beneath the hard enamel and dentine, there is a soft centre called the pulp — a small bundle of nerve and blood vessels that runs from the crown of the tooth down through narrow channels in the roots, the canals. The pulp does its real work while a tooth is forming; once the tooth is mature it can get along without it. When that pulp becomes infected or badly inflamed, though, the tooth cannot heal itself, and there are really only two ways forward: clear the infection and keep the tooth, or take the tooth out. A root canal is the first of those. It removes the diseased pulp, cleans and disinfects the empty canals, and seals them so bacteria cannot find their way back in — so the tooth stays, and only the trouble inside it goes.
The pulp usually gets into difficulty for one of a few reasons: decay that has reached deep enough to touch the nerve, a crack or a knock that has let bacteria in, or a tooth that has simply had a lot of work done on it over the years. Whatever the cause, an infected pulp does not settle on its own, which is why leaving it rarely ends well. The good news is that caught in reasonable time, a root canal is a routine, predictable piece of dentistry, and the tooth it saves is still your own.
Does it actually hurt? The reputation versus the reality
Root canals have a worse name than they deserve, and most of that reputation is decades out of date. The tooth is fully numbed with a local anaesthetic before anything begins, so during the appointment you should feel pressure and movement but not pain — most people tell us afterwards that it was not far off having a filling. The pain that people associate with the words “root canal” is almost always the toothache or abscess that sent them in, not the treatment. The treatment is the thing that takes that pain away. Modern tools make a real difference here too: fine rotary instruments shape the canals gently and efficiently, and an apex locator measures each canal precisely so it is cleaned to just the right depth. Afterwards the tooth and gum can feel tender for a few days, which ordinary painkillers handle easily, and that settles rather than builds.
The signs that point to a root canal
Several things can hint that the pulp is in trouble: a toothache that will not let up or wakes you at night, hot or cold that hurts and then lingers long after the drink or the food has gone, pain when you bite down, a tooth going darker than its neighbours, tenderness or swelling in the gum, or a small recurring spot like a pimple on the gum that comes and goes. Not every one of these means a root canal, and occasionally an infected tooth gives little warning at all and is only spotted on an X-ray taken for another reason. That is exactly why we take an X-ray before deciding — it shows what is happening inside the tooth and at the root tip, and tells us honestly whether a root canal is the right call or whether the tooth is past saving.
When is root canal treatment needed?
The trouble starts when the soft pulp inside a tooth — the nerve and blood supply — gets infected or inflamed. That can follow deep decay, a crack, repeated work on the same tooth, or a knock. Once the pulp is infected it does not recover on its own, and if it is ignored the infection spreads down to the bone and the tooth is often lost.
Severe or persistent toothache
Prolonged sensitivity to hot or cold
Darkening of the tooth
Swelling or a gum abscess near the tooth
The goal is to save your natural tooth
Nothing replaces a natural tooth quite as well as the tooth itself, so wherever it is sensible we try to save it. A root canal followed by a crown, with decent hygiene afterwards, can keep that tooth working for life — usually a simpler and cheaper path than taking it out and replacing it later.
Preserves your natural tooth and root
Avoids the cost and recovery of extraction and replacement
Treated tooth restored with a crown for strength
Normal eating and function restored
Root canal treatment at Apex Dental, with prices
How involved a root canal is depends mainly on which tooth is affected and how many canals it has. These are the ways it is treated and priced — all including the filling that seals the tooth once the canals are clean.
A front tooth
Front (anterior) teeth usually have a single canal, so treatment is more straightforward and quicker. Root canal treatment on a front tooth is €250, including the filling.
A back tooth
Molars and premolars have several canals to clean and seal, which is more work. Root canal treatment on a back (posterior) tooth is €280, including the filling.
Re-treatment
A tooth that has had a root canal before can flare up again if bacteria find their way back in. Re-treating it — reopening, cleaning and resealing the canals — is €320.
A post and core
Where little natural tooth is left above the gum, a post set into the canal gives the filling or crown something solid to hold onto. A post and core build-up is €70.
A crown afterwards
Most root-treated teeth, especially back ones, are crowned afterwards to stop them cracking. A crown is priced separately and quoted before we start.
When it cannot be saved
Occasionally a tooth is too broken down for a root canal to be worthwhile. We will tell you honestly rather than treat a tooth that will not last, and talk through replacing it.
Saving the tooth, or taking it out?
When the nerve of a tooth is infected there are really two paths: clear the infection and keep the tooth with a root canal, or take the tooth out. Saving it is usually the better first option. Your own tooth sits and bites in a way no replacement quite matches, and an extraction leaves a gap that in turn needs a bridge, an implant or a denture — more treatment, and more expense, over time. A root canal followed by a crown is often the simpler path. When a tooth genuinely cannot be saved, we say so honestly and go through the options for replacing it.
Keeps your own tooth and root in place
Avoids the gap an extraction leaves behind
Often simpler and cheaper than extraction and replacement
Honest advice when a tooth truly cannot be saved
What to expect, step by step
Assessment and X-ray
We examine the tooth and take X-rays to see the canals and how far the infection has reached, and to confirm a root canal is the right call rather than an extraction.
Cleaning the canals
With the tooth numbed, we remove the infected pulp and clean, shape and disinfect the canals to clear out the bacteria causing the trouble.
Sealing the tooth
The cleaned canals are filled with a sealing material to keep bacteria from getting back in, and a filling closes the tooth.
Crown placement
In most cases we follow up with a crown, which protects the now more brittle tooth from cracking and gets it back to full strength.
Front tooth or back tooth, and making the result last
Why a front tooth and a back tooth are not the same job
Not all root canals are equal, and which tooth is affected is the main thing that decides how involved the treatment is. The front (anterior) teeth usually have a single, fairly straight canal, so cleaning and sealing them is more straightforward and often done in one visit. A front tooth can sometimes be restored with a filling alone afterwards, though a crown or veneer is advised where a lot of the tooth has been lost. The back teeth — the molars and premolars — are a bigger task: each has several canals, often curved, which all need to be found, cleaned and sealed, and that simply takes more time and care. Back teeth also take the brunt of chewing, so they are nearly always crowned afterwards to stop them cracking. This is why the fee for a back tooth is higher than for a front one; it reflects the extra work, not a different standard of care.
How long a treated tooth lasts
A tooth that has had a good root canal, been properly sealed and crowned where needed, and is kept clean can serve you for the rest of your life. The two things that matter most are protecting it from fracture — which is what the crown does on a back tooth — and keeping up your regular check-ups so anything is caught early. A root canal is not a guarantee, and very occasionally a tooth becomes re-infected if bacteria work their way back in, but this is uncommon when the tooth is restored well and looked after. Where it does happen, the tooth can often be re-treated rather than lost.
What happens if you leave an infected tooth
An infected pulp does not get better by itself. Left alone, the infection travels down through the root into the bone, where it often forms an abscess, and the pain and swelling usually get worse rather than fade — sometimes flaring up badly at the least convenient moment. By that stage the tooth is frequently beyond saving, and the treatment needed is bigger than it would have been. Losing the tooth then leaves a gap that in turn wants filling, whether with a dental implant, a bridge or a denture, which is more treatment and more expense over time. Dealing with an infected tooth early is almost always the simpler, cheaper and more comfortable path, which is the real reason not to sit on a toothache.
After the root canal: protecting the tooth
A tooth that has had its nerve removed is no longer fed from the inside, so over the years it can become more brittle and crack under normal biting. That is why we usually fit a crown over a root-treated tooth — particularly a back tooth, which takes the brunt of chewing — to hold it together and bring it back to full strength. For a few days afterwards the tooth and gum can feel tender, which ordinary painkillers manage, and favouring the other side helps. Once it is crowned and settled, you care for it exactly like any other tooth.
A crown guards the tooth against cracking
Mild tenderness for a few days, eased with painkillers
Cared for like a natural tooth once healed
Regular check-ups keep it in good order
A painful tooth that will not wait
A tooth heading for a root canal often announces itself with pain that builds rather than fades, and that is not something to sit on — the sooner the infection is dealt with, the more straightforward the treatment tends to be. Root canal treatment at Apex Dental is carried out by our general and restorative dentists at our main clinic at Trident Park in Mrieħel and at St Anne’s Clinic in Birkirkara, both in central Malta. Both clinics are open six days a week, and Trident Park also covers dental emergencies on Sunday mornings, so a tooth that flares up over the weekend does not have to wait until Monday.
Carried out by our general and restorative dentists
Two clinics in central Malta — Trident Park and St Anne’s
Open six days a week at both clinics
Sunday morning emergency cover at Trident Park
Transparent pricing — no surprises
Root canal prices include the filling that seals the tooth. A post or a crown afterwards is priced separately, and only when the tooth needs it.
View full price listFrequently asked questions
Concerned about a painful tooth?
Toothache and swelling do not sort themselves out, and waiting usually makes the treatment bigger. Book an appointment and we will find out what is going on and deal with it.