Level 17, 111 Elizabeth Street, Sydney NSW 2000
Level 17, 111 Elizabeth Street, Sydney NSW 2000
General Dentistry · Endodontics
Root canal treatment removes infected or dead pulp from inside a tooth, disinfects the canal system and seals it, allowing you to keep a natural tooth that would otherwise be lost. Done to the highest standard it is one of dentistry's most technically demanding and most successful procedures. It is also the subject of a genuine debate in holistic dentistry, because no root canal can be guaranteed perfectly sterile. At Sydney Holistic Dental Centre we present both sides of that debate honestly, we perform root canal treatment with 3D cone beam imaging and surgical microscopy when you choose it, and we offer a careful biological extraction pathway when you choose otherwise. Led by Dr Craig Wilson, who holds a graduate diploma in clinical endodontics.
Image of Root Canal Treatment
Each tooth contains dental pulp: nerves, blood vessels and connective tissue. When deep decay, a large filling or trauma injures the pulp beyond recovery, it dies, and the canal system becomes a protected space where bacteria multiply beyond the reach of your immune system and antibiotics. Left untreated, infection spreads to the bone around the root, often forming an abscess.
Two important facts follow: the problem does not resolve on its own, and pain is a poor gauge of it. A dying nerve can stop hurting entirely while the infection continues, which is why 'it settled down' is not the reassurance it feels like.
Once a pulp is irreversibly damaged, there are two paths, and honest dentistry names them both plainly.
Option
What It Involves
Key Considerations
Root canal treatment
The canal system is located, measured, cleaned, disinfected and sealed; the tooth is then restored, usually with a ceramic crown or onlay.
Preserves your natural tooth, bite and bone stimulation. Success depends heavily on technical quality. Residual bacteria cannot be reduced to absolute zero.
Extraction and replacement
The tooth is removed using a careful biological technique; the gap is restored with an implant, bridge or denture, or in some cases monitored.
Removes the infected tooth entirely. Replacement adds cost and treatment time, and no replacement is quite the equal of a healthy natural tooth.
Modern endodontics, performed with rubber dam isolation, microscopy and 3D imaging, achieves high published success rates, and the mainstream position of the Australian Dental Association and the American Association of Endodontists is that root canal treatment is safe and effective, with no sound evidence linking properly treated teeth to systemic disease. When post-treatment imaging shows bone healing around the root, the immune system is demonstrably managing whatever minimal bacterial load remains. Keeping a natural tooth preserves bone, bite force, and adjacent teeth in ways no replacement can fully match.
The canal system is microscopically complex, with lateral canals no instrument can reach, so complete sterility cannot be guaranteed, only minimised. The precautionary view holds that a persistent low-grade bacterial presence inside the body is a burden some patients, particularly those with compromised immune function, may reasonably choose to avoid. Not all root canal treatment is performed to the standard the success statistics describe, and a poorly done root canal is genuinely a problem. Patients who prefer extraction over retaining a treated tooth are making a considered choice, not an irrational one.
"I trained in endodontics because if this procedure is worth doing, it is worth doing at the highest standard that exists. My advice differs patient by patient: the tooth, the imaging, the person's health picture and their own values all count. What never changes is that the patient hears both cases before deciding, and I tell them honestly what I would do if it were my tooth."
DR CRAIG WILSON — PRINCIPAL DENTIST (GRAD DIP CLINICAL ENDODONTICS)
Craig image
1
Lingering pain to hot or cold that continues after the stimulus is removed, rather than fading in seconds.
2
Spontaneous toothache, especially at night, or pain on biting and release.
3
A tooth that hurt for a while and then went quiet. A nerve that dies stops reporting, and silence is not the same as health.
4
A pimple-like swelling on the gum near a tooth, which can be a draining abscess, often painless.
5
Darkening of a single tooth, particularly after an old injury, sometimes years later.
6
An abscess or bone change found on routine X-ray with no symptoms at all, which is how a large share of these problems are discovered.
The honest secret of the root canal debate is that both sides are often describing different procedures. A root canal performed blind on a molar with three curved canals is a different operation to the same tooth treated under a surgical microscope with 3D imaging of the canal anatomy, rubber dam isolation, electronic length measurement and modern antimicrobial irrigation.
The published success rates belong to the second procedure. At SHDC, that second procedure is the only one on offer, and Dr Wilson's graduate diploma in clinical endodontics exists precisely because this is a field where craftsmanship is the treatment.
Image of Craig with patient and equipment
We define success the objective way: the infection resolved, the bone around the root regenerating on follow-up imaging, and a comfortable, functioning tooth under a sound restoration. Every root canal treated tooth at SHDC is reviewed on that standard, because a root filling without follow-up is a promise nobody checked. Where healing does not progress as it should, we say so early and revisit the options, including retreatment or the extraction pathway, with the same honesty as the original decision.
1
3D cone beam imaging to map the true anatomy of the root system and the state of surrounding bone, beyond what a flat X-ray can show.
2
An honest prognosis for this specific tooth: some teeth are excellent root canal candidates; others are poor ones, and we say so.
3
Your whole health picture, including immune considerations, in the assessment.
4
Both options costed side by side in writing, including what replacement would involve if you choose extraction.
5
Time. This decision is almost never an emergency once acute infection is controlled, and we will not rush you.
Treatment is performed under rubber dam isolation with high-powered magnification, the canal system measured electronically and cleaned with modern antimicrobial irrigation protocols. Most cases take one to two visits, and the tooth is then restored with a crown or onlay to protect it long term. We monitor healing with follow-up imaging to confirm bone regeneration around the root, which is the objective measure of success.
We use a careful biological technique: preserving bone wherever possible, thoroughly cleaning (curetting) the socket, and using your own platelet-rich fibrin (PRF) to protect the site and support healing. Replacement options, including the ceramic implant pathway, are planned before the tooth comes out, so you are never left without a plan for the gap. Details are on the Biological Extraction and Ceramic Implant Pathway pages.
Is root canal treatment painful?
The procedure is performed under local anaesthetic and most patients report it feels similar to a long filling appointment. It is the untreated infection that causes the pain root canals are famous for.
How long does a root canal treated tooth last?
With a quality root filling and a proper crown, many treated teeth last decades. Longevity depends on the technical standard of treatment, the restoration on top, and your ongoing oral health, which is why we monitor with follow-up imaging.
Do root canals cause disease elsewhere in the body?
The mainstream evidence does not support that claim, and we do not make it. The honest version of the concern is narrower: sterility cannot be absolute, and some patients weigh that differently, particularly with compromised immunity. Both readings are on this page because you deserve both.
Can I have the tooth out instead?
Yes. Extraction with a planned replacement is a legitimate choice, and for some teeth and some patients it is the better one. We will give you an honest recommendation either way.
What does it cost?
Root canal treatment is priced by the tooth's complexity (front teeth have one canal; molars have three or more) plus the restoration afterwards. Both paths are costed in writing at assessment.
Book a comprehensive consultation and we'll assess your tooth honestly, present both paths with costs, and give you time to decide.
BOOK A COMPREHENSIVE CONSULTATIONCraig image
Dr Craig Wilson
Principal Dentist — Grad Dip Clinical Endodontics
Dr Craig Wilson has practised at Sydney Holistic Dental Centre since its founding and holds a graduate diploma in clinical endodontics. He leads the practice's endodontic programme.
