Most people who come to Casas Clinics are not looking for a root canal. They are coming for a full set of crowns, a smile makeover, or implants with crowns on top. Then the examination happens, and we tell some of them something they were not expecting: before we can crown these particular teeth, two or three of them need root canal treatment first, because there is infection or decay inside them.

That is the conversation this page is about.

It is not an upsell and it is not a complication. It is the difference between crowns that last and crowns that have to be cut off in six months. A tooth with a dying or infected pulp does not stop being infected because something beautiful has been cemented on top of it. The pain arrives later — and by then the only route to the infection is through the crown you have just paid for. A crown placed over an untreated tooth means the crown comes off, the root canal is done, and a new crown is made. Three procedures instead of one, and a second trip.

We would rather tell you on the day of your examination than six months after you fly home.

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AT A GLANCE

• Casas Clinics treats most patients for full-arch crowns, smile makeovers and implants with crowns. Root canal treatment appears in those plans when the examination finds infection or decay inside a tooth that is due to be crowned.

• A tooth whose pulp is infected or dying must have root canal treatment before a crown goes on it. Crowning over it does not stop the infection; it hides it until it becomes painful.

• When a crown is placed over a tooth that needed a root canal, the usual sequence is severe pain weeks or months later, removal of the crown, root canal treatment, and a new crown. You pay for the crown twice.

• Many of the teeth that need this feel completely normal to you. Chronic infection around a root tip is often painless and visible only on a radiograph, which is why we never prepare a tooth for a crown on appearance alone.

• A root canal can usually be completed in one visit. A Cochrane review of 47 trials and 5,805 patients found no difference in one-year healing between single-visit and multi-visit treatment (relative risk 0.93, 95 per cent confidence interval 0.81 to 1.07).

• Single-visit treatment does carry a slightly higher chance of soreness in the first week (relative risk 1.55, confidence interval 1.14 to 2.09), with no difference in swelling or flare-ups. We tell you that before you choose, not after.

• Teeth that are root-treated and then properly crowned do well. Ten-year survival of root-treated teeth pools at 86 to 93 per cent (Ng, Mann and Gulabivala, International Endodontic Journal, 2010), and 94.4 per cent of 517,234 root-treated teeth in a Taiwanese national record study were still in place (Lin and colleagues, Journal of Endodontics, 2014).

• Because your crown was already part of the plan, the restoration that protects the tooth is already accounted for. In your case the question is not whether to crown it. It is what is underneath.

• Canals are missed even in ordinary practice: in a study of 2,305 root-treated teeth, 12 per cent had a canal that had never been found, and 82.6 per cent of those teeth showed infection around the root (Baruwa and colleagues, Journal of Endodontics, 2020).

• We treat inside Özel Florya Hastanesi, a full general hospital in Istanbul, so extensive work — multiple root canals and a full set of crown preparations — can be done under conscious sedation or a general anaesthetic administered by an anaesthesiology and reanimation specialist.

• If root canal treatment is needed, we tell you at the planning stage wherever we can see it, before you book flights — and if it only becomes clear once we are working, we stop and tell you and change the plan rather than finishing inside your dates.

• Your treatment carries a written five-year guarantee: if a complication arises from treatment we performed, the revision is carried out at Casas Clinics in Istanbul free of charge.

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WHY A TOOTH THAT IS GOING TO BE CROWNED MIGHT NEED A ROOT CANAL FIRST

Inside every tooth is a soft core — the pulp — with nerve and blood vessels running down narrow canals to the tip of each root. When decay, a crack, a leaking old filling or heavy previous drilling reaches that core, bacteria get in. The pulp cannot recover once it is infected. It dies, and the infection travels out of the root tip into the bone.

A crown covers the outside of a tooth. It does nothing to the inside. So if the pulp is already infected or dying when the crown is fitted, the infection carries on underneath it.

There are four situations we see most often in patients planning crowns:

Deep decay reaching the pulp. Often under an old filling, often invisible to you, sometimes invisible until the old filling is removed. Once it has reached the pulp, cleaning the decay away is not enough.

Chronic infection at the root tip with no symptoms. The pulp died quietly, perhaps years ago after a knock or a deep filling. There is a dark area on the radiograph at the end of the root and you feel nothing at all. This is the one patients argue with us about, and it is the one most likely to cause trouble under a new crown.

Heavy previous dentistry. A tooth that has already had a large filling, or has already been drilled down for an older crown, has a pulp that is closer to the surface and has been irritated before. Preparing it again carries real risk.

An existing root canal that was not done properly. If a tooth has already been root-treated but the filling is inadequate or a canal was missed, the infection is still there. A new crown over it fails for the same reason. In a study of 3,396 teeth in London patients, 44.3 per cent of existing root canal fillings did not meet European Society of Endodontology standards, and infection around the root was present in 14 per cent of adequately filled teeth against 68.6 per cent of inadequately filled ones (Di Filippo, Sidhu and Chong, British Dental Journal, 2014).

There is one more thing worth knowing, and it is the honest reason we are careful about how many healthy teeth get crowned at all. Preparing a tooth for a full crown removes a lot of tissue and is itself a stress on the pulp. That is an acceptable risk in a tooth that genuinely needs a crown. It is not an acceptable risk in a healthy tooth being crowned only for appearance. The more healthy teeth a treatment plan crowns, the more teeth are exposed to that risk — which is why we plan the smallest intervention that achieves what you came for, and why we will tell you when bonding or veneers would do what full crowns are being proposed for.

 

WHAT HAPPENS IF A CLINIC CROWNS THE TOOTH ANYWAY

This is the section we would like you to read even if you buy nothing from us, because it is the mechanism behind most of what you have read in the British press.

Between 2018 and 2023, 131 articles appeared in UK newspapers about dental treatment abroad. A study in the British Dental Journal in 2025 analysed all of them: 92.4 per cent were tabloid, 80.9 per cent in the Sun or the Daily Mail, and the recurring patient complaints were pain, infection, and what one account called dead stumps under crowns. The same paper was careful to say something that often gets left out, and we agree with it: the "Turkey teeth" label is unfair, and there is no objective evidence that overseas care produces worse outcomes as such.

But the mechanism in those stories is real, and it is almost always this one.

A patient arrives with a fixed number of days and a fixed package price. One or two of the teeth being prepared are not healthy. Treating them properly means more appointments, more cost, and sometimes a second trip. Crowning them without treatment means everything looks finished on the day the patient flies home. Weeks or months later the pulp dies under the new crown, the tooth aches badly, an abscess can form, and the only way in is through the crown.

What that costs the patient, in order: the new crown is cut off and destroyed. The root canal is done, now through a tooth that has already been drilled down and is harder to work on. A new crown is made and fitted. Often a flight back, or remedial work at home at local prices. The British Dental Association surveyed 1,000 UK dentists: 94 per cent had seen patients treated abroad, and of those, 86 per cent had treated post-treatment problems — crowns in 87 per cent of cases, failing or failed treatment 86 per cent, pain 76 per cent. Half of those patients paid more than £1,000 to put it right and one in five paid more than £5,000.

So the question to ask any clinic, including us, is not what the package costs. It is: what will you do if you find an infected tooth on day one of a five-day plan?

Our answer is that we change the plan and tell you what that means in days and in money, before we prepare a single tooth. A clinic that cannot afford to give you bad news in the middle of your treatment is not cheap. It is expensive later.

 

HOW WE FIND IT BEFORE WE START

• Before you travel. You send photographs and any radiographs you have. We tell you what we can see and what we cannot. If we cannot tell from what you send, we say so rather than guessing — an outline plan sent without radiographs is a sales document, not a treatment plan.

• On arrival, before any preparation. Clinical examination and radiographs of every tooth in the plan. Pulp testing where a tooth's vitality is in question.

• Cone-beam CT where it is clinically indicated — complex or additional canals, inconclusive conventional radiographs, a suspected root fracture, a previous root canal that has not healed, perforation or a separated instrument, or surgical planning. We do not scan everybody as routine: the joint position statement of the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology sets out specific indications, and a limited field of view is preferred for lower dose and higher resolution. For scale, a small-field dental scan delivers roughly 11 to 102 microsieverts against a natural background of about 2,400 microsieverts a year.

• Again during treatment. Some teeth only declare themselves when an old filling comes out and the decay underneath is visible. If that happens, we stop and tell you.

• The written plan. Which teeth need root canal treatment, which day each stage happens, what it adds to the cost, and whether it changes the number of days you are in Istanbul.

What we will not do

• We will not prepare a tooth for a crown without looking inside it first.

• We will not crown a tooth with an infected or dying pulp to finish inside your travel dates.

• We will not devitalise a healthy tooth to make a cosmetic case faster or easier.

• We will not quote you a package price that quietly assumes none of your teeth will need anything.

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WHAT IT ADDS TO YOUR TREATMENT, IN DAYS AND IN MONEY

Honest answer: it adds something. Here is what.

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Time. A root canal can usually be completed in one appointment. The 2022 Cochrane review of 47 trials and 5,805 participants found radiological failure at one year was essentially identical between single-visit and multi-visit treatment — relative risk 0.93, confidence interval 0.81 to 1.07, graded moderate certainty — with no difference in swelling or flare-up rates. So finishing in one sitting is not a shortcut, and in a multi-tooth crown plan the root canals are normally done in the same phase as the preparations, before the definitive crowns are made.

The honest cost of single-visit treatment is a slightly higher chance of soreness in the first week: relative risk 1.55, confidence interval 1.14 to 2.09. In a full-arch case, where you are going to be a bit sore anyway, most patients take that trade. It is still yours to make.

 

Treatment period; Root canal treatment does not extend your treatment time.

 

Money. Root canal treatment is charged per tooth and it is not included in a crown price anywhere in the world. We quote it as a separate line so you can see exactly what changed and why. Please check our ''Price List Page'' to see the prices and compare to your home country.. 

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​What it saves you. Compare that against the alternative, which is not "no root canal". It is a root canal later, through a crown that has to be destroyed first, plus a replacement crown, plus either a flight or UK private prices. A tooth treated properly now costs one root canal and one crown. The same tooth crowned over costs one wasted crown, one root canal, and one more crown.

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ON POSTS, AND ON THINGS THAT GET ADDED TO THE BILL

Two places where patients get sold more than the evidence supports. We would rather you knew about both.

Posts. You will sometimes be told the tooth needs a post inside the root to "strengthen" it. A 2022 review screened 495 studies and found only one randomised controlled trial, which showed no significant difference between posts and no posts. In the large UK cohort data, a cast post and core was associated with a higher hazard of tooth loss, around 2.6. We place a fibre post when there is genuinely not enough tooth left to hold the core, and not as a routine addition.

Equipment claims. We are not going to tell you that our microscope raises your success rate, because a Cochrane review in 2015 looked for randomised trials on magnification in endodontics and found none that were eligible. What does have evidence behind it is duller: a rubber dam. In the Taiwanese study of 517,234 teeth, rubber dam use was associated with a lower rate of eventual extraction, adjusted hazard ratio 0.81. It is a basic standard of care and it is widely skipped — in a survey of 524 general dentists, only 44 per cent always used one for root canal treatment and 15 per cent never did, while 100 per cent of endodontists always did. We use one every time. Ask any clinic you are considering whether they do.

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THE CROWN THAT GOES ON TOP

In your case the crown was already the plan, so this is mostly reassurance rather than a decision — but the evidence is worth seeing, because it explains why we insist on finishing the crown rather than sending you home on a temporary.

Teeth that are root-treated and then left without a proper restoration do badly. In a study following 203 root-treated teeth, those that did not receive a crown were lost at six times the rate of those that did — hazard ratio 6.0, 95 per cent confidence interval 3.2 to 11.3 (Aquilino and Caplan, Journal of Prosthetic Dentistry, 2002). In the UK cohort work by Ng, Mann and Gulabivala, a cast restoration reduced tooth loss by roughly sixty per cent, while leaving a temporary restoration in place raised the hazard of loss seven- to eight-fold.

Timing is just as stark. In 4,012 teeth followed for eight years, survival was 72 per cent when the definitive restoration was placed within fourteen days, 51 per cent at fifteen to fifty-nine days, and 39 per cent beyond sixty days (Sadaf, Therapeutics and Clinical Risk Management, 2020).

That is why we plan the definitive crowns around your root canals rather than the other way round, and why we will tell you plainly if your case needs a second trip rather than letting you fly home on temporaries for three months.

One honest counterweight, because it affects what we recommend on back teeth that are not part of a cosmetic arch: a randomised trial published in the Journal of Dentistry in 2025 compared crowns with direct composite in root-treated molars that still had three or more intact walls. Three-year survival was 93.3 per cent with crowns and 76.7 per cent with composite — a difference that did not reach statistical significance, p = 0.061, in a trial of sixty teeth. What was significant was grinding, with a hazard ratio of 12.8. So a largely intact molar outside the visible zone, in someone who does not grind, may not need a crown at all. If that is your tooth, we will say so rather than adding it to the plan.

 

IF YOU ALREADY HAVE CROWNS AND THEY HURT

A number of our patients arrive in exactly this position: crowns fitted somewhere else, in the UK or abroad, and now one or more of the teeth underneath is painful, or there is a dark area on a radiograph, or there has been swelling.

This is treatable and the tooth is usually savable.

• Retreatment through the existing crown. Often the crown can be opened, the old root filling removed, the missed anatomy found, the canal re-sealed, and the access repaired without replacing the crown. Pooled complete healing after retreatment is around 77 per cent (Ng, Mann and Gulabivala, International Endodontic Journal, 2008), and in the UK cohort data four-year survival after retreatment was 95.3 per cent — effectively the same as after primary treatment at 95.4 per cent.

• Retreatment with a new crown. Where the existing crown has to come off, or is poorly fitting anyway.

• Surgery, an apicoectomy. Removing and sealing the root tip from the outside, when retreatment is not possible or has not worked. Technique matters enormously here: a systematic review of 1,624 teeth found 93.5 per cent success with modern endodontic microsurgery against 59.0 per cent with traditional root-end surgery (Setzer and colleagues, Journal of Endodontics, 2010).

• Extraction and replacement. When the root is fractured vertically, when there is not enough tooth above the bone to restore, or when the supporting bone has already gone.

Send us photographs and whatever radiographs you have. We will tell you which of those four we think applies, and we will tell you if we think it can be sorted out where you are rather than on a flight.

 

WHEN THE TOOTH CANNOT BE SAVED — AND WHY WE TRY FIRST

In a full-mouth plan there is often a tooth where the choice is root canal treatment or extraction and an implant. Some clinics reach for the implant. It is worth understanding that an implant and crown is a larger sale than a root canal and crown, and then looking at what the evidence says.

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In a matched study of 196 pairs of root-treated teeth and single implants, failure rates were identical — 6.1 per cent in both groups. The striking difference was in further intervention afterwards: 17.9 per cent of the implants needed additional treatment, against 3.6 per cent of the root-treated teeth (Doyle and colleagues, Journal of Endodontics, 2006). A separate systematic comparison put single-implant survival at 96.0 per cent across 55 studies and restored root-treated teeth at 94.0 per cent across 13 studies, and found no meaningful difference (Iqbal and Kim, 2007). A UK health-economic model published in the International Endodontic Journal in 2009 found root canal treatment extended the life of a tooth at five to eight pounds per year of tooth life, retreatment at twelve to fifteen, with implants justified as a third-line option (Pennington and colleagues).

 

There is also a cost to extraction that appears on no price list: the bone goes. A systematic review of ridge changes after extraction found 3.79 millimetres of width lost in six to seven months — between 29 and 63 per cent of the original width — and 1.24 millimetres of height (Tan and colleagues, Clinical Oral Implants Research, 2012). That loss is why implants placed years after an extraction so often need grafting first.

 

So: save the tooth if it can be saved. Take it out when it cannot. We sell implants and we sell root canals, and we would rather sell you the one your mouth needs, because a patient whose teeth we saved talks about us for twenty years.

 

DOING IT ALL IN ONE GO, ASLEEP IF YOU WANT

A full-arch plan with several root canals in it is a lot of chair time. For some people that is the main obstacle — not the cost, not the flight, the hours in the chair.

Because our dental clinic sits inside a general hospital, we can offer what a dental practice cannot:

• Local anaesthetic alone, for most people, most of the time.

• Conscious sedation, so you are awake, relaxed and remember very little of it.

• A general anaesthetic, in a hospital operating theatre, with an anaesthesiology and reanimation specialist — for severe dental phobia, for very extensive treatment in a single sitting, or where a medical condition makes a long awake appointment inadvisable.

 

In the 2009 Adult Dental Health Survey of 11,382 British adults, 11.6 per cent scored in the high-anxiety range on the Modified Dental Anxiety Scale. The Scottish Dental Clinical Effectiveness Programme's guidance on conscious sedation lists among its indications dental anxiety and phobia, a need for prolonged or traumatic procedures, and medical conditions potentially aggravated by stress. Those three describe most full-mouth cases and most of the people who have been putting this off for a decade.

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Özel Florya Hastanesi performs more than a thousand operations a month, keeps close to a hundred inpatient beds occupied daily, has more than twenty tertiary-level intensive care beds, sees more than four thousand outpatients and more than fifteen hundred emergency attendances a month, and is inspected by the Turkish Ministry of Health several times every year. Cardiology, internal medicine, neurology, respiratory medicine and anaesthesiology are in the same building as the dental chair.

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A recovery room is a room where you wake up. An intensive care unit is where you are kept alive. In Turkey, dental facilities that are not hospitals do not have intensive care at all, and are not permitted to administer general anaesthesia. Our sedation and general anaesthesia page sets out exactly which facilities are legally allowed to do what — it is a shorter list than most patients assume.

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A note on anaesthesia, honestly

A tooth with an acutely inflamed pulp is genuinely harder to numb than a healthy one. In a network meta-analysis of 46 randomised trials and more than 5,000 patients with symptomatic irreversible pulpitis in lower molars, a standard inferior alveolar nerve block achieved adequate pulpal anaesthesia in only about half of cases. The answer is not to push on and hope, and it is not to repeat the same injection. It is to use supplementary techniques — intra-osseous, intraligamentary, or intrapulpal. If you have been told before that you are "hard to numb", this is why. We plan for it.

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If you have a medical condition

Most people with chronic conditions can have a root canal in an ordinary dental surgery, and we are not going to tell you otherwise in order to sell you a hospital.

On blood thinners specifically: the Scottish Dental Clinical Effectiveness Programme classifies orthograde root canal treatment as a low bleeding-risk procedure and advises treating without interrupting anticoagulant or antiplatelet medication. Any clinic telling you that your warfarin or apixaban means you need a hospital for a root canal is either misinformed or selling.

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Where the hospital does matter is sedation and general anaesthesia in people whose general health is poor. The same guidance states that many ASA grade III patients will need referral to secondary care, and that ASA grade IV patients requiring dental sedation should be referred to an appropriate secondary care facility. That is the situation we are built for — and it is also why patients who have been refused extensive dental treatment elsewhere because of their medical history can usually be treated here.

 

DOES IT HURT, AND WHAT IF IT STILL HURTS BEFORE MY FLIGHT

During the procedure, with proper anaesthesia, usually not. Afterwards, often a little, and we would rather give you the real numbers than tell you it is painless. Across published studies, 81 per cent of patients were in pain before treatment, 40 per cent at twenty-four hours, and 11 per cent at one week — with severe pain in 54 per cent before, 24 per cent at a day, and 5 per cent at a week (Pak and White, Journal of Endodontics, 2011).

So some soreness in the first days is normal. It is a tooth and a ligament that have been worked on.

What is not normal: swelling that is increasing, pain that is getting worse rather than better after the third day, fever, or a bad taste.

If that happens while you are still in Istanbul, you come back to the hospital and we see you — the same building, the same records, the same team, with an emergency department on site.

If it happens after you have flown home, you contact us first. If we have a partner dentist or clinic in your region, we refer you there — for examination and X-rays only — and they report their findings to us. If we do not have a partner in your region, you describe the problem and its history to us directly, send photographs, and our dentists in Istanbul review it. If the problem is covered by your guarantee — that is, if it arises from treatment we performed — we invite you back to Istanbul and carry out the revision free of charge.

The partner clinics do not treat you. They are not our branches and they do not take your case over. Their job is to establish what is wrong, close to home, and tell us. The clinic that did the work is the clinic that should be correcting it.

We are not going to pretend that a tooth flaring up two weeks after you land in Manchester is convenient for anybody. We are telling you what actually happens when it does.

 

HOW LONG WILL IT LAST

Be careful with the figures clinics quote, including ours, because success and survival are two different measurements and they give very different numbers.

Survival means the tooth is still in your mouth. Across two to ten years that pools at 86 to 93 per cent (Ng, Mann and Gulabivala, 2010). The Taiwanese national record study of 517,234 teeth found 94.4 per cent survival.

Success means the infection around the root has fully healed on a radiograph. By strict criteria that pools at 68 to 85 per cent across 63 studies (Ng and colleagues, International Endodontic Journal, 2007) — and the same review noted, uncomfortably for the profession, that this had not improved over the preceding four or five decades.

Anyone advertising "98 per cent success" is quoting a survival figure and calling it success.

What makes yours more likely to work, from the same body of research: no infection visible around the root before treatment; the root filling reaching within two millimetres of the tip with no voids; a sound definitive restoration placed promptly; both neighbouring teeth present; the tooth not being used as a bridge anchor; and the tooth not being a molar.

And one that is about who treats you rather than which tooth you have: whether the canals were all found. In that study of 2,305 root-treated teeth, 12 per cent had a missed canal, and nearly two-thirds of all missed canals were in one specific place — the mesiobuccal root of the upper first molar, which was 3.1 times more likely to show infection around the root as a result.

 

COULD THE TOOTH BE TREATED WITHOUT A FULL ROOT CANAL?

Sometimes, and it is worth asking rather than accepting a root canal as automatic on every inflamed tooth.

A systematic review of vital pulp therapy in mature permanent teeth found 93.1 per cent success, including 93.8 per cent in teeth diagnosed with irreversible pulpitis (Sabeti and colleagues, Journal of Endodontics, 2021) — though the authors graded the certainty of that evidence as very low to low. In practice this means that in some teeth, removing only the inflamed part of the pulp and sealing the rest can keep the tooth alive, with no root canal at all.

It is not right for every tooth and the evidence is not yet strong. But a clinic that goes straight to a root canal on every inflamed tooth it is about to crown is making a larger sale than it may need to. We will tell you honestly whether your tooth is a candidate.

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FRONT TOOTH, BACK TOOTH

A front tooth usually has one canal, is straightforward to reach, and in a crown or veneer plan it is already going to be restored. Its particular problem is colour: a root-treated front tooth can darken over time, and ordinary whitening will not correct it, because the discolouration is inside the tooth. If the tooth is being crowned anyway, this is solved by the crown. If it is not, internal bleaching, composite or a veneer are the options.

A molar has three or four canals, sometimes more, and they curve. It takes longer, the chance of a canal being missed is higher, and it carries the heaviest chewing load in your mouth. Being a molar is itself one of the factors associated with lower survival in the published cohort data.

This is also why a molar root canal costs more than a front tooth one, everywhere in the world. A clinic charging the same for both is either overcharging for the front tooth or cutting something out of the molar.

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REGULATED, INSPECTED AND INSURED

Casas Clinics treats patients in the dental clinic of Özel Florya Hastanesi, a licensed private hospital in Istanbul, inspected by the Turkish Ministry of Health several times every year across all of its departments. Our international patient activity is carried out under Turkey's international health tourism regulations.

You are treated by one institution, with one set of records and one clinical team. Not by a dental clinic with an arrangement with a building.

 

QUESTIONS PATIENTS ASK

I came for crowns. Why are you telling me I need a root canal? Because the examination found infection or decay inside one or more of the teeth due to be crowned. A crown covers the outside of a tooth and does nothing to the inside. If the pulp is infected when the crown goes on, the infection continues underneath it.

But that tooth doesn't hurt at all. Chronic infection at a root tip is frequently painless. It shows as a dark area on the radiograph and you feel nothing. That is exactly the tooth most likely to become painful under a new crown, which is why we look rather than ask how it feels.

 

What happens if I just have the crown and skip it? The usual sequence is severe pain weeks or months later, removal of the crown, root canal treatment through a tooth that is now harder to work on, and a new crown. You pay for the crown twice, and often for a flight as well.

 

Is this an upsell? It is a fair question and we would rather you asked it. Our answer: we will show you the radiograph and point at the lesion, we charge root canal treatment as a separate transparent line rather than folding it into a package, and we will also tell you when a tooth does not need something — including when bonding or veneers would achieve what full crowns are being proposed for, and when a largely intact back tooth does not need a crown at all.

 

How much does it add to my treatment? To see the prices and compare to your home country please check our ''Price List'' web page. 

 

How many extra days do I need in Istanbul? Root canal treatment does not extend your treatment time.

 

Can the root canal and the crown be done on the same trip? Usually yes, and that is how we plan it. Placing the definitive restoration promptly matters a great deal: survival at eight years was 72 per cent when it went on within fourteen days and 39 per cent beyond sixty days. If your case genuinely needs a second trip, we will say so before you book the first one.

 

Can the root canal be done in one visit? Usually. A Cochrane review of 47 trials found no difference in one-year healing between single-visit and multi-visit treatment. Single-visit treatment does carry a slightly higher chance of soreness in the first week.

 

Does it hurt? During treatment, with proper anaesthesia, usually not. Afterwards, 40 per cent of patients report some pain at twenty-four hours and 11 per cent at one week.

 

Why does my tooth still ache a few days later? Because the tissue around the root tip has been disturbed. It should improve day by day. Pain increasing after the third day, increasing swelling, fever or a bad taste are different — contact us.

 

Will I need antibiotics? Not routinely. Antibiotics do not replace cleaning the canal; they are prescribed where there is spreading infection or systemic involvement.

 

I have crowns from another clinic and one of them hurts. Can you help? Usually yes. Often the root canal can be done through the existing crown without replacing it. Pooled healing after retreatment is around 77 per cent, and four-year survival after retreatment matches primary treatment at about 95 per cent. Send photographs and any radiographs.

 

Can a root canal be redone through an existing crown? Often, yes. Sometimes the crown has to be replaced, and we tell you that before we start, not during.

 

What is an apicoectomy? Surgery to remove and seal the root tip from the outside, when retreatment is not possible or has not worked. Modern microsurgical technique achieved 93.5 per cent success in a review of 1,624 teeth against 59.0 per cent for traditional technique.

 

Should the tooth just be taken out and replaced with an implant? Sometimes, but not usually as a first move. In a matched study of 196 pairs, failure was identical at 6.1 per cent, while 17.9 per cent of implants needed further intervention against 3.6 per cent of root-treated teeth. Extraction also costs you bone: 29 to 63 per cent of ridge width in the first six to seven months.

 

Can I have all of this done asleep? Yes. Conscious sedation, or a general anaesthetic in a hospital operating theatre with an anaesthesiology and reanimation specialist. Extensive treatment in a single sitting is one of the recognised indications.

 

Why does a general anaesthetic for dental treatment need a hospital? Because of what has to be in the building if something goes wrong. In Turkey, dental surgeries and oral health polyclinics are not permitted to administer general anaesthesia and do not have intensive care. Our sedation and general anaesthesia page sets out which facilities may do what.

 

I'm on blood thinners. Is that a problem? Not for a root canal. Guidance classifies orthograde endodontic treatment as low bleeding risk and advises treating without interrupting the medication.

 

I've been refused extensive dental treatment at home because of my medical history. Can you treat me? Often, yes — that is one of the reasons we work inside a hospital. Send us your medical history and medication list and we will tell you honestly.

 

Will you use a rubber dam? Yes, every time. It is associated with lower eventual tooth loss. It is also widely skipped: only 44 per cent of general dentists in one survey of 524 always used one.

 

Do you scan everybody with CBCT? No. We scan where there is a clinical indication, with a limited field of view for lower dose. Routine screening scans are not supported by the position statements.

 

Will a root-treated front tooth go dark under a crown? No. The crown covers it. Darkening is a problem for root-treated front teeth that are not being crowned, and it does not respond to ordinary whitening because the discolouration is internal.

 

How long will the tooth last? Survival of root-treated teeth pools at 86 to 93 per cent over two to ten years, and 94.4 per cent in a study of 517,234 teeth — provided a sound restoration is placed promptly, which in your case it is.

 

What if it fails after I fly home? You contact us first. If we have a partner dentist or clinic in your region, we refer you there for examination and X-rays, and they report their findings to us. If we do not have a partner in your region, you tell us what has happened and send photographs, and our dentists in Istanbul review it. If the problem is covered by your guarantee, we invite you back to Istanbul and carry out the revision free of charge. The partner clinics diagnose; they do not treat you.

 

Can the partner clinic do the treatment instead of me flying back? No, and we would rather say so now than after you need it. The partner clinics examine and diagnose. The treatment is done by us, in Istanbul, by the team that did the original work and holds your records.

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