alternatives to root canals

Losing a tooth can be emotionally challenging. Fortunately, root canal treatments provide a great way to save your tooth. With a 97% success rate being recorded by the US National Institute of Health, root canal treatment is highly recommended as it helps the patient keep their non-vital (dead) tooth mechanically functioning.

Understanding Root Canal Treatment

A root canal is a space within your tooth, which houses the dental pulp. The tooth pulp contains the nerves, blood vessels, lymph vessels and connective tissues which convey sensitivity and pain signals to your brain. They also help to nourish your tooth.

Root canal treatment is a type of dental treatment where the dentist drills through the tooth surface to remove an infected, decayed or sensitive dental pulp, clean the canal, seal the area with a filling and affix a crown that essentially conserves your tooth.

Why you need it

There are some reasons why you might need a root canal treatment;

  • If you have inflammation or an infection in the dental pulp area
  • If you have suffered an oral injury that has exposed the pulp of your tooth causing irreversible inflammation or necrosis (death) of the tooth nerve
  • If your pulp has been exposed by extensive dental caries
  • If you have nerve irritation due to trauma or previous dental restorations such as a deep dental filling

If untreated, a damaged pulp can cause inflammation, which leads to abscess or cyst formation at the root tip causing further pain and infection. A root canal treatment aims to save a tooth from needing to be extracted.

For urgent bookings or pressing teeth related treatment questions, call Savina Clinic today on (+356) 2125 7253 (Malta) / (+356) 2155 7323 (Gozo).

How it works

The root canal procedure involves several steps and is usually carried out over three visits. Your dentist will start by taking a radiograph and removing the damaged section of the tooth pulp. During this procedure, a local anaesthetic will be administered. The inside of your tooth will then be cleaned and disinfected before it is filled with dental material known as gutta-percha and sealed. Once the root canal treatment is completed, your dentist will restore the tooth with a permanent filling followed by crown placement.

What are the symptoms of someone who needs a root canal?

Some of the symptoms you need to watch out for include;

  • Severely sensitive tooth exacerbated by cold or hot stimuli
  • Spontaneous pain in a particular tooth
  • Tenderness (pain) of the tooth when eating or trying to get teeth into contact
  • Localized swelling of the gum around the tooth or swelling of the face
  • Severe trauma to a tooth
  • Tooth severely damaged by caries
  • Pain that wakes you up at night

Are there any downsides with root canal treatment?

While a professional root canal can relieve your pain and infection, there are a few downsides associated with it.

Root canals can fail

When removing the pulp from the tooth, it is impossible for the dentist to remove the nerve tissue from the canal entirely -usually, an average of three miles of microscopic tubules is present within a single tooth. Also, it is not possible to sterilise the pathway, even in a properly done procedure, as instruments and irrigants are unable to sufficiently access the microscopic branches of nerve canals at different angles to the main nerve canal (the root canal system can be compared to tree branches – large main branches with several smaller ones arising from them).  As a result, any remnant bacteria continue to live in the tubules anaerobic environment, potentially causing further inflammation as your immune system tries to fight off the infection.

Crown placement

After the procedure is completed, the dentist places a permanent filling for a few weeks until the tooth settles down completely. However, this expected to be replaced by a permanent cap that can properly protect the weakened dead tooth. However, the permanent cap will need some maintenance with the average crown lasting up to 10 years.

Ineffective in clearing an infection

If during the root canal procedure an infection is present, your dentist will prescribe some antibiotics before the treatment to reduce the remnant bacteria and inflammation. However, sometimes this treatment is not effective, majorly due to the lack of blood supply to the tooth, making it difficult for the medicine to reach the area where the bacteria is located. It is important to note that antibiotics affect your gut flora since they wipe out all bacteria, including the good ones. Therefore, they should only be used where necessary and balanced with probiotics.

Alternative Options to Root Canal


other ways to treat a root canal treatment

This is one of the most popular alternatives to root canal treatment. Instead of keeping a dead tooth, a lot of people opt to have it removed even if it can still function. They are then given several possibilities for closing the gap;

Extraction & replacement with an implant

A dental implant is an artificial root that is screwed into the jawbone and then topped with an artificial tooth. It is made of durable, biocompatible material such as Zirconia or titanium. Today, dental implants are replacing certain root canal treatments because they feel, function and look like a natural tooth. They also don’t get in the way of normal oral activities. A well cared for implant can last much longer than a root-treated, crowned tooth and can therefore potentially save money in the future.

Extraction & replacement with a bridge

A dental bridge is another alternative to root canal treatment. Dental bridge placement involves trimming down at least one tooth on either side of the gap and these are then crowned to support the missing one – three crowns splinted together. These bridges can be costly and might involve trimming down healthy teeth simply to support a missing one.

Extraction & replacement with a partial denture

This is your least expensive options when it comes to root canal alternatives. A few years back, partial dentures were offered by all dentists to replace missing teeth. While the current generation finds it as a questionable choice because of their many disadvantages, they are suitable options where bridge or implant placement is not possible.

Adjuncts to root canal treatment


This treatment aims at disinfecting the tooth as much as possible to promote healing during root canal treatment. It is an important adjunct to such treatment.

Ozone Gas

Ozone gas can also be used to irrigate the root cavity. According to a study done by the Interventional Neuroradiology, this gas penetrates the tubules of the tooth beyond the drilled area to kill bacteria.

Laser Disinfection

A laser beam can also be used to disinfect root canal systems as it can penetrate the network of canals more efficiently than irrigants and can also penetrate beyond the root tip, helping to eliminate any bacteria present in the surrounding bone. It is therefore also highly beneficial in root canal re-treatments (re-doing a root canal filling when a previous one has failed).

Calcium hydroxide

Calcium hydroxide paste is placed inside the root canals between visits physically and chemically inhibit the growth of bacteria. According to the AAE, calcium hydroxide dissolves any dead tissues and inhibits the progression of bacteria and therefore promotes healing.

A report by the American Association of Endodontists (AAE) says that these alternative treatments to root canal don’t compare with the benefits of saving the natural tooth.

Why Root Canal is preferred to Extraction

Most dentists prefer root canal treatment to other therapies due to the multiple benefits it comes with. First and foremost, it enables patients to retain their natural teeth, allowing them to smile with confidence and chew effectively. It is also less expensive than implant or bridge placement. Additionally, according to the AAE, the effectiveness of a root canal treatment is well established, and patients should be more open to it.

Can you prevent the need for root canal treatment?

Yes, by following a healthy diet, following a daily oral hygiene regimen and visiting your dentist for regular check-ups and radiographs. This will help prevent dental caries, which, when undetected or left untreated, can lead to the necessity of root canal treatrment.

Have You Tried Our Free e-Consultation Service?

If you are worried about a dental related issue, interested in travelling to Malta for a dental holiday or have questions about any of the treatments we offer, please contact us using our new free e-Consultation service. One of our highly-qualified team will respond to your query as soon as possible. Our e-Consultation service is live 9am – 6pm Monday to Friday.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.