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Front teeth (incisors and canines) have 1 root and 1 canal. Side teeth (premolars) have 1-2 roots and 1-2 canals. Rear teeth have 3 roots and 3-4 canals (upper molars), or 2 roots and 3-4 [...]]]> All teeth have roots, and canals within these roots. Different teeth have a different number of roots and canals.

Front teeth (incisors and canines) have 1 root and 1 canal. Side teeth (premolars) have 1-2 roots and 1-2 canals. Rear teeth have 3 roots and 3-4 canals (upper molars), or 2 roots and 3-4 canals (lower molars). The cost of private root canal work depends on the particular tooth involved and how complicated the work is. If there is infection this must be removed/resolved and then either a filling or a crown must be placed at the end of the treatment.

A tooth has an outer layer of enamel, and pulp, nerves and blood vessels inside the tooth. Sometimes the pulp can become infected because there has been trauma to the tooth or because of decay, fracture or gum disease, and the tooth can die.

The options are to try and save the tooth with root canal treatment or extract the tooth. If the tooth is left untreated, the infection will spread, bone levels around the tooth will begin to lower, and the tooth may fall out. The patient normally has pain and this can become intense.

To save the tooth with root canal treatment the dentist drills into the centre of the tooth, removes the diseased tissue, cleans out the canal and places a root filling (a rubbery material) in the subsequent space to prevent recontamination. The work can be straightforward and routine and take about 1 hour for the dentist to do, or can be very complicated and take significantly longer than this, and can sometimes involve multiple trips to the dentist. Heavy infection will require more time and will not be routine.

When the root canal work has been completed a filling or a crown will be needed to permanently seal the area.

There is just no incentive for NHS dentists to do complex and time consuming work such as root fillings. In fact doing root canal work can actually penalise an NHS [...]]]> There are lots of stories in the press this week reporting that tooth extractions have soared by 30% in four years. What a surprise!

There is just no incentive for NHS dentists to do complex and time consuming work such as root fillings. In fact doing root canal work can actually penalise an NHS dentist. A NHS dentist has to achieve his UDA target (he is contracted by his Primary Care Trust to do a set number of UDAs, units of dental activity) and because he is allocated the same UDA for doing an extraction (which might take a few minutes) or root canal work (which might take 1-2 hours) the NHS dentist is of course going to suggest an extraction to the patient.

So what is happening? Patients are having their teeth removed unnecessarily when more complex treatment could have saved the teeth. What a scandal.