2650 Lake Sahara Dr., Suite 160, Las Vegas, NV 89117 New Patients Emergencies 702-734-0776
Sandquist Dentistry
Restorative Care

Root Canal Treatment

Diagnosed here, treated by a specialist we trust

Updated September 15, 2026

Here’s how a root canal works in our office, in a nutshell.

We figure out whether you actually need one. An endodontist does the root canal. We rebuild the tooth afterward, usually with a crown, and we plan both parts as one sequence from the start.

If you’re still trying to figure out whether your symptoms point to a root canal at all, that has its own article, including the tooth that stops hurting but hasn’t actually gotten better. This page is about what happens once it looks like you need one.

First, making sure it’s a root canal

Several things can feel like a tooth that needs a root canal: a cracked tooth, pain coming from the other jaw or a sinus, grinding, or just a filling that sits a little high. You don’t want to treat the wrong tooth, or treat a tooth that didn’t need it.

So we test instead of guessing. We put cold on the tooth we suspect and on the teeth next to it, tap to check the tissue around the root, and take digital X-rays to look for the dark spot at the root tip that shows up once infection has reached the bone. When a regular X-ray can’t show enough, 3D CBCT imaging can.

Comparing with the teeth next to it is the key part. A tooth that responds differently from its neighbors is telling you something. A tooth that responds the same way probably isn’t the problem, no matter how much it hurts.

Why an endodontist does the root canal

An endodontist is a dentist with extra specialty training in exactly this, who does root canals all day. The canals inside a tooth are tiny, curved and often more complicated than an X-ray shows, and endodontists usually work under a surgical microscope.

It’s the same reasoning we use for surgery: some cases that look routine aren’t, and you often can’t tell which until you’re in the middle of one. Instead of doing the easy ones and referring the hard ones, we send them all to someone who’s better at it, and we keep the diagnosis and everything that gets built afterward.

What goes with you

  • What we found, and why we think a root canal is the answer.
  • Your X-rays, and 3D images if we took them.
  • The plan for rebuilding the tooth, so the endodontist knows it’s getting a crown and when.

The endodontist then does their own exam and makes their own treatment decisions. Once in a while, they decide the tooth can’t be reliably saved. If that happens, we’d much rather know before treatment than after.

What decides whether it lasts: the crown

A back tooth that’s had a root canal almost always needs a crown, and it’s better to hear that at the start than as a surprise later. The treatment hollows out the inside of the tooth, and the tooth has usually already lost structure to the decay or crack that made the root canal necessary. What’s left is more likely to split when you chew.

And the crown shouldn’t wait. A study of back teeth treated at a university endodontic clinic over eight years found two things worth knowing:

  • Teeth that only got a filling or buildup were about 2.3 times more likely to be pulled than teeth that got a crown.
  • Teeth that got their crown more than four months after the root canal were more than three times as likely to be pulled as teeth crowned within four months.

Pratt I, Aminoshariae A, Montagnese TA, et al. Eight-year retrospective study of the critical time lapse between root canal completion and crown placement: its influence on the survival of endodontically treated teeth. J Endod. 2016;42(11):1598-1603. Hazard ratios 2.29 and 3.38. A retrospective study from a single graduate clinic, so it shows an association and doesn’t prove the delay caused the losses.

This is a common way a successful root canal still ends with the tooth coming out. The treatment works, the tooth stops hurting, life gets busy, and months later a tooth with only a temporary filling on top cracks. That’s why we plan the crown before the root canal starts, not after.

Front teeth are different. A front tooth that hasn’t lost much structure and doesn’t do heavy chewing doesn’t always need a crown, and we decide that tooth by tooth.

How long a tooth lasts after a root canal

Generally, a long time. A systematic review of fourteen studies put tooth survival after a root canal at 86% at two to three years, 93% at four to five years, and 87% at eight to ten years.

Ng YL, Mann V, Gulabivala K. Tooth survival following non-surgical root canal treatment: a systematic review of the literature. Int Endod J. 2010;43(3):171-189. Most included studies were retrospective and differed a lot in design, which the authors noted makes direct comparison difficult. Read the figures as a broad range, not a precise prediction.

That matters because the alternative to a root canal is usually losing the tooth. Keeping your own tooth keeps something no replacement fully matches: the ligament that holds it in the bone, and the natural feel of your bite that comes with it. Our article on implants makes that case, even while arguing implants are the best replacement.

If the tooth can’t be saved

Sometimes the crack goes too deep, there isn’t enough tooth left to rebuild, or an old root canal has failed in a way that redoing it probably won’t fix. Then the conversation turns to what replaces it. It’s much better to have that conversation before the tooth comes out, because the plan for the space can change what the surgeon does that day. How we plan implants.

About cost

The endodontist sets and bills their own fee. The root canal and the crown after it are one sequence with a real combined cost, and we’d rather you see the whole number at the start. That combination is also one of the most common ways people use up their dental insurance annual maximum all at once. How insurance works here.

In pain right now?

If you have tooth pain today, call 702-734-0776 and we’ll get you in as quickly as we can. If you have swelling spreading toward your eye or into your neck, trouble swallowing or breathing, or a fever with swelling, go to a hospital emergency room. Our emergency page explains why.

Root canal treatment is referred to endodontists. Diagnosis, planning and the restoration afterward are done here. Survival figures are pooled or single-study results and can’t predict how any one tooth will do. This is general information, not a substitute for an exam.

Common Questions

Do you do root canals?

We diagnose them and rebuild the tooth afterward. The root canal itself is done by an endodontist, a dentist with specialty training who does root canals all day, usually under a surgical microscope. The canals inside a tooth are often more complicated than an X-ray shows, and a case that looks routine can turn out not to be. We plan the root canal and the crown after it as one sequence.

How do you know I need a root canal and not something else?

We test instead of guessing. We put cold on the tooth we suspect and on the teeth next to it, tap to check the tissue around the root, and take digital X-rays to look for the dark spot at the root tip that shows up once infection has reached the bone. When a regular X-ray can’t show enough, we use 3D CBCT imaging. Comparing with the neighboring teeth matters most, because a cracked tooth, pain coming from somewhere else, grinding and a high filling can all feel like a tooth that needs a root canal.

Do I need a crown after a root canal?

A back tooth almost always does. A root canal hollows out the inside of the tooth, which has usually already lost structure to decay or a crack, and what’s left is more likely to split when you chew. In an eight-year study of back teeth at a university endodontic clinic, teeth that only got a filling or buildup were about 2.3 times more likely to be pulled than teeth that got a crown. Front teeth that haven’t lost much structure don’t always need one, and we decide that tooth by tooth.

How soon after a root canal should I get the crown?

Soon. In the same eight-year study, back teeth crowned more than four months after the root canal were more than three times as likely to be pulled as teeth crowned within four months. It was a retrospective study from one clinic, so it shows an association, not proof. But it matches a common story: the tooth stops hurting, the crown gets put off, and later a tooth with only a temporary filling cracks. That’s exactly why we plan the crown before the root canal starts.

How long does a tooth last after a root canal?

Generally, a long time. A systematic review of fourteen studies put tooth survival at about 86% at two to three years, 93% at four to five years, and 87% at eight to ten years after a root canal. The studies varied a lot in design, so read those as a broad range. Getting a crown on a back tooth in good time is one of the things that helps it last.

Is a root canal better than pulling the tooth?

When the tooth can be reliably saved, usually yes. Keeping your own tooth keeps the ligament that holds it in the bone and the natural feel of your bite, which no replacement fully matches, and it avoids the months of healing an implant takes. When the tooth can’t be reliably saved, because a crack goes too deep or there isn’t enough tooth left to rebuild, taking it out and replacing it may be the better plan. That’s worth deciding before anything comes out.

Can an old root canal be redone?

Often. A failed root canal can sometimes be redone by an endodontist, who will look at the tooth and the images to decide whether redoing it is likely to work. If it isn’t, the conversation turns to what should replace the tooth.

How much does a root canal cost?

The endodontist sets and bills their own fee and will give you an estimate. The root canal and the crown after it are one sequence with a combined cost, and we’d rather you see the whole number at the start. That combination is one of the most common ways people use up their dental insurance annual maximum in a single year.

Is tooth pain with swelling an emergency?

If you have swelling spreading toward your eye or down into your neck, trouble swallowing or breathing, a change in your voice, or a fever with swelling, go to a hospital emergency room, not a dental office. In rare cases a tooth infection can spread into the neck and affect your airway. A toothache without those signs, however painful, is a call to us so we can see you as soon as possible.

Told you need a root canal?

Tell us what is going on and we will help you find the piece that is missing. No pressure, no obligation.

Schedule an Appointment → Or call: 702-734-0776