Endodontic treatment can often be performed in one or two visits, depending upon the source of the problem and the complexity of the tooth. The first step is to examine, test, and x-ray the tooth. The area is then numbed with local anesthetic to reduce or eliminate pain. Next, a rubber dam is placed to isolate the tooth from the rest of the oral cavity, creating a barrier to prevent bacteria and saliva from entering the tooth during the procedure. We then use a handpiece to open access into the pulp chamber and root canals. Very small instruments are used to clean and shape the pulp chamber and root canals to remove the nerve, blood vessels and connective tissue, and to prepare the canals for the root canal filling material.
Filling the Canals
After the space is cleaned and shaped, we fill the root canals with a biocompatible material which is placed with an adhesive cement to ensure the complete sealing of the root canals. The goal of the filling material is to create a barrier so that no cells, fluids, or other matter enters the tooth at the tip of the root. In some cases, a temporary filling is placed to prevent anything from entering the tooth from your mouth. It is important that this temporary is replaced by a final restoration in a short amount of time as it is not meant for long term wear.
Restoring the Tooth
If the tooth lacks sufficient structure to hold a restoration after the root canal, a core build-up or post will need to be added inside of the tooth. This provides a solid foundation for a crown and fills the hollow space that was created to access the pulp and canals of the tooth. A crown or other restoration is then placed on the tooth to protect and restore it to its full function.
How a Tooth with a Simple Cavity Can Require a Root Canal
Sometimes when a cavity goes untreated and other attempts to treat the tooth have failed, a root canal may necessary. As an untreated cavity progresses, it breaks through the enamel and enters the dentin. The dentin is much softer and once the decay enters this layer, it spreads faster and moves toward the pulp.
Once the decay enters the pulp, the pulp is also exposed to bacteria from your mouth. At this point, you either need to have a root canal or have the tooth extracted. It is also possible for the infection to lead to a condition called bacterial endocarditis, which is extremely serious. It can take years for the cavity to