The first step in the procedure is to take a digital x-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. We will then use local anesthesia to numb the area near the tooth.
Next, to keep the area dry and free of saliva during treatment, the doctor will place a rubber dam (a sheet of rubber) around the tooth.
An access hole will then be drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals.
Once the tooth is thoroughly cleaned, it is sealed. Sometimes we may prefer to wait a week before sealing the tooth or we may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep out contaminants — like saliva and food — out between appointments.
At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth’s root canal. A temporary is placed again.
The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a dental crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your dentist will discuss the need for any additional dental work with you.