Local anesthesia is administered via injections to numb the tooth to be treated and the surrounding tissues. If the pulp in a tooth is acutely inflamed, and therefore very painful, it may take a while to get it numb, but your dentist will not start the treatment until it is.

A dental dam — a thin sheet of rubber or vinyl — will be placed over the affected and adjacent teeth. The tooth undergoing treatment protrudes through a hole punched in the dam, isolating it from the rest of the mouth. This allows the root canal treatment to be carried out in a sterile environment free from contamination by bacteria found in saliva or the rest of the mouth.

A small access hole is drilled through the biting surface of an affected back tooth or from behind a front tooth, allowing access to the pulp chamber and root canals for treatment. The diseased and dead pulp( pulp tester ) tissue is removed from the tooth with specially designed instruments used to clean out the root canals and pulp chamber. This is not painful; the area is numb and the tissue being removed is either dead or dying. Once the pulp, along with the nerves contained in it, is removed, the tooth itself can no longer feel pain.

Root canal fillings are selected that will exactly fit into the freshly prepared canals. Usually a rubber-like material called gutta-percha is used to fill the canal space. It is a thermoplastic material (“thermo” – heat; “plastic” – to shape), which literally is heated and then compressed into and against the walls of the root canals to seal them.

Together with adhesive cement called a sealer, the gutta-percha fills the prepared canal space. Sealing the canals is critically important to prevent them from becoming reinfected with bacteria.

Be sure to follow the instructions of your dentist or endodontist( dental endo motor ) carefully. After-effects of treatment are minimal, generally lasting from a couple of days to about a week. It is normal to have some minor discomfort after treatment including slight soreness that can usually be managed with over-the-counter (aspirin, ibuprofen) medications or prescription (codeine-type) drugs, or a combination of the two.

Your tooth will need a permanent restoration — a filling or a crown — to replace lost tooth structure, and provide a complete seal to the top of the tooth. Your endodontist will send you back to your general dentist to determine which type of restoration is best for you.