Endodontic procedure, what does it involve?

Endodontic treatment is usually preformed in one or two visits and involves the following steps:


1) The patient will be examined using x-rays and specific endodontic tests in order to determine if endodontic treatment is necessary. Local anesthetic will be administered if treatment is required. After the tooth is numb, a small protective dental dam will be placed over the tooth to keep salvia from contaminating the root canal and to keep endodontic rinses and medicaments from getting into the mouth.



2) An opening will be made into the crown of the tooth to access the root canals after all of the tooth decay is removed. Small endodontic instruments called files will be used to clean and shape the root canal so it can the be filled.


3) After the space is cleaned and shaped it will be filled with either a permanent biocompatible root canal filling material or an intra-canal medicament if the tooth has a bad abscess. I will be filling the tooth with a biocompatible polyester/composite material called resilon (RealSeal or Epiphany). This material has only recently become available, and has been shown by clinical studies to provide the best seal and increase the strength of the root, following the filling (obturation) compared to other filling materials.


In some cases a biocompatible rubber-like material called gutt-percha and a adhesive cement (sealer) will be used to fill the root canal. This has been the standard filling material for nearly 100 years in endodontics. In most cases, a temporary filling material will be placed in the crown of the tooth in order to seal the root canal until the tooth is permanently restored by your general dentist.



4) The tooth will usually need to have a permanent restoration placed by your general dentist after your final endodontic visit within a timely manner (one to two months at most) in order to restore the tooth to proper form and function and seal off the root canal treatment from contamination.


Your dentist will remove the temporary filling and restore the tooth with a base filling and usually a new crown (cap). Often a new crown will not be required if the root canal was completed through an old crown. Your dentist will make this determination.


5) Your dentist may have a post placed into one or more of the root canals if there is not enough tooth above the gum-line to hold the crown or restoration in place.