Root canal treatment will require at least two visits, the first to complete the actual root canal procedure, and the second to fit a permanent crown over the damaged tooth. The permanent crown can only be measured for once the original endodontic treatment is completed, thus the need for the second visit. It may be necessary for your endodontist to request a 3-D image of your tooth for better diagnostic information.
- Your dentist or endodontist will examine and usually x-ray the tooth to determine where s/he needs to work. Local anesthesia is usually administered, as for a “filling”, although this may not be necessary if the nerve of the tooth is no longer viable. A rubber sheet, or “dam” is placed around the tooth to keep saliva (containing potential infective bacteria) away from the pulp cavity.
- A small opening is made in the enamel of the crown. The contents of the pulp cavity are carefully cleaned out with a series of increasing-diameter files, until healthy tissue is exposed. The holes made are rinsed out with water or sodium hypochlorite (diluted bleach) to make sure that all evidence of infection is removed. If the infection/damage is particularly severe, your dentist may fill the pulp cavity with an antibiotic-containing solution, place a temporary filling and wait a day or two before performing the next step. This is unusual, however.
- The cavity is then filled with a mixture of adhesive and a neutral rubber-like material, called gutta percha. Once this is done, a temporary filling is placed to seal off the pulp cavity. If a large part of the tooth has been removed in order to clear the damage or infection, the dentist or endodontist will place a small metallic post in the pulp cavity projecting upwards, so that the new tooth (crown) can be constructed over that. Once this is all done, measurements will be taken for the permanent crown that will need to be placed at the next visit. Until the permanent crown is placed you will usually be advised to stay away from chewing on that tooth to prevent that temporary crown from breaking and allowing the pulp to be re-infected.
- At the second visit, the temporary filling will be removed, and the crown placed. This should restore the tooth to full and normal function.