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The Root Canal Process: Endodontics 101

September 20, 2019
Woman Getting Root Canal

Endodontics is a dental specialty focused on the pulpal tissue within teeth. Endodontic procedures can oftentimes save a tooth with extensive decay from requiring an extraction.  The most common endodontic procedure is a root canal. However, saving some teeth may require additional procedures. Here is what you should know.

Root Canal

Although root canals can cause many patients anxiety, they are actually quite simple.  Modern technology and pain management techniques have made them nearly pain-free.

Root canals are performed when the pulp tissue within a tooth becomes inflamed and/or infected.  Left untreated, the infection can develop into an abscess, compromising the jawbone and inviting the risk of serious complications. If a tooth needs a root canal, the only alternative is extraction.

First, we numb the entire tooth and surrounding tissues with a local anesthetic. Next, we drill a small access in the crown of the tooth to expose the pulp chamber. Using specialized tools, we carefully remove all the damaged tissue from the root canal(s).  The canals are then shaped to allow disinfection with a cleansing solution. The remaining space is then filled with gutta percha; a biocompatible material. Finally, a temporary filling is placed to seal the access from bacteria. You will then visit your regular dentist to begin the process for a crown. Pain is usually minimal and responds well to over the counter pain medications, with most people returning to work in just two days.

Root Canal Retreatment

Root canals have a success rate of 95% when performed by an endodontist.  However, a root canal can fail. Common causes include a tooth fracture, a loose crown, or new decay in the tooth. When this happens, a root canal retreatment is the ideal course of action.

After thoroughly numbing the tooth and surrounding tissues with a local anesthetic, we remove the crown, reopen the tooth, disassemble any restorative materials, and remove the gutta percha. We then carefully examine the inside of the tooth to locate the source of the problem. We can then clean the canal(s) and re-seal the them. Your dentist will place a new customized crown.


If a root canal retreatment fails, an apicoectomy may be the treatment of choice. In this procedure, we remove the tip of the tooth root and replace it with a filling.

After using a local anesthetic to thoroughly numb the tooth and surrounding tissues, we push back the gum tissue, exposing the tooth root. We use highly precise instruments and magnification to carefully remove the tissue believed to be causing the infection, which is typically just a few millimeters of the tooth root. We then place a retrograde filling and replace the gum tissue with sutures. Over the next several months, the bone will heal around the treated root.

Endodontics can also include some less-common procedures such as root resection or repair. In all cases, our focus is on treating the tooth’s roots, helping you keep a tooth that would otherwise have to be extracted.

Ready to Get Started?

If you need a root canal from an endodontist you can trust, contact North Shore & Brookline Endodontics today at the location that is most convenient for you.

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