Step 1 – Placing the rubber dam
After numbing you up, your dentist with dental apex locator and dental electric pulp tester will “isolate” your tooth by way of placing a rubber dam.
A “rubber” dam is really a thin sheet of latex (usually about 6 x 6 inches).
Your dentist will punch a tiny hole near its center.
They’ll then stretch the sheet over your tooth so it alone sticks through the punched hole.
A metal clamp is then positioned to hold the dam in place.
As explained in our slideshow, the portion of the tooth that sticks through the dam lies in a region where its environment can be controlled. The tooth can be washed, dried and kept saliva-free.
Why is tooth isolation important?
One of the fundamental goals of root canal therapy is removing contaminates from within the tooth.
Since saliva contains bacteria and other debris, a rubber dam acts as a barrier that helps to keep the tooth isolated (clean, dry, contaminate-free) during its procedure.
Note: Placing a dam is a part of the general “standard of care” that any and every dentist must responsibly provide. If your treatment doesn’t involve using one, you should be asking questions.
Step 2 – Creating the access cavity.
As a starting point for performing your tooth’s treatment, your dentist will need to gain access to its nerve space. This step is called creating an “access cavity.”
An access cavity in the chewing surface of a molar.
The hole through which the dentist performs their work.
Your dentist will use their dental drill to make a hole that extends through the surface of your tooth to its pulp chamber.
This is the opening through which they will perform their work.
With back teeth, the access cavity is made right through the tooth’s chewing surface (as shown in our picture).
With front ones, it’s made on their backside.
When creating the access cavity, the dentist will also remove all tooth decay, and any loose or fragile portions of the tooth or its filling.
Step 3 – Measuring the length of the tooth.
Your dentist’s goal will be to treat the entire length of your tooth’s nerve space but not beyond.
To be able to work within these confines, your dentist must measure the length of each of your tooth’s root canals. This measurement is typically calculated to the nearest 1/2 millimeter (about 1/50th of an inch).
Step 4 – Cleaning and shaping the tooth’s root canals.
he next step of the root canal process involves “cleaning and shaping” the interior of the tooth (the tooth’s pulp chamber and each of its root canal treatment equipment.
In regard to this step:
Its cleaning aspect removes nerve tissue (live and/or dead), as well as bacteria, toxins and other debris harbored inside the tooth. (Here’s more detailed information about why this is needed.)
Shaping refers to a process where the configuration of a tooth’s canals are enlarged and flared, so they have a shape that’s ideal for the procedure’s filling and sealing step.
The whole process is a balancing act. One where the dentist seeks to accomplish the goals above without removing so much internal tooth structure that the integrity of the tooth is compromised.
Step 5 – Sealing the tooth.
Once the interior of the tooth has been thoroughly cleansed and properly shaped, it’s ready to be sealed (have its hollow interior filled in).
In some cases, the dentist will want to place the filling material immediately after they’ve finished cleaning the tooth.
With other cases, they may feel that it is best to wait about a week before performing this step.