The endodontist would numb the tooth area and place a rubber dam. An opening would be made through the crown of the tooth and the pulp would be removed. The canal or canals would be cleaned with files or small dental instruments that would be alternated with irrigants using hand-held or mechanical instruments. The canal would be shaped to the desired size and filled with an endodontic sealer and gutta-percha. The cavity would be filled with a temporary filling that may contain medications to heal the tooth and left open for the infected liquid to drain. The dentist would prescribe antibiotics to help in preventing infection. The next visit would involve removal of the temporary filling and replaced by a permanent one along with placement of a porcelain or gold crown according to preferences.
Bacteria is commonly present in the mouth but when it enters a tooth or teeth through filling that is old and broken down, decay, a gap and/or a fracture, it becomes pathologic or diseased in nature. In some cases, the condition deteriorates quickly and in others it is slow to manifest. An endodontist or a general dentist will clean, fill and seal the chamber of the tooth after removing the infected pulp.