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Endodontic therapy treats infections that enter the soft tissue or pulp of a tooth to eliminate infection and protect the tooth from future infection. Treatment relieves dental pain and provides a healthy base for a restored tooth. While this procedure is commonly referred to as a "root canal", this term is inaccurate, as root canals and their associated pulp chamber are the hollows inside a tooth which contain nerve tissue and blood vessels, while "endodontic therapy" refers to the process itself. Endodontic therapy involves the cleaning and shaping of the canal system, accomplished under local anesthesia, the removal of degenerated tissue with small hand files and rotary instruments, and a permanent root canal packing, such as gutta percha, which is placed in the canal system. Gutta-percha is a natural polymer which is melted and injected to fill the root canal passages. This filling will be opaque to X-rays, allowing verification afterward that the passages have been properly filled in, without voids. After the surgery the tooth will be nerve-free or "dead."

If a tooth is considered so threatened by decay or fracture that future infection is considered likely, a pulpectomy, or removal of the pulp tissue, is recommended to prevent this from happening. As some inflammation or infection is likely to be present in this situation, the dentist will need to go into the pulp chamber and remove the infected pulp from the root canals to cure the infection and save the tooth, The dentist then fills the cavity and seals up the opening. Once the nerves and blood supply have been removed from the tooth, it is recommended that the tooth is fitted with crown, which greatly increases the longevity of the tooth.

While modern root canal treatment is relatively painless, it inaccurately remains one of the most stereotypically feared dental operations, and, in the United States, a common response to an unpleasant proposal is, "I'd rather have a root canal." With the use of local anesthesia, this fear is completely unwarranted. Lidocaine, (generally referred to as novocaine), is a commonly used local anesthetic for this purpose, and other pain control medication may be used either before or after treatment if required.

In the last ten to twenty years, there have been great innovations in the art and science of root canal therapy. Dentists specializing in this field must now be educated on the current concepts in order to best perform a root canal. Endodontic therapy has become more automated and can be performed faster, thanks to advances in automated mechanical instrumentation of teeth and more advanced root canal filling methods. Newer technologies also exist that allow more efficient measuring of the root canal to be filled. Should you require root canal therapy at some point, rest assured that you will receive the most modern and efficient care and be well on your way to optimal dental health.