Deep dental decay, trauma, chronic inflammation, and other conditions can cause the soft tissue inside the tooth to become diseased. If this condition fails to respond to other means of treatment or if it progresses into an abscess teeth can be saved through endodontic treatment (root canal therapy).

The diseased pulp is accessed through a small opening prepared in the top of the tooth and fine instruments remove the diseased tissue. Then the canal system is sealed completely with warmed gutta percha and a special sealant. A filling closes the access opening on the top of the tooth and finally a crown is usually recommended to protect the tooth once treatment is completed.

Contrary to urban legend, the vast majority of endodontic treatment is performed painlessly under profound local anesthesia. In cases where there is significant bacterial infection or severe inflammation post-op pain medications and antibiotics may be prescribed. In other cases, either no medication is necessary or over the counter analgesics suffice.