When the nerve of a tooth dies, it is necessary to remove the compromised nerve contents. Otherwise, it will cause an infection and possibly fever, swelling and an abscess (collection of pus).

The process of removing the infected nerve contents (or Root Canal Treatment) normally takes 2 or 3 visits and involves cleaning the root canals with special instruments called files and eventually filling the canals with a biocompatible sealer. The tooth is then ready for a permanent restoration.

Different teeth have different numbers of nerve (or root) canals. An incisor might only have 1 nerve canal whilst a molar could have as many as 4. Treatment complexity increases (as those the number of visits required) with the number of root canals.

Surgical endodontics is sometimes required to save badly compromised teeth. Such procedures include:

• Apisectomies: In this procedure, the tip or apex of the root is surgically removed along with the surrounding infection to allow the bone to heal right up to the amputated root. 

• Root resection: This is when an entire root of a multi-rooted molar tooth is removed to save the remaining tooth 

• Hemisection: Up to half the tooth might be removed here to save the rest. The remaining tooth structure can then be restored and tooth loss minimised

Occasionally, we have to root treat children's teeth. The treatment is essentially the same except that the sealer is resorbable so as to dissolve along with the tooth as the child grows.