During the first appointment, the dentist will remove the infected nerve tissue, and place an anti-biotic medication inside of the canal/s to settle the tooth. 

At the second appointment the dentist will thoroughly clean and slightly widen the root canals in preparation for the gutta-purcha filling which is placed at your third appointment. The tooth is then permanently sealed.

Following root canal therapy it is highly recommended that the tooth is crowned. Removal of debris from within the nerve canals causes slight weakening of the tooth. The extra strength offered by the crown can prevent future cracks which are likely to be terminal to the tooth. 

Root end microsurgery is not a particularly common procedure however in specific cases where root canal therapy is not sufficient to save a tooth it may be performed. Situations where root end microsurgery may be required include:

• If significant calcium deposits develop inside the nerve canal of an unwell tooth, they can prevent dental tools from being able to clean and shape the inside of the tooth. In these cases root end microsurgery would be required to facilitate complete cleaning and sealing of the tooth.
   
• In some cases symptoms may not resolve following root canal treatment or even re-treatment. Symptoms may persist or reappear months to years later. In these situations root end microsurgery is an option to save the remaining tooth.
   
• Sometimes large infections can spread to the surface of the tooth root, or to the bone. In these cases root end microsurgery may be required in order to completely remove the infection. Treatment is an apicectomy, involving the surgical removal of the tip of the infected root. This is the most common microsurgery performed by endodontists. 

Significant dental trauma can often cause premature death of the tooth. Depending on the severity of the trauma this can occur immediately following the injury or years later. Teeth are more likely to die prematurely if the individual was older when they sustained the trauma. Removal of the nerve with root canal therapy resolves any associated pain and infection.

Trauma often results in discolouration off the tooth. As the nerve dies, it releases red blood cells which stain the tooth internally. Internal bleaching, usually performed alongside root canal treatment, is an option to improve the appearance of teeth that have discoloured following trauma.