The electric pulp tester is placed on the tooth to be tested, along with a drop of conducting paste. Then the tester is set at the lowest setting an a button pushed. Generally there will be no response. Then the dial is turned up a little and the test repeated. Eventually a little buzz is felt in the tooth and the patient signals to the dentist. The lowest level of response is then recorded. Generally the test is then repeated on teeth on each side of the tooth and often on corresponding tooth on the other side. Then the results are interpreted.
No response from the tooth generally indicates the tooth has died and needs the root canal therapy (or removal). A very quick response compared to the adjacent teeth generally indicates that the tooth is inflamed and probably is heading toward pulp death. If it responds the same as the other teeth then it is considered to be healthy.
The endodontist generally anaesthetizes the tooth and then a rubber dam is placed to isolate the tooth and keep mouth fluids from contaminating the inside of the tooth.
Then an opening is made into the tooth and small files are used to remove the remaining pulp tissue and to smooth and clean the canal. The canal is regularly irrigated, usually with a dilute bleach solution, which cleans out the filing chips and also to sterilize the interior of the tooth.
When the canal is clean and smooth down to the tip of the root then the canal is filled usually with gutta percha, a rubber-like material and a sealer. Later a final filling may be placed in the opening of the tooth, or it will probably be suggested that a crown be placed on the tooth if there was a pre-existing filling.
The filing of the tooth has been compared to having someone file on a piece of wood held in your tooth, no pain, but often some vibrations.
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