Assisting with an Endodontic Procedure

The dental assistant passes the mirror and explorer to the dentist and then passes a 2 x 2 gauze to dry the muccobuccal fold and the topical anesthetic syringe. When the dentist completes placing the anesthetic, the dental assistant rinses the area with the air/water syringe and aspirates excess water with the HVE tip.

The dental assistant or dentist places the rubber dam on the affected tooth. The dental assistant should inform the patient of the purpose of the dental dam and that if there are any concerns to let the dental team know.

The dentist creates an opening in the tooth with the high-speed handpiece and bur. The dental assistant should keep the rubber dam free of debris but be sure to stay out of the dentist's line of vision.

The dentist uses the slow-speed handpiece and round bur to remove caries and to access the pulp chamber. The dental assistant may quickly rinse the area to improve the dentist's field of view.

The dentist may want to use the endodontic spoon excavator to remove caries and the endodontic explorer to locate the pulp chamber and canal openings.

The dental assistant passes a barbed broach for the dentist to remove pulpal tissues from within the root canal. The dentist may want several broaches, especially if the tooth has more than one root.

The dental assistant passes a #10 or #15 reamer with stoppers to measure the lenght of each canal. The dental assistan exposes a radiograph so the dentist can measure the lenght of each canal with the file(s) or reamer(s) in place. The radiograph and working lenght of each canal are recorded in the patient's chart.

The dental assistant passes additional files in progression until the proper width and lenght of the canal are achieved. The size and lenght of the final file used are recorded in the patient's chart.

The dental assistant passes the irrigating syringe with irrigating solution to the dentist. The dentist irrigates the canal(s). The dental assistant must keep the tip of the HVE very close to the tooth so the irrigating solution is efficiently aspirated and not allowed to splash the patient or the dental team.

The dental assistant passes paper points with locking cotton pliers and continues to pass paper points until the canal or canals are completely dry.

The dental assistant passes a small cotton pellet containing medication to the dentist who places it in the tooth. (At this point the dentist places a temporary filling material into the tooth or continues to obturate the canal and completes the root canal treatment. If a tooth is severly infected, the dentist may elect to have the patient return at a later date to complete the endodontic theraphy.)

A master gutta percha point is selected that matches the width size of the last file used in each canal. The dental assistant exposes a radiograph to verify the proper lenght and seal.

The dental assistant mixes the endodontic sealer to a creamy consistency and passes it to the dentist, so he or she can coat the tip of the master gutta percha point. The dentist places the gutta percha with cement into the canal. (Some dentists will use a lentulo spiral to place the endodontic sealer deep into the canal before placing the gutta percha point.)

The dental assistant passes the endodontic spreader and additional accessory gutta percha points and continues to pass the spreader and an additional point until each canal is full.

The dental assistant passes the endodontic condencer and prepares the torch. The dental assistant holds some 2 x 2 gauze squares and holds the HVE tip close to the tooth.

The dentist heats the tip of the endodontic condenser and melts off the excess gutta percha material. It is important to adequately heat the instrument to avoid removal of the gutta percha filling from the canal. The dental assistant ensures that the HVE tip aspirates any smoke and receives the melted gutta percha from the dentist with a 2 x 2 gauze.

The dental assistant prepares the temporary filling material and passes the Woodson. The dentist places the filling. The dental assistant passes a lightly dampened cotton applicator to the dentist, who uses it to smooth the temporary restoration.

The dental