There are times when we see our patient a bit later than we would have liked and the tooth had already been compromised, i.e. caries reaching the nerve chamber,  there are certain options we can approach.

1. If the tooth has no previous history of prolonged pain and there is no root abscess and there is a chance of keeping the tooth viable, we will try our best to save the nerve by applying a medicament (MTA) directly over the nerve.  This procedure is still fairly new and some insurance do not recognize it yet.  Our position is that it has worked on all the patients we have tried so far in the past 2-3 years and it is definitely worth a try.

2. If the tooth has history of pain and evidence of an abscess, a root canal treatment will be needed to keep the tooth. Root canal treatment is a procedure in which the nerve tissue is removed from the tooth and then it is sealed  with a cement and a root filler. Subsequently, the tooth will need a buildup and a crown to protect and restore the tooth back to full function.  Root canal treatment if done properly will eliminate pain and allow us to keep the tooth rather than extracting it.