Because the nerve tissue is present in the soft tissue in the canal, the procedure requires the use of some anesthetic. Generally it is a local anesthetic which makes the tooth and the area surrounding the tooth numb. Once the anesthetic kicks in, the dentist then drills down through the tooth and removes the infected or decaying tissue. A manual device will be used by the dentist in order to extract all the soft tissue from where the canal narrows down in the actual root stem.
This space which is left by the extracted tissue will be filled by rubbery cement. Dentist will take an x-ray of the treated tooth in case an air pocket is found. In case an air pocket is found, it will lead to dentist removing the cement and refilling the canal. Sometimes it has to be repeated several times in order to make sure, no air pocket is found. Finally, when the dentist becomes satisfied with the treatment and he is sure that no air pocket is present, He will permanently seal the hole and the remaining cavity present in upper part of tooth will be filled.