An X-ray is taken as the first step of the root canal procedure. This allows your dentist to see the shape of the root canal, and ensure there are no signs of infection that have reached the bone. A local anesthesia is then applied to numb the area. Although numbing may not be necessary when the nerve is dead, it is typically still used to help ensure the patient is not in pain during the procedure. A rubber dam is then placed around the infected tooth in order to keep it dry and free of saliva. A small access hole is drilled into the tooth, and special files are inserted to scrape and scrub the sides of the root canals. This results in the nerve, the pulp, and any bacteria or debris being removed and flushed away. Finally, the tooth is sealed. Depending on the level of decay and potential infection, a second office visit may be needed. In these cases, your dentist will treat the infection and make sure everything is healed before sealing up the tooth. Of course a temporary filling would be used so you could function as normal until your follow up visit. Some other restoration techniques may be required to restore the tooth to full function, especially in cases of extreme decay.