Since the primary goal of endodontic therapy is the
elimination of bacteria from the root canal, an essential
requirement during treatment is that it be undertaken
in a sterile environment where further contaminating
micro-organisms can be reliably excluded from the
canal. The treatment of root canal infections is unique
in the sense that it is possible to isolate the area from
the rest of the oral cavity by use of rubber dam.
Efficient methods are available for disinfection of the
operative field, the tooth and rubber dam. The
importance of using sterile instruments and an aseptic
technique in a disinfected field cannot be over-emphasized,
since failure to do so may have a direct
bearing on the outcome of treatment.
Every effort should be made to exclude and eliminate
micro-organisms from the operative field and the root
canal itself. Application of the rubber dam is mandatory
for endodontic treatment. The rubber dam must
properly isolate the tooth from the oral cavity to ensure
an aseptic field.
Once the tooth is isolated from the oral cavity, the
tooth surface and adjacent rubber dam should be cleaned
with 30% hydrogen peroxide, taking care to ensure that
the skin and eyes of the patient and staff are protected.
The same area is then carefully disinfected by scrubbing
the area with 5% tincture of iodine,
sodium hypo-chlorite
or 2% chlorhexidine in alcohol. These
procedures are simple yet effective and greatly reduce the
chances of contaminating the open root canal.