The practice of endodontics is concerned primarily with the removal of diseased dental pulp and its replacement with filling material, an operation known as root canal therapy. After the pulp is removed, the tooth continues to be nourished by connecting blood vessels in the jaw. The tooth is then considered to be dead, although the fibres that hold the teeth in the jawbone are alive.

Operations on the pulp are performed with the aid of local anesthesia. Preservation of the natural tooth in this manner serves both appearance and utility; a natural tooth implanted in the jaw maintains the integrity of the dental arch and can withstand about 10 times more pressure than can artificial teeth.