Preserve Your Tooth Nerve | 医療法人社団EPSDC

The nerve removal is done at the Tokyo International Dental Clinic Roppongi near the Azabu-jubann station.

The nerve is removed due to severe pain from the tooth.

Don’t Give Up Yet — For Patients Told “The Nerve Must Be Removed” If you were told “We need to remove the tooth nerve” and felt shocked, please read on. At our clinic we prioritize preserving the dental pulp whenever possible, because removing the nerve can shorten the life of the tooth. Many patients who were told elsewhere that “root canal treatment is the only option” have been able to retain their pulp after treatment here. We carefully examine each tooth and provide safe, evidence‑based care based on our clinical experience. Even with deep decay, we do not give up quickly — we pursue approaches that put the long‑term future of your tooth first.

What is the “Stepwise Technique”? An advanced, nerve‑preserving treatment We use a procedure called the “stepwise technique,” an approach designed to control caries progression while preserving the pulp. Unlike the traditional method of removing all decayed tissue at once, stepwise treatment requires highly precise technique and careful staging.

Key points of the procedure:

Two precise treatment visits of about 90 minutes each are required.
There is an interval of approximately six months between the two visits to allow changes inside the tooth (pulp and dentin) to occur.
We use magnification and rubber‑dam isolation and perform the procedure under strict, controlled conditions to maximize the likelihood of pulp preservation.

Evidence and guidelines The stepwise technique is supported by scientific evidence in endodontics. In 2019, the European Society of Endodontology published guidelines recognizing staged caries management methods. We follow these international guidelines and the latest literature to carefully evaluate which teeth are suitable candidates, and to weigh risks and limitations for each patient before recommending treatment.

Thorough explanation and shared decision‑making For delicate cases where decay is deep and the pulp is at risk of exposure, clear explanation and informed consent are essential. Before starting treatment we explain in detail:

The aims of the treatment and the exact treatment steps
The required number of visits and expected treatment time per visit
The potential benefits, including an increased chance of keeping the nerve
The limitations and possible disadvantages, such as a longer overall treatment period and the possibility that symptoms may appear during the interval

We welcome any questions at any stage. We will review with you honestly whether pulp preservation is realistically achievable in your case, and support you so you can choose the treatment you feel comfortable with.

Why preserving the nerve matters Keeping the dental pulp not only helps extend the lifetime of that tooth, it also contributes to overall oral health and function. Before deciding to remove a nerve, please consult with us — you may have options you were not previously told about.

Make an appointment for consultation today.

Tokyo International Dental Clinic Roppongi

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