How long does a root canal take?
While some root canal treatment procedures can be completed in a single dental visit, in many cases, two or more appointments are necessary. In cases where two appointments are needed, at the first visit, the dentist will clean out the damaged pulp from inside the chamber of the tooth and prepare it for filling and restoration. Then, at the second visit, the dentist will fill and seal the cleaned out tooth. At the end of the first visit, the dentist may place a medicated solution inside the tooth, further treating it to prevent future infections. The duration between the two appointments will largely depend on what sort of medicated solution is used and its expected duration of effectiveness, but in most cases, the second visit will occur between 1 and 3 weeks after the first. Not only does this gap between appointments allow the inside of the tooth to continue to be treated, it will also allow the dentist to observe and repair any problems that may remain inside the treated tooth and evaluate the tooth’s healing process before closing and sealing the tooth.
It wasn’t until the 1900s that dentists began regularly performing root canal treatments in a single office visit, as a result of increased efficiency and technological advances that accelerated treatment times without reducing quality. The efficiency of single-appointment treatment appeals to many patients, though these appointments may need to be extended for a longer duration -- about 90 minutes -- if the procedure is being formed on molars, which have multiple roots. Single-appointment treatment may also be more cost-effective for the patient. Some dentists prefer single-appointment treatment because it allows them to gain more familiarity with the tooth, in a single sitting, and it also removes the risk of bacteria leaking into the tooth between appointments. However, all dentists agree that each patient’s needs should be assessed on a case-by-case basis to determine if a single-visit treatment is best for them. If a tooth is very infected, for example, the dentist may prefer to perform the root canal treatment over two visits, allowing the placement of a medicated solution inside the tooth between visits. This sustained exposure to the medicated solution is believed to be a more effective disinfectant for the tooth’s canal system, and it is impossible to achieve this with a single visit.
If the problem with your tooth is limited to a small amount of infected pulp tissue in a portion of the tooth, and the majority of the tooth’s tissue is still alive, a single-visit treatment is often the preferred approach. This may be the case when patients are dealing with nerve tissue that was exposed through trauma or injury, or it may be preferable for teeth that haven’t experienced significant damage, in the early stages of disrepair.
Sometimes, the entire system of canals in the tooth may harbor bacteria. In these cases, single-visit treatment may not be the most appropriate choice. In cases where the pulp inside teeth has completely died, or where teeth are actively infected, two visits may be preferable. Dentists often also prefer two-visit treatment when retreating teeth that have previously undergone root canal treatment. Generally, dentists gauge the needs of the patient during an initial consultation; if the patient complains of tenderness, pain, or swelling, the dentist may assume infection and therefore recommend multiple visits, thereby allowing medicated solution to treat infection between visits. Dentists also recommend more than one appointment in cases where they need more time to complete a procedure, such as with molars or other teeth with a more complex root system.
In recent years, new developments have improved the efficiency of root canal treatment procedures. These developments have greatly contributed to the increased ability to complete the root canal treatment procedure in a single visit. In most cases, a single appointment will last between 30 minutes and an hour, while in more complicated cases, the duration of the procedure may last as long as 90 minutes. The number of canals in the tooth is the primary determinant of duration for the procedure. In most cases, front teeth have only one canal that contains a root, while molars have as many as three. If you prefer shorter appointments, it is likely that you will need to schedule more of them, but you should let your dentist know if this is the case. It also may be likely that a root canal specialist, or endodontist, can complete a root canal treatment procedure more quickly than a general dentist might, so you may want to seek the services of an endodontist. In most cases, however, a general dentist is perfectly equipped to perform the procedure skillfully.
In cases of severe, active infection the dentist may not be able to perform the root canal treatment procedure until preliminary steps are taken. Infection may reduce the effectiveness of the anesthetic. Infection is also more likely to spread during a root canal procedure when it is active and harder to contain, and, following the operation, the infection is more likely to continue. For these reasons, your dentist may prescribe a course of antibiotics before the procedure, which helps control acute infection, or your dentist may choose to open the tooth to allow the infection to drain, then sealing the tooth and allowing it to heal before performing a complete root canal procedure. In both cases, the dentist will prescribe a waiting period to determine whether the infection has subsided before performing the root canal procedure.
Additionally, talk to your dentist about any other pre-procedure conditions. Some patients prefer sedation for dental procedures, which may require some pre-appointment preparation, like following dietary restrictions and arranging transportation. Some dentists recommend that patients begin treatment with anti-inflammatory medications, like acetaminophen or ibuprofen, before the procedure, which may reduce discomfort following the procedure. Finally, if you plan to become pregnant, or if there is a chance that you are pregnant already, be sure to disclose this to your dentist. While it is possible for pregnant women to undergo root canal procedures, dentists will take pregnancy into consideration when determining the timing of the procedure or procedures, number of x-rays given, and types of drugs to be used.
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