How long does a root canal take?

How long does a root canal take

A root canal is a common procedure worldwide and 8.5% of the global population has at least one root canal. It is a lengthy procedure requiring several steps to completely clean and fill the root canals. The time needed for a root canal varies depending on the complexity of the individual case. In this article, I will discuss how long a root canal and crown take and factors that can prolong and reduce the treatment time.

What is a root canal?

Root canal therapy is a procedure done in deep, painful cavities and necrosed teeth. The process involves the removal of infected pulp from root canals and filling the canal with a biocompatible material. 

The pulp forms the soft, innermost layer of the tooth and is rich in blood vessels, nerves, and reparative cells. 

How long does a root canal take?

A root canal is a lengthy procedure and requires more time as compared to filling, as root canal treatment involves disinfection and filling of long torturous root canals. 

On average, a single appointment takes 60-90min. However, it varies depending on how much work is done in one appointment. 

How many appointments are required for a root canal treatment?

Usually, root canals take two to three appointments to complete. 

First appointment  

The first appointment involves the following steps:

  • The x-ray of the problem tooth is taken, and a diagnosis is made.
  • A rubber dam is placed to isolate the tooth from salivary contamination. 
  • The tooth is anesthetized with a local anesthetic injection. 
  • A hole is then made in the tooth with a dental drill to access the pulp. 
  • Next, files, needle-like instruments, are used to locate the canals. 
  • Once the canal or canals are found, the length of the canal is determined with an X-ray or apex locator. 
  •  The infected or dead pulp is removed with files and flushed with a disinfectant solution to clean the canals thoroughly.
  • The cleaned canals are now shaped with files of larger diameter. Canal shaping is required to eliminate surface irregularities so a filling can be packed without voids. 
  • The prepared canals are washed and dried with paper points. Paper points are cones made of paper to absorb all the canal moisture. 
  • The dried canal is filled with latex cones (aka filling) dipped in a sealer paste that fills the space around the cone. The root canal is now sealed. 
  • The tooth is finally filled with a composite or amalgam filling. 

Note: For molars, the dental work is often split into two or more appointments depending on the complexity of the root canals and the severity of tooth infection (discussed below).

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Second appointment 

If you wish a get a crown, the tooth is cut with a drill to make room for the crown. The impression of the prepared tooth is taken and sent to the lab. 

The prepared tooth is covered with a temporary crown. 

Third appointment 

The dentist will recall you for the crown try-in after 7-10 days.

During crown placement, the temporary crown is removed, and the permanent crown is seated on the prepared tooth for fit and accuracy. The crown is finally cemented to the tooth, and the bite is checked. 

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What Factors Influence the root canal treatment time  

The factors described below either increase or decrease a root canal treatment time:

Tooth being treated 

Every tooth root has canals. Front teeth (incisors and canine) have a single, long, and large canal. Premolars have one or two roots with two to three canals and molars have two or three roots with three to four canals. 

Molars and premolars don’t follow the one root and one canal principle. Some roots contain two or rarely three canals. Each canal requires proper disinfection, shaping and filling. That’s why molars require more chair time and multiple appointments than front teeth. 

Presence of calcified masses in the tooth 

Young pulps are vascular, but as you age, pulp recedes and becomes smaller because of the increased deposition of dentin on the inner walls. Also, discrete calcified masses form within the pulp chamber and in root canals, obstructing the navigation of the instrument to the root apex (end). Root canals require complete canal disinfection for a successful treatment. 

Sometimes the canal entrance is blocked by a stone, hindering canal location and navigation, requiring more time to complete a root canal. 

The removal of calcific blockages requires filling the canal with EDTA and closing the tooth with a temporary filling, and calling you the next day. ETDA is a solvent placed in the canals to promote the dissolution of calcified tissues. 

Type of instruments used 

The time required to perform a root canal also depends upon the type of instruments used. 

The use of rotary files significantly reduces chair time to half in locating, disinfecting, and shaping the canals. They also give better quality of canal preparation, and are safer than manual files.

The manual filing take more time to clean and disinfect each canal.

Severity of infection

The severity of the infection determines the time required to complete a root canal. Teeth with acute infection, swelling, and abscess take more appointments to complete. 

During the first appointment, if the abscess is soft, a cut is given on the swelling and compressed to allow the pus to drain. It is followed by disinfection by saline solution.

Next, a hole is made in the tooth to access the pulp, and a canal location, disinfection and shaping are done to allow the pus to escape. This procedure will relieve your pain. You may be given antibiotics for 5-7 days.

You will be recalled for the next appointment at the end of your antibiotic treatment. On the next appointment, the dentist will evaluate the tooth. They will proceed with the final filling of the canals after thorough canal disinfection when the swelling or abscess resolves.

The tooth may be filled with a disinfectant medicament between the visits to reduce the bacterial count.

If you wish to get a crown, the tooth cutting will be done at the same appointment or the next. The decision is based on how long you can keep your mouth open. 

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