A root canal treatment is a dental procedure to save an infected tooth. It is a lengthy procedure that involves cleaning and filling the root canals. The time required for a root canal treatment varies based on the complexity of the individual case and tooth involved. In this article, I will discuss how long a root canal takes and the factors that can prolong and reduce the treatment time.
What is a root canal?
The root canal therapy treats deep, painful, and infected teeth. The process involves the removal of infected pulp from the root canals and filling them with a biocompatible material.
The pulp is a soft, innermost layer of the tooth, rich in blood vessels, nerves, and reparative cells.
How prevalent root canal is? Nearly, 8.5% of the global population has at least one root canal.
How long does a root canal take?
A root canal treatment requires more time than a filling to disinfect and fill the long, torturous root canals. There are two types of files (needle-like instruments) used for canal disinfection:
- Rotary files are attached to a high-speed dental drill, allowing quick and efficient root canal cleaning.
- Hand filing involves manual files that clean and shape the canal with hand motion. It takes more time than rotary files. On average, a single appointment takes 60-90min.
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How many appointments are required for a root canal treatment?
Because of a single, large and straight canal, front teeth are treated in a single appointment. However, the molar root canal takes 2-3 appointments due to multiple, thin, and curved canals. Canal negotiation often takes time, and canal location is essential for a successful root canal treatment.
Let’s see how a root canal is done, and what happens during each appointment:
First appointment
The first appointment involves the following steps:
- The x-ray of the concerned tooth is taken to diagnose the problem.
- If the root canal is anticipated in the same appointment, 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 intruments) are used to locate the canals.
- Once the canals are found, an individual canal length is determined and noted with an X-ray or apex locator.
- After the working length determination, the infected or dead pulp is removed by rotating the files in a clockwise and anticlockwise direction, followed by a wash with a disinfectant solution to remove the debris and dental shavings. The canal length determination allows the dentist to clean the canal till its apex.
- The cleaned canals are shaped with files of a 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 the canal moisture.
- The dried canal is filled with a latex cone (filling) coated with a sealer (paste like substance). The sealer fills the excess-space around the cone and seals the canal.
- The cavity is finally restored with a composite or amalgam filling.
Note: The dental work is often split in two appointments for molars because of multiple curved canals.
Second appointment
After a root canal treatment, the tooth is cut with a dental drill to make room for the crown. The impression of the prepared tooth is taken and send 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 one or more canals. Front teeth (incisors and canines) 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 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 canal walls. Also, discrete calcified masses within the pulp chamber and in root canals obstruct the navigation of the instrument to the root apex. The canals require complete disinfection for a successful treatment.
Sometimes, a stone blocks the canal opening, hindering its location and navigation and requiring more time to complete a root canal.
Management of calcified blocked canals: The calcified canals are filled with a decalcifying solvent, EDTA. EDTA takes 24-48 to dissolve the calcified mass, and thus, can prolong the root canal treatment time.
Type of instruments used
The type of instruments used may influence the treatment duration.
The rotary files significantly reduce the treatment time to half. They also give better canal preparation, and are safer than manual files.
The manual or hand filing takes more time and energy to clean and disinfect each canal.
Severity of infection
The severity of the infection also impacts the treatment time. Painful teeth with swelling or abscesses require additional treatment time.
In a soft abscess, the swelling is incised (a small cut) and compressed to allow the pus to drain, followed by saline disinfection. The root canal is commenced after the resolution of a swelling.
In a hard abscess, the tooth is drilled to access the root canals. The canal disinfection makes passage for the pus to escape and relieves pain. You may be given antibiotics for 5-7 days.
The root canal treatment is continued after the resolution of swelling.
Occasionally, between visits, the tooth is filled with a disinfectant medicament to reduce the bacterial count.