Why Would a Root Canal Be Done in Three Stages?

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Hi, I’m Dr. B, practicing functional dentist for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California. I'm on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. Learn more about Dr. B

Q: Why would a dentist do a root canal in three steps?

A: Kat, I’m sorry you needed a root canal. Whether it takes one visit or three, it’s not an easy thing to sit through.

There is no set schedule or regimen for how long it takes to do a root canal. Years ago, it was typical for the root canal to be done in two visits because if the tooth was filled after having cleaned it out in the same visit, sometimes the tooth would flare up.

Now, due to improved methods and better ways to clean the inside of the tooth, root canals are routinely done in one visit. This is certainly more convenient for the patient as well as for the dentist.

Typically, root canal specialists (known as endodontists) will complete a root canal in one visit. This is certainly more convenient for the patient but it’s also cost-effective. Speed and efficiency translate to lower cost in the long run.

Each tooth is different and the anatomy of each one can vary greatly from the others. This makes some root canals very difficult and makes it necessary for multiple visits to achieve a successful operation.

Some upper first molars, perhaps the most difficult teeth to perform root canals on, can take more than just two visits to completely seal. These teeth can have three to five canals where a lower first premolar will have only one canal. It depends on which tooth you have a root canal on; some are easy and some are more complex in their internal anatomy, hence, require more time. Cost is also usually commensurate with the complexity of the treatment

In regards to your mention of a third visit in order to place pins, I don’t believe that pins are a good thing to place inside of the tooth. They typically lead to a weakening in the structure of the tooth and micro-fractures, and down the road, problems that lead to the loss of the tooth. Using modern composite bonding techniques, it is usually possible to avoid the use of pins. This last step in the root canal is referred to as the “build up,” which is a process that involves restoring the original mass of the tooth so that the dentist can place a crown over the tooth.

To answer your question, this must have been a very difficult root canal to perform. Thankfully, dentists charge by the procedure and not by the hour.

Mark Burhenne DDS

Learn More: Digging the Root Canal