Why is my root canal being done in two visits?
April 16, 2009 11:40 AM   Subscribe

Just had a root canal this morning, but have to go back next week to finish it. Why didn't they do it all at once?

From what I understand, they went in and removed the nerve and filed the canals a bit. Then they filled it in with a temporary filling until I can come back next week to have the canals filled up.

If you're already in there with everything opened up, why not finish everything up while you're there?
posted by J Parker to Health & Fitness (13 answers total)
Are you getting a cap?

Mine was done in 2 sessions, but I had a temporary cap while waiting for the custom cap to be made.
posted by The Deej at 11:43 AM on April 16, 2009

Will it have a resin filling (tooth-colored)?

If so, the amount of blood and inflammation can make the filling turn pink.

It's likely the dentist wanted your inflammation/irritation/pain to subside before he finished the tooth.

Next time ask your dentist. Make sure he tells you everything about the procedure. You're the patient and it's your mouth, you have the right to know.

posted by royalsong at 11:45 AM on April 16, 2009

I've had thirteen gazillion root canals and from what I've been told (because I asked ;) the first visit is to remove the infected roots/pulp and to form the canals. Usually a temporary wad of sterile cotton soaked with meds is stuffed into the now open canals, and a temporary filling is put on the tooth. During the second visit, the temporary filling is removed, the cotton is removed, the the roots get filled up and then sealed. The time in between the two visits allows the roots and the tissues around the infection to settle down (the swelling and inflammation dissipates) so that everything is back to normal before the canals are filled.
posted by iconomy at 11:53 AM on April 16, 2009

I have had two root canals (awesome, I know). The first time it took three visits, and they said later the reason was because otherwise it's too exhausting and traumatic for the patient. The second time I had it all done at once and I could sort of see what the first Dr was talking about - root canals aren't painful, but they do take forever and it's exhausting.
posted by lunasol at 11:54 AM on April 16, 2009

Mine was done in two visits. The dentist explained that the roots were "hooked" at the end and she couldn't get all the way in to remove the root/nerve. So, she injected something that would slowly dissolve the part she couldn't reach.
posted by yqxnflld at 11:59 AM on April 16, 2009

Mine was a three part procedure, because I had an absess, and it had to drain and heal. Second step was de-pulping, and the third step was putting in the post and core and filling. Each step took and hour plus.

I suspect the explanations already given -- that it is so time consuming and that the tooth gets inflamed -- are right. The pulp removal seemed particularly traumatic to the surrounding gums.
posted by Astro Zombie at 12:01 PM on April 16, 2009

Thanks for the help everyone. It makes more sense now.

Unfortunately, he didn't tell me it would be two visits until he was finished with the first one, and my face was numb at that point, and I felt silly trying to talk. So, it was my vanity that kept me from asking i'd imagine ;)
posted by J Parker at 12:05 PM on April 16, 2009

It's been quite a while, but I did get it done 3 times (youthful playground accident that finally caught up with me in college, good times). My understanding was:

1. The stages of the procedure are lengthy and it would get to be an excessive session for both you and the dentist.
2. The excavated tooth was packed with antiseptic materials to ensure the complete elimination of infection
3. To check for hidden infection that may have been missed in the procedure (evidenced by pus, renewed pain etc.)

As to the last point, I did have one where there was a pocket of infection that did not show up on the X-ray and led to some of the most astonishing pain I've ever experienced in my life shortly after the first procedure. Emergency dental intervention was required. So there may well be something to that.

I've been told that an endodontist can do a more invasive surgical procedure that can be completed in one session but that it is substantially more expensive, but that's second hand. I can tell you that multiple visits are very standard for the procedure, and more complicated cases can require more than 2.
posted by nanojath at 12:07 PM on April 16, 2009

Hmm, "preview" you say.
posted by nanojath at 12:08 PM on April 16, 2009

I've had three root canals and they all took more than 2 visits. My most recent one included a small infection that kept draining, and I had a weird and winding root, so my dentist wanted to go slowly and make sure everything was properly removed and healed before sealing it with a cap. Once it's sealed, she says it's a bigger pain to go in if things go wrong. From what I can tell from my root canal experiences, at least 2 sessions is to be expected unless you go to an endodontist. Basically, I think the info everyone is providing here sounds about right.
posted by katie at 1:27 PM on April 16, 2009

adding a data point and some experience, having had more root canals that I care to remember: you wouldn't want a (however microscopic) residual part of a root nerve to 'go off' under a sealed tooth.
posted by _dario at 1:44 PM on April 16, 2009

Huh. I've had two root canals and they both took two visits, one to have the actual root canal and the second to put on a crown. (I had the second crown put on just yesterday). The appointments usually take about 1.5 to 2 hours each. Maybe my procedure was slightly different than what some of you are describing. But then my dentist knows to give sensitive, jumpy me the heavy duty freezing plus gas, so I slept through most of both appointments. Ah, nitrous oxide, you dark angel, you.
posted by orange swan at 8:45 PM on April 16, 2009

Everything you ever wanted to know about root canals. But if you think you don't want to know everything (like, what can go wrong) then don't click. Wait until your followup is complete and everything has settled down.
posted by Joh at 9:17 PM on April 16, 2009

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