Root Canal Treatment (RCT)

Root Canal Treatment, also known as Endodontic Treatment, is a dental procedure in which the diseased or damaged pulp (core) of a tooth is removed, and the inside areas (the pulp chamber and root canals) are filled and sealed.

Timeline for Single RCT with Crown:
Total working time: 3.5 hours
Total appointments: 5
Total days to complete: 12 Days (Includes necessary lab gaps).

Pre-Operative Instructions

Blood sugar, blood pressure & thyroid levels should be under control prior to surgery. (Consult physician)
Start taking prescribed medications 2 days prior to the date of surgery or as instructed by the doctor.
Patients should have a heavy breakfast or meal 1 hr prior to coming for surgery.
Patient should avoid smoking, alcohol consumption, tobacco chewing, or use of mishri 48 hrs prior and 72 hrs post-surgery.
Patient should be accompanied by a close friend or relative.
Kindly refrain from using any kind of makeup or cosmetics on the day of surgery to avoid contamination.
Patient should be present 15-20 mins before surgery timing to avoid anxiety.

Post-Operative Do’s & Don’ts

Do not leave hospital premises immediately after root canal. Relax for 10-15 mins.
Avoid eating till the effect of anaesthesia goes off completely to avoid biting lips/tongue.
Refrain from using straw, smoking, mouth rinsing, spitting, or brushing the area for 24 hrs.
Do not eat hot/spicy/hard/fried/sticky food for 2-3 days.
Complete the course of prescribed medicines.
Some bruising, swelling, slight pain & discomfort, or stiffness is common.
Avoid exertion or strenuous activities. Take rest for 24 hrs.
Patients should visit for follow up after 3 days of surgery.

Educational Video Guide

The Treatment Process

Appointment 1 (Day 1) - Endodontist Appointment

Time Required: ~ 1 Hour

Step 1: Anaesthesia

Careful administration of Lignocaine (Local Anaesthesia). Wait for at least 5 to 10 mins to get profound numbness around the working tooth.

Step 2: Root Canal Opening (RCO)

With the help of a high-speed air rotor, a small hole is made on the tooth surface to gain access to the infected pulp chamber.

Step 3: Finding Canal Orifices

Using diagnostic K-files to find small canal holes at the bottom of the pulp chamber to access the canals in the root of the tooth.

Step 4: Biomechanical Preparation (BMP)

Using specialized rotary or hand files to thoroughly clean, shape, and enlarge the root canals.

Step 5: Sterilization of Canal

Irrigate the root canals with a 5% Sodium hypochlorite solution to eliminate bacteria and debris.

Step 6: Obturation (Filling)

Fill the prepared canals with Gutta Percha cones (made of rubber/plastic) to achieve a perfect, hermetic seal at the tip of the roots.

Kindly Note: A mandatory 3-day gap is required for medication and pain relief before proceeding to the next step.

Appointment 2 & 3 (Day 5 & 6)

Appt 2: Post Obturative Restoration (POR)

Time: 45 mins. The access hole at the top of the tooth is filled with a composite restorative material. Sometimes a dental Post is needed for better structural strength.

Appt 3: Crown Preparation

Time: 45 mins. With the help of a high-speed air rotor, the tooth is prepared (approx. 2mm reduction on all walls and top) to make room for the artificial crown.

Appointment 4 (Day 7)

Impressions

Time: 30 mins. Using high-precision rubber base material, impressions of both upper and lower dental arches are taken.

Lab Dispatch

Impressions are sent to specialized Dental Labs. It usually takes 5 to 7 working days to manufacture a custom-fit dental crown.

Appointment 5 (Day 12) - Final Cementation

Cementation of Crown

Time: 30 mins. Using a strong luting cement, the custom-made crown is permanently fixed onto the prepared tooth.

Finishing Touch

Using articulating (bite) paper to check for high points on the new tooth surface. Any high spots are reduced with burs to ensure a perfect balance between upper and lower jaws.

Frequently Asked Questions

Usually, it takes 3 to 4 appointments for a single RCT by BDS graduates. They need a total of 2 to 4 hours of working time in separate appointments of half to 1 hr each. But Endodontist MDS post-graduates can perform Single Sitting RCT. They need a maximum of 1 hour of working time in a single visit.

Note: After RCT, Crown placement on the tooth is mandatory, so the time given above excludes Crown preparation & placement (which further needs 4 appointments & 5 working days for lab manufacturing).

Endodontists are MDS (Masters in Dental Surgery); they are masters in that field. They studied RCT for 3 more years than a graduate dentist. They are well-trained to perform reliable, accurate RCT. It is convenient & time-saving as they are experts in doing single-sitting root canals. You will need to take antibiotics for fewer days (minimum 3 days) as the treatment is done in a single visit.

Rotary Machines have three basic components:
A. Apex Locator: Works digitally to give an accurate reading of how far the root apex is from the top of the crown.
B. Rotary Handpiece with adjustable Torque: Rhythmically controls cleaning and shaping of complete root canals.
C. Rotary File system (e.g., Protaper Next, Heroshapers, or gold-plated files): Made of Titanium alloy, so they are stronger yet more flexible, offering fewer chances of file separation inside canals which was common with traditional K-files.

A. Choice of Dental Clinic
B. Choice of Doctor (Graduate vs. Post-graduate)
C. Use of Advanced Technology
D. Justified Time given to the procedure
E. Patient Co-operation (taking medication on time)
F. Medical Conditions (BP, Diabetes, Thyroid, Blood Disorders)
G. Post-operative care (missed placement of crown after RCT, eating hard food, or trauma to the tooth).

Placement of a Crown is mandatory after RCT. Many people fail to get it done because their pain is relieved after the root canal, and they postpone the crown. This leads to further damage, as the treated tooth becomes brittle due to a lack of nutrition through blood supply. Your tooth will fracture in small pieces and one day you may have to lose it due to ignorance.

Cost of Root Canal Treatment

RCT + Post & Core + Metal Crown

MDS Endodontist Fees
Includes Sterilization + Disposable accessories

Rs. 15000

RCT + Post & Core + PFM Crown

MDS Endodontist Fees
Includes Sterilization + Disposable accessories

Rs. 21000

RCT + Post & Core + Ceramic Crown

MDS Endodontist Fees
Includes Sterilization + Disposable accessories

Rs. 24000

Root Canal Therapy

Author: Dr. Avinash Bamane (MUHS) | Published: 2008-01-01

Abstract: Root Canal Treatment, also known as Endodontics Treatment, is a dental procedure in which the diseased or damaged pulp (core) of a tooth is removed, and the inside areas (the pulp chamber and root canals) are filled and sealed.