4 dental visits for one tooth???

I’m still relatively new to the wonderful world of root canal work, so every dental visit is giving me new surprises. For example: I thought today that one tooth was already finished, and that we were gonna go to work on something else (another root canaled tooth that we started in early December).

So the dentist put a lot of stuff in my mouth. And then, much to my surprise he went to work on this other tooth… for the third time. I guess he assumed I knew what was up, but with all the purple impression glop, gauze, and hoses in my mouth I never got the opportunity to tell him otherwise.

I found out from the hygienist that I still need one more visit before this tooth is done. Dentist being long gone.

I just want to make sure I’m not getting taken for a ride here. Four hour-long visits for one tooth seems excessive to me, but then this is one reason why I’m not a dentist…

My root canals have usually taken three visits (I’ve had five, thanks to the joys of genetics). Oh, and IANADentist.

1st - begin root canal
2nd - complete root canal, take impression for permanent crown, get temporary crown
3rd - get permanent crown
With one, I had an additional appointment for them to “build up” (no, I don’t know what that really means) before I could have the permanent crown seated.

At the same time, I’ve had a couple that only took two visits. The root canal was completed and the crown work done the same day. I just had to return to have the permanent crown done.

Just ask them why it took so many visits.

IANAD but I don’t think four visits is necessarily over the top. I probably had something like that for my root canal work but they didn’t last anything like one-hour apiece. I think they have to be sure that they’ve cleaned all the infection out before doing the final filling and they need to give it a few days after each cleaning to be sure the infection is gone. If there are still signs, they’ll poke around a bit more and ask you to come back. I presume you’re paying him/her a set amount for the work, regardless of the number of visits. If that is the case, you should be thankful you’ve got a conscientious dentist.

Hey I went to a dentist where it took four visits just to get the teeth cleaned. Needless to say, I stopped going there. I had good dental insurance and I think it was a big ploy to ping the insurance carrier for an office visit, every time I walked into the place. Can’t respond to the OP, but are there any dental-worker types here who can explain why the procedure above requires more than one visit? Why do they have to give you a temp. crown first? Why can’t they just drill out the root and crown it?

In case you were wondering, the four appintments were for:

  1. Initial consultation, set next three appointments
  2. Take x-rays
  3. Actually clean teeth
  4. polish the teeth.
    When I was a kid, all that would have taken just one visit. I think the multiple visit thing that I see so prevalently now, is all about collecting insurance payments.

I remember when I was a kid, the dentist took x-rays, cleaned my teeth, and filled any cavities all in one visit. Now, as in the OP, my dentist requires 3 or 4 visits for the same routine. I went a few months ago to fix a chipped tooth. At that time they said I had three cavities and would need to come back to have them treated. First visit was a cleaning. Second was a deeper cleaning. Third was the fillings, and the only reason there wasn’t a fourth visit is that I insisted they finish everything on the third visit, which they did. What irks me as well about this is that each time I’d sit in the chair, the dental assistant would ask me what I needed done that day: ‘Are you here for a cleaning?’ - Not conversational, but to find out what I wanted done. I always told them ‘I’m here because I have cavities and the dentist told me to come back. If that means I need a cleaning, then clean. If I don’t need a cleaning then don’t clean.’ Translation: ‘If you really need me to tell you what to do, then please give me some dentist training manuals and my x-rays and I’ll get back to you.’

Anyway, to answer the OP, 4 visits for one tooth is consistent with my experience. In the future, I would recommend that when you make the appointment, you ask what all will need to be done and can they schedule you for as much work as possible in one visit. My guess is that dentists have decided that people don’t like having their mouths forced open for extended periods, which I suppose is a legitimate concern.

Oh yeah - on my last visit they left one of those gauze tubes under my tongue. I didn’t realize it was there until after the novocaine wore off and I felt this stinging, which I initially thought was just the pain from the procedure. I finally looked in the mirror to see if there was anything wrong, and there was that gauze sponge. Unbelievable.

I work for a dentist. manwithaplan has it right about the need to make sure the infection is gone.

Many endodontists will complete the RCT in one visit. They will generally be using rotary insruments. Most general dentists I know still do hand instrumentation, which may take 2 or 3 visits, depending on the number of roots (and canals) the tooth has. The first visit is for pulp removal and gross debridement of the canals, the second for canal shaping and obturation, or filling.

The tooth, especially a decayed molar, will then need to have a “build-up” or post and core to have enough stucture for the crown to hold on. This is done by basically rebuilding the tooth with resin or amalgam and sometimes a post that is cemented into a canal. Crowns are not flat-bottomed. Many people call them caps, which is pretty much what they do. They slide over the tooth stump and fit like a hat. Without the build-up there is nothing for them to hang on to.

Crowns are custom made to fit the tooth and must mesh with opposing teeth or your bite will be way off. The impressions are sent to a lab, where several days are needed to make the crown. Porcelain requires dust free conditions and must be placed in layers and then fired at high temperature. The gold substructure is cast to exacting standards for each crown. Newer materials, pressed lucite and resin, need pressure chambers. We do some lab work in my office, more than most dentists, but are not equipped to do this stuff onsite.

Some dentists have started using CAD/CAM equipment to make crowns in office. One manufacturer is Sirona. http://www.planetcerec.com/ The crowns are made and cemented during one visit. They can be great for molars, but are too opaque for use in the anterior part of the mouth. The blocks used for milling are of uniform color, unlike natural teeth. That plus the high cost of the equipment is what keeps the technology out of offices that do not do crown work as the bulk of their practice.

A lot of repeat visits are due to scheduling. When you make an appointment for an exam, you (generally) get the x-rays, cleaning, and polishing, and the dentist can count on this taking 15 minutes of his time (while the hygenist does most of the physical work). If you have cavities detected, then you’ve blown the timeline – you’ve gotta come back when the dentist can plan on giving you more than 15 minutes of his attention.

My wife’s molar root canal took two visits (regular dentist – not endodontist). One for the root canal with buildup (post, temporary crown, etc.) and then another one for the permanent crown. I guess between the time the root canal was done and the time we returned for the crown would have been enough time for another abcess to form were there still any infection. In which case I guess they’d’ve had to undo the crown buildup.