Number of visits for a root canal

[Raryn]

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Just wondering exactly how much a dental office is trying to scam a patient of mine: Mostly unrelated to why he's seeing to me, guy describes that he recently had to have a root canal for an abscess that was found on imaging only (otherwise completely asymptomatic). Says that he scheduled one visit for it at the dentist, who says he will have to come back for at least 1-3 more visits to "wash out the canal" and watch it heal. Then come back for at least 2 visits to fit/place the crown. Comes to 4+ visits total. Needless to say, it sounded strange to me, but I figured the dentists were the experts in this.

Are they just bilking the insurance company or does that actually sound like SOP? I'd hate to have my patient delay other needed care while his dentist plays around trying to max out his earnings.

 

[Koalafied]

Just wondering exactly how much a dental office is trying to scam a patient of mine: Mostly unrelated to why he's seeing to me, guy describes that he recently had to have a root canal for an abscess that was found on imaging only (otherwise completely asymptomatic). Says that he scheduled one visit for it at the dentist, who says he will have to come back for at least 1-3 more visits to "wash out the canal" and watch it heal. Then come back for at least 2 visits to fit/place the crown. Comes to 4+ visits total. Needless to say, it sounded strange to me, but I figured the dentists were the experts in this.

Are they just bilking the insurance company or does that actually sound like SOP? I'd hate to have my patient delay other needed care while his dentist plays around trying to max out his earnings.

You remind me of a close friend whom's a MS2! It's always healthy to be skeptical, always.👍x5

I'm neither a dentist nor a dental student, yet; perhaps reduced bias?

Anyhoo..... the length of a RCT depends on what the case is, and also dependent on how cooperative/synergistic the relationship between the patient and dentist is. Assuming proper standard of care, Between 1-3 visits sounds about right. Although I've witness a RCT converted to an implant case, and that patient never returned again, so . Both tx are both time consuming and very expensive.

http://en.wikipedia.org/wiki/Endodontic_therapy
http://www.mayoclinic.com/health/root-canal/DE00010&slide=3
http://www.ncbi.nlm.nih.gov/pubmed/17936128
https://www.aae.org/about-aae/news-room/press-releases/dental-implants---root-canal.aspx
http://endoexperience.com/userfiles...Planning/Implants Vs Endo/Implant_or_Endo.PDF
http://www.youtube.com/watch?v=HGPbcTBdcso
http://www.youtube.com/watch?v=jHHn52KhBkQ

I agree, the video makes this procedure seem rather quick; it's not; for the most part, it's meticulous and tedious for both dentists and patients alike. Again, dependent on the case.

Good luck w/your patient&residency.🙂

 

[doc toothache]

Just wondering exactly how much a dental office is trying to scam a patient of mine: Mostly unrelated to why he's seeing to me, guy describes that he recently had to have a root canal for an abscess that was found on imaging only (otherwise completely asymptomatic). Says that he scheduled one visit for it at the dentist, who says he will have to come back for at least 1-3 more visits to "wash out the canal" and watch it heal. Then come back for at least 2 visits to fit/place the crown. Comes to 4+ visits total. Needless to say, it sounded strange to me, but I figured the dentists were the experts in this.
Are they just bilking the insurance company or does that actually sound like SOP? I'd hate to have my patient delay other needed care while his dentist plays around trying to max out his earnings.

You are kidding, right?

 

[NileBDS]

Just wondering exactly how much a dental office is trying to scam a patient of mine: Mostly unrelated to why he's seeing to me, guy describes that he recently had to have a root canal for an abscess that was found on imaging only (otherwise completely asymptomatic). Says that he scheduled one visit for it at the dentist, who says he will have to come back for at least 1-3 more visits to "wash out the canal" and watch it heal. Then come back for at least 2 visits to fit/place the crown. Comes to 4+ visits total. Needless to say, it sounded strange to me, but I figured the dentists were the experts in this.

Are they just bilking the insurance company or does that actually sound like SOP? I'd hate to have my patient delay other needed care while his dentist plays around trying to max out his earnings.

Standard procedure for a necrotic (abscessed) tooth.


The dentist will probably loose money seeing this patient (no kidding), and He/She will be reimbursed the same amount of money from the insurance company whether it takes 1 or 15 visits. It is not in the practitioners interest to prolong the duration of the treatment. It just sounds like He/She cares.

 

[billythekid]

Standard procedure for a necrotic (abscessed) tooth.


The dentist will probably loose money seeing this patient (no kidding), and He/She will be reimbursed the same amount of money from the insurance company whether it takes 1 or 15 visits. It is not in the practitioners interest to prolong the duration of the treatment. It just sounds like He/She cares.

Yep

 

[gryffindor]

Bilking the insurance company? Dental insurance works nothing like medical. It's not even "insurance." It's more like a $X coupon off toward a dental procedure for the patient. The insurance company will pay the dentist same amount of money toward the procedure regardless if it takes 1 visit or 6 - if this is private insurance we are talking about.

But if this is some type of government/medicaid clinic or insurance, some of those places are paid by the visit so yeah, they might be "bilking the insurance company."

My first molar root canal in dental school took me 5 visits. And that was just for the root canal. Another 3 or 4 visits for the crown. The patient had no insurance. He was just unemployed with a lot of patience.

ETA - 1 to 3 visits for a root canal in private practice is completely normal. It is best to make sure the tooth has healed and is asymptomatic before proceeding to the crown stage. 2 visits for a crown is also very normal - First visit is to prepare the tooth and take a mold which is sent to a dental lab that actually has to custom-make the crown by hand from metal and/or porcelain. The following visit to cement this customized crown in the mouth. Crowns for adults are custom made for the patient and his tooth and are typically not one-size-fits-all if they are done properly.

 

[taloncusp]

Standard procedure for a necrotic (abscessed) tooth.


The dentist will probably loose money seeing this patient (no kidding), and He/She will be reimbursed the same amount of money from the insurance company whether it takes 1 or 15 visits. It is not in the practitioners interest to prolong the duration of the treatment. It just sounds like He/She cares.

Agreed. The dentist will lose money by seeing this patient multiple times for the same tooth. Lower chance of post-op discomfort if a necrotic tooth is treated in multiple visits. This dentist cares.

 

[Contach]

This dentist cares.

****... who would have thought? Sadly, this is the reputation that dentists get in hospitals =\

But yea.. you can't diagnose an 'abscess' on a radiograph alone. There was likely some miscommunication somewhere...

 

[Shunwei]

****... who would have thought? Sadly, this is the reputation that dentists get in hospitals =\

But yea.. you can't diagnose an 'abscess' on a radiograph alone. There was likely some miscommunication somewhere...

As far as I am aware of there is nothing in the literature supporting the purported efficacy of multiple visits for root canals.

 

[djeffreyt]

While literature does not support or deny the claim that multiple visits help in asymptomatic tooth RCTs, if the dentist wants to clean and shape and check for bone regeneration on a radiographic lesion before obturating the root canal or fabricating a crown, it's completely warranted to do multiple visits. The dentist is being extra cautious, possibly for no reason, but it's not really doing any harm here.