What a Root Canal Actually Involves, Visit by Visit

Quick answer: A molar root canal is usually four appointments over six to eight weeks: emergency pain relief, completing the canals, building the tooth back up with a post and core, and fitting a crown. The pain stops at the first visit; the rest is rebuilding.

The call

Sara, 45, from Givat Sharett, came in with a badly broken-down lower molar and one question she asked three times in the first ten minutes: how many visits, and how long will each one take? She worked shifts and had four children. The clinical plan was straightforward; the scheduling was the thing she actually needed answered.

So here is the whole sequence, laid out the way we laid it out for her.

What we found

Lower left first molar. Half the crown missing, decay to the pulp, no response to cold, tender to bite, and a small lesion at one root tip. The tooth had enough sound structure below the break to be restorable, and good bone support.

What we did

Visit one — emergency (60 minutes). Anaesthetic, rubber dam, access through the top of the tooth, and removal of all the infected pulp tissue from the canals. This is the visit that stops the pain, and it is the one people remember as "having the root canal". We measured each canal's length electronically, cleaned and shaped them, placed a calcium hydroxide dressing and sealed the tooth with a solid temporary. She left comfortable.

Visit two — completing the canals (60 minutes), three weeks later. The dressing comes out, the canals are irrigated again and dried, and then filled with gutta-percha and sealer to the exact working length, confirmed with an x-ray. Once this is done the inside of the tooth is permanently sealed. There is no more infection to treat.

Visit three — post and core (45 minutes), a week later. With so little of the crown left, there was nothing for a crown to hold onto. We removed a few millimetres of root filling from the largest canal, cemented a fibre post into it, and built a core around it in composite — effectively constructing a new tooth stump. Then the tooth was prepared for a crown, scanned, and a temporary crown fitted.

A note on posts, because they are widely misunderstood: a post does not strengthen a tooth. It anchors the core. If enough tooth structure remains, no post is needed, and one should not be placed.

Visit four — fitting the crown (30 minutes), two weeks later. Temporary off, crown tried in, contacts and bite checked and adjusted, then cemented. Done.

The outcome

Six weeks and four appointments, and the tooth has been functioning normally for four years.

The point Sara took away, and which we tell everyone: the pain is dealt with at the first visit. Everything afterwards is scheduled work on a comfortable tooth, and it can be arranged around your life.

What to do if this happens to you

1. Ask for the whole plan and the whole cost at the start, not visit by visit.
2. Do not skip the crown. A root-treated back tooth without one has a substantially higher fracture rate. This is the step people postpone and regret.
3. Chew carefully on the temporary. It is not built for hard food.
4. Expect mild tenderness for a few days after each of the first two visits. Ibuprofen covers it.
5. Go back promptly if the temporary comes out. An unsealed root canal reinfects.
6. Ask about scheduling. Most of these appointments can be combined or spaced to fit around work.

Need a root canal in Beit Shemesh or RBS? Ramat Beit Shemesh Urgent Dental Care gives you the full plan and cost up front. 055-985-8845 · WhatsApp https://wa.me/972559858845 · Harav Kook 28/1, Beit Shemesh.

Based on real cases treated at the clinic. Names have been changed.