MEDICINE: RCT

ENDODONTIST

​"A smile is an inexpensive way to improve your looks."

​But is it true?

Are smiles inexpensive?

Let's find out​!

Multiple Choice

Endodontics is a specialized area of dentistry. Injury to which part of the teeth is focused on by endodontists?

• Enamel

• Dentin

• Pulp

Pulp.

As explained in the video, endodontists are dental specialists, who treat pulp injuries and infections.​

Multiple Choice

Why is it important to numb the area around the tooth during the root canal treatment?

• To isolate the infected tooth from other teeth

• To make sure that the patient does not feel any pain

• To avoid moisture getting into the infected teeth

To make sure that the patient does not feel any pain.

As explained in the video, endodontists numb the area around the infected tooth to ensure that the patient does not feel any pain in the area where the procedure is to be performed. For isolating the tooth and keeping it dry, the doctor would use a small shield.

Now that you have understood the ​root canal procedure, let's experience a day in the life of an endodontist!

A patient has come to you with a severe toothache.

Let's assess her condition!

You are a renowned Endodontist practicing in India.

Patient Name: Ruchi

Patient ​Age: 28 yrs ​

Symptoms: Experiencing severe toothache for the past 2 days.

Medication: ​Took pain medicine but didn't help.

​

​Patient Details

​Dental X-Ray

Multiple Choice

What is your initial diagnosis after analyzing the patient's dental X-ray?

• The patient has pulp infection in 1 teeth

• The patient has pulp infection in 2 teeth

• The patient has pulp infection in 3 teeth

• The patient d not have any pulp infection

If you observe the dental scan, you would see that the infection has progressed to the pulp area only in the 2 teeth marked with a red circle.

​The patient has a pulp infection in 2 teeth.

Multiple Choice

Considering that you only go for RCT if the pulp is infected, how many teeth require RCT?

• 1

• 2

• 3

• 4

2 teeth are experiencing pulp infection. Thus, you should perform RCT on both of them to avoid further infection.

​2 teeth.

Root canal treatment ideally is done in 3 sittings/tooth but it can be done in a single sitting/tooth if the infection is severe.

It is preferred to not rush the treatment​ unless necessary. Also, doctors prefer to do only one tooth at a time.

Multiple Choice

The infection is considered severe when there is the presence of an abscess or pus in the root area. Keeping that in mind, how many sittings do you need for both the tooth RCTs?

• 2

• 3

• 4

• 6

Upon observation, you can see that there is only one tooth with an abscess/pus in the root area​. Thus, only one tooth has a severe infection and you need to perform RCT in a single sitting for that tooth. But in the case of the other tooth, you should take 3 sittings and not rush the treatment. Therefore, 4 sittings are needed.

4 sittings.

Multiple Choice

You charge your patients ₹2,500/sitting for RCT. Considering you have promised Ruchi a 20% discount on the total amount, how much would Ruchi have to pay for both her RCTs?

• ₹5,000

• ₹8,000

• ₹10,000

• ₹12,000

Calculations:

• ​Total no. of sittings required for both RCTs = 4

• Price for one sitting of RCT = ₹2,500

• Price for 4 sittings = ​₹2,500*4 = ₹10,000

• Discount promised to Ruchi = 20% of ​₹10,000 = (20*10,000)/100= ₹2,000

• Total amount to be paid by Ruchi​ = ₹10,000-₹2000 = ₹8,000

₹8,000.

Great job!

The RCT of both the teeth was successfully done and Ruchi's condition is much better now.

​

But after root canal treatment, chances of fracture of the tooth is more.

Thus, it is advisable to get a crown as soon as possible.

Other possible causes of fracture may be chewy/hard food​.

​

Multiple Choice

Post RCT what would be your instructions for Ruchi?

• Consume liquid food for a few days

• Don't consume candies and gums

• Get crown for the teeth asap

• All of these

Eating hard food, candies and gums might cause a fracture of the newly repaired tooth as it is still sensitive from the procedure.​ Not having a crown would expose the tooth to infection and pressure which might lead to fracture. Thus, it is important that the patient gets a crown immediately and consumes liquid food, and avoids candies and other chewy stuff.

All of these.

You gave her all the instructions and explained the crown procedure step-by-step through this video:

You booked an appointment for her to take the impression of her customized crown.

But she didn't ​show up on the date of the appointment!

Multiple Choice

Upon analysis, you observed that the damage was not much and still the tooth can be restored without repeating RCT. Considering her tooth is still very sensitive and the permanent crown will take 3 weeks to arrive, what would you do?

• You leave the implant open without any cover and let it heal

• You put a temporary crown on top of the implant and let it heal

The patient has already had a fracture and the tooth is extremely sensitive. Keeping this in mind, you should put a temporary crown/cap on the tooth to avoid any further damage.

You put a temporary crown on top of the implant and let it heal.

Multiple Choice

You usually charge ₹2000/permanent crown from your patients. You had to do extensive cleaning and it took extra time for the procedure because of Ruchi's negligence. Considering that you don't want to make a loss, would you charge Ruchi any extra amount or take just ₹4,000 for 2 crowns?

• No, just charge ₹4000 for 2 crowns

• Yes, charge extra

Ruchi didn't attend her scheduled appointment ​and you had to spend extra time cleaning because of her negligence. You could have attended to another patient during that time. Thus, to compensate for your time lost, she should pay an extra charge.

Yes.

You informed Ruchi about the extra charge. She accepted her mistake and is willing to pay for the extra time you spent because of her negligence.

WELL DONE!​

Ruchi's permanent crowns are also placed and the pain is gone too.

She can't stop smiling, all thanks to you!​

Poll

Would you like to be an Endodontist in the future?

• YES

• MAYBE

• NO

Poll

On a scale of 1-5 stars (1 being the lowest and 5 highest), how much would you rate this challenge on fun and learning?

Open Ended

What changes would you suggest for this challenge?