Following a definitive diagnosis of the need for root
canal treatment, the treatment planning stage should
be straightforward if a logical sequence of decision-making is followed.
Very few contra-indications
exist for providing root canal treatment, but the
planning must include several aspects. Firstly, is root
canal treatment best for the patient to maintain a
functional dentition long term? Secondly, who
should provide the treatment? Thirdly, what are the
restorative options that will ensure the best long-term prognosis?
The sequencing of root canal
treatment generally occurs early in a typical treat-ment plan,
and prompt restoration after treatment is
crucial to long-term survival of the tooth
The goal of endodontic treatment is to preserve the
tooth as a functional unit within a functioning
dentition. As such the endodontic treatment must be
integrated into a comprehensive treatment plan that
includes restorative and periodontal management.
Clinical management begins with an accurate diagnosis
of the cause of endodontic pathology.
Sometimes, it is
necessary to deal with acute pain and swelling
associated with a tooth that requires endodontic
treatment before being able to offer a definitive
treatment plan.
The proposed endodontic treatment
should be part of an agreed, comprehensive treatment
plan that includes the patient’s participation in the
treatment decisions. In order to give good advice, the
dentist will need to exercise clinical judgement that is
based on rational treatment principles. It is the skill and
care with which these judgements are made that
distinguish the really good dentist from the merely
good dentist.