Dental Root Canal Checklist: Procedure & Post-Op Instructions
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Pre-Procedure Assessment
Review patient history, radiographs, and clinical findings to determine suitability for root canal therapy.
Patient's Last Dental Visit
Patient's Age
Medical History Review (allergies, medications, conditions)
Dental History (previous treatments, concerns)
Chief Complaint
Radiographs (Current)
Sensitivity to Hot/Cold
Anesthesia & Isolation
Confirm adequate anesthesia; establish rubber dam isolation ensuring a clear working field.
Anesthetic Type
Anesthetic Dosage (mg)
Vasoconstrictor?
Time of Anesthetic Administration
Rubber Dam Placement?
Comments on Anesthesia/Isolation
Canal Access & Negotiation
Create coronal access cavity; locate and negotiate canals to working length.
Working Length (mm)
Access Cavity Shape
Locating Methods Used
Number of Canals Located
Notes on Canal Anatomies
Pre-operative Radiograph
Canal Cleaning & Shaping
Irrigate canals thoroughly; shape canals to appropriate dimensions using files.
Working Length (mm)
Initial File Size
Irrigation Solutions Used
Irrigation Frequency (cycles)
Instrumentation Technique
Notes on Canal Anatomy (e.g., curves, bifurcations)
Number of Files Used
Obturation
Obturate canals with appropriate filling material (gutta-percha); ensure complete seal.
Warm Vertical Compaction Temperature (°C)
Number of Gutta-Percha Cones Used
Obturation Technique
Detailed Description of Obturation Procedure
Radiograph Post Obturation
Sealer Type
Coronal Restoration
Restore coronal access cavity with temporary or permanent restoration.
Restoration Type
Composite Fill Size (mm³)
Notes on Restoration Placement
Crown Type (if applicable)
Crown Cementation Date (if applicable)
Post-Operative Instructions
Provide patient with detailed post-operative instructions regarding pain management, oral hygiene, and follow-up appointments.
Pain Management Instructions
Oral Hygiene Instructions (Specifically Regarding the Treated Area)
Prescription Refill (Days)
Follow-up Appointment Scheduled?
Date of Follow-up Appointment
Contact Method for Questions
Radiographic Confirmation
Take and review radiographs to confirm adequate obturation and healing progress.
Radiograph Exposure Factor (kVp)
Radiograph Exposure Time (Seconds)
Radiographic View(s) Obtained
Radiographic Findings Description
Radiographic Assessment
Radiograph Image Upload
Documentation & Record Keeping
Thoroughly document procedure details, materials used, and patient instructions in the patient record.
Procedure Notes
Working Length (mm)
Filling Material Used
Date of Procedure
Procedure Start Time
Doctor Signature
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