The decision to do RCT can be taken based on the following factors.
- Patient’s symptoms.
- Clinical examination.
A good digital x-ray will reveal if the cavity is involving the nerve, then RCT is recommended. In case of borderline scenario where the cavity is deep but not involving the nerve, a decision can be taken after completely removing the decay .If the nerve gets exposed then RCT is necessary. Remember the primary goal of attending to that tooth is to remove the decay from it. So it is best to take a decision on the spot after removing the decay .If RCT is needed to save the tooth then it is recommended.
We have a STANDARD PROTOCOL in such a case- In case of a cavity which we start out as a filling but realize that it is deeper and we feel that RCT is needed- then the patient will be explained about the situation and the cost. If the patient agrees then we can start the RCT right away. Otherwise we can only give a temporary filling not a permanent filling.