Chapter 3 – Health Care Operations

3.3.2.9 Endodontics

• Policy

  • All California Department of Corrections and Rehabilitation (CDCR) patients shall be eligible to receive limited endodontic (root canal therapy) services at CDCR dental clinics.  Endodontic services within the CDCR shall be performed in accordance with established criteria and within the specific guidelines of this chapter.

• Purpose

  • To establish dental treatment parameters for providing patients with endodontic services in CDCR dental facilities.

• Procedure

  • Endodontic procedures shall not be performed when extraction of the tooth is appropriate due to non-restorability, periodontal involvement or when the tooth can easily be replaced by an addition to an existing or proposed prosthesis in the same arch.

  • Endodontics, or root canal therapy, shall only be performed for a patient on the upper and lower six anterior teeth when all of the following conditions are met.

    • The retention of the tooth is necessary to maintain the integrity of the dentition.

    • The tooth has adequate periodontal support and a good prognosis for long-term retention and restorability.

    • The tooth is restorable using CDCR approved methods and materials and does not require extensive restoration including either a pin or post retained core build up.

    • There is adequate posterior occlusion, either from natural dentition or a dental prosthesis, to provide protection against traumatic occlusal forces.

  • A CDCR 7424, Consent for Root Canal Treatment, must be completed and signed by the patient prior to the initiation of treatment.

  • Apicoectomies, retrograde fillings, posterior root canal therapies, hemi-sections, root amputations and re-treatment of root canal therapies are excluded procedures and as such require prior approval of the Dental Authorization Review Committee. (Reference the Health Care Department Operations Manual [HCDOM], Section 3.3.4.5(c)(3) and (4)).

  • Posterior root canal therapy may be considered if all of the following conditions are met:

    • Conditions listed in Section (c)(2)(A) through (D).

    • The tooth in question is vital to the patient’s masticatory ability.

    • The tooth in question is essential as an abutment for an existing removable cast partial denture or is necessary as an abutment on a proposed removable cast partial denture for that arch.

  • Palliative endodontic therapy (Dental Priority Classification [DPC] 1) shall be available, on an emergency basis only, for patients with less than six months of verifiable, continuous incarceration time remaining on their sentence (i.e., only emergency pulpal debridement for the relief of acute pain shall be provided).

  • Root canal therapy (DPC 3) shall be available to all patients within the guidelines of this chapter, according to their dental treatment plan, PI score and with the approval of the treating dentist.

  • All root canal therapy shall be completed at the dental facility where the procedure was initiated.  A hold shall be placed on all patients whose root canal therapy cannot be completed in one appointment.  The hold shall remain in effect until the root canal therapy is completed. (Reference the HCDOM, Section 3.3.6.6(c)(2) regarding placing a hold).  Patients undergoing palliative endodontic therapy are excluded from this “hold” process.

• References

  • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.4.5, Dental Authorization Review Committee

  • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.6.6, Dental Holds and Patient Transport-Transfers

• Revision History

  • Effective: 04/2006
    Revised: 11/2017, 11/2020, 02/2022