To give readers a step-by-step account and commonly asked queries about Root Canal treatment, we approached Dr Sujatha Shetty. Here is her version.

To understand what? Why? & How? Of a RCT, we better look at a normal tooth.

Why is a Root Canal Treatment required?
Root canal treatment is needed when an injury or a large cavity damages the tooth’s root. The root becomes infected or inflamed.

Step 1

A Route to the Root: The dentist numbs the tooth. An opening is made through the crown of the tooth to the pulp chamber.

Step 2

Removing the Infected/Inflamed Tissue: Special files are used to clean the infection and remove the unhealthy pulp out of the canals. Then the dentist shapes the canals for the filling material. Canals are irrigated to help clean and remove the debris.

Step 3  

Filling the Canals: The canals are filled with a permanent material known as gutta-percha. This helps to keep the canals free of infection or contamination in future.

Step 4

Rebuilding the Tooth: A temporary filling material is placed on top of the gutta-percha to seal the opening. The filling remains until the tooth receives a permanent filling or a crown. A crown, also called a cap, looks like a natural tooth. It is fixed over the top of the tooth.

Step 5

Extra Support: In some cases, a post is placed into the root next to the gutta-percha. This gives the crown more support.

Step 6

The Crowning Touch: The crown is cemented into place.

FAQs

Q – What is root canal treatment?

A – Root canal treatment (also called endodontics) is needed when the blood or nerve supply of the tooth (known as the pulp) is infected or injured.  One may not feel any pain in the early stages of the infection.  In some cases, the tooth may have darkened in colour, which may mean that the nerve of the tooth is dead (or is dying).  This tooth needs root canal treatment.

Q – Why is root canal treatment needed?

A – If the pulp becomes infected, the infection may spread through the root canal system of the tooth.  This may eventually lead to an abscess.  An abscess is an area in which pus collects and can cause swelling of the tissues around the tooth.  The symptoms of an abscess can range from a dull ache to severe pain and the biteis tender.  If root canal treatment is not carried out, the infection will spread and the tooth may need to be taken out.

Q – Does it hurt?

A – No.  Usually, a local anaesthetic is used and it feels not much different than an ordinary filling.  There may be some pain on touch later but it gradually gets better over time.

Q – What does it involve?

A – The aim of the treatment is to remove all infection from the root canal.  The root is then cleaned and filled to prevent any further infection.Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to the dentist. At the first appointment, the infected pulp is removed, and any abscesses can be drained.  The root canal is then cleaned and shaped ready for the filling.  A temporary filling is put in and the tooth is left to settle. The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.

Q – What does the tooth look like after treatment is over?

A – In the past, a root-filled tooth would often darken after treatment.  However, with modern techniques this does not usually happen.  If there is any discolouration, there are several treatments available to restore the natural appearance.

Q – What if it happens again?

A – Root canal treatment is usually very successful.  However, if the infection comes back, the treatment can sometimes be repeated.

Q – What if one doesn’t want to get it done?

A – The alternative is to remove the tooth. Once the pulp is destroyed it can’t heal, and it is not recommended to leave an infected tooth in the mouth.

Although some people would prefer to have the tooth out, it is usually best to keep as many natural teeth as possible.

Q – Will the tooth be safe after treatment?

A  – Yes.  However, as a dead tooth is more brittle, it may be necessary to restore the tooth with a crown to provide extra support and strength to the tooth.

Q – Where can this treatment be carried out?

A – Root canal treatment is a routine dental procedure, which your dentist will be happy to do for you. However, sometimes your dentist may refer you to an endodontist, who is a specialist in this type of treatment.

Q – What about aftercare?

A – Root-treated teeth should be treated just the same as any other tooth.  Remember to clean the teeth for two minutes, twice a day with fluoride toothpaste.  Cut down on sugary foods and drinks and keep them only to mealtimes if possible.  See your dentist as often as they recommend for regular check-ups.

Q – What complications can one expect?

A -Signs of a failed root canal treatment
-Mild to severe tooth pain
-Slight to more pronounced tenderness or swelling in the gums in the area near the tooth that can either be in a persistent or transient mode following root canal treatment.

Dr Sujatha Shetty, M.D.S. (Prosthodontics); Practicing since 1988; is a senior consultant at the Asian Heart Institute, BKC, Mumbai; is a member of the International Team of Implantologist, Mumbai Coast as well as a Member of Indian Society of Implantologist.