For anyone who has ever had dental problems and is not a dentist, there are three words that can send shivers down your spine - ‘Root Canal Treatment’! The thought of lying helplessly awake on a chair under a bright glare while a stranger operates with syringes and needles inside your mouth! Most people would consider it their worst nightmare. Why wouldn’t you be scared? It involves someone passing very narrow pins through millimeter-wide canals that contain the most sensitive nerve endings inside your teeth. I’m sure by now, whoever is reading this is seriously reflecting on their oral hygiene habits.

The hard tissue of a tooth, apart from helping us chew and making us look adorable when we smile, also serves the function of protecting the pulp (The hollow center of the tooth which contains capillaries and nerve endings, nourishing it and keeping it vital). This is why when ‘tooth decay’ initially occurs in the form of a cavity, we barely notice it let alone feel it. It doesn’t hurt because the enamel and dentin is shielding the pulp and the nerve endings from the site of decay. It may not even be a cavity, but a small black spot with a pinpoint depression that your dentist points out to you when you go for a routine dental checkup or to get your teeth cleaned. 

This small discoloration is nothing but a group of bacteria that have managed to colonize a part of your hard tissue. Your dentist will recommend that he remove it and restore it with a type of dental cement. If you’re smart, you’ll heed the advice. The over-smart ones will think the Doctor is trying to make some extra cash by advising treatment for something that doesn’t even hurt them. Bacteria, on the other hand, don't discriminate between smart people and ignorant ones. If you let them live in a nutrient-rich environment, they will grow exponentially and colonize more. And where can you find a more nutrient-rich environment in the body for the bacteria, than the one place through which food is ingested?

How can one prevent the need for an RCT?

The people who fail to get their cavities cleaned and filled when they notice them are the ones who later return with shooting pains in their mouth for the dreaded root canal treatment. The bacteria present in the cavity of a decayed tooth keep digging deeper till it reaches the pulp. When it is just about to reach the pulp, the nerve endings get sensitized and give out warnings in the form of mild pains and toothaches. Even at this stage, a need for Root Canal Treatment can be prevented provided you consult a Dentist immediately. Once a bacterial infection reaches the pulp, the tooth is considered ‘non-vital’ or dead. The pulp chamber and all the canals of the roots are now infected and colonized by the microbes that caused the decay and since these are remote locations that cannot completely be accessed by the normal blood vessels of our body, antibiotics alone cannot cure a pulp-infected tooth.

Pulp infections can occur not only from unchecked cavities but from periodontal infections (infections of the gum) too. One can prevent the need for RCTs by getting regular dental check-ups, getting cavities detected early and filling them, getting a full mouth cleaning every six months, and by maintaining strict oral hygiene with correct brushing techniques and flossing.

If you are past the stage of prevention and are now faced with the prospect of getting an RCT soon, here are some of the most common and pertinent questions you may have.

Are Root Canal Treatments painful?

The answer is no. Root Canal Treatments are not painful. At least they aren’t supposed to be. In India, Root Canal treatments are commonly done under Local Anesthesia but some dentists prefer to put their patients under ‘conscious sedation’ as is done in more developed countries. The latter is more expensive and is being increasingly practiced in metro cities.

How is a Root Canal Treatment done?

The Dentist drills through the infected cavity both vertically and horizontally to open up and gain complete access to the pulp chamber. They then proceed to clean out the pulp chamber and remove all infected tissue. The next step is to identify and clean out all the root canals through narrow pointed metallic instruments called ‘Dental files’. Once the infected tissues have been completely removed from the pulp and the canals, they are ‘obturated’ or filled up completely using an inert material without leaving any more space to prevent a re-infection in the future. Once the Root Canal treatment is completed, the crown (the visible hard structure) of the tooth is restored using Dental Cements or Ceramic Caps. 

Whom should you approach to get a Root Canal Treatment done?

Although most Dental practitioners are capable of doing Root Canal Treatments, the Dentist who specializes in Root Canal Treatments is known as an Endodontist. In fact, the actual name of Root Canal Treatment in Dentistry is ‘Endodontic Treatment’. As they are specially trained for this procedure, most patients prefer an Endodontist to do their Root Canal Treatments.

How long does it take to complete a Root Canal Treatment?

The classic form of Root Canal Treatment, done using hand files, takes 4-5 appointments to complete. But with advancements in biomedical technology, most modern-day Dentists use Rotary files and Endomotors instead of hand files and this has significantly reduced the treatment time. Single-sitting RCTs are very common nowadays although some dentists still prefer the old-school version.

Are Root Canal Treatments expensive?

The treatment costs vary depending upon various factors. The presence or absence of specialization, the experience, and reputation of the practitioner, and the choice between hand files or endo motors, all play a role in how much Dentist charges for a Root Canal Treatment. The average cost of a Root Canal Treatment in India ranges between 2000-3000 Rupees for anterior teeth and between 3000-5000 rupees for posterior teeth, excluding the cost of the final crown restoration. However, if you are under financial constraints and yet require a Root Canal Treatment, you can always walk into an Endodontic Clinic of a Dental College where charges are always significantly lesser than in private dental clinics and even free in some cases. Most people are apprehensive about getting treated by students from Dental Colleges, but the reality is that every step of the procedure will be monitored and assessed by professors with plenty of years of experience, and the quality of treatment is as good as you’ll get from any private clinic. The only downside is the extended duration of treatment.

All in all, Root Canal Treatments aren’t as bad or as painful as they sound. The psychological fear associated with sharp objects like needles and files operating in our mouths makes Root Canal Treatment a bigger deal than it actually is. Before this procedure came into practice, the only treatment for a pulp-infected tooth was its removal. Hence, Root Canal Treatments help us hold on to our teeth when they die once and give us a chance to take care of them one more time. A Root Canal Treated tooth will any day feel better than an artificial tooth or no tooth.  Let’s cherish our pearly whites and thank the pioneers of Root Canal Treatment for the gift they have given us.