Root Canal Treatment(RCT) is the process of removing the infection from root canal, protecting it from reinfection and saving the natural tooth. The procedure involves removing of the infected pulp, cleaning and disinfecting inside of the tooth, filling and sealing.

At KPHB Branch, Hyderabad which is an advanced center for Laser Dentistry, Laser Root Canal Treatments are also performed apart from the conventional Root Canal Treatments by our experienced endodontists. Root Canal Treatment is a process of saving the natural tooth and you should try to save it if there is even a slightest chance and our dentists too would recommend the same.

Tooth has three layers Enamel, Dentine & Pulp. Pulp chamber consists of nerves, blood vessels and connective tissue. Root Canal Treatment is needed in those conditions where dental caries extends to Pulp chamber. When this happens, the oral bacteria is directly communicating with blood vessels of the tooth causing persistent tooth pain which may get severe during night or in cold climate and become unbearable.

The Pulp may become inflamed and this allows the bacteria to multiply and spread, and in some conditions where there is poor oral hygiene, it may multiply faster, may become necrotic and may not cause pain but have a sudden onset of swelling.

Additionally, a Root Canal Treatment is needed, in case of a traumatic accident in which tooth is broken up to the Pulp chamber level or becomes Non-Vital (discoloured). In the first case, there would be high sensitivity – less resistant to cold air or water and in second case there will be a Tooth discolouration & may have a sinus opening. A Root Canal is also needed in case of Vertical Fracture of tooth which extends up to CEJ (Cemento Enamel Junction) – in this case there would be severe pain when force has been applied on it.

Root Canal Treatment is a Restorative Dental Procedure, removing an infection from inside the tooth and to protect the tooth from further infections. It is thought to be a Painful treatment but it is in fact a Pain-relieving treatment.
RCT is done in Three Basic Steps:
1. Cleaning the root canal by making a small access hole on the tooth surface and removing all the infected and/or dead pulp tissue with the help of very small files under Local anaesthesia.
2. Shaping the root canal, removing infected dentine by using hand or rotary files and decontaminating the canals by using irrigation solutions.
3. Filling the root canal with a rubber-like material called Gutta-Percha points, using an adhesive cement to seal the canals completely and placing a permanent restorative material in crown part.

In a painless or pain-free root canal treatment, the Root Canal Treatment is done in a completely pain-less way. This is usually accomplished by means of a local anaesthetic, the effects of which usually wear off shortly.

Laser Dentistry has drastically changed the way dentists approach a root canal procedure as it is more precise and advanced treatment with several advantages when compared to the traditional method.
Unlike traditional method, Laser RCT is done by using Hard-tissue laser to drill to access the pulp chamber and a soft-tissue laser is used to sterilize the canals, structures of the tooth, and to remove dentinal tubules that may be hard with conventional treatment. It offers a highly precise way to explore pulp chamber, to preserve more healthy tooth structure and in shaping the dentinal walls of the root canal. There is absolutely no pain or discomfort during this procedure.

Re-Root Canal is a last attempt to save the tooth from extraction. Sometimes after a Root Canal procedure, some teeth may not heal as expected or may develop a new infection, necessitating re-root canal.
This occurs when the infection wasn’t completely removed during the initial treatment; when decay again accumulates in the treated area; or when the tooth becomes cracked or loose, and is exposed to new infection.
Some patients may not experience any symptoms/signs from a reinfection, while others experience swelling or pain while chewing.
The procedure is to regain the access to the root canal filling. The filling material from the initial treatment is removed and canals are thoroughly cleaned, searched for any additional canals or pulp tissue remnants; and then by placing a medicament inside the tooth and to gradually wait for the symptoms/signs to subside and finally restore it with Permanent filling and Crown.
As prognosis of this procedure is not good in some cases, extraction or endodontic surgery can be preferred.

Root Canal Treatment costs vary according to the type, condition, severity of problem and the type of root canal that is chosen. Saving the natural tooth is the number one priority of the dentists. Root Canal is the procedure to save the natural tooth. Tooth removal should be opted only in very specific and rare cases. When compared to the tooth removal and replacement with implants or opting for a bridge, the root canal with crown for a single tooth is very affordable while also saving the natural tooth. Laser Root Canal Treatment is slightly more expensive because of the proven 100% sterilization in the root when compared to the conventional Root Canal.

The answer is Yes, but not in the primary teeth. In primary teeth when pulp is infected, a similar procedure as RCT called Pulpectomy is performed. In Pulpectomy, a root canal filling is done to support the resorption process of tooth structure and in RCT it is done to preserve the tooth structure.
In kids, a Root Canal treatment is done in a permanent tooth, if a tooth is affected, but the Age of the patient and Apex Closure of the tooth root has to be considered.
RCT is done if the tooth root apex closure has been completed. In case of immature tooth without Apical Closure, the teeth have wide open apexes and the walls of the root canal diverge toward the apical tissues. According to the condition of the immature tooth, Apexification with Mineral Trioxide Aggregate(MTA) is performed along with RCT and/or Apexogenesis is performed to maintain vitality of pulp, formation of further root and closure of apex by using MTA or Ca(OH)2.

Root canal treatment is done in two to three sittings because of anticipation of better prognosis in which first sitting includes infected pulpal tissue removal and second includes Biomechanical preparation and in third sitting filling with root canal filling material (Gutta-Percha).
However Root canal treatment is done in one or two sittings, if there is no infection/mobility of tooth.
Depending on infection of tooth, no of sittings may vary from three to five.

Yes, in the absence of any peri-apical abscess and pain, endodontists may opt for single sitting root canal treatments.

Avoid Chewing immediately after the procedure because local anesthesia will continue to have effect even after session and there is a high risk of biting the cheek and tongue because of the numbness.
Maintaining proper oral hygiene to keep the area clean and avoid infection.
The tooth undergoing root canal treatment is usually very weak till the crown is placed over the tooth so avoid having medium to hard food items over that particular tooth.
Avoid taking alcohol & smoking while undergoing RCT
Use the medicines prescribed by the dentist.

A Cap or Crown is a must after Root Canal Treatment. After the RCT, the treated tooth becomes very brittle because of no blood supply to the tooth and is considered dead physically. This increases the chances of breakage, thus needing a dental crown. Dental crown or cap is placed not only for aesthetic purpose but also for functional purpose. Even after placing a dental crown precautions should be taken by the patient which is like avoid chewing sticky or too hard substances on that particular crown. If a Dental crown gets dislodged, consult with a dentist and re-cement the crown or opt for a new crown.

Metal Crown: Most affordable and the oldest crown is the Metal crown which is made of Cobalt-Chromium which is not advisable anymore.
Metal Ceramic Crown: Metal-Ceramic crown is made of cobalt-chromium and porcelain finish is usually recommended for its cost effectiveness, as it has the ceramic coating on top and matches the tooth shade.
DMLS Crown: DMLS crown (Direct Metal Laser Sintered) is done using 3D CAD-CAM Technology and has greater strength when compared to the Metal Ceramic Crown. This is usually the starting crown for best results.
Zirconia Crown: Zirconia Crown is the strongest and are made from zirconia blocks. They can match the tooth shade perfectly and last very long when maintained properfly.