TOOTH RESTORATION WITH RCT

Your tooth is made up of three primary layers- the outer hard white enamel, the middle yellow dentine and the innermost nerve called the pulp. The pulp is essentially a collection of blood vessels that help to build the surrounding tooth. The pulp provides life to the tooth. These nerves run inside the root within filamentous ‘canals’ and these canals are nothing but the ‘root canals’. 

Tooth decay starts with Caries, which if not treated in time, develop into Cavities. The food gets stuck in these cavities and promote bacterial infection. If left untreated, the bacteria continues to degenerate the tooth, and eventually infects the nerves inside the roots. This is when you start feeling sensation in your tooth, and urgently need to get it treated. Root canal Treatment or RCT is a ‘life saving’ procedure for severely decayed or damaged teeth. 

SIGNS THAT YOU NEED RCT

1. Severe toothache
2. Prolonged sensitivity
3. Discoloration (darkening) of the tooth
4. Swelling and tenderness in nearby gums
5. A persistent or recurring pimple on the gums

THE TREATMENT

RCT is performed by a root canal specialist (Endodontist) in cases where the nerve of the tooth is affected and the only way to save the tooth is by removing the affected nerve and replacing it with a filling. During the treatment, the Endodontist removes the infected pulp (or gutta-percha in case of Re-RCT) using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris. Once the cleaning is completed, the Endodontist may prefer to disinfect these by putting chemical solution for a week or so. Finally, the tooth is sealed with Dental Composite, Inlay, Onlay, or Crown. The complete RCT treatment may be done in one single sitting but in case of severely infected tooth, multiple sessions may be required to disinfect the roots.

Until your root canal procedure is completely finished i.e. the permanent filling is in place and a crown, if needed, is in place, it's wise to minimise chewing with the tooth and to avoid recontaminating the tooth’s interior. For the first few days following the completion of treatment, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. But post treatment pain usually subsides with generic painkillers prescribed by the dentist. If pain persists beyond two weeks, it's better to consult your dentist for further action, if so required.

1. Complexity of the case - Whether your tooth is less infected or more infected,  whether it is on the upper jaw or the lower jaw, whether it is straight or tilted and many such factors determine the complexity of the case. The more the complexity, more would be the cost of treatment. 
2. Re-RCT - Reworking on an already treated tooth is a very complicated process as earlier RCTs have already damaged a lot of healthy enamel and thus made roots fragile. Thus, retouching an already treated tooth requires specialist skills and experience.
3. Anterior vs Posterior - The pre-molar and molars have complex tooth structure compared to anterior tooth, and as such require more effort during treatment.
4. Health of side walls of the tooth -  In case of damaged side walls, additional cost is incurred in building the lost wall using Post and Core.
5. 3D Obturation - The purpose of obturating the prepared root canal space is to eliminate all avenues of leakage from the oral cavity or the periradicular tissue into the root canal system.  This requires special equipments to fill the dental material into the root canal cavities.
6. Microdentistry - It ensures precision dentistry with focus to save healthy tooth as much as possible while eliminating the infected part with minutest detail under enhanced magnification.