Indian Dentists Urge Caution in Root Canal Treatment for Children

Tragic Death Prompts Questions on Invasive Dental Interventions for Toddlers

INDIA: The recent death of a three-year-old child in Kerala following a root canal treatment has ignited concerns among parents about the necessity and safety of such invasive procedures for toddlers. 

Questions arise regarding whether these treatments should be conducted under local or general anaesthesia and if there are specific protocols for handling very young patients.

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Lack of Centralised Record on Root Canal-Related Deaths

While dentists emphasise the need for extreme caution and thorough history-taking before initiating such treatments, a senior health official acknowledges that India presently lacks a centralised record of root canal-related deaths among children. The recent incident in Kerala has raised questions about the safety measures and protocols in place for such procedures on young patients.

Importance of Evaluation and Follow-up

Dr. Ajay Sharma, a senior dental surgeon from Max Hospital, Delhi, underscores the importance of evaluating a child before a root canal procedure and ensuring proper follow-up to prevent complications. He outlines the general protocol, which involves a check X-Ray of affected teeth. 

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If there is a considerable time before the eruption of permanent teeth, a root canal for primary or baby teeth may be recommended; otherwise, tooth removal with a space maintainer is suggested.

Root Canal Procedures for Toddlers

Root canal procedures for toddlers encompass therapies such as pulp therapy, pulpotomy, and pulpectomy, depending on the severity and location of the infection. The duration of a root canal procedure varies, with simple cases taking 30 to 60 minutes and more complex procedures lasting approximately 90 minutes. 

The cost of root canal treatment in India ranges from ₹1,500 to ₹12,000, depending on factors like tooth position and severity.

Meticulous Consideration in Pediatric Dentistry

Dr. Adosh Lall, senior consultant dental surgeon at Indraprasth Apollo Hospital, emphasizes the need for meticulous consideration and a tailored approach when performing root canals on children, especially on primary (milk) teeth. The unique nature of pediatric dentistry requires adherence to specific precautions and protocols, ensuring a child-friendly atmosphere, swift yet precise procedures, and thorough aftercare instructions for parents.

Dr. Elizebeth Jacob at Mar Baselios Dental College, Kothamangalam, Kerala, highlights that root canals among toddlers are a common dental practice, and deaths associated with the procedure are extremely rare. The incident in Kerala, while tragic, stands as an exception in the broader context of pediatric dental care.

The unfortunate incident prompts a broader discussion on the necessity, safety, and protocols surrounding root canal treatments for very young children, emphasising the importance of caution and tailored approaches in pediatric dentistry.