It's better to go for RCT, decay already reached nerve zone.. Go to near by dentist n get it done

Yes the tooth needs root canal treatment, get the treatment done as soon as possible please ask the doctor to adjust the dental chair which you are sitting in such a way that u will not have gag reflux. (Probably a straight position of patient back will allow to have less gag)Ask him to give short breaks during treatments and most importantly dont try to breath with your mouth and dont try to swallow water which comes out of drilling unit(airotor)

RCT followed by crown is the only treatment advisable as per your x-ray report.must get it done by the endodontist.

If you are in severe pain and  have tried dentist for regular RCT... Then don't waste time go for RCT under General anesthesia Regards

Yes rct is a must to save the tooth.

Your IOPA reveals that your pulp is exposed and indication for Root Canal Treatment. You can go for RCT of this teeth.The gag reflex is very much disturbing to both patients as well as dentist.In patient with gag reflex patient is advised to breath through the nose.We also try to make the sitting as small as possible.

Your x-ray reveals that your tooth is infected and RCT is recommended. Gag reflexes can be controlled by proper anesthesia