Dental Care

Root Canal Complications


Do you experience the odd coincidence of having root canal complications?

Once you've had a root canal, you should expect your tooth to last for a lifetime.  Right?  Well, not always.  What, you are asking, can possibly go wrong? 

We have already explained in another article on this web site that a root canal treatment cleans out the bacteria and toxins that render your nerve tissue unhealthy. It eliminates all irritants that were present inside the tooth. 

And as part of the process -known as the obturation- the dentist has filled and sealed off the nerve space inside the tooth.  There is literally no area or location within your tooth where bacteria can possibly still reside. 

There is no inflammatory debris left.  Any post-procedure germs can be handled by an antibiotic plus your body's self defense mechanisms. 

Root canal complications can occur if your tooth remains infected or becomes re-infected afterward.  The tissues adjacent to the root of your tooth might continue to be inflamed.  You might be subjected to swollen gum tissue as well as pain in the tooth and in the area around it. 

In some cases, there is no pain, but a fistula develops -it looks like a pimple on your gums.  It is your body's way of draining away the infection.  It will develop, then it will seem to go away, and then it recurs.

Some people will not experience any of these symptoms, but x-ray examination performed at some point after the root canal demonstrate that infection is still present in the tooth.  Root canal complications occur about five to ten percent of the time. Here we will look at the causes for this:

Causes of Root Canal Complications

One cause involves difficulty in shaping the interior of the tooth.  This part of the procedure is called the debridement

The dentist uses a variety of tiny instruments to clean out the affected tissue.  In rare cases, an instrument can break while the dentist is working.  It happens to lots of good dentists. 

If possible, he finds and removes this piece, but even if he leaves it in the root canal might be a success. The little piece of instrumentation is sterile, and so it's not likely to instigate an infection if it's left in your tooth. 

The biggest problem in leaving it inside occurs when it is in the same canal where the dentist needs to install the dental post.  If you don't want to take a chance on having the root canal finished with the instrument piece inside, ask your dentist to put a temporary filling in the tooth, and then you can visit an endodontist -a root canal specialist- who will have the means to extract the little piece. 

Root canal complications can occur with the existence of tiny canals that the dentist could not previously see on x-ray.  The bigger the tooth is, the more canals it has.

There is also the possibility that the tooth has a tiny crack in it so that even after the dentist finishes the root canal new bacteria can invade it. With today's technologies, either of these problems can be discovered on follow-up x-rays.  A repeat root canal can remedy the problem. 

There is always the possibility that the seal placed on top of the filled tooth will fail.  If the inner tooth is not successfully sealed off, then re-treatment will be necessary sooner or later. This results from coronal leakage, which is discussed fully in another article. 

Often it's best to visit the endodontist when a root canal is revisited for any reason.  The endodontist will present you with a couple options.  One of them involves a procedure called apicoectomy

The word "apicoectomy" refers to the apex, or the tips of the dental roots.  The endodontist actually cuts a flap into the gum tissue so that he can approach the tooth and its roots from the side rather than drilling in from the top.  He uses special microsurgical instruments for this. 

If you experience root canal complications, for whatever reason, the dentist or endodontist has to evaluate the tooth in terms of its overall condition and location.  In many cases, your best option might be to have it extracted.

 

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