Root Canal (cont.)
Steven B. Horne, DDS
Dr. Steve Horne began his career at Brigham Young University obtaining his BA in English. He earned his Doctorate of Dental Surgery in 2007 from the University of Southern California where his pursuit for academic excellence landed him on the Dean's List. He was recognized for his superior clinical skills and invited to help teach other dental students in courses on restorative dentistry, prosthodontics, and tooth anatomy. During dental school, he provided dental care for underserved populations of Los Angeles and Orange County, Mexico, and Costa Rica with AYUDA. Following dental school, Dr. Horne entered active duty with the U.S. Army and practiced dentistry at Fort Knox, Kentucky, for four years. During this time, he was deployed to Baghdad, Iraq, and received multiple Army Achievement Medals, the Army Commendation Medal, and served as Company Commander. Dr. Horne currently practices full time at Torrey Pines Dental Arts in La Jolla, California, as a general dentist. Dr. Horne is a member of the American Dental Association, the California Dental Association, and the Academy of General Dentistry. Dr. Horne is married to his wife, Christy, and they have a chocolate Labrador named Roscoe.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is a root canal?
- Why is a root canal necessary?
- What happens during a root canal procedure?
- Is there pain associated with getting a root canal?
- Are there special considerations for getting a root canal during pregnancy?
- What kind of problems or complications may occur after getting a root canal?
- How long do root canals last?
- How much does a root canal cost?
- Are there any alternatives to a root canal?
- Find a local Doctor in your town
What kind of problems or complications may occur after getting a root canal?
Since a tooth that has had a root canal has been hollowed out to a certain degree, it is more prone to fracture. Getting a crown placed on the tooth will almost completely prevent this, but it can still happen. Sometimes there may have been an undetected crack at the time the root canal was performed, and the tooth may need to be extracted even though the tooth was treated with a perfect root canal.
In excessively curved roots, a file could break off inside the canal. Sometimes these files can be retrieved, but many times they cannot. If this happens, the tooth will be filled to the level of the file and monitored closely. If it was thoroughly cleaned before the file broke, the tooth may be unaffected. If not, it may need a surgical procedure to finish the root canal treatment.
Sometimes, if the pulp canal is difficult to find due to narrowing or calcification, the tooth may become perforated while attempting to locate the canal. The tooth is perforated when the dental drill starts from the inside of the tooth and communicates a hole through to the outside of the tooth instead of remaining centered. Many perforations can be repaired, but if severe, may cause the tooth to have to be extracted.
A root canal can become reinfected if the restoration has leaked, the patient doesn't have good oral hygiene, or because the sealing materials have degraded or broken down over time. Sometimes there may be more than the normal number of root canals in a tooth and the treating dentist may have missed the extra canal. This canal will still have infected tissue in it and will need to be cleaned out and filled. If a root canal has become reinfected, it can usually be retreated with another root canal. In this procedure, the endodontist will simply remove the gutta percha and sealing material through the opening in the tooth, clean out the canals and any additional canals, and seal them back up again. A retreatment is likely to be done in two visits. Sometimes a retreatment isn't possible and a tooth will require a surgical procedure to be saved. In this case, an endodontist may perform an apicoectomy, which involves accessing the root of the tooth through an incision made in the gums and bone. The tip of the root may be cut off and the area is cleaned and sealed from the end of the root.
Another condition that can occur after a root canal is discoloration of the tooth. Sometimes, this will even happen when the nerve in the tooth dies and can be the first sign indicating that a root canal is necessary. The tooth typically will become dark yellow, brown, or gray -- much more than surrounding teeth. If this color is an esthetic concern to the patient, especially if it is a front tooth, it can be treated with internally bleaching that specific tooth in a dental office or covering the tooth with a veneer or crown.
There have been claims that leaving a tooth treated with a root canal inside the mouth causes a variety of health problems, including cancer. These claims are based on an assumption that root canal treatment can never fully get rid of the infected tissue and tooth structure and that keeping infected tissue inside the mouth induces a response by the body that leads to health problems. Such claims are not based on sound scientific evidence and rely on coincidence and correlation for substantiation. Often, such claims are used to promote expensive alternatives to traditional dental treatments that result in profit for those making the claims. There is more evidence to refute such claims than to support them. People who believe they may need a root canal should seek out a competent licensed dentist whom they can trust to diagnose disease and deliver evidence-based dental treatment, including root canal treatment when needed.
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