Dr. Hall,
My dentist performed a root canal today and informed me that a tip of one of the metal instruments broke off in the canal. (I actually heard it and thought my tooth had broke!) He informed me that he was not going to try to fish it out. Since it was ‘sterile’ he was just going to leave it in the canal and put the post and cap on.
Is this what he should be doing? Or will it hurt me in the long run? This doctor has become notorious for not taking a lot of time with patients and overcharging, so I am nervous.
Thanks in advance for your help.
– Connie in New Jersey
Connie,
These metal files can break off easily, and that happens to a lot of dentists. And while it is best to retrieve the broken piece, that can be difficult to accomplish and can be beyond the ability of many general dentists. If your dentist can negotiate around the broken piece and seal the apex of the tooth, the root canal treatment will probably be successful. If the broken piece blocks access to the apex of the tooth, the root canal treatment could still be successful but the chances for success are greatly diminished.
If the tooth has problems later, it could end up needing re-treatment for the root canal. Cementing a post in the tooth could possibly make re-treatment impossible, depending on how many roots this tooth has. If the dental post is to be in the same canal as the broken instrument, I’d advise you not to let him put the post in the tooth.
The safest thing would be to ask to be referred to an endodontist (root canal specialist), who should have special equipment to be able to retrieve the broken instrument and fill the root canal. Depending on your relationship with the dentist and your personality, you may or may not want to do this. However, if the post is needed to help hold the crown on and if it is in the same canal as the broken root canal file and that broken file blocks the canal, I would insist on seeing an endodontist. If your dentist doesn’t refer you to one, you can seek one on your own. Otherwise the risk of losing this tooth would be too great, in my opinion. Meanwhile you could wear a temporary crown on this tooth or a temporary filling.
– Dr. Hall
Related information:
Failed root canal treatment
Root canal surgery
Dead tooth
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
MAVIS says
The dentist I saw broken one of the posts he put into my root canal tooth. I heard it crack. Then he put the cap on it, but later that cap just fell out of my mouth and I saw the pin sticking out of it. I hope it can be fixed or reglued. Can the other damaged post be removed and added to fix and secure it and then cemented so this does not happen again?
– Mavis
Mavis,
Removing a post in a tooth is very tricky and risky, especially if it is broken off. They usually are placed rather deep into the tooth and cemented well. It would have to be drilled out, and, that deep into the tooth, there would be a high risk of drilling through the side of the tooth which would ruin the tooth and it would have to be extracted. I would find a prosthodontist (crown and bridge specialist) for a second opinion on how to get the crown to stay on.
– Dr. Hall