Dear Dr. Hall,
I have patch tested positive to many metals and chemicals. I had a root canal 5 years ago that got botched and the file was broken. I then went to an endodontist and he tried to go through the top to remove the file, but ending up going through the bottom and cutting. It has never felt right and I went to a dentist who said I had an infection under it. I was diagnosed also by allergist at my local university hospital with TILT, same thing as multiple chemical sensitivity. I know I have allergies to dental cement, formaldehyde, cobalt, chromium, titanium, and many chemicals. Right now I have very bad eczema from all allergies, but I am in pain and just want this root canal tooth pulled and cultured to see what type of infection it is. I am looking for a dentist. I will travel for someone knowledgeable on type IV metal allergies. Could you help me?
I don’t think you necessarily need a dentist trained in your specific allergies, and I don’t know that there is any such dentist. What you need, I think, is a dentist willing to work with you and to work around the list of allergies that you have. And I think for that, you need to call around and ask offices if they are willing to do that.
When I was in practice, I was willing to work with people with multiple sensitivities, and I would have some of them come to me with a list of dental products that they were sensitive to. These were Clifford tests. They are controversial, and I didn’t want to get into the controversy, but I would honor the findings of the doctor that had run the tests, and we would avoid all of those materials for which the patient tested sensitive. I know from interviewing many dentists that most are not willing to deal with issues like that, but a few are. In the dental marketing that I do, when a dentist is willing to work with those Cliffords tests, we market them as holistic dentists.
I can think of a couple of dentists I know who are within reasonable driving distance (2-4 hours) for you who might be willing to accommodate you. If you’d like me to call and ask, let me know, and I’ll get back to you.
Or another option would be to run a search yourself in Google for dentists who hold themselves out as holistic. And then call the office and tell them about your problems and see if they’re willing to work with you.
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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
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
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