I just found out my dentist inserted a stainless steel post into my root canal tooth—my upper molar. A temporary crown is placed over it now and a permanent crown will be placed in a week. My question is can the post be removed and a zirconia or carbon post (I don’t think he does those) be put in instead? I don’t want steel in my mouth even though he said it’s encased. My ears have been pulsating since. Please tell me it’s removable!
– Linda from Brooklyn
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Yes, a stainless steel post probably can be removed, though there may be some risk involved.
Let me give a little background on this to frame my answer.
When a tooth is “bombed out,” needing a root canal treatment and with little tooth structure left, a dental post is often placed in the tooth. This post can serve a couple of purposes. For front teeth and premolars, it can strengthen the tooth against horizontal fracture. For molars and any other teeth, it can also provide additional retention for the crown. If there is little of the original natural crown of the tooth left, the post, anchored in the root of the tooth, will help retain a buildup in the tooth, and the buildup retains the crown.
There is a history to the material out of which the post is made. In the 1970s and earlier, stainless steel was the material of choice for prefabricated dental posts. However, in the 1980s it was discovered that even though a post is cemented inside the tooth and doesn’t come into contact with the bloodstream at all, metal ions were found to leach through the tooth and into the bloodstream. Stainless steel contains nickel, which causes sensitivity reactions in many people (see some of our blog posts on metal allergies). To guard against potential reactions as you seem to be experiencing, many dental practices, including mine, switched to titanium, which is not only very strong but the most biocompatible metal available. In the 1990s, other materials were introduced for posts, including carbon fiber and fiberglass. More recently, zirconia has been used for posts. Zirconia is a ceramic that has high flexural strength and is also very biocompatible.
So yes, you have a legitimate concern about this stainless steel post. Your dentist should get with current technology. From what you are telling me, he isn’t into any of these newer post materials, most of which have been around for twenty years or more.
Now, as to removing the post that is in there, that could be tricky and, depending on the situation, you may not want to trust your dentist to do this but may want to see a root canal specialist or another dentist who feels comfortable doing this. It depends on how deeply the post goes into the root of your tooth and how well it is cemented. It may be possible to dislodge it with an ultrasonic tip. I remember one patient I had who was adamant about removing several metal posts in his teeth. I don’t remember why his posts were so difficult to remove, but I ended up telling him that I had to drill out all of these posts and I had him sign a paper acknowledging that I had told him there were serious risks in doing this, that I could perforate the roots of any or all of these teeth, leading to the loss of the teeth. He was willing to accept those risks. The good news is that I got out all of the posts without any accidents, but I remember it was very stressful for me.
If you feel that you are experiencing a sensitivity reaction to the post, I would put a halt to the crown procedure until you can have the post removed. Cementing a crown on the tooth will only make it more difficult, as your dentist would have to start by drilling through the crown, possibly ruining the crown.
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