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Root Canals

Root canal problem - instrument issue

10/23/2006

Question:

Similiar to another post I found. I am just looking for answers. I had a root canal done a long time ago. During the procedure, one of the saws (instruments) broke. BUT this was "during" the procedure. So, I am not confident that the entire root was cleaned out because this happened before they were done. Several months ago, I begun having intense pain in the tooth. Which makes no sense. My dentist said that an instrument broke during the procedure but there is infection in there. 1st round of antobiotics. Later, then advised to see an endo. Endo confirmed the same, infection, another round of antobiotics, and come back again. What the heck! During all of this, no one asked me if I was allergic to any materials. On my skin, I have allergic reactions to surgical steel, nickel, etc. Anything that is not pure silver or gold, I have a reaction on the skin. So, I just thought of this because here I am AGAIN, in excrutating pain, about to pull a CHuck and just rip out my rooth because I cannot bear the pain anymore......Would any of this be result of the continuous infection? There is a partial instrument in the site of the root canal! I thought maybe the pain was from sinus headaches but it hasnt stopped. Why am I going back and forth again and then to an endo for a procedure that had a mis-hap. When wouldnt the original dentist be responsible? Shouldnt he fix this?? I am at a loss and I know this is alot of information. Eeeks. I appreciate any input you may have. The pain is a 12 on a 1-10 scale. I just need some direction. Thank you soo much! :) Have a good day!

Answer:

I certainly can understand your frustration, especially since you are having a lot of pain.  Your infection may or may not be related to the separated instrument in the tooth.  My guess is that the tooth has simply gotten reinfected due to leakage of the restoration on the tooth. 

Unfortunately, I do not know the status of the tooth prior to the initial root canal done years ago.  If it had been badly infected back then, the infection would most likely not have cleared up.  You would have had problems long before the current one.  The fact that this problem has just recently cropped up makes me think about recurrent decay or leakage of the crown/filling now present.  Again, I just do not have enough info.  All crowns do eventually begin to leak and need replacement.  The average lifespan of crown is around 5 years.

Your skin allergy to nickel/stainless steel probably is not an issue, since again, the separated instrument is within the tooth and not in the bone around the tooth.  However, with time even surgical stainless steel will oxidize to some extent, especially if there is leakage, but I cannot tell you if this would be the cause your problem.

I would suggest that you continue to have treatment with the endodontist and try to have the tooth retreated with the hope that the separated instrument can be removed.  If it cannot be removed, an endodontic surgical technique may be necessary to remove that part of the root that contains the instrument and save the tooth.  Of course, the final solution is to have the tooth removed.

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Response by:

John M Nusstein, DDS John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University