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Thursday, December 5, 2013
Risks/benefits of root canal
I am confused about whether or not to have a root canal. I suffered a blow to a front tooth 20 years ago. Over the years, the tooth has discolored but has never caused a problem. Turns out that it is dead and the canal is calcified. The endodontist I saw said a root canal is advisible but may not be possible due to the calcification. He also said that it is possible that the procedure will create problems that I might not otherwise run into and could even result in the loss of the tooth. Of course not doing anything could result in the loss of the tooth, too, but I haven`t had any trouble all these years....
These types of teeth can be tricky. If there is no pathology on the x-ray and the tooth is not bothering you, then a root canal is probably not indicated. The issue of calcification is tough - do you do the root canal now while a canal can still be found (even if there is no indication for treatment) or wait until there are symptoms and the canal is almost completely closed down and there is a greater risk to the root when treatment is attempted?
Only around 5% of traumatized teeth that have calcified develop pathology/lesions at the end of the root, so the non-treatment choice appears to be the more conservative choice. However, if you are concerned about the discoloration that has occurred because of the trauma, then root canal treatment may be needed. Conventional bleaching will not work well on these teeth. A crown may be a better choice to mask the discoloration.
John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University