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Root Canals

The lost file

12/20/2007

Question:

I had a root canal 10/31/07-the pain was terrible-tooth finally settled down but reached a point and stopped healing-I had the endodonist redo it but he only redid one canal on 12/06-2 wks later I`m still having trouble and he says I should plan on extracting the tooth-I went to another endodonist-he says ask the first one if he broke a file off in the canal-if so I can`t help you-I asked him and he admitted he had but said there are a million people walking around with root canals that have broken files in them to give it more time-what should I do? sometimes I can take it-most of the time it is a burning pain that drives me nutz

Answer:

There seems to be a lot of complications for this tooth and that makes it almost impossible for me to advise you on what needs to be done next. It sounds like the initial problem with the tooth has not been resolved. That means either the initial treatment did not or could not resolve the problem, or the problem may not be entirely associated with the tooth (referred pain). The retreatment of the one canal did not resolve the issue either. The fact that a separated instrument is now involved complicates the treatment on the tooth, but probably hasn't added to or caused the symptoms you continue to have.

The best course of treatment would be to have the entire root canal procedure redone (if possible), and then give the tooth 4-6 weeks to heal. If that fails to resolve your symptoms, then you need to decide to have further evaluations to determine if there is another source for your symptoms or have the tooth taken out (this may not resolve your symptoms either).

When I hear a patient describe pain as "burning," my tendency is to look at potential neurological problems. The tooth may be a trigger for the pain, but is not actually the source of the pain. You may need to see a neurologist who specializes in facial pain for an evaluation also.

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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