To perform a root canal, specialized files and other instruments are used to clean the root canal space. On a rare occasion, instruments may separate inside the canal space when a dentist attempts to navigate and clean the tooth. Teeth with sharp canal curvatures and tight or calcified canals have a higher chance of causing instrument separation. During root canal treatment, it is important to completely clean the tooth and all its root spaces. A separated instrument can impede access to the area of infection in the tooth’s roots. Blockages caused by instruments can reduce the long-term success of treatment. Sometimes an attempt to remove an instrument by a dentist can lead to additional damage to the tooth’s root. This can be an extremely technical procedure and can require multiple visits to correct. Removal should be done under the high magnification and very bright light of a dental microscope and by someone with experience in removing these instruments. A trained endodontist with a dental microscope would be the ideal clinician to manage these situations.
At Midtown Root Canal we follow 3 rules for instrument removal:
1. Disinfect the tooth fully and use our instruments gently and smoothly to avoid separation of instruments in the first place. This is another reason to see an endodontist. The risk of file breakage is reduced drastically because endodontic specialists have a lot of experience in the instrumentation of very tight or curved canals.
2. If an instrument does separate, then an attempt to remove it is performed. Removal is dependent on the size of the instrument, location of the instrument within the canal, and few other factors. If removal is too risky and has a high chance of compromising the tooth, then we attempt to bypass the instrument. Leaving the instrument in the tooth, especially if removal is too risky, does NOT pose a danger to the tooth or your body. Its presence poses an issue ONLY when it is a hindrance to thorough tooth disinfection.
3. If the infection is advanced and the instrument cannot be removed or bypassed then you might be a candidate for root canal surgery. The surgery can correct the errors from the previous treatment and allow for completion of care to help maintain and save your tooth.
Dentists historically have placed a post in the tooth after root canal treatment in order to help increase support for a prosthetic crown. Today, we always recommend avoiding placing a post when possible. Although some cases do in fact fair better with a post, modern understanding of dental procedures indicate that posts, in most instances, cause more damage than they do good. When a root canal would need to be retreated, removal of the post is necessary to access the site of infection. At Midtown Root Canal we have the experience and equipment necessary to remove even the most stubborn of posts.