Root canal problems and complications.

root canal is a thin canal that run inside tooth roots and crown that contains blood vessels, nerves and connective tissue. when the tooth pulp is diseased due to bacteria invasion from caries or deep gingival pocket pulp may become irreversibly inflamed or even completely dead witch will cause severe pain, abscess formation and discoloration.  In this case the only available treatment other than extraction is root canal treatment.

Root canal is considered in many cases the last solution before we think of extracting the tooth. Extracting teeth will cause a very significant drop in mastication, appearance and even phonetics as the extracted tooth will leave an empty space that will cause the food to escape from being chewed also extracting the tooth will cause the opposing tooth in the other jaw to be non functional as it will bite on air also the neighboring teeth to move in the empty space which may cause over eruption of the opposing tooth and drifting of the teeth in the same jaw to the empty space which can cause gaps that the food will be impacted into. Sure you should ask your dentist if the option of root canal treatment is available before thinking in extraction.

Root canal treatment procedures is simply started by removing the dead tissue from the tooth pulp then irrigating the empty canal with a disinfectant then widening of the canal to the needed diameter using what is called root canal file instrument. After that the empty canal is filled with natural resin and the tooth crown is restored using any filling material.

We have to say that root canal treatment don’t deserve it’s bad reputation as the process now is very traditional with success rate about 95%. Also the treatment is not painful as you expect as long as the dentist work under anesthesia. But like any other medical procedure root canal have some problems and complications that sometimes annoy the patients which we will discuss here.

Root canal problems during the process of cleaning and filling:

1-pain:

pain is the biggest fear when we speak about this kind of dental treatment. You don’t have to worry about this any more most of patients admit that they almost have no pain during root canal treatment. Some patients are very sensitive to pain and will need more than one injection and this is ok as the dental anesthesia is safe even at 4-5 injections so just inform your patient that you have pain and  he will manage it with no problems.

sometimes infection may prevent the anesthesia from working properly so the dentist have to manage the infection first before start of the treatment.

also it is normal to have some discomfort or affordable pain between visits that is normal and respond well to over the counter pain killers but if the pain is beyond the limit call your dentist.

2-Fracture of instruments during instrumentation:

This is a  problem that happen during root canal treatment and usually happen when the root is curved or obliterated.  It is ok if the file break after canal disinfection and reaching the end of the root but if the file break before canal cleaning or not reaching the end of the root this may cause the tooth to be extracted or require endodontic surgery to fix the situation

3-Tmj (The jaw joint) pain due to lengthy wide opening the mouth especially if the tooth to be treated is not accessible enough like posterior molars. all you have to do is to inform your dentist and he will manage this easily or will give you a brief rest period.

4-root fracture sometimes the root fracture during condensation of the root canal filling material the fracture usually cause the tooth to be extracted.

5-any other problems that can prevent cleaning or filling the root canals like pulp stones ,missed canal problems etc.

Problems and complications after finishing the treatment:

1-pain:

It is normal to feel little discomfort or affordable  pain  with biting on the treated tooth for few days after treatment and usually this pain respond well to analgesics if the pain continue more than few days you should call your dentist as this may be a bad sign.

2-swelling and redness or bus oozing in the gums above tooth.

This can happen because of infection, The dentist failed to properly clean and disinfect the root canal due to the presence of excess canals that don’t appear on xray or too short or too long root canal filling sometimes the infection happen with no apparent reason. Generally root canal retreatment  have a very high success rate especially if started early.

3-The tooth crown become really brittle after rct and may fracture even under normal masticatory force so you should cover the tooth with a tooth caps or crown after rct.

last thing don’t panic this problems happen only in about 3% of the cases and most of it can be managed and retreated easily with no problems