Dealing with Calcification in Old Dentures: Seeking Better Solutions

Remove the calcification inside the old dentures?

Hello, I have been dealing with an old dental crown from over a decade ago.
X-rays revealed that there are still three nerves that have not been fully treated, and there is also decay present.
The dentist has performed root canal treatment twice, but has been unable to successfully remove the three nerves.
During the first attempt, they mentioned that one nerve was stuck and another was only partially accessible.
In the second visit, they did not take another X-ray and only referred to the first X-ray, indicating that another tooth had a nerve (which I assume is a root canal) that appeared to be absent in the X-ray of my old tooth, showing a white area without that canal.
The dentist was unclear whether this was due to calcification or another issue, and seemed somewhat resigned, suggesting that if the next attempt fails, they would seal it up and reassess later.
I thought to myself that a seasoned dentist should not be encountering this situation for the first time.
After the dental post was removed, they should have informed me to seek a referral if they were unable to proceed, rather than continuously drilling and cleaning, only to later suggest sealing it.
I am quite frustrated.
I remembered that I had previously inquired about a clinic that performs root canals using a microscope.
Would it be more appropriate to choose a clinic that uses a microscope to continue treatment on this tooth? Or are there other methods available?

Fanrao de Mao, 30~39 year old female. Ask Date: 2018/11/27

Dr. Zeng Guanghui reply Dentistry

If the root canal appears completely white on the X-ray, there is a high likelihood of canal calcification, which can pose challenges during clinical root canal debridement.
If the root canal debridement cannot be completed, it may be advisable to consult a specialist in endodontics to evaluate the possibility of using a microscope for the root canal treatment.

Reply Date: 2018/11/27

More Info

Dealing with calcification in old dentures, particularly when it involves complex dental issues like nerve removal and potential calcification, can be quite challenging. It sounds like you are experiencing a frustrating situation with your current dental treatment, and it's understandable to seek better solutions.

Firstly, it's important to understand that calcification in dental contexts often refers to the hardening of tissues, which can occur in the pulp of the tooth, especially in cases of chronic inflammation or infection. This can complicate root canal treatments, as you've experienced. When a dentist encounters calcified canals, it can make the procedure more difficult, and sometimes, as you've noted, they may not be able to fully access the nerve due to the calcification.

Given your situation, here are some considerations and recommendations:
1. Seek a Specialist: If your current dentist is struggling with the procedure, it may be beneficial to seek a referral to an endodontist, a specialist in root canal treatments. Endodontists often have more advanced training and experience dealing with complex cases, including calcified canals. They also typically have access to specialized equipment, such as operating microscopes, which can enhance visibility and precision during the procedure.

2. Microscopic Endodontics: You mentioned that you had previously consulted a clinic that uses microscopes for root canal treatments. This is a great option, as microscopic endodontics allows for better visualization of the tooth's internal structures. This can be particularly helpful in identifying and navigating calcified canals, potentially increasing the chances of a successful treatment.

3. Alternative Treatments: If the root canal procedure continues to be unsuccessful, your dentist may consider other options, such as:
- Apicoectomy: This surgical procedure involves removing the tip of the tooth's root and any infected tissue. It can be an alternative if the root canal treatment fails.

- Extraction: In some cases, if the tooth is deemed non-restorable, extraction may be necessary. Following extraction, options for replacement, such as dental implants or bridges, can be discussed.

4. Communication with Your Dentist: It’s crucial to maintain open communication with your dentist about your concerns and frustrations. If you feel that your current treatment plan is not progressing effectively, don’t hesitate to express this. A good dentist will appreciate your input and may be willing to refer you to a specialist or explore alternative treatment options.

5. Second Opinion: If you are unsure about the current treatment plan or feel that your concerns are not being adequately addressed, seeking a second opinion from another dental professional can provide you with additional insights and options.

In summary, dealing with calcification in old dentures and the complications of nerve removal can be complex. Seeking a specialist, particularly one who utilizes advanced techniques like microscopic endodontics, may provide a more effective solution. Always ensure that you are comfortable with your treatment plan and don’t hesitate to seek further opinions if needed. Your dental health is important, and you deserve a treatment approach that addresses your concerns effectively.

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