Root Canal Treatment During Orthodontics: What You Need to Know

Q: Root Canal Treatment During Orthodontics: What You Need to Know

Hello： If you are eager to get braces immediately, it is advisable to first discuss with an orthodontist whether you should remove the orthodontic appliances and then have the braces placed before reapplying the orthodontic appliances. <br>This is a response from Dr. <br>Lin Chia

Root canal treatment during orthodontic treatment?

Hello Doctor, I am currently undergoing orthodontic treatment, but my orthodontist did not address my cavities before starting the treatment.
Throughout the process, I repeatedly asked the doctor if my cavities should be prioritized, and the doctor indicated that there was no major issue.
Recently, during a dental cleaning, I discovered that my cavities were very severe.
After evaluation, the doctor found that they were close to the nerve, so I underwent root canal treatment.
However, since I am using traditional braces, I asked the dentist about getting a crown, and they informed me that it is currently not possible.
When I inquired about what to do if my tooth breaks without a crown, the doctor told me that it would be beyond saving, but did not provide a solution to my problem.
I am feeling very anxious and unsure about what to do next.
Should I remove the braces to get a crown, or should I continue with the orthodontic treatment? Thank you!

Pang Mei, 20~29 year old female. Ask Date: 2021/03/17

Dr. Lin Jiayong reply Dentistry

Hello: If you are eager to get braces immediately, it is advisable to first discuss with an orthodontist whether you should remove the orthodontic appliances and then have the braces placed before reapplying the orthodontic appliances.
This is a response from Dr.
Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/03/17

More Info

When undergoing orthodontic treatment, the management of dental issues such as cavities or the need for root canal therapy can indeed be complex. Your situation highlights the importance of addressing dental health comprehensively before or during orthodontic treatment. Here’s a breakdown of what you need to consider regarding root canal treatment during orthodontics.

Understanding Root Canal Treatment
Root canal treatment (RCT) is a dental procedure aimed at treating infection or damage to the pulp of a tooth. This treatment is often necessary when decay has progressed to the point where it threatens the nerve and blood supply of the tooth. The procedure involves removing the infected pulp, cleaning and disinfecting the canal, and then filling it with a material to seal it.

The Impact of Orthodontics on Dental Health
Orthodontic treatment, particularly traditional braces, can complicate dental care. Braces can make it more challenging to maintain oral hygiene, potentially leading to cavities. If cavities are not addressed before or during orthodontic treatment, they can progress to the point where root canal therapy becomes necessary.

Your Current Situation
In your case, it seems that the orthodontist did not prioritize the treatment of your cavities, which has now led to a severe situation requiring root canal therapy. The fact that your root canal dentist has indicated that you cannot have a crown (or "fake tooth") placed immediately after the root canal is concerning. This is typically because the tooth needs time to heal, and the orthodontic appliances may interfere with the placement of a crown.

Options Moving Forward
1. Consult with Your Orthodontist: It’s crucial to have a detailed discussion with your orthodontist about your current dental health. Explain your concerns about the risk of tooth fracture and the implications of not having a crown placed. They may need to adjust your treatment plan based on your dental health.

2. Temporary Solutions: If your root canal treatment is completed and the tooth is stable, your dentist may suggest a temporary crown or filling to protect the tooth while you continue with orthodontic treatment. This can help prevent fracture while allowing for healing.

3. Timing of Orthodontic Treatment: Depending on the severity of your dental issues, it may be advisable to pause orthodontic treatment until your dental health is fully addressed. This could mean removing braces temporarily to allow for the placement of a crown or other necessary treatments.

4. Long-term Considerations: If the tooth is at high risk of fracture and cannot be adequately protected, your dentist may discuss the possibility of extraction and replacement options, such as implants or bridges, after your orthodontic treatment is completed.

5. Seek a Second Opinion: If you feel uncertain about the advice given, it’s perfectly reasonable to seek a second opinion from another dental professional. They may provide additional insights or alternative treatment options that could better suit your needs.

Conclusion
In summary, managing root canal treatment during orthodontics requires careful coordination between your orthodontist and endodontist (root canal specialist). Open communication about your concerns and the risks involved is essential. Prioritizing your dental health will ultimately lead to better outcomes in both your orthodontic and overall dental treatment. Make sure to advocate for yourself and seek clarity on any treatment decisions that may impact your dental health in the long run.

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