Dealing with Dental Discrepancies: Broken Files in Root Canal Treatment

Q: Dealing with Dental Discrepancies: Broken Files in Root Canal Treatment

Hello： If you have already placed a lot of trust in Dr. <br>A and have been receiving treatment there for a long time, it is advisable to continue following Dr. <br>A's treatment plan and approach. <br>However, if you have doubts due to the opinions of a physician in the southern

Broken needle?

I am currently undergoing root canal treatment.
Originally, I was scheduled to see Dr.
A, but I was unexpectedly sent on a business trip to the southern part of the country for a week and couldn't make my appointment.
One day, while I was in the south and experiencing discomfort in the tooth undergoing root canal treatment, I visited a local clinic.
After taking an X-ray, Dr.
B informed me that there was a broken file inside my tooth, and he could not treat me; he advised that I return to Dr.
A for further management.

I then endured the discomfort and returned to Taipei to see Dr.
A.
After reviewing the X-ray, he firmly stated that what Dr.
B identified was not a broken file but rather a result of medication placement, assuring me that I should not worry.
However, I found an article online discussing "cases of broken files that were not detected by dentists," which made me quite anxious.

Since the two doctors have differing opinions, I am unsure if I should seek a third opinion to confirm the situation.
If it turns out that there is indeed a broken file, how should I approach Dr.
A for treatment, considering he is adamant that it is just medication? Thank you for your response.

KK, 20~29 year old female. Ask Date: 2022/02/24

Dr. Lin Jiayong reply Dentistry

Hello: If you have already placed a lot of trust in Dr.
A and have been receiving treatment there for a long time, it is advisable to continue following Dr.
A's treatment plan and approach.
However, if you have doubts due to the opinions of a physician in the southern region, and this has led to a dispute with Dr.
A, I recommend visiting a medical center in Taipei (such as National Taiwan University Hospital, Mackay Memorial Hospital, or Veterans General Hospital) and making an appointment with the Department of Endodontics.
Clearly express your desire to confirm whether there is a broken instrument and seek advice on the treatment plan.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2022/02/24

More Info

Dealing with discrepancies in dental treatment, especially regarding root canal therapy, can be quite stressful. In your case, you have encountered conflicting opinions from two different dentists regarding the presence of a broken file (or "broken needle") in your root canal treatment. Here’s a comprehensive approach to address your concerns and the steps you can take moving forward.

Understanding the Situation
1. Root Canal Treatment Basics: During a root canal procedure, the dentist removes infected or damaged pulp from the tooth and cleans the inside of the tooth to prevent further infection. Sometimes, small instruments used in this process can break and remain inside the tooth, which can complicate treatment.

2. Conflicting Diagnoses: You have received two different opinions: one dentist (Dr. B) claims there is a broken file, while the other (Dr. A) insists it is just a medication that has been placed inside the canal. This discrepancy can understandably cause confusion and concern about the integrity of your dental treatment.

Steps to Take
1. Seek a Third Opinion: Given the conflicting diagnoses, it is advisable to seek a third opinion from another qualified dentist, preferably one who specializes in endodontics (root canal therapy). An endodontist has advanced training in diagnosing and treating complex root canal issues, including broken instruments.

2. Diagnostic Imaging: Ensure that the third dentist performs a thorough examination, including X-rays. High-quality imaging can help clarify whether there is indeed a broken file or if the substance seen is merely medication. Cone beam computed tomography (CBCT) may be used for a more detailed view if necessary.

3. Discuss Treatment Options: If it is confirmed that there is a broken file, the treatment options may include:
- Retrieval of the Broken File: This is often the preferred method if the file is accessible. The dentist will use specialized instruments to remove the broken piece.

- Non-surgical Retreatment: If retrieval is not possible, the dentist may recommend retreating the root canal, which involves cleaning and disinfecting the canal again.

- Surgical Options: In some cases, if non-surgical methods fail, an apicoectomy (surgical removal of the tip of the root) may be necessary.

4. Communicate with Dr. A: If you find that the third opinion confirms the presence of a broken file, you should discuss this with Dr. A. It is essential to maintain open communication. You can express your concerns and the findings from the third opinion, and ask how he plans to address the issue. A good dentist will appreciate your proactive approach and work with you to resolve the problem.

5. Monitoring Symptoms: Keep track of any symptoms you experience, such as pain, swelling, or sensitivity. If symptoms worsen, it may indicate that the infection is persisting or that the broken file is causing complications.

Conclusion
Navigating dental discrepancies can be challenging, but seeking a third opinion is a prudent step to ensure you receive the best care. It’s essential to have confidence in your dental treatment, especially when it involves complex procedures like root canals. By consulting with a specialist and maintaining open communication with your current dentist, you can work towards a resolution that ensures your dental health is prioritized. Remember, your comfort and understanding of the treatment process are vital in achieving a successful outcome.

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