Dealing with Broken Dental Needles and Deep Cavities: What to Do? - Dentistry

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Cavities and broken needles inside the tooth?


About three years ago, I underwent root canal treatment.
Since I experienced slight pain when tapping on the tooth, I have not had a crown placed.
Later, I visited another clinic, and the dentist informed me that there is a broken file inside the tooth.
What should I do? Additionally, for a molar with deeper cavities, where the diameter of the cavity is approximately 1mm, can it still undergo root canal treatment, or does it have to be extracted? The dentist mentioned that if I proceed with root canal treatment, the crown can only be placed externally and cannot reach the root, so it would not be effective, and extraction would be the best option.
Currently, my tooth root is still intact, and the cavity has reached the surface, with about 3-3.5mm of tooth structure remaining.
The cavity is located in the interproximal area.
Can you provide me with some advice?

A-Rong, 30~39 year old female. Ask Date: 2010/03/22

Dr. Huang Zhicheng reply Dentistry


1.
If there is a broken endodontic file and symptoms are present, it is advisable to seek treatment from an endodontic specialist.
In some cases, the broken file may need to be removed using specialized ultrasonic instruments under a microscope, followed by disinfection and complete filling of the root canal.
2.
If there is deep caries on the proximal surface of a molar, periodontal surgery may be performed after root canal treatment to expose the deepest area, which can then be covered with a crown.
However, if the caries is too extensive and a post is required to support the crown, the post may exert a splitting force on the fragile tooth root, increasing the risk of root fracture under heavy occlusal load.

Respectfully, Dr.
Huang Chih-Cheng, Attending Physician, Taoyuan Hospital, Department of Health, Executive Yuan.

Reply Date: 2010/03/22

More Info


Dealing with broken dental needles and deep cavities can be a complex issue, especially when it involves previous root canal treatments and the presence of decay. Based on your description, it seems you are facing two main concerns: the broken dental needle within the tooth and the deep cavity in your molar.

Firstly, regarding the broken dental needle, it is essential to address this issue promptly. A broken needle can potentially lead to complications, including infection or further damage to the tooth structure. The best course of action is to consult an endodontist, a specialist in root canal treatments. They have the expertise and tools necessary to locate and remove the broken needle safely. Attempting to remove it yourself or delaying treatment could lead to more severe complications, including the risk of infection spreading to surrounding tissues.

As for the deep cavity in your molar, the situation is indeed concerning. A cavity that has progressed to the point where it is close to the pulp (the innermost part of the tooth containing nerves and blood vessels) can be treated with root canal therapy, provided that the tooth structure is still viable. If the cavity is approximately 1mm in diameter and has not yet reached the pulp, there may still be a chance to save the tooth through restorative procedures. However, if the decay has reached the pulp, a root canal may be necessary to remove the infected tissue and prevent further complications.

Your dentist's recommendation to extract the tooth may be based on the extent of the decay and the structural integrity of the tooth. If the tooth is significantly compromised and cannot support a crown or restoration, extraction might be the only viable option. However, if the tooth root is intact and there is enough remaining tooth structure, a root canal followed by a crown could be a feasible solution.

In your case, since you mentioned that the tooth root is still intact and there is approximately 3-3.5mm of tooth structure remaining, it may be worth seeking a second opinion from another dental professional, preferably one who specializes in restorative dentistry or endodontics. They can assess the situation more thoroughly and provide you with options based on the current state of your tooth.

Additionally, it is crucial to maintain good oral hygiene and follow up with your dentist regularly to monitor the health of your teeth and gums. If you have concerns about pain or discomfort, do not hesitate to reach out to your dental care provider for advice.

In summary, here are the steps you should consider taking:
1. Consult an Endodontist: Seek a specialist to address the broken dental needle and evaluate the condition of your tooth.

2. Get a Second Opinion: If you are uncertain about the recommendation to extract the tooth, consider consulting another dentist or specialist for a different perspective.

3. Maintain Oral Hygiene: Continue to practice good oral hygiene to prevent further decay and complications.

4. Follow Up Regularly: Schedule regular dental check-ups to monitor your oral health.

Remember, timely intervention is key to preserving your dental health and preventing further complications.

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