Root Canal Complications: What Can Go Wrong?

Root Canal Complications
Root Canal Complications

Root canal complications, root canal treatment have a 90% success rate without complications. A successful root canal treated tooth can serve for a lifetime. However, like any medical procedure, root canal complications may occur. To understand how root canal complications can occur, you should know the anatomy of the tooth and how a root canal is performed?. Inside the tooth, there is a sensitive, soft tissue mass known as dental pulp. It contains nerves and blood vessels. The pulp is well protected by hard tooth substance (enamel and dentin). If the dental pulp is seriously injured by caries or trauma (accident), it becomes inflamed, causing toothache. In this case, the tooth usually has 2 options: root canal or extraction.

Tooth Anatomy and Root Canal Complications
Tooth Anatomy: to understand how root canal complications can occur, you should know the anatomy of the tooth.

Root Canal Treatment Steps

To understand how root canal complications can occur, you should know how a root canal is performed?.

  • The removal of dental caries: the dentist removes dental caries and opens the pulp with a drill under local anesthesia.
  • Cleansing of the root canal system: with small, flexible files and disinfectant agent, the dentist removes the inflamed or dead tooth pulp and cleanses the entire root canal system to make the tooth germ-free.
  • Root canal filling: once all root canals have been found, cleaned, and disinfected, the dentist fills the root canals with a special material called gutta percha to prevent the recurrence of infection.
  • Dental crown: after the root canal treatment, the dentist will place a tooth filling such as an amalgam or composite to restore the shape and function of the tooth. Also, a dental crown may be needed to protect and rebuild the damaged tooth.

What is The Possible Root Canal Complications?

As with any medical procedure, root canal complications may occur. The complications decrease the prognosis of root canal treatment and may lead to a dental abscess and eventually tooth extraction. The possible root canal complications during and after the procedure, include:

Root canal complications during the procedure

  • Fracture of instruments: the dentist uses small, flexible files to remove the dead or inflamed pulp tissue and cleanse the canals. In some cases, the dental file may break off especially in narrow or curved canals. The removal of the broken instrument is usually very difficult. If the broken file can’t be removed, it will remain permanently in the canal even after the root canal has been filled.
  • Perforation of the pulp chamber: the perforation may occur at the floor of the pulp chamber by the drill during the search for a root canal. The perforation can be sealed by a material called mineral trioxide aggregate (MTA).
  • Perforation in the root canal: the perforation may occur during the cleansing of root canals with dental files especially in strongly curved canals. The perforation is simply closed during the sealing of root canals.
  • Missing root canal: the number of root canals varies from tooth to another. A missing root canal may contain inflamed or dead pulp tissues and bacteria, causing toothache, dental abscess, and root canal complications. In this case, root canal treatment must be repeated and the missing canal should be found and cleaned.
  • Poor root filling or tooth filling: the root is sealed with a material called gutta percha and the tooth crown is sealed with tooth filling such as composite or amalgam. Improper sealing of the root canal or tooth crown may lead to bacterial leakage and recurrence of infection.

Root canal complications after the procedure

  • Postoperative pain: root canal treatment involves the cleansing of root canal system with dental files and disinfectant agent. This may cause dull to sharp pain in the days following the dental procedure. However, if the pain is continuous, contact your dentist right away for follow up. Continous pain after root canal treatment may be caused by recurrence of infection.
  • Recurrence of infection: sometimes the dentist fails to adequately cleanse the root canal system, for example, the root canals are very narrow or strongly curved. Also, a missing root canal may cause recurrence of infection.
  • Fracture of tooth crown: the tooth becomes brittle after root canal treatment. So, a dental crown is recommended.
  • Tooth discoloration: the dead pulp tissues start to decompose and permeate to the surrounding dentin, causing permanent discoloration of the tooth. The treatment options for tooth discoloration may include internal whitening, dental crown, or veneer.