Emergencies are frequent in the daily routine of a dental practice and one of the most common is a fractured tooth that had the canal treated previously.
In most cases, the tooth in question (despite having endodontic treatment), had not been restored properly and improperly treated canals nearly always result in painful, costly emergencies down the line.
Simply put, canal treatments consist of removing tissues that make up the dental pulp from within various tooth ducts, then sealing them with appropriate material. This becomes necessary usually when cavities are deep or there is trauma, fracture, etc., and the pulp becomes infected or necrotic.
Root canal treatments leave the tooth more brittle because it loses its internal hydration and because the dentist has to remove a considerable amount of dental tissue to access the canals. When treatment is due to deep cavities, the area is further aggravated because the decay will also need to be cleaned out.
In cases that eventually result in fractures, what I often have observed is that the impacted tooth had not received adequate protection after endodontic treatment. Teeth with treated canals and very large fillings are great candidates for fracture. The correct treatment is usually to protect the remaining dental structure with a dental crown, which covers the tooth as a whole and ensures that forces generated on the tooth will be evenly distributed so the tooth can be preserved.
Unknowingly, patients can further aggravate matters by ignoring fractured teeth with treated canals, because the tooth no longer has innervation (e.g. it does not hurt). The dangers of doing this is that the tooth will eventually break even more, making it no longer viable. In such a case, what could have been resolved with a simple procedure will result in an extraction, bone grafting and replacement of the tooth by implant or different types of prostheses.
Thankfully great advancements have been made, to ensure accurate determination of root canal spaces. Electronic apex locators can assure utmost precision in determining canal positions and lengths, then for treated root canals to stay healed over the years, state-of-the-art obturation technology ensures canals are filled completely and densely, with airtight seals.
In summary, particularly when it comes to root canals, my advice is to ensure your dentist has adequate experience and top-notch technology to offer you the best treatment possible, and either with a crown or other restoration protect the impacted tooth against future fractures.
Avoid opting for cheaper solutions because a wrong choice can create a snowball effect that will end up not only costing you more money but also causing you eventual tooth loss.
For more information contact Lake Lucerne Dentistry at (407) 410-4489.