Broken file in root canal?

Hoot_Owl

Hi, today I had my very first root canal on an upper molar tooth. I was referred to an endodonist and cost me £700.

The root canal took just over 2 hours (including removal of amalgam filling, core build up etc). Having no previous experience of root canals the whole thing was very arduous, but I can praise the dentist for doing a very thorough job at least and I was relieved when it was all finished.

Unfortunately after he showed me the X-ray, he told me part of the file broke off inside the root and he couldn’t get it back out!? I asked him if this would cause any complications but he said it would be fine. But getting back home and having had a quick look online I’m disappointed and discouraged to read a few places a broken file can indeed compromise the lifespan of the root canal, increase the risk of infection etc?

I know there are a few dentists on here and would love for some advice please.

Did I just waste £700 on a now comprised root canal tooth? (Just to add I only have minimal discomfort in the tooth which I was told was to be expected).

brook2jack

A file breaking during root canal is a common occurrence. They are very fine instruments a fraction of a millimetre wide in places and often have to go down very narrow , curved canals.

Providing the root canal was cleaned out well and filled well the fractured piece of file will not be a problem or impact on the tooth prognosis.

Hoot_Owl

brook2jack wrote: »

A file breaking during root canal is a common occurrence. They are very fine instruments a fraction of a millimetre wide in places and often have to go down very narrow , curved canals.

Providing the root canal was cleaned out well and filled well the fractured piece of file will not be a problem or impact on the tooth prognosis.

Thanks your post brook2jack, this has reassured me a little more.

The endo did spend a good amount of time rotary filling and disinfecting the 3 root canals, Taking the first set of X-rays and not being completely satisfied went back to filing and cleaning until he was happy.

Hopefully the stuck file won’t cause any issues down the line.

Toothsmith

If the file breaks early on in the process when there is still a lot of dead tissue still in the canal below the broken file, then that can be a problem.

If a file breaks later on in the process after lots of disinfection and previous filing has essentially cleaned the canal, then all the broken file is is a rather expensive, but very effective root filling material!

It would not be in the interest of the dentist to try and cover up the situation, as it would be easy for any other dentist to see whether it was true or not. Just in the same way the dentist told you it had happened, as not telling you, and it being found later on would be a bigger sin than not telling you.

I would be reassured by what you've been told. As Brook said, it is not an uncommon event.

Hoot_Owl

Thanks Toothsmith, I agree he did the right thing telling me after the procedure (would look bad if I had to be told by another dentist like you say), but in a funny way I wish he hadn’t since ignorance is bliss and all!

Tbh I don’t know exactly at what point the instrument broke off during the procedure or what part of the root. I’ve got to go back next week to have a filling/core adjusted as it’s too high, so I’ll ask him then.

From what I gather, the endo filed each canal to the apex (using a machine that beeps like a parking sensor on a car lol). I don’t know if that means the breakage happened after or if maybe it was possible to ‘bypass’ the file to the bottom of the root? Fingers crossed it will all be ok.

Toothsmith

Ok - if it had got to the end then that's good.

I agree that sometimes it's best not knowing - and in my early career I must admit I didn't tell patients if I thought they were the worrying kind!!!

Those were different times though - and now full disclosure is key. You can be absolutely crucified if you even try to apply a bit of thought to what might be best! Well - if it's found out, anyway!

chr15hewitt

Hi. Sorry to jump in. I’m currently having a root canal redone. The emergency dentist I first saw mentioned it was six years since the original procedure was done. My dentist asked if I remember who did the initial treatment as there is no records of it. The X-ray said there was no sign of a root canal as no root filling was present. In attempt to save the tooth we agreed attempt to re do the procedure which the dentist informed me afterwards that one of the roots was blocked and she had to negotiate around the blockage as it could not be removed. She said that she could not confirm but said it looked like a broken file. I am concerned because 1. I was never informed of any instrument breaking off and being left in my tooth. and 2. The X-ray suggested the root canal had not been completed the first time which may be the reason for the recurrence. I was quoted £1000 for a bridge if I lose the tooth and more fore a single implant. Any advise is welcome.

brook2jack2

Where did you have the root canal done in the same practice as the emergency dentist or the same practice as your own dentist, in other words who did the original work , was it done as an emergency treatment? 

Root canal takes several stages and if you were originally seen as an emergency patient 6 years ago only the initial stage would have been done , you would have had to return to your own dentist to complete treatment. Without seeing the notes, x rays and understanding what exactly has gone on it is impossible to comment on what has happened. 

MalMonroe

chr15hewitt said:

Hi. Sorry to jump in. I’m currently having a root canal redone. The emergency dentist I first saw mentioned it was six years since the original procedure was done. My dentist asked if I remember who did the initial treatment as there is no records of it. The X-ray said there was no sign of a root canal as no root filling was present. In attempt to save the tooth we agreed attempt to re do the procedure which the dentist informed me afterwards that one of the roots was blocked and she had to negotiate around the blockage as it could not be removed. She said that she could not confirm but said it looked like a broken file. I am concerned because 1. I was never informed of any instrument breaking off and being left in my tooth. and 2. The X-ray suggested the root canal had not been completed the first time which may be the reason for the recurrence. I was quoted £1000 for a bridge if I lose the tooth and more fore a single implant. Any advise is welcome.

Hi, well this is an old thread but - oh well!

I think you should get some more information - unless you are seeing private dentists because bridges come under NHS Band 3 and should only cost £282.80. Implants may be more but if it's a molar I don't think it's worth it, who'll see it? I had a bridge fitted about 6 years ago. It's fine. Feels like my own tooth and hasn't, so far, caused any problems.

There seems to be so much uncertainty around this whole thing though that if it were me, I'd really have to ask for another opinion before I plunged into any treatment. The dentists you have seen so far just don't seem to know what they're doing. ("no records of treatment", "can't confirm" - it's all too vague.)

brook2jack2

In general , on the NHS , bridges would not be provided to replace molar teeth . They would only be available privately. Nhs treatment is there to secure oral health in the simplest way possible and replacing a molar tooth with a bridge would not qualify for that criteria. 

chr15hewitt

My main concern is whist at my initial emergency appointment they told me the root canal was done six years ago upon return I was told there are no records of who, what or when. The X-ray showed no root filling and the dentist found a blockage which she thought could be a broken file. The original treatment was at the same premises but they changed name since. Why are my records incomplete? Why was I not informed of the broken file? Did the previous dentist cause the blockage then fail to complete the procedure and inform me so? Is there a way I can retrieve this information?