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Dentistry/calcified root canal


hi. my dentist attempted a root canal for an infection. however, he said he couldnt do it because of calcification and referred me to an endodontist. i will be going soon for an evaluation first. i am nervous about any procedure. my question is can a successful root canal be done when its calcified?  is there a possibility that i would have to have the tooth pulled? i had a cap put on this tooth about a year ago. shouldnt the cap have prevented this? what can i expect in happening during the procedure? pain afterwards? right now i am taking an antibiotic to help clear up the infection. will i need more after this? thank you for all your help.

Good morning Sibylle,

I'm sorry to hear you have this going on. Let me first explain a bit about calcified roots to help you understand what's going on.

When a tooth has deep fillings, crowns, decay or other things that irritate the nerve(pulp)of the tooth, the pulp responds by laying down extra tooth structure to try to insulate it from the irritation. When this happens, the channel down the root gets smaller and in some cases, will close off completely. The problem for you dentist is finding this reduced in size hole so a root canal can be done. Once that hole is found, then the root canal becomes just like any other root canal. The risk is drilling out the side of the tooth as we look for that hole. That's why your dentist referred you to an endodontist. We specialize in dealing with these problems and are often able to do things that a general dentist can't. We have special equipment, like a microscope, as well as lots of experience since we only do root canals. Your dentist showed good judgment referring you since it showed he knew his own limitations.

Now to deal with some of your other concerns. If the canal can't be found and there is infection at the end of the root, it may be possible to do a surgical procedure on the end of the tooth called an apicoectomy. That will remove the infection and seal off the tooth from the other end. Your endodontist would be the one to do that, but I wouldn't worry about it until after you see the endodontist. I'm just trying to tell you there are other options beside extraction.

Having the cap on the tooth was probably necessary due to decay or a large filling. Rather than preventing the calcification, it may actually partially cause it to calcify farther. Without old & new x-rays, that's a tough call.

The procedure itself should not really be a big deal. Basically, it is just drilling and some pressure as the endodontist tries to find the hole. There should be NO pain. If you should feel anything, let him/her know. We want our patients comfortable. Afterwards, the tooth may be a little sore for a day or two, but should be controlled by aspirin or Tylenol. As for the antibiotic, it will depend on what the endodontist finds and how you respond. We try to keep antibiotic usage to a minimum, but when it's needed we use it. I can't really forecast that for you.

I hope this helps. I'm sure you will do fine. If you need more clarification, please write back.

Gary Backlund DMD, MSD  


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Gary Backlund, DMD, MSD


I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.


25 years practicing as a specialist

American Association of Endodonists, Past President Washington State Association of Endodontists.

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