Dentistry/Root canal and calcified root
About a year ago I had RCT on tooth #4. The Endodontist said he complete CRT on to root but the third one he could not get to, I even went back for a third time but he could see it on the X-ray but could not treat it. He said it was small but should not give me a problem....
Well a month later I still had swelling in my cheek so instead of putting on a crown I went to an oral surgeon who said he did not consider the Root canal complete as he could see the untreated third root..
Well I had a little medical problem the side tracked me for 6 months but I did go see another Endodontist. He took a ct scan of my teeth and saw the same untreated root. He said he would have to do an apicoectomy .
His assistant called him over and must have informed him I was on Coumadin , as this was just a consultation.
After this information he said he looked over the X-rays again and said the third root was calcified and there was no need for a root canal. He wrote my primary about his finding and saw no reason why this tooth should be bothering me, and I should get a crown on it.
When I went to my primary dentist for the crown, they took an X-ray again but this new dentist questioned why the 3rd root was left untreated, the other dentist explained that it was calcified ( I overheard this). I was puzzled why she didn't see the root as being calcified on her X-ray....
Well I guess my ultimate question is could a calcified root cause slight swelling an occasional pain as I no it is not in my head ?
Mant thanks in advance
I'm sorry to hear you are needing to deal with all this. Basically, there are two issues here. One is the calcified root. If an endodontist was unable to locate the opening to that root, then treating it is not a likely possibility. When a root calcifies, extra tooth structure is laid down due to some sort of irritation the tooth is undergone. Decay or a large filling is the most common irritation. The problem is, if the endodontist drills too aggressively, it is possible to drill out the side of the tooth and then you have real problems.
The other issue is what is going on at the end of that root. Since the root has not been treated, it is possible that a very small canal still exists and is causing an abscess at the end of the root. Usually that can be seen on an x-ray as a dark spot at the end of the root. If that's the case, this could certainly cause your swelling and occasional pain.
The only ways to deal with this problem is to do surgery on the end of the root, cut that root off, or extract the tooth. Since all these are surgical procedures, your Coumadin becomes an issue. In our office, we sometimes face this. Usually we consult with the patient's physician and usually it is possible to reduce Coumadin levels temporarily, get your pro-time before the surgery and go ahead with the surgery, whichever option is best in your case. There is always some risk and bleeding will be a little more, but when done in conjunction with the physician, we have never had a real problem.
I hope this helps explain things.
Gary Backlund DMD, MSD