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Dentistry/Unreachable canal quandary

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Question
I'm 61, and recently the upper right molar just in front of my wisdom tooth needed RCT, but the dentist could only get three of the four canals - he said the fourth was now just the width of a human hair, and after failing to soften the calcification with lots of sodium hypochlorite, and after breaking a file, he gave up.

He then said that in his experience, such a canal rarely gave trouble (and he's been practising since 1976), put a Fuji 7 (I think) filling in it and said he'd do the crown in a fortnight if everything seemed OK.

But I keep thinking: if those other three canals had to be treated, what's to stop the fourth causing problems? This has me wondering if I should see an endodontist - but if my dentist can't get into this canal, could an endodontist?

I'd love to just let him crown it, because he'll do it for free (the deal is that if he crowns a 'borderline RCT' tooth and it still turns out to need RCT, he does the second crown for nothing). With my finances the way they are, I could do with that - and not having an endodondist's fee to pay.

But I'm also desperate to keep this tooth - I've never lost a tooth yet.

What do you think, Dr Backlund? Thank you.

Answer
Hi Malcolm,

I'm sorry to hear you are dealing with this situation. It's really a tough call. Some canals are SO calcified that no one, even endodontists, can negotiate them. However, if it is your general dentist trying to do, he/she may not have the skills, knowledge or equipment that an endodontist might have.

If I were you, I would at least get an examination by an endodontist. I would explain your situation and the options you have. Ask him/her what the chances are that the canal can be treated. If the chances are good, then go for it because an unfilled canal can cause problems in the future. If chances aren't too good, then maybe just go with what your general dentist is offering. I would also be upfront with your general dentist and ask him/her for a referral to an endodontist for a 2nd opinion.

I hope this helps some anyway. If you remember, let me know what you find out...just curious.

Gary Backlund DMD, MSD

Dentistry

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Gary Backlund, DMD, MSD

Expertise

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.

Experience

25 years practicing as a specialist

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

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