Tara,

I'm sorry, you are correct in that you did mention the overfill in the first post. Thank you for clarifying that

Some dentists are of the "(dis)belief" that an overfill of the rc material actually guarantees a seal of the apex. This "guarantee" is unfounded and it is also not well received by oral surgeons as they know how irritating this "foreign" chemical (bio-compatible or not) is to the bone and it can be difficult to remove because it becomes embedded in the nooks and crannies of the bone. In these cases, the longer the material is present in the bone, the more integrated it becomes. The truth of the matter is this, an overfilled root canal has always been a sign of over instrumentation and poor quality control of the procedure. However, because it occurs so frequently, some dentists have managed to convince others in the profession that an overfill is a good thing!!! Get the picture?

It is imperative to discuss the removal of the tooth as well as this blob of filling material in enough detail so that the surgeon understands what your expectations are and you understand his.

Bryanna

Okay..I am so overwhelmed.

I just got home from the oral surgeon. I got a chance to see the x-ray and the overfill was bad. It is a long string extending 1/2 - 2/3 way under my tooth. The surgeon called an endodontist who recommended I remove the tooth and material asap. I had to have a dental CT and it showed the calcium hydroxate sealer is in the nerve canal!
Tomorrow at 1, he is going to remove the tooth and material. There is no infection in my bone. Out of all the dentist I saw, only 1 said there was infection. Her partner didn't even agree. So, I have no infection that is visible in the jawbone. He said he would remove any infection and he will have to go into the nerve canal and try to remove as much of the sealer as he can without damaging the nerve. I am going to just have local anesthesia during the procedure bc I don't like be sedated.

What are you opinions on this? Is this the correct way to treat this?

I am terrified!!!!

I am scared the nerve damage is irreversible.. Right now I have feeling, but it just feels a bit odd.

I am scared the pain will be there forever.

I am scared of further damage.

And …i'm wondering….why did the dentist who performed the root canal say it is biocompatible and will be absorbed?

How did the material get INTO my nerve canal?

Thank you. I'm feeling scared and overwhelmed

I wouldn't recommend just local anesthesia for this.

I really, really don't want to have this surgery today.
As far as not even doing it under local? Why not? The oral surgeon didn't have a problem with it and said the whole surgery would last an hour.

I have been reading numerous studies that show that using the tooth to irrigate the nerve canal has been successful. Before removing the tooth, should I try to find an endodontist to try to "wash" the sealer out of the nerve canal?

I barely have any symptoms of it. Will it eventually just go away?
I feel so lost! I have no idea what to do.
I have made the wrong decision before….getting the crown and then root canal…what if this is wrong too? please help...

Tara,

Please calm down. Your case is another perfect example of the many serious risks associated with root canal therapy that are never discussed with the patient prior to the procedure and then are made light of after it's done.

The rc filling material that was used is bio compatible. However, that simply means that it is considered compatible with living tissue and not meant to cause an immunological reaction when used as it is intended. At the same time, it is not meant to be used as a overfill in rc teeth because it does not get absorbed and is a constant irritant when it is placed in areas that recognize it as an offensive foreign material.

Not to make light of your situation by any means but just to inform you ..... although your dental situation is very unfortunate it is NOT uncommon. Meaning it is typical for root canals to be done this way and over shoot the filling material ... it is typical for the dentist who did the root canal (and for others to cover for him) to make light of the overfill ..... it is a common surgery for an oral surgeon to perform because it is seen ALL the time. Is the surgery without risks? No. Is it wise to leave this diseased tooth and irritating material in the bone or nerve canal? No.

It is important for you to understand that it is rrelevant of whether or not the radio graphs show infection, irrelevant of whether or not you have pain in this tooth..... the tooth itself is infected due to the necrotic nerve tissue stuck inside of the dentin tubules. I want to make that clear to you because you are gauging this problem on your physical symptoms which is truly not wise because the longer you put this off, the more likely you are to develop systemic problems and the more complicated the surgery would become to remove the tooth, etc.

Your oral surgeon sounds like he will do a thorough job but take every precaution to minimize trauma to the nerve. However, he cannot guarantee that he will be able to remove all of that material. He cannot guarantee that you will not have some nerve damage or whether it will be temporary or permanent. There is no way to know what the neurological outcome will be but you will be ridden of a very sick tooth. So the concerns over the "progression" of an infection and the progression of neurological problems will be minimized if not completely eliminated after the tooth and material is removed.

Bryanna

Tara,

I know you are scared and the lack of intense symptoms is masking the real problem. This is not going to get better on it's own.... the situation is not going to improve as long as the tooth is present.

Regarding the anesthetic..... the iv sedation medication that is used to perform oral surgery in the office is a light mixture of drugs that cause the patient to go into a "twilight" sedation. It is very very different than general anesthesia. Under twilight, you are asleep, feel nothing and have no recollection afterwards. However, after the procedure you wake up fairly easily and the residual affects of the meds are not intense nor do they linger heavily for any length of time. However, you have to refrain from eating for at least 6 hours or more prior to the surgery. Sometimes it is more comfortable for the anxious patient to have the iv sedation as it lets the surgeon do his thing and you have no recollection of it. If the surgeon did not mention this form of sedation to you, then he thinks you will be okay with just the local anesthetic. However, you can still discuss this with him before he does anything.

As far as using the tooth to irrigate the nerve canal......

One, the tooth is chronically infected. Keep in mind the sick nerve tissue inside of the dentin tubules making this tooth chronically ill. There is no means of favorably altering that infection status.

Two, it is risky to attempt to flush out the material via this procedure because it can actually push the material further into the canal and cause further trauma. This material is sticky and somewhat attached to whatever it comes in contact with. Again, someone is making it sound like it can easily be flushed out.... not so.

Tara, your symptoms are not definitive in measuring the extent of the problem. Don't let them fool you into thinking this will just go away on its own.

Bryanna

Thank you Bryanna. I really appreciate it. It is so hard to find information about this, I'm so thankful you are here to help me understand. I just want to make the right decision.

I'm not sure if I mentioned this before, but the oral surgeon's first opinion was to wait and see. However, while I was there, he called an endodontist that he works with and she said the remove the tooth immediately. This had me a bit worried, because it seems that he has never seen this problem. However, he is an MD, DDS and surgeon , so I'm sure he's familiar with nerve canals and what is under my tooth.

I have called so many doctors and dentists, no one can help at all.

My main concern was that I would remove the tooth and then not be able to use it to flush the material out. Thank you for clearing that up for me. I certainly don't want to send the material further down the canal.

The dentist who performed the root canal is going to speak to the oral surgeon. I'm not sure what that will accomplish, but in my panic state I have called everyone I can think of.

You feel the right thing to do is, to remove the tooth, and then open the nerve canal and remove as much of the sealer as possible? Is that right?
That sounds like the thing that would help me heal the most?

Thank you…i'm a mess!

I was in the hospital under sedation for 3 hours during my nerve surgery. If you don't feel comfortable doing this today, then cancel the appt.!

If the OS has never done this type of surgery? I wouldn't subject myself to being the first in line!

Tara,

Let me try to briefly explain a bit about dental politics.......

No dentist wants to go against another dentist, irrelevant of how negligent they think the situation may be. There are many reasons for this but perhaps the main reason is because dentistry is very complicated and every dentist has his own way of doing things. So no one can be sure of exactly what took place at any procedure unless they performed it themselves or seen it being done. Dentists, not all, take short cuts and some utilize materials that others have banned from their practice. So although there is a text book that they all have learned from, they each do their own thing.

There are always risks associated with dental procedures and not all dental problems cause a lot of pain until they are severe. Dentists do not like to be the one to fix a problem that was caused by another dentist because they are then the one to likely be blamed or given credit for whatever the outcome may be. So that is why a dentist may initially suggest to take a wait an see approach, because they know eventually the problem will become more obvious to the patient. At which time that would be a better time for the new dentist to step in and try to help the patient but only to avoid be blamed for anything. It's a difficult call because the new dentist knows it is best to go in before the problem gets worse but they are really taking a risk in being pro active.

The only means of attempting to eradicate the infection brewing in the tooth and to remove the filling material that extends past the tooth is to remove the tooth and the material. To leave either or both the tooth and the material, is to retain the problems.

I wish I could hold your hand through this, I know you are scared and reluctant. I can only provide you with information and reassurance that it is never healthy to retain diseased teeth or rc filling material in the bone.

Please check in with us later today if you can.
Bryanna

Well….it's out!!

The tooth was extracted and there was no visible sign of infection. ( I know it was still an infected tooth though…so i'm glad it's gone!) He had the tooth out in minutes, but it took awhile to remove some of the calcium hydroxide sealer. He did the panoramic x-ray and it showed some material still in there. He went back in and tried to get more. Each time he touched the nerve I felt it. ugh. He removed more, but the next x-ray still showed some material. He said he got all he could without actually damaging the nerve more. He felt pretty optimistic that I would have a complete recovery. He said the decompression of the nerve should help. The numbness is starting to wear off and I can already tell I have feeling in my lip. I know it may take awhile to heal, but I trust God will bring complete healing.

Thank you so much for walking me though this difficult time.

I will never have a root canal again. What do you recommend for preventing these problems to begin with? I try to eat healthy, but I do love sweet tea
I use a sonicare toothbrush and floss. I know I need to get some fillings, but any dental procedure terrifies me now. ANy thoughts?