One of the worst “surprises” a patient can receive during a root canal is the diagnosis of a root fracture.
What is a Root Fracture?
There are different types of root fractures, and they are all bad news. A crack or fracture of the root of a tooth can occur as the result of an injury, heavy clenching or grinding forces, or dental treatment. While an injury may cause a horizontal root fracture, which is visible on dental x-rays, the majority of root fractures that we see are vertical. This means they run from the biting surface of the tooth toward the root. This type of fracture is not visible on a dental x-ray until it is severe.
Why is a Root Fracture Bad News?
The goal of any dental treatment on a tooth is to restore it to a state of normal function. In the case of root canal treatments, we remove the infected or injured nerves and blood vessels from the internal chamber of the tooth and fill it with a biocompatible material. The success of this root canal filling depends on its ability to seal out any bacterial contamination. A root fracture compromises that ability.
For this reason, the presence of a root fracture gives a tooth a poor long-term prognosis. When a crack is present on the root of a tooth, it is a constant source of bacterial contamination into the interior of the tooth.
Root fractures are a common reason behind root canal failures. Even the most beautiful, well-done root canal treatment cannot seal bacteria out of a fracture.
As bacteria infiltrates the tooth through the root fracture, the tooth often becomes re-infected, requiring further dental treatment.
How Does the Endodontist Know I Have a Root Fracture?
Endodontists, the specialists in root canal therapy, use high-powered microscopes to evaluate the internal surface of a tooth as they clean and prepare it for the filling of the root. They are able to visually detect root fractures. This is why it is important to see an endodontist for treatment of any complicated root canal treatments.
Root fractures do not always cause symptoms, especially in teeth with previous root canal treatments. When they do cause symptoms, they are often vague and difficult to isolate. Patients may complain of a dull ache or inconsistent pain on chewing.
What is the Treatment for a Root Fracture?
Your doctor will discuss the long-term possibilities of retaining the tooth as well as removing the tooth. As long as you understand the risk for future failure of the tooth, you can proceed with a root canal treatment in order to keep the tooth as long as possible.
Some people prefer to choose the treatment option with a more predictable outcome, and in the case of root fractures, that would be extraction of the tooth. Your endodontist will refer you back to your dentist to discuss your options for replacing the missing tooth.
More Questions about Root Fractures?
Contact Empire Dental Specialty Group to schedule a consultation with one of our board-certified endodontists. We can answer any question you have about root canals or root fractures and assess any specific areas of concern you have. We have appointments at either our Beavercreek or West Chester offices.