Doctor Shervin here from Artistic Dental Studio. Today I’m going to cover a very important topic which people as patients are not really aware of and you can put the blame on us as dentists because we are the people who need to give you a heads up about this.
Let me drive in: the agenda is about people who have root canal treatment done, specially on back teeth. Over the last 25 years I’ve had many patients who have asked for this type of treatment and some of those were the people who were businesspeople. They were on tight schedules and wanted to get out of pain as quickly as possible and then hop on their next flight. This is where the problem begins, because fracture of back teeth after root canal treatment could happen as early as one or two weeks after the root canal treatment. I’ve seen many cases in which I have warned them that they had better receive at least some form of protection before going away, but they rejected for any given reason. They went on the business trip, then got back, gave me a call, and then they said the tooth was broken. This has happened to me several times and the reason why this thing happens is the subject of today’s blog.
As you may know, root canal treatment involves removal of the nerve from within the tooth. There is a more important function to the nerve that you may not be aware of: nerve send some impulses to the brain from within the tooth and whenever the tooth is overloaded for any given reason, these impulses from the tooth to the brain triggers the brain to send some impulses to the muscles. Therefore, brain programmes the muscles in a way that muscle contractions are minimal to support the tooth. After root canal treatment, with complete removal of the nerve, this protective mechanism is completely lost. This is one of the reasons why the tooth that has undergone root canal treatment breaks after a while.
The second thing is that when we do the root canal treatment, we do not just remove the nerve from within the tooth. Nerve and blood vessels are like a bundle in the tooth. So, when we remove the nerve were remove the blood vessel as well. Blood vessels are responsible for nutrition and hydration of the teeth, so when we remove the blood vessels, the teeth get dry and dehydrated. it is like a green and dried tree branch. You can easily bend the green one, but it’s not possible to bend the dried one, because it snaps easily. This is another problem that happens after root canal treatment. So as you can see, the combination of these two factors could make that tooth very vulnerable to fracture.
Unfortunately, it is not the end of story. Back teeth have divided shapes in form of cusps. They are designed in a way to crush the food easily and this is why they are more vulnerable because there are subjected to greater forces. This is the third factor why back root canal treated teeth break so often.
And the last factor that could contribute to teeth fracture after root canal treatment is something a bit more technical. Whenever we do root canal treatment, we have to create a relatively large opening in the centre of the tooth. As we create this opening, we reduce the thickness of the tooth walls, therefore weakening them and cause them to break more easily down the track.
Now there is a question:
Is it possible to wait until the weakened tooth breaks, then do the treatment?
Well, I wish that was the case. In many cases, it is not just a simple chip. The line of fracture often goes diagonally underneath the gum level. If such a thing happens then it is very hard to save the tooth, if not impossible. So, you can imagine you were very keen to save the tooth, you had root canal treatment done in at least three sessions, spent some money, and now your tooth is quite stable and you’re very happy. But suddenly, you hear a crack, you go to your dentist, and they say they can’t save the tooth! How disappointing is that?!
This is the thing you need to be careful about. Have a chat with your dentist and see if you have any root canal treated back teeth. Get them protected as quickly as possible.
What do I mean by protection? The simplest way to protect a root canal treated tooth is to cover the perimeter of it. It could be done with a crown. A crown provides support to the tooth and will never allow it to splitter. This could be done in an hour these days. How cool is that?! The easiest thing your dentist could do is to put a temporary crown out of plastic on your tooth, so if there are sudden high forces, this temporary crown will break rather than your actual tooth.
I hope you enjoyed this piece of information, thank you so much for your attention, stick around for other informative blogs.
Have a fabulous day!