How difficult is a root canal on a front tooth with a wide canal?

[MountainMama]

My front tooth has an abscess and needs a root canal. I was hit in the mouth 30 years ago with a shopping cart and broke my tooth. It was filled and I haven't had any issues with it until last week.

The dentist said the tooth pulp chamber and canal basically never changed from when I was 9, so it has a large chamber and wide canal in the root that is open. She said she could do the root canal at her office, but will send me to the endodontist if the canal is too wide and she can't get it with her files.

How difficult is this procedure? Anyone else have this issue or can a dentist chime in? After having a failed root canal (that still hasn't been extracted, I am super wary of root canals now. I have an extraction of a different molar tomorrow, then the root canal next week. I am terrified that it will fail, as it is my front tooth!!

She said the abscess is fairly large so she doesn't want to put a crown on it right away.

 

[drhirst]

Hey there,

A wide canal on it's own is not a problem. What is important is whether the root had finished developing when you hit it. If the tooth died before the root had finished developing it will have a wide opening at the end of the root. This makes root filling it difficult for a general dentist, although an root canal specialist should be able to deal with it. Now, on average a front upper incisor will finish developing at 10 years old. From what you say your tooth died at nine years old,so he end of the root (called the apex) may not be fully formed.
If this is the case you will be referred and the specialist should be able to take care of it very well indeed.

Hope it all works out

Lincoln

 

[MountainMama]

Hey there,

A wide canal on it's own is not a problem. What is important is whether the root had finished developing when you hit it. If the tooth died before the root had finished developing it will have a wide opening at the end of the root. This makes root filling it difficult for a general dentist, although an root canal specialist should be able to deal with it. Now, on average a front upper incisor will finish developing at 10 years old. From what you say your tooth died at nine years old,so he end of the root (called the apex) may not be fully formed.
If this is the case you will be referred and the specialist should be able to take care of it very well indeed.

Hope it all works out

Lincoln

The dentist said the the end of the root was wide open (she showed me the opening in the xray and it was the same width as the canal). She said she would be able to do it at the office, though. Should I ask for a referral to the endodontist? The dentist is getting me in next week, but the endodontist wait time is generally 3 weeks. The dentist was worried about the size of the abscess and wanted me in as soon as possible.

 

[drhirst]

She clearly feels she can do something to help. She may just be intending to start to control the infection rather that do the whole job. Discuss the situation with her when you see her.

 

[MountainMama]

She clearly feels she can do something to help. She may just be intending to start to control the infection rather that do the whole job. Discuss the situation with her when you see her.

I called this morning. She said she is fully confident that she can do the procedure and described how she will put a material in the root apex to form a plug. She said if she runs into any issues, she will put a temporary seal in and send me to the endodontist. She is very concerned about getting rid of the abscess before it gets any larger.

I really like this dentist and trust her so I am going to go for it. Thank you for your responses!

 

[MountainMama]

It is done. She said it looks great on the x ray, but it was difficult. She was very thorough, and cleaned the canal multiple times. She had to cut the gutta percha to make it fit my canal, since the apex was wide open, and took x rays multiple times along the way to make sure it was the way she wanted it. She said she is very pleased with it, but that we won't know for sure, so she wants to wait about 6 weeks before getting the crown.

 

[krlovesherkids777]

Mountain mama,

Glad you made it through and hope it is feeling better soon! She sounds very thorough, and conscientious in her work and thoughtful!! These are all great things!! Hope it all heals well and you can go onto to the crown!

 

[MountainMama]

Mountain mama,

Glad you made it through and hope it is feeling better soon! She sounds very thorough, and conscientious in her work and thoughtful!! These are all great things!! Hope it all heals well and you can go onto to the crown!

Thank you! It went better than I had expected, with my anxiety. The antibiotics had reduced the abscess enough that she could get me numb with just one extra injection. She started drilling, and at a certain point I started feeling a zing, like extreme cold sensitiviy, so she stopped and gave another shot, which did the trick. It was a much simpler procedure than the root canal on the molar.