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Article: The unfinished root canal: a hidden danger DR. JERRY GORDON
An unfinished root canal will eventually cause many problems.

Once a tooth is infected, the only way it can be saved is with a procedure called root canal. During a root canal, the infected nerves and blood vessels are removed from the tooth's root(s), just like taking the core out of an apple. After the roots have been shaped and disinfected, they are filled with a rubber-like filling material to prevent bacteria from re-infecting the tooth. A root canal is usually completed in one to three visits. If a root canal is started but never completed, the tooth can become a source of pain and infection for the patient. There are several reasons why a root canal may be left unfinished. The first is that the dentist may not have explained the procedure well enough to the patient. There may also be additional confusion because the process of rebuilding a tooth that has had root canal usually involves three separate procedures. The first is the root canal itself. The second is the post, a titanium rod that is placed into the root, necessary to help build up the tooth above the gum-line. The third procedure is the crown, or cap. The crown is porcelain and gold, and fits over the tooth, protecting and restoring it. A patient may be in the middle of any of these three procedures and not actually know if the "root canal" or other aspect of their treatment has been completed. The second reason that a root canal may be left unfinished is that in many cases, after a root canal has been started, the pain in the tooth will temporarily go away. The patient may believe that the procedure is finished because he or she is comfortable.

An unfinished root canal will eventually cause many problems. The most common complication is that the tooth will begin to cause pain. There is also a risk that the tooth may fracture or cause a potentially dangerous swelling of the gum. Despite these problems, in many cases, the tooth can still be saved and pain eliminated if the root canal is completed, but this is not always so. If the tooth has become fractured or is badly decayed, it may need to be removed. Fortunately, a new trend has emerged for the root canal procedure. In most cases, a root canal can be completed in one visit, which prevents the possible complications that result from the unfinished root canal. In fact, after I complete a root canal in one visit, I will also place the post, when needed, on the same visit (procedures one and two). This makes the tooth less vulnerable to fracture before the crown is prepared, and saves time.

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Dr. Gordon is the dental columnist for the Bucks County Courier Times. He has published more than 300 articles since 1998. Dr. Gordon was recently asked to provide commentary about mid-level providers for the influential dental journal Dental Abstracts.

Dr. Gordon responds to an article in Dental Abstracts challenging his views.

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