Successful Calcified Root Canal Treatment

There are 2 steps for successful calcified root canal treatment:

1. Find all of the canals in the tooth.
2. Clean all of the canals you find.

Theoretically, successful calcified root canal treatment is that easy.  Many dentists find it so hard to complete these two steps and provide the successful root canal treatment that their patients deserve, because they do not have the right equipment for the job!  The secret to successful root canal treatment is visualizing the canals that need to be treated.  You simply can't treat what you can't see!

Mandatory Equipment for Treating Calcified Canals

Many dentists struggle to treat calcified canals because they don't have the right equipment.  Sure, some dentists can successfully treat calcified canals with basic equipment just like a blind squirrel can sometimes find a nut. You might ask yourself, "Why don't all dentists simply buy the equipment that they need?"  The answer is simple, money.  The three mandatory pieces of equipment needed for successful calcified root canal treatment are a dental microscope, a 3D Xray machine and ultrasonics.  These three pieces of equipment can cost over $150,000 dollars and not all dentists want to invest just to treat difficult calcified root canal cases.

Dental Microscope

A dental microscope changes root canal treatment and is an indispensable piece.  Although most dentists use some sort of magnification mounted on a pair of glasses, this type of magnification cannot compare to the high powered magnification of a dental microscope. Orascoptic, one of the best selling magnification glasses, has a pair that can magnify up to 5.5 times.  Global Dental Microscopes can magnify the tooth up to 19 times magnification and can help a dentist find difficult calcified canals.

3D X-ray Machine (CBCT)

3D x-ray machines (CBCT) can show a dentist where to start looking for difficult calcified canals.  Although 2D x-rays are helpful for diagnosis, they do not provide the same clarity and spacial orientation that a 3D x-ray provides.  By using the most advanced radiographic technology available, dentists can locate calcified canals more efficiently.  This allows the dentist to remove less tooth structure and retain the structural integrity of the tooth.

Ultrasonics

Dental ultrasonics are a modern dental technology that allows dentists to remove small amounts of tooth structure at a time.  Traditional dental drills remove tooth structure at a higher rate and the dental handpiece can block the dentist's view.  By removing smaller amounts of tooth at a time, dental ultrasonics allow a dentist to preserve tooth structure and retain the tooth's original strength. Dental ultrasonics are smaller and let dentists visualize the tooth more clearly as they work.

Untreated Calcified Canal

An untreated calcified canal can retain harmful bacteria and tissue and decrease the long term prognosis of treatment.  Successful root canal treatment depends on the dentist's ability to remove the tissue and harmful bacteria in all of the tooth' s canals.  If an untreated calcified canal was left during original treatment, a root canal retreatment might be necessary.  The original root canal material must be removed and the untreated calcified canal identified.  Your dentist will then disinfect all of the canals.  After the canals are disinfected, new filling material is placed to complete the root canal treatment.

Calcified Root Canal Pain

Failure to clean all of the canals in a tooth can result in leaving remnants of tooth nerves that can cause tenderness and severe pain.  Leaving remnants of living nerve tissue can be painful, but leaving bacteria and necrotic tissue can be equally painful.  If the bacteria proliferates and exits the tooth, bacteria can spread to the surrounding bone.  When bacteria reaches the surrounding bone and ligaments, pain and swelling can cause severe symptoms and swelling.  If you are experiencing calcified root canal pain, antibiotics and pain medications may be necessary before your root canal treatment.

Cost of a Calcified Root Canal

Although there is an additional fee for successful calcified root canal treatment, dental insurances often cover the additional cost.  D3331 "Treatment of Root Canal Obstruction" is a common treatment code on your treatment plan. To lower your out of pocket expenses, find a dentist who is in network with your dental insurance.

Are Calcified Root Canals a Growing Problem?

The average American lifespan is currently 79 years old.  In the last 40 years, the average  lifespan has increased by 18 years. With this increasingly aging population who retain their teeth longer, there is a growing number of calcified root canal that require treatment.  The management of calcified canals has always been a complication of root canal therapy, because it can be difficult to identify, clean, and shape calcified root canals.

Although dental implants are an option, we can’t simply recommend extracting a tooth and replacing it with an implant simply because it has calcified canals. Also, not every patient may be a candidate for dental implants.  Older patients have a higher incidence of diabetes, osteoporosis and bleeding disorders that may lower the success rate of dental implants. So in many cases, no matter how severely calcified a tooth can be, we may need to deal with calcified roots. Many of these difficult calcified root canal treatments are best handled by an endodontist.

Calcified root canals are not only an issue for the aging population.  Increased sports activity among children and high school aged kids has led to an increase in facial trauma.  Tooth trauma can cause bleeding in the canals and this bleeding can become a focal point for calcification.  Although the trauma may not be sufficient to cause the nerve to die, the trauma may cause the tooth nerve to calcify.

Alternatives to Treating Calcified Root Canals

Not all calcified root canals can be successfully treated.  For example, sometimes severe root calcification extends around a curve in the root.  In these cases, other dental procedures may provide the best results.  Two alternatives are an apicoectomy or a dental implant.

Apicoectomy to Treat a Calcified Root Canal

If your calcified root canal is untreatable with traditional root canal treatment, an endodontist can still save your tooth with an apicoectomy.  An endodontist will make an incision in your gums and locate the tip of your tooth root in the bone.  After making a small window in the bone, a small segment of the tooth root is removed.  The endodontist will then place a small fill at the end of the root.

Implant Replacement of Untreatable Teeth

Sometimes due to severe calcification and unfavorable circumstances, a tooth simply cannot be saved with traditional root canal treatment or an apicoectomy.  There have been significant scientific advances in dental implant in the last few decades.  Dental implant have built a reputation of having a high success rate and a high rate of patient acceptance.  Simply put, patients love dental implants.