My dentist told me that a metal tip from his instrument broke off in my tooth during root canal treatment. I heard it break. However, my dentist said the instrument was sterile, so he didn’t want to probe my tooth for the metal tip and potentially irritate it. I asked for a temporary cap only until I decided what to do. Should he have left the metal tooth? Could I develop an infection later? I don’t want to pay for a final crown and then need it removed to get the metal tip out. I’m unsure that my dentist knows how to remove it anyway. Thanks. Quinn from TN

Quinn,

It’s not uncommon for dentists to encounter situations where a metal file breaks during a procedure. These files are delicate and can break easily.  If the tip of a file breaks, a dentist would need to navigate around it to seal the tip of the tooth root. However, if the metal tip obstructs the root tip, it increases the risk of root canal failure. Depending on the location of the root tip in your tooth’s canal, you may need to repeat root canal treatment, underscoring the importance of getting the tooth evaluated.

Asking your dentist to refer you to an endodontist (root canal specialist) will increase the chance of a better outcome. A file tip can be challenging to remove for many dentists. However, an endodontist’s specialized tools can reach deep into a tooth’s canal to extract the tip of a metal file.

If your dentist hesitates to refer you to an endodontist, insist on it or find one yourself. You were wise to explain to your dentist that you want to keep the temporary crown until you decide how to treat the tooth. Ensure you see an endodontist to resolve the issue rather than relying on a general dentist. It can help you avoid another infection and root canal failure, which can lead to replacing the tooth with a dental implant.

Dr. Steven Brooksher, a Baton Rouge cosmetic dentist and a Fellow of implant dentistry, sponsors this post.