Dental Forum

Broken instrument during root canal treatment

By david 8/9/2010 7:52:08 PM
i just had a root canal,the dentist broke a file off in my tooth and left it in. is this dangerous? what are the problems that can occour? if i have a cat scan will it pull out of my tooth. should it be removed?
Posted By : Dr. Ritz on 8/9/2010 7:52:08 PM

It depends upon when and were the instrument is broken. If it is broken when the canals are prepared and is broken like it can be bypassed then it can be left in the canal. When the file is broken in the canal the problem one can face is the infection and in that case if file can not be retrieved then tooth has to be pulled out. For more info onroot canal treatment you can visit the following link on our website.....

Posted By : Lydia on 8/23/2010 6:15:24 PM
I had a root canal 3 years ago. A file was left in the root canal. I have been in constant pain for the last 3 years. But, I just learned that there was a file in the canal. I have cleanings and x rays regularly. I am surprised that I am just now finding this out, after insisting something is wrong! I have complained about the tooth for the last three years! I am now going to have oral surgery to remove the file and infection. Following, I will have a bridge. I was not informed initially. Should I have been informed? Should I be financially responsible for the mistake of someone else?
Posted By : Dr. Ritz on 8/25/2010 9:38:30 AM
Yes if the file is broken inside the root canal, you should be told about that by dentist though it is accidental. It does happen and may not be dentist's fault. Why would dentist break file. After informing youa about this, you should have been told about pros and cons and afterwards you could have decided whether to save the tooth or extract it. Anyway your insurance must be covering it.
Posted By : judi on 2/8/2011 2:54:27 PM

I was having a root canal done and the instrument broke and is in my tooth. It is almost down to the gum. I am on medication for breast cancer and my immune system is not good. He suggested I go to a root canal specialist. He should pay for this. It has been a week and I have niggling pain constantly. Should I sue or not.

Posted By : Dr. Ritz on 2/8/2011 7:51:24 PM
Broken instrument while doing Root Canal Treatment is common problem which happens sometimes as in Root Canal Treatment there is no direct visibility. Root Canal Treatment is always best performed by Endodontist as they are well trained and if some complication do happens then they have expertise to take care of that and due to this they charge more than General Dentist. I think if you are on insurance, you will be paid by insurance. You can talk to your GD on the issue.
Posted By : Jonathan on 6/27/2011 12:17:50 PM
I had a file seperate in my mouth while having a root canal. My dentist told me everything was fine. He never told me that there were risks involved or referred me to a specialist. My mouth got infected and I had to have the file removed by having my gum cut open. That hurts. I went back to the dentist to ask to be reimbursed for the oral surgery and he refused and told me that it was my decision to have the instrument removed. What should I do???
Posted By : Dr. Ritz on 6/27/2011 7:07:22 PM
It is not very uncommon that files break while doing Root Canal Treatment. It should have been told referred you to Endodontist after file break. But it is not always that you have infection after file breakage in canal so may be due to that you are not referred or told. General dentist do the RCT but the Endodontists are specialists and are trained to handle these kind of things. Now you have to talk to your dentist about this. If you have insurance then your surgery cost must have been reimbursed by insurance.
Posted By : patty finkral on 6/28/2011 3:43:27 AM
I guess I was lucky. I had a file break off in mine after 4 hours of the dentist trying to do a root canal. He explained what happened and that he went ahead and filled it in anyway. It has never bothered me almost 10 years later.
Posted By : ldean on 7/11/2011 12:47:01 PM
Dentist broke a file off during a root canal. I went to another dentist for pain/soreness. This dentist told me I should have the file removed by edodontist, because there was an open space below where the file broke off. The dentist that did it will not pay for the fix. I have no insurance. What should/can I do?
Posted By : Dr. Ritz on 7/11/2011 6:12:41 PM
Yes if you really want to save the tooth, you have to get the broken file removed from and Endodontist as only they are experts in handling this sort of situations. In your case you pain and soreness that means the infection is not removed completely and due to broken file in canal it is imposssible to clean the infection. This now can be done by and Endodontist who will take out broken instrument and complete the root canal treatment. The expense of this has to be borne by you. General dentists charge less for Root Canal Treatment and Endondontists charges almost double of an General Dentist for Root Canal Treatment. Now if you donot have insurance the you can try some dental school near your home where the treatment is definately cheaper than private dentist and they have all the experts. If you are lucky you may get free treatment as in dental school, it is subsidised for dental students. You can also get the treatment financed from CareCredit.
Posted By : vesna galic on 7/11/2011 8:40:59 PM
I had a root canal 3 years ago and the dentist BROKE A FILE and did not inform me.I have been so unwell and recently found that she had done this.It definately causes problems long term as now my other teeth are also dying because the infection was so severe.With all due respect to dentists they have different opinions and it didnt happen to them so how would they know what the true long term effects are. I belive the dentists that dont inform the patient should held accoutable for their actions as it is criminal .
Posted By : ldean on 7/13/2011 9:38:43 AM
Dr. Ritz. Thanks for the response, but I searched "CareCredit" and there are no dentists w/in 50 miles of my home that accept it. Also, the closest "dental school" is about 250 miles. I live in western North Carolina, disabled, fixed income . . . appreciate the thought. Guess I'll just have to lose the tooth and the $2,000.00 I paid to save it.
Posted By : klb on 8/9/2011 10:35:59 PM
@ Idean.....I am SO sick of bad dentist:/ Just had a root canal ...due to my dentist misdiagnosis of new crown, thinking I had a bite issue...the crown was seated on a sick tooth, if they had actually listened to my complaints of severe pain and X-rayed the entire tooth, they would have seen the abscess...that was allowed to fester for 6 months:/ I was prescribed amoxicillin, then clyndamycin...and now suffer with C.diff from the rounds of antibiotics. The endodontist also left a file in my root canal, she did tell me, .... it feels strange to bite down....Idean...I think you need to tell your dentist you are calling the State dental board about leaving a file in your tooth with an open space.. they should MAKE the dentist give you your money back.... that is what I intend to do!
Posted By : tina on 9/8/2011 9:24:03 PM
I had a root canal with crown 6 years ago, without any problems. Now I'm having extreme pain in my cheek and upper jaw. Went to the same dentist and referred me immediately to see an Endodondist which said that I have a broken file that blocks the canal of one of the roots!He is suggesting extracting and implants right away due to an abscess. Do you think this is wise? and why did I have the pain 6 years later? Do u think the brain MRI that I had recently due to Jugular vein DVT moved the metal and created pain and infection?
Posted By : Dr Ritz on 9/8/2011 11:51:51 PM
Tina, If the file remains in the canal after root canal procedure, it can cause pain and infection. If canals are sterilized before the file gets broken, then the broken file doesn’t usually cause any symptoms otherwise it causes pain and infection. Pain and infection can’t be because of brain MRI which you have gone for. Infection may progress gradually. If the file remains in canal, then the dentist can perform re-root canal procedure or can go for apicoectomy or can extract the tooth if the infection is severe and the dentist doesn’t feel that re-root canal procedure will be successful. Get the treatment done for tooth infection before the pain aggravates.
Posted By : Smriti Singhal on 9/12/2011 11:53:33 AM
I am under going a root canal treatment. A small part of file has been in my tooth. I dont have any pain now. But my dentist says its savable. If he will not be able to remove the file he will seal it with some sealent and then it will never bother me. Should I go ahead with it. Please let me know soon.
Posted By : Dr Ritz on 9/13/2011 12:04:50 AM
Smriti, if the canals are clean and sterilized before the file gets broken, then the broken file doesn’t cause any pain or other symptoms but if the file is broken before cleaning the canal, then it causes pain and infection. Your dentist will try to remove the file before sealing it. Preferably, file should be removed before sealing the root canal. If it remains in the canal, it may cause pain later on and then you may require re-root canal treatment for it. Without clinical and radiographic examination, it is difficult to comment whether the file will cause pain or not. You can take second opinion of an endodontist in this regard who specializes in doing root canal procedures.
Posted By : Genuinely Concerned on 10/2/2011 1:27:04 AM
I believe dentists who do root canals and leave "lost" files behind buried in the gums("swept under the carpet") is SO WRONG. The system has no feelings or consideration towards patient(s) and the unncessary PAIN they are going through. Dental Board should hold an urgent meeting and fix this problem so that it doesn't happen in future. I'm sure there is something they can do. STOP GRABBING THE MONEY for faulty works and stop making errors. Shame on you!
Posted By : vesna galic on 10/8/2011 5:47:16 PM
Dr RITZ could you please tell me why my teeth are discouloured - only the teeth in the area where the broken file was left behind. Why do I keep getting infections too even after file was taken out
Posted By : Dr Ritz on 10/9/2011 11:28:42 PM
Vesna, if cleaning of canals is not done well and by insufficient use of irrigants like hydrogen peroxide during root canal therapy,hemosiderin (By product of hemoglobin) flows through the dentinal tubules and causes discoloration of the tooth. Infection after root canal therapy can be because of infection still left in the tooth even after root canal or can be because of gum infection in relation to that tooth. If infection is still left in the tooth, then re-root canal treatment may also be required for the tooth.
Posted By : wayne s. on 10/17/2011 9:49:52 AM
just reading some of these problems, and dr. ritz's comments, its a wonder why you crappy dentists arent in court everyday getting sued. the dentist's defense is that "hes cheaper than a specialist" so that justifies breaking files in peoples teeth and then washing his/her hands of the matter? im experiencing the same issue with a broken file and now jaw/bone infection. i think its time to call a lawyer.
Posted By : vesna galic on 10/23/2011 11:49:36 PM
hi Lydia and wayne My name is vesna.Your stories are very similar to mine.My dentist hid the fact that she broke the file and i was in constant pain for 3 yrs.I had the tooth extracted when i found out she left it in there but now that side of mouth hurts with most of my teeth having problems with infection etc. have been through hell. how are you now ? ps lawyers in australia dont want to know about it....i cant believe how much i have been through and noone is accountable. i was in perfect health prior to this. now i am in pain and on antibitoics all the time. dr ritz thankyou for your responses but my problems are not going away because a good dentist is very hard to find..all they want is money. how can they live with themselves after doing somethinglike this..all she had to do is tell me and I would have it removed...thats criminal ...and dentists that do this should be accountable
Posted By : BRIGITTE genuinely concerned on 10/24/2011 9:30:16 PM
I believe that todays day and age, people are no different from thousands of years ago. People are in modern clothing and modern environment but there is and always will be a "system" of global organisational meetings to benefit academics and their pockets. No one genuinely cares for the patients who are suffering in pain, as its all about the $$$$$$ being grabbed and closing the door ! So please, how about the Dental Board or someone out there create a separate organisation to help patients who are suffering in pain due to mistakes made by "professional doctors/dentists". Please!
Posted By : tina on 10/24/2011 10:18:48 PM
Hi Dr. Ritz, thank u for your response last month. I just had a re-root canal to that tooth with the broken file. Endo did remove the piece of file successfully and just today filled the hole that he drilled in my crown.He also said that he wasn't sure if the infection was gone! Otherwise he has to surgically cut off the tip of the pulp. Do u think I took the right decision by solving this problem this way or should have done the surgery immediately? since he just saw a dark area on x ray that could indicate infection!
Posted By : Dr Ritz on 10/24/2011 10:51:18 PM
Tina, as of now you can wait. If you experience pain later on, then you can get apicoectomy procedure done. If you have any pain later on, then you can consult your endodontist and get surgical procedure done for the tooth.
Posted By : vesna galic on 10/24/2011 10:52:11 PM
dr RITZ i need to ask you how can i know if my root canal tooth is cracked/failed as I am getting sick/infections alot more since I had the last root canal which haad to be redone..i would pull it out but have lost 2 already on that side due to the file being left behind please tell me the symptoms in detail as the dentists dont tell me much here. specialistsaid im imagining the pain....
Posted By : Dr Ritz on 10/24/2011 11:49:18 PM
Vesna, In case of root canal failure, patient will experience pain in the tooth. If root canal treated tooth has fractured or cracked, then it will pain on chewing. If infection is still left after root canal treatment, then dental abscess may be formed at the apex of tooth and it will cause severe, throbbing pain. In case of dental abscess after root canal treatment, patient will experience pain and may have fever or enlargement of lymph nodes along with it.
Posted By : vesna on 10/28/2011 3:52:22 AM
dr ritz thanks for your advice. i had a cat scan today and they cant see anything on there but my tooth hurts after i bite down and pain radiates to top teeth ... is that a sign of fracture ..can bottom tooth 35 make top teeth hurt if tooth 35 is cracked or fractured.. appreciate your help with this .. ps the tooth feels better when i hold it but when i let i have that spreads across to other teeth
Posted By : Dr Ritz on 10/28/2011 4:38:19 AM
Vesna, If there is pain on biting, then it can be because of cracked or fractured tooth. It is difficult to diagnose cracked tooth clinically or with x-rays and pain due to cracked tooth may radiate to the other teeth. If there is vertical fracture or crack line present on the cervical portion of the tooth, then tooth extraction may also be required. Pain can also be because of gum infection in relation to the tooth. Refer to your dentist so that he can diagnose the cause of pain and treat it.
Posted By : petra on 1/27/2012 12:00:01 PM
I had the same thing happen to me yesterday at the denist office. Part of the instrument used (pin) broke off and the denist left it in there. My question is can I get a infection? What are the risk? I'm worred that years down the road I might be running into some problems with this. I asked the dr. why he didn't get it out. he said he couldn't "I don't understand" Advice please thank you
Posted By : Dr Carl on 1/28/2012 12:37:44 AM
Petra, During cleaning and shaping of canals, endodontic file breakage is one of the procedural accidents which can occur. If the root canals are cleaned and sterilized before the endodontic file gets broken, then broken file doesn’t usually cause any symptoms. If endodontic instrument is broken before the canals are sterilized, then it has to be removed before filling of root canals. If file can’t be removed by dentist, then he usually sends the patient to an endodontist who is specialist in root canal treatment. Broken file in root canal may or may not cause pain and infection later on. If you feel pain in the tooth, then you can visit an endodontist to get the file removed.
Posted By : jennifer on 1/28/2012 5:14:47 AM
I had a tooth that was chipped (popcorn, right up the middle of the tooth, a chunk missing all the way to the gum) It happened when I was preganant so had to wait almost a year before having it fixed. During that time, it only hurt if food wa stuck in it. I had a cleaning and he snapped a file before temp filling it. I had that for a week with no pain at all. I went back for the actual root canal and he said he couldn't get the pin out and just did the other three roots in the molar and closed up. That was a week ago. I have constant throbbing now, pain when I bite down and it wakes me several times at night. Is this from the pin or just normal healing time? After shelling out thousands for this, I am too broke to go back to the dentist again!
Posted By : Dr Carl on 1/28/2012 5:40:17 AM
Jennifer, Pain can be there because of broken file in tooth or can occur because of normal healing or can occur because of high point on tooth. If the root canals are cleaned and sterilized before the endodontic file gets broken, then broken file doesn’t usually cause any symptoms. If endodontic instrument is broken before the canals are sterilized, then it has to be removed before filling of root canals. If file can’t be removed by dentist, then he usually sends the patient to an endodontist who is specialist in root canal treatment. In case of severe infection in tooth before root canal procedure, pain occurs even after root canal treatment. If tooth was badly infected before procedure, then antibiotics are given to control the infection. Throbbing pain and pain on biting down can also occur because of high point on tooth and selective grinding is done in this case. Without clinical examination, it is difficult to give definite diagnosis. You can visit your dentist for evaluation. By the time you visit a dentist; you can avoid eating from side of root canal treated tooth and maintain good oral hygiene.
Posted By : Lynn on 2/24/2012 10:49:25 AM
Is there any possibility that a broken file can travel outside the canal? I had a file break many years ago during a root canal, and coincidentally, have had neck and upper back pain over the same period of time. Could this be related somehow? I was told the file would not move from where it broke. Thanks.
Posted By : Stephanilyn on 3/8/2012 9:30:46 AM
A few weeks ago I went to my dentist for a root canal. The procedure took two hours, after the procedure my doctor had told me he had broken an insturment off in my tooth and couldn't get it out. He then told me i was most likely not going to have any problems with the tooth. A week or two later it was still bothering me bad. My mom called my dentist and they perscibed me Antibiotics' for a week. The pain was still bad, so my mom called one last time and they had told her i was probably going to have to have surgury and that my insurence wouldn't cover it and that I WOULD HAVE TO PAY FOR IT!! I'm only eighteen years old and i don't have a job. This made me really upset and didn't make any sence to me, they did this to my tooth so shouldn't they have to pay to fix it.? is there anything i can do about this?! Please help..
Posted By : greg on 3/23/2012 10:05:29 PM
Same thing happened to me a couple weeks ago. Dentist had a paper that explained what the procedure is and the potential risks. Had to sign that first. If you signed a paper like that, then the dentist shouldn't have to fix it for free or give your money back
Posted By : Kim on 3/28/2012 9:31:43 AM
Just yesterday I was at the school of dentistry in my home town because I had a tooth that needed a root canal and didn't have insurance to have it done. I had a file broke in one of my canals. After my treatment I was told about it and they said that it happens and shouldn't be any problem but if I wanted it removed that they would refer me to the endo dept and have it removed. After reading these posts I'm just not willing to take the chance on it getting infected and possibly losing the tooth later on. Thank you for sharing. I just called the school and am setting up the appointment for removal. I know these things happen and still am so thankful that the school did the root canal for just a fraction of the cost it would have been if I had the root canal done in a dental office. I'm sure it's embarassing for this mistake to happen and was glad they fessed up to it.
Posted By : Hidy on 7/24/2012 3:36:59 PM
I wonder why the dentist inform the patient about the broken instrument inside the canal and let them be worried more. This is very common and it will consider as a normal filling, particularly if the patient not feel any pain ,and if they feel with pain, they can go back to their dentist and he will solve the problem
Posted By : Dr.Ritz on 7/25/2012 12:47:40 AM
Dear HIDY, Its the duty of the doctor to tell each and everything to the patient. S/he shouldn't hide. It's as per law only that an informed consent is taken prior to the treatment in which all the pros and cons regarding the treatment are discussed with the patient or the guardian.
Posted By : Naomi on 4/2/2013 4:08:19 AM
Hiya, I had a root canal back in 07, have had issues and have gone back a week ago to discover a snapped piece of a tool is stopping them from completing another root canal, I am in constant pain and now have been told my only option is a) to remove my 2 front teeth as abscess is between them both or go to a specialist and somehow frin in excess of £1000, I was never informed of the tool breaking in my tooth back in 07.
Posted By : McKenzie on 6/13/2013 6:19:48 PM
I had a root canal done a year ago and the dentist broke a file. Now I have an infection and am seeing a different dentist. The dentist im seeing now highly suggests I see an endodontist. I feel that the previous dentist should have to pay for me to get this fixed. Ill had that the day I got the root canals done I was not informed. Basically what happened is that the dentist did x rays on the veneers I have and decided to do two root canals that visit. While these decisions are being made I am not being informed. When the procedure was about to start the dentist just ran everything by me, didn't suggest I see an endodontist, nor did he even tell me he decided to do two root canals. He also did my veneers,which were done poorly since one broke and the other does not fit correctly in my mouth. I havent had any previous problems until I began to see the dentist I speak of. Once again my question is should the dentist who broke the file have to pay for me to see and get it fixed by the endodontist?

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