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Left tooth roots after extraction

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Posted by: palmreader  (10 years ago)
Dear all,

Two days ago, I had a toothache and immediately went to the dentist. She said I needed a root canal and had started with the treatment. After about an hour, she said she could not continue with the root canal as the tooth was in a bad condition and would proceed with the extraction. As she was working on my tooth, I had seen several swabs covered in blood being changed every few seconds. She told me she was able to remove my tooth but roots were left in. Since I had a massive bleeding, she asked me to come back the next day.

When I went in yesterday, I was a little bit nervous. I told the dentist about it and asked if she could give me a numbing shot, which has a relaxing effect. After the injection (I don’t know what medication she used), I started to feel sickly and light headed. My body was shaking. My heart was pumping so fast. The dentist said I have possibly taken a reaction to the injection. She scheduled me again the next day and sent me on my way. I felt nervous the whole night and decided not to see the dentist today. What are the risks involved in leaving the roots in my gums? I felt pain but can manage it with the help of painkiller. I am scared to go back to the dentist to get the roots out. Can anyone please advise me? I would appreciate any help or advice. Thank you very much.
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Posted by: Novocaine  (10 years ago)
Hey palmreader,

I'm sorry to hear about your rather painful situation. But, I've got good news for you and long story short, you can keep the roots in your jaw and avoid getting it extracted. Retained root tips are one of many common extraction complications a dental surgeon faces. In cases that involve the upper teeth, extraction procedures that complicate removal of root tips are usually left alone due to the possibility of rupturing the maxillary air sinus.

Also in your case, the relative benefits of extracting the root (high possibility of dry socket) compared to leaving it alone and saving you the stress (and the anesthesia you are allergic to) isn't really worth it. If you left it alone, in a couple of years, the roots would be a non-issue. But, if in any case, they make an infectious comeback, extracting it would probably be over in a jiffy (considering the fact that they could be loosened already due to the infection). Take care!

P.S. The anesthetic medication that made you feel light-headed is Nitrous Oxide (Laughing Gas).

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Of the many teeth I have extracted only once have I left a root tip, it was sitting right on top of a nerve I did not want to damage. Leaving any root tip is not a good idea, I do not agree with the post above, you should have returned to the dentist, if she could not get it out she should refer you to an oral surgeon. As to the reaction to anesthesia, it happens from time to time, and doesn't mean it will happen the next time.
Posted 10 years ago
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Dentist
Dear all,

Two days ago, I had a toothache and immediately went to the dentist. She said I needed a root canal and had started with the treatment. After about an hour, she said she could not continue with the root canal as the tooth was in a bad condition and would proceed with the extraction. As she was working on my tooth, I had seen several swabs covered in blood being changed every few seconds. She told me she was able to remove my tooth but roots were left in. Since I had a massive bleeding, she asked me to come back the next day.

When I went in yesterday, I was a little bit nervous. I told the dentist about it and asked if she could give me a numbing shot, which has a relaxing effect. After the injection (I don’t know what medication she used), I started to feel sickly and light headed. My body was shaking. My heart was pumping so fast. The dentist said I have possibly taken a reaction to the injection. She scheduled me again the next day and sent me on my way. I felt nervous the whole night and decided not to see the dentist today. What are the risks involved in leaving the roots in my gums? I felt pain but can manage it with the help of painkiller. I am scared to go back to the dentist to get the roots out. Can anyone please advise me? I would appreciate any help or advice. Thank you very much.


Depends on how large the roots are, and where they are located. Sometimes the surgical risk of removal outweighs the danger of leaving them in. Trouble is, to get them out will probably involve a good bit of sacrifice of bone.

Unless they are very near a nerve or a sinus, I recommend having them out, THEN GRAFTING WITH BONE AND COVERING WITH A MEMBRANE. Then you will have plenty of bone left in which to place an implant later.

Dr. Henry
Posted 10 years ago
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Posted by: Novocaine  (10 years ago)

When I went in yesterday, I was a little bit nervous. I told the dentist about it and asked if she could give me a numbing shot, which has a relaxing effect. After the injection (I don’t know what medication she used), I started to feel sickly and light headed. My body was shaking. My heart was pumping so fast. The dentist said I have possibly taken a reaction to the injection.

Upon a second reading, I have realized that I overlooked the fact that you mentioned your anesthetic was 'injected' rather than 'inhaled' (which is what I mistook it for). Your post-anesthetic symptoms are characteristic of a panic attack when one is hypersensitive to epinephrine/ adrenaline (usually contained in dental anesthetics like Lidocaine etc.). Although uncommon, Epinephrine does tend to evoke a 'fight or flight' response and tricks your body into thinking you are undergoing an emergency. Stress or an accidental injection of this anesthetic into a vein can also make this feeling worse. Next time around, let your dentist know you would prefer an epinephrine-free anesthetic jab, or better still, a whiff of the laughing gas.

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Posted by: Novocaine  (10 years ago)

Of the many teeth I have extracted only once have I left a root tip, it was sitting right on top of a nerve I did not want to damage. Leaving any root tip is not a good idea, I do not agree with the post above, you should have returned to the dentist, if she could not get it out she should refer you to an oral surgeon. As to the reaction to anesthesia, it happens from time to time, and doesn't mean it will happen the next time.

Although I go by the standard operating procedure of always extracting a tooth completely out of its socket, exceptions are inevitable and all things considered, the OP does indeed qualify for one. The fact that his tooth has been under the knife twice and the professional sloppiness that he has had to experience from this dentist (RCT to extraction, broken roots, anesthetic complication, etc.) lend more reason to my suggestion.

I don't know about you, but I think two times is too many for a regular extraction procedure. Meddling with the alveolar bone, traumatizing it (dry socket), dislodging the clot again and tamper with the healing process repeatedly in such a short period, is frankly not worth it, and is something I would avoid. Honestly, if I was the one wielding the forceps and had this happen, I'd make sure an OS was called in and complete it on that very first day. Finally, if the OP opts for an epinephrine-free anesthetic to avoid its side-effects, he might experience massive bleeding again.

To each to his own, though. I say keep the roots and let it heal in its socket. In future, you can always get x-rays done periodically to rule out any untoward infections.
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