If you've an unfinished root canal and the temporary filling falls out, you should see your dentist immediately due to increased risk of re-infection.
Treatment options for fallen out temporary root canal filling:
Replace temporary filling
Crown with core build up
Root canal retreatment
Extraction
Everyone's tooth condition may differ but typically you can expect one of the above to be done. Which one you'll need? You won't know until you see your dentist!
Increased risk of infection without temporary filling in unfinished root canal
The most severe consequence of a missing temporary filling that has fallen out of an unfinished root canal is the potential for re-infection.
Purpose of the temporary filling: The purpose of placing a temporary filling over the unfinished root canal is to seal the access opening and prevent leakage of food and bacteria.
Prevents bacteria. An open tooth that is left wide open is an invitation for bacteria to enter and cause an infection. This may result in an abscess forming and your face swelling up. Sealing the tooth with a temporary restoration can prevent this from occurring.
Prevents stuck food. A root canal creates a hole through the top of the tooth called an access opening. If the temporary is missing, this is will become a large cavitation that food can get stuck in it. What that means is it can develop into a cavity over time if that food is not removed.
The intraoral photo below (taken at our Long Island City dental practice) shows a root canal treated tooth without a temporary filling. If it looks unstable and unfinished to you, that is because it is. This tooth needs a temporary restoration to seal and cover it!
Below is an intraoral photo that shows a root canaled tooth that is properly sealed. As you can see, that white filling material covers up the hole and helps to prevent leakage of bacteria or food from getting into the tooth.
Ultimately there is a greater chance of an infection if the tooth is left exposed after a root canal. If your temporary fell off for whatever reason, you need to have it addressed pronto.
Treatment options
Professional treatment is required for an unfinished root canal temporary filling that fell out. Yes, you will need to see your dentist and you will need one of the four treatments below depending on your specific condition.
Temporary filling replacement
Replacing the temporary filling may suffice if your root canal is unfinished and you still need to go back to the endodontist to have it completed.
What to expect for replacement: Placing a new temporary root canal filling is a quick and painless process. Your dentist can have you in and out of the office in 5-10 minutes at most. There will be no injections necessary so don't let that deter you from making the appointment.
When a replacement can work: A replacement is the treatment option of choice if you are in between root canal appointments, meaning your dentist/endodontist has not completed it yet. This is usually the case if the tooth is very infected and they have to place an antibiotic ointment within the canals to kill the bacteria. This medicament is left there to kill the bacteria before they finish the procedure.
Crown with core build up
If your root canal has been filled, the next step is to return to your restorative dentist to have a crown placed on it. If this is your situation, you might as well go ahead with the permanent restoration. Your dentist would need to remove the temporary to place a core build up and a crown on it anyway.
When this may happen: Typically after the root canal, you wait about 1-2 weeks with the temporary before going back to your dentist for the crown. This waiting period is to make sure that the tooth no longer hurts and no abscess forms. If the temp falls out during this period, you may want to expedite the restoration phase!
Root canal retreatment
If the root canal tooth is left without a temporary for an extended period of time, the tooth could very well get re-infected. If this occurs you will need to have the root canal redone and you'll most likely have to pay for the retreatment!
How to tell if it has been re-infected:
Gum boil. A tell-tale sign of an infected root canal is the presence of a pimple on the gums otherwise known as a gum boil. This little pimple is a pus filled sac of bacteria.
Tooth pain. A successfully treated root canal tooth should be devoid of pain. If it hurts it means that something is wrong.
The photo above shows what a gum boil can look like. Even if it pops it doesn't mean that the infection has gone away.
Tooth extraction
An unprotected root canal tooth will have an increased risk for tooth fracture. Yes, that means the tooth could split in half rendering it non-restorable. If your tooth cracks because of a missing temporary filling, it will need to be extracted.
Below is an image showing what a fractured root canal tooth without a temporary looks like. You can clearly see a crack line running straight through the middle of the molar.
Unfortunately if your condition looks like the above, you will need the whole tooth removed. You just wasted your money and time on getting the root canal. This is of course the most severe consequence of a missing temporary.
Takeaway
If the temporary filling falls out of your unfinished root canal you need to contact your dentist right away to have it treated. If you're near Long island City, our dentist can help you replace the temporary or even have it restored with a dental crown.
You definitely don't want to wait too long because you run the risk of it getting infected again or worse, fracturing.
