Understanding Perforations

A perforation is a hole that occurs in the root canal space of a tooth. It exposes the material inside your tooth to the exterior tissue and materials in your mouth. 

Though the term “root canal” typically refers to a dental procedure that treats infections in your tooth, it also describes the hollow section of your tooth that leads from the top of the tooth to the end of the tooth root. 

The root canal contains nerves, connective tissue, and blood vessels. A perforation exposes these components to the outside of the tooth, making them susceptible to external bacteria and debris.

Endodontists Rick Davis, DDS, Rick Schwartz, DDS, and the professional team at Endodontic Consultants of San Antonio are experts in the diagnosis and repair of perforations. Using state-of-the-art technology and the most current endodontic procedures, our team has the experience necessary to give you the best possible chance of saving a tooth damaged by perforation.

How perforations occur

A perforation can occur naturally as the result of excessive tooth decay or internal or external root resorption. Resorption can be triggered by infection, trauma, or exposure to extreme heat or chemicals.

Internal resorption results in the absorption of the dentin, bone, and other inner components back into the tooth, eventually causing a hollow tooth. External resorption typically affects the cementum, the material that covers your tooth’s roots, by allowing it to be absorbed by the tooth.

A perforation can also result from a failed root canal, in which too much of the inner tooth material was removed during the preparation for a root canal procedure.

Signs of perforations

No matter how a perforation occurs, it results in a hole in the wall of your tooth. Once this important barrier is pierced, it leaves your tooth vulnerable to bacteria, which can result in pain, inflammation, and total tooth loss.

The infection that follows a perforation can cause the formation of an abscess, a pocket of pus, along the tooth root. Swelling and discoloration of the tooth and surrounding areas may also occur.

Treatment of perforations

Getting immediate, professional endodontic treatment gives you the best chances of having a perforation repaired and your tooth saved. Since the perforation typically affects the internal components of your tooth, dental X-rays may be required for an appropriate diagnosis and evaluation of the damage. 

The size and location of the perforation, along with the degree of damage, determine the appropriate course of treatment. Some perforations can be repaired using restorative materials such as amalgam, fold, or composite materials to cover the hole. 

A perforation that occurs because of decay or resorption may require root canal therapy to remove the infected pulp inside the tooth.

Consideration is also given to the impact of the infection on neighboring teeth or gum tissue. Surgical techniques such as crown lengthening, which involves reshaping gum and bone tissue to eliminate an infected periodontal pocket, may be necessary.

If the infection causes extreme deterioration of the tooth and surrounding tissue, removal of the tooth may be necessary. A dental implant can restore cosmetic and functional replacement of the extracted tooth.

Early diagnosis and treatment can increase your chances of saving a tooth affected by a perforation. Regular dental checkups can help identify a perforation before it progresses beyond repair.

Find out more about perforations and how the professionals at Endodontic Consultants of San Antonio can help you save your teeth from infection. Schedule an appointment online, or call our office to arrange a consultation.