Can a Broken File from a Root Canal Cause Sinus Problems?

I had a root canal done on tooth #3 about 3 months ago. The tip to the file broke off in the canal after it was all cleaned out. Instead of it breaking off straight in the tooth canal, it is slanted out the side, touching my least according to the xray. I have had a sinus headache on that side since this happened and I never had headaches or sinus problems before... is it coincidence or is the file irritaing my sinus and should I have it surgically removed? who should pay for it?

Doctor Answers 5

Root canal and Sinus problem

 It is not uncommon to break a file when doing a root canal. No dentist wants a file to break, but it does happen. Depending on where the file is when it breaks is a large factor on how to treat the tooth.  I would treat your symptoms as a sinus infection initially. I would check the occlusion (how you bite) on the tooth also.  Some  teeth have accessory canals (extra microscopic canals), that are often hard to see or treat.  Sometimes those are the culprits for symptoms.   Another question is did you have a large abcess and swelling before you had the root canal?? That could also affect how you sinus is acting now. I always say try to avoid surgery , any type, unless you absolutely can't avoid it. I would also recommend going to see an endodontist ( root canal specialist) to see if they could possibly retrieve the or by pass the broken file. If you do need surgery the endodontist is a good candidate to do it.  

San Antonio Dentist

Root canal file and sinus problems.

Definitely the file could cause an exacerbation of any sinus inflammation.   The root canal was performed because there was an infection, and if the file is broken then the infection is likely still there.

I would recommend that you have the tooth extracted, let the area heal and replace the tooth with an implant.

You will have a longer lasting restoration that is much more likely to be trouble free.

Hope this helps,

Dr. Alper

Steve Alper, DMD
New York Dentist
5.0 out of 5 stars 3 reviews

Sinus problems

I would start a prescription of 875 mg of Augmentin disp 20 BID. The infection from the root can most definately cause the sinus to be infected especially if the tooth was necrotic before the endo. the solution for this would be to have the file removed and the root canal redone but the break is pretty deep in the root and may need to be surgically treated. If the infection is only on one side then my bet is the tooth is the problem causing the sinus infection. A head and neck CT would give the best picture of the situation.

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Sinus Problem and Broken File

We don't like to see it happen, but unfortunately root canal file breakage can occur.  Depending on whether the need for the root canal procedure was to treat infection or structural and at what point in the procedure the file separated is needed to answer the question. 

The x-ray you provided is a two dimensional image.  A 3-D Cone Beam Scan would be needed to determine if the file is in the canal or perforating the root tip and into the sinus.  If the file is puncturing the sinus membrane, it needs to be surgically removed.  If the tooth had an abscess on that root tip, an apicoectomy may be needed to clear up any residual infection.  If the file is fully encased in root canal sealing material, it is inert and poses no problem. 

I suggest you have an Oral Surgeon or Endodontic Specialist look at the situation and help point you in the right treatment direction.

Marc Zive, DMD
Springfield Dentist

Root Canal and Sinus problems

A broken file can lead to a sinus issue, although not too often.  Usually when the tooth is being cleaned via a root canal.  Usually the tooth is thoroughly cleaned and th einfection is removed. The file could have been broken early in th eprocedure as well which would lead to a persistent infection.  If this was performed by a general dentist, then I would proceed to an endodontist (Specialist) to try to get the file removed or to have an apicoectomy procedure to remove it.  I agree with others in that you need an antibiotic prescription. The xray also looks as though the canal was translocated and in need of further treatment.  I would definitely go to a specialist for further treatment.

Keith Blankenship, DDS
Jacksonville Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.