As endodontists, we sometimes treat patients who have a reinfected root canal. Often those patients ask how this happened and what to do about it. Whether we are retreating from work done by a different dentist or our own work, we strive to restore the patient’s wellbeing.
This article isn’t a substitute for medical care, and we hope it is informative and empowering. Informed patients are in a better position to recognize complications and to seek immediate care from their endodontist.
The vast majority of root canals are successful and provide relief from pain. Each year endodontists and dentists perform over 15 million root canals in the United States. Over 95% of those root canals are effective.
A successful root canal saves the natural tooth and extends its life to match the other healthy teeth. However, once in a while, a root canal isn’t successful and needs retreatment.
Root canals are highly effective, but any treatment runs a small risk of complications. The European Journal of Dentistry found that the overall success rate of a root canal and other endodontic treatment ranges from 86% to 98%. According to the study, various factors can contribute to failure, including the persistence of bacteria, untreated canals, or other complications.
About Reinfected Root Canals
When a root canal is unsuccessful, symptoms may return anywhere from a few months to a few years later. Sometimes endodontic retreatment offers relief and helps restore balance and health.
Endodontic retreatment is a procedure where an endodontist removes the original root canal fillings then cleans and disinfects inside the tooth. Next, the dental professional refills and reseals the canals. The goal is to save the natural tooth, just like with any other root canal.
Although general dentists also perform root canals, many patients feel more secure turning to a specialist. An endodontist specializes in root canals and retreatment. According to the American Association of Endodontists (AAE), an endodontist typically performs 25 root canals weekly, while a general dentist usually performs just two. In addition to earning a general dentistry license, an endodontist also completes an additional specialized training program.
Why Retreatment is Sometimes Necessary
The success of any root canal treatment largely depends on effectively eliminating harmful bacteria from the root canal system then sealing it to keep more bacteria from getting inside the tooth or roots. That description oversimplifies the process due to the unique nature of each individual’s teeth and roots.
As you may know, teeth are not solid. The inner layers contain dentin which is a porous tissue and soft tissue known as pulp. The nerves and blood vessels are in the pulp, and infected pulp leads to pain. The endodontist removes the pulp from the infected tooth, disinfects, and reseals it during a root canal.
The AAE identified various circumstances that sometimes prevent healing after a tooth is treated with a root canal. These include:
- The root canal structure is very tiny. Sometimes a dentist misses hidden canals or curved canals. Bacteria may remain inside those missed canals.
- Sometimes a delay in placing a protective filling may allow new bacteria to enter the tooth.
- Sometimes bacteria from saliva may get under the filling material before it is sealed, potentially leading to reinfection.
- New cavities may later develop due to poor dental hygiene, and this can even happen on teeth where there already was a root canal.
- New bacteria may find a way in after a crown or tooth cracks, fractures, or breaks.
- Complicated root canal system anatomy.
Now that you understand why retreatment is sometimes necessary, it may help recognize signs when it may be needed.
Possible Symptoms of a Reinfected Root Canal or Other Issues
The following symptoms may indicate a need for endodontic treatment or retreatment. If you experience them, please inform your dentist or endodontist.
- Increased sensitivity to temperature, lingering pain after eating either hot or cold food.
- Constant pressure or pain.
- Pain when tapping teeth together,
- Swollen gums.
- Pimple on the gums near the tooth.
- Yellowish, greenish pus or discharge.
- Dull, consistent ache in a specific area.
- Intense pain in or around the tooth more than a week after a root canal treatment.
- A bad taste in the mouth or bad-smelling breath.
Keep in mind that reinfection might happen weeks, months, or even years after the original root canal. Sometimes non-surgical retreatment isn’t an option. In those cases, endodontic surgery might be the best alternative to an extraction.
Contact your dentist or endodontist for an examination. The sooner the diagnosis, the sooner the problem may be fixed and the pain relieved. Prompt attention may result in saving the tooth and ending the pain and infection. Sadly, if the root canal fails and the tooth becomes reinfected, that infection will not just go away on its own. Either some form of retreatment or extraction is necessary to restore health after reinfection.
Next Steps: Contact a Skilled Dental Professional
If you believe you may need retreatment, please do not hesitate to contact a skilled endodontist. The specialists at Ballantyne Endodontics know firsthand the importance of prompt treatment. Ballantyne’s own Sonja Chopra, DDS, describes herself as not just an endodontist but also as “the ultimate dental patient.” After failed treatments, a compassionate endodontist effectively provided treatment and relief.
The entire team at Ballantyne Endodontics shares Dr. Chopra’s passion for saving teeth and ending pain. They balance this passion with cutting-edge technology and best practices in endodontics, leading to the best patient experience possible.
Some patients worry that if the root canal they had years ago was unsuccessful, the same is likely to happen again. The science of endodontics continues to advance, so new, improved techniques and tools may not be available to your previous dentist. However, your endodontist will need to perform an examination to determine whether you are a good candidate for retreatment.
Charlotte-area residents trust Ballantyne Endodontics to save their natural teeth and restore balance and wellbeing to their mouths. Contact us today to schedule a consultation or learn how you may request a referral from your general dentist.