Originally posted by Rutgers81:
Originally posted by RUaMoose:
Anyone ever have a root canal redone years after originally done ? I had a root canal done in my early 20s and now about 25-30 years later the tooth ( a back lower molar) is acting up. The dentist put me on antibiotics and the problem went away -- temporarily. Obviously the antibiotics addresses the symptom (infection) but not the root cause, therefore the infection returns. They took an x-ray and it indicated there was a little "cloudiness", a tell-tale sign of infection. I've been doing a little of my own research and have noticed this (root canal re-do) is not uncommon. Dentist also indicated there's a procedure where they drill through the gum to get at the base of the tooth rather than go through the top again. He wouldn't do this procedure; instead he would send me to a endodontist. I have an appointment on Monday. I was also thinking of asking him to take the crown off to see if there's decay under there that the X-ray didn't pick up. Curious if anyone else has been through this or if there's a dentist that can speak to it. Last thing I want is the tooth pulled but that may be what has to be done.
This thread is right in my wheel house because I am a dentist with 30 years experience doing root canals, extractions and implants. In addition I am the clinical director/owner of a Group Dental Practice that has an Oral Surgeon, Endodontist and Periodontist on staff. So I have seen it all.
I will try to answer some of the questions of the OP and anyone that has questions.
Root Canal success rate is not 100% (actually 85-90%).
As occasionally happens with any dental or medical procedure, a tooth may not heal as anticipated after initial treatment for a variety of reasons:
Narrow or curved root canals sometimes pose complications during the initial procedure.
Complicated root canal anatomy (shapes and forms) went undetected in the first procedure.
The placement of the crown or other restoration was delayed following the treatment, resulting in reinfection of the root canals.
An inadequate seal of a restoration (filling) allowed recontamination of the inside of the tooth.
Some of these issues do not give rise to symptoms, but can give rise to chronic infection, often seen in an x-ray picture as a small black area around the end of an affected root. New problems too, can jeopardize a tooth that initially had successful root canal treatment. For example:
New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
A loose, cracked or broken crown or filling can expose the tooth to new infection.
A tooth sustains a fracture of the crown or root.And yes, the antibiotics can reduce the symptoms of a re-infected root canal but not cure it.
The only way to clear the infection is by doing one of these:
1: Redoing the root canal (best option for small infections)
2: Apicoectomy (cutting through the gumline and bone and scooping out infection directly - done on teeth where redoing the root canal is not a good option)
3 Extraction, Bone graft and Implant.
In our office we have a Cone Beam Xray which we use to get more info about the infected tooth. This is basically a 3D x-ray. Most general dentists don't have this x-ray. Many specialists do. The cone beam is the best information a dentist can get to help the patient and dentist make the best decision about treatment.
Whatever you do, don't just extract the tooth without a bone graft or you will lose 60% of the bone in the area. This will lead to more problems down the road if you choose to replace the tooth.