Retreating a Root Canal with Infection

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In most cases, with the right care, teeth that have had an endodontic treatment known as a root canal can last just as long as natural teeth. In fact, when properly performed, there’s a 97 percent success rate with endodontic therapy.  And, the success rate of root canal treatment is the same as implant placement. But, like with any medical procedure, there will be some failed root canal treatments.

In some cases, a tooth with a root canal doesn’t heal properly or it becomes infected. Sometimes, the tooth can become diseased or painful a few months or even years after you’ve received treatment. Fortunately, retreatment is often successful.

Making the choice of whether you should pursue endodontic retreatment or another alternative —  like a tooth extraction — depends on various factors.

Why Does a Root Canal Fail?

Your root canal can fail or become infected because of a number of factors, including having a:

  • Root canal abscess

  • Fractured tooth after root canal

  • Extensive gum disease or decay

Root Canal Abscess

Infected root canal complications can happen.  While it’s not common for individuals to develop an infection after they’ve had endodontic treatment, there is a small risk of this occurring. And, infections after a root canal can occur as early as a week after your treatment to many years later.

Some common reasons for a failed root canal are:

  • The tooth had an irregular amount of canals the dentist didn’t see, therefore, they left a canal unclean.

  • The dentist used a defective restoration over the root canal which allowed bacteria to enter and recreate an infection.

  • The tooth’s root had an undetected crack.

  • There was a breakdown of the sealing placed which allowed bacteria to contaminate the tooth’s inside.

When it comes to a root canal treatment, endodontists are typically very careful of infections. However, some infections, like one an abscess causes, form before the endodontist performs the root canal. Others experience infections after the completion of their treatment.

Fractured Tooth After Root Canal

When you have root canal treatment to a tooth, the tooth isn’t as structurally sound as it was before. Because of this, it often requires a dental crown for protection and strengthening.

If a tooth that’s been treated with a root canal breaks, it’s not always a huge issue. If the damage consists only in the tooth’s crown portion and not in the root, chances are the tooth may be rebuilt. Sometimes, the repair might require a dental post and core placement.

Now, if the crack is extending all the way into the root of the tooth, the endodontist will need to evaluate the tooth to see if it’s possible to make a successful repair.

Extensive Gum Disease or Decay

Like with any other teeth, a tooth that’s had endodontic treatment is still at risk of gum disease and tooth decay formation. If left untreated, either one of these conditions can lead to the loss of the tooth.

What are My Failed Root Canal Options?

You have a few failed root canal options. The two most common are

  1. Endodontic retreatment

  2. Tooth extraction

Endodontic Retreatment

If the root canal didn’t heal or it developed an infection, it still could have a second chance. The endodontist will sit down with you and go over all of your treatment options. The endodontist may be able to perform another procedure to save the tooth and support the healing.

If you’re experiencing discomfort or pain in a tooth previously treated, discuss the option of retreatment with your endodontist. If you both decide on retreatment, they’ll reopen your tooth to get to the material of the root canal filling. Often, they must disassemble and remove complex restorative materials like crown core and post material to get to the root canal.

After they remove the canal filling, they’ll:

  • Clean the canals.

  • Examine your tooth’s inside carefully using illumination and magnification.

  • Search for any other unusual anatomy or canals that require treatment.

Once clean, they’ll fill and seal the canals, placing a temporary filling in your tooth. If your canals are abnormally blocked or narrow, they might suggest endodontic surgery where they make an incision, allowing the other root end to be sealed.

After they complete the retreatment, you’ll have to make an appointment with your dentist immediately after to have a new crown or other type of restoration option placed over your tooth to restore it to full function and protect it.

When it’s possible, the best course of action is to save the natural tooth. Teeth that have been retreated often function for many years; sometimes for a lifetime.

There aren’t any guarantees, however, just like with any other dental procedure. You’ll want to discuss your chances of success with the endodontist before you receive retreatment.

Tooth Extraction After Root Canal Failed

Another alternative when you have a failed root canal or infection after one is to have the tooth extracted. After this procedure, your dentist will need to replace the extracted tooth and you actually have a few options. You can choose from:

  • A bridge

  • An implant

  • A removable partial denture

This will restore your function of chewing and prevent your surrounding teeth from shifting. Since extensive dental procedures or surgery on other healthy, adjacent teeth are required, they are often more expensive and time-consuming than restoration and retreatment of your natural tooth.

A common complication after a tooth extraction is an infection because your mouth is loaded with bacteria. Your dentist will decide if a course of antibiotics is a good idea after your extraction. Usually, antibiotics aren’t required with a simple tooth extraction, but if you have swelling, pain or pus in gums after tooth extraction, they may recommend preventive antibiotics.

Common signs of infection are bleeding and acute pain that continues for a couple days after you’ve had your tooth extracted. To avoid further complications, if you experience either one of these symptoms, see your dentist right away.

Can An Infected Root Canal Kill You?

If a tooth with a root canal remains infected, it can spread throughout other areas of your body. The bacteria forming in a tooth with a root canal release strong toxins that rapidly fosters tooth deterioration . A lot of dentists try to sterilize the tooth with the root canal still intact, and believe this act of irrigating and instrumenting the canal will get rid of all the bacteria —but this isn’t always the case.

The best course of action when you find out you have a root canal infection, is to get an immediate appointment with a dental specialist or your primary care doctor. Both will be able to write you a prescription for some well needed antibiotics. An untreated infection or tooth abscess can cause life-threatening complications.

To recap, the most preferred option is to save your natural tooth. And, technology advances are continually changing the performance of endodontic treatment and you could benefit from newer techniques that didn’t exist with your first procedure. Again, there aren’t any guarantees, but retreated teeth can function as long as a lifetime and have a high success rate. Sit down with your endodontist to discuss your treatment options and see if endodontic retreatment is a good option for you.


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