Root canal treatment is a common dental procedure that can save a tooth from extraction. Despite a high success rate of over 90%, no dental procedure is immune to failure, and root canals are no exception.
For anyone that has had root canal therapy, it is important to know the symptoms of a failed root canal and understand that occasional failures are inevitable.
Quick Answer: What are the Symptoms of a Failed Root Canal?
Failed root canals, although rare, can happen. Possible symptoms include pain, swelling, a foul taste or odor, prolonged sensitivity, or a bump on the gums. If you experience these symptoms, consult a dental professional promptly for a proper evaluation and treatment plan.
Understanding Root Canal Treatment
A root canal involves removing the infected or decayed pulp inside a tooth and cleaning, filling, and sealing the canals. Failures can occur due to various factors, but it's essential to recognize that occasional failures are inevitable, even with the best care and technique.
Common Symptoms of a Failed Root Canal
Pain and Discomfort: Persistent or recurring pain in the treated area.
Swelling and Inflammation: Noticeable swelling around the tooth or gums.
Foul Taste or Odor: An unpleasant taste or smell emanating from the tooth.
Prolonged Sensitivity to Hot or Cold: Sensitivity that lasts longer than expected after the procedure.
Bump on the Gums: A noticeable bump or pimple-like formation on the gums near the treated tooth.
Causes of Root Canal Failure
Complex Root Anatomy: Some teeth have complex root structures that may be challenging to navigate, leading to incomplete cleaning and sealing.
The number, shape, and location of canals is often different from one tooth to the next.
Undetected Canal Branches: Missed or undetected branches of the main root canal may harbor infection and cause failure.
Calcified Canals: Over time, canals may become calcified, making them difficult to access and properly clean. In these cases, it will be impossible to entirely clean, shape, and disinfect the canal.
Material Breakdown: The breakdown of the sealing material over time can allow bacteria to re-enter the tooth.
Microscopic Contamination: Tiny particles of contamination left inside the canal can lead to infection and failure.
Incomplete Disinfection: Remaining bacteria within the tooth can cause reinfection.
Broken Dental Instruments: Instruments can break within the tooth, and often cannot be retrieved without damaging the tooth.
Microleakage: Leaking of bacteria into the treated area.
Note: While the success rate for root canals is over 90%, it's never 100%, and failures, though rare, are inevitable.
My Root Canal Has Failed – Now What?
Consult Your Dentist: Immediate evaluation is essential to determine the cause of failure and the appropriate treatment.
Follow Professional Guidance: Adhere to your dental professional's advice and treatment plan to resolve the issue and restore your oral health.
Discuss Possible Treatments: Note that this is dependent on the cause of failure and the prognosis of further treatment, so not all options will be possible in every case.
Understanding Treatment Options
If a root canal fails, it can be an unnerving experience, but it's essential to recognize that there are several available treatment options to address the issue. An experienced dental professional will assess the situation and recommend the most suitable approach for you.
Here are some common treatment options for a failed root canal:
Retreatment of the Root Canal: If the failure is due to incomplete cleaning or sealing, the dentist may suggest a retreatment of the root canal. This process involves reopening the tooth, removing the previous filling, cleaning the canals again, and resealing them.
Apicoectomy: This surgical procedure targets the root tip (apex) itself. It involves removing the tip of the root and sealing the end to prevent further infection. Apicoectomy is often considered when retreatment isn't feasible.
Tooth Extraction: If the tooth is too damaged or if other treatments are not suitable, tooth extraction may be necessary. Following extraction, options such as dental implants, bridges, or partial dentures can restore the appearance and functionality of the missing tooth.
Endodontic Surgery: Specialized endodontic procedures might be needed in some cases to access areas of infection that conventional treatments cannot reach.
Antibiotic Treatment: In some instances, antibiotics may be prescribed alongside other treatments to control and eliminate the infection.
Monitoring and Maintenance: In minor cases, the dentist might opt to carefully monitor the tooth and recommend maintenance procedures like regular cleanings and check-ups.
My Root Canal Tooth Hurts When I Chew -- Is It Getting Infected Again?
Experiencing pain while chewing with a tooth that has had a root canal treatment can be alarming. However, it's essential to understand that this discomfort is often not indicative of reinfection or an issue with the root canal itself.
Here's what you need to know:
High Filling or Crown: If the pain occurs specifically when chewing, it might be associated with a high filling or high crown. This means that the filling or crown is slightly mispositioned, causing uneven pressure when biting down. This can lead to irritation and discomfort but doesn't necessarily signal a problem with the root canal.
Other Potential Causes: Other potential causes for the pain could be related to the adjacent teeth or gums, rather than the treated tooth itself. A comprehensive dental examination can help identify the exact cause.
When to Seek Professional Help: If the discomfort persists or worsens, it is advisable to consult your dentist. They will perform a thorough examination to determine the root cause of the pain and recommend appropriate adjustments or treatments.
Treatment: Treatment may include adjusting the height of the filling or crown, monitoring the tooth for any other underlying issues, or treating adjacent areas that might be contributing to the pain.
In summary, while pain when chewing might be concerning, it is often unrelated to a root canal failure or reinfection. By seeking professional guidance and following the recommended care, you can ensure that the issue is properly diagnosed and treated, allowing you to return to normal function and comfort.
Is My Dentist/Endodontist Responsible for a Failed Root Canal?
Root canal treatment is a complex and technique-sensitive micro-surgery. While dental professionals strive to provide successful treatment, it's essential to understand that failures can occur, and they are usually not a result of negligence or error on the part of the dentist or endodontist. Here's what you should know:
Inherent Risks: Root canals have a success rate of 90% or more, but no medical procedure can guarantee a 100% success rate. Failures may occur for various reasons that are beyond the control of the dental professional.
Justified Reasons for Failure: As previously discussed, several justified reasons can lead to root canal failure, such as complex anatomy, persistent bacteria, calcified canals, irregular number of canals, file separation, or even a fracture in the tooth.
Professional Assessment: If you suspect a failure in your root canal treatment, it is best to communicate openly with your dental provider. They can assess the situation, explain the potential causes, and discuss the next steps for treatment or referral to a specialist if needed. **It is important not to skip this step! Operate in good faith and give your dentist or endodontist a chance to evaluate and provide recommendations.
Second Opinion: If you have concerns about the quality of the care you received, seeking a second opinion from another dental professional can provide additional insight and peace of mind.
Legal Considerations: In rare cases where you believe that negligence or unprofessional conduct has occurred, consulting with a legal professional may be an option. However, it's essential to recognize that a failed root canal does not indicate malpractice.
In summary, while it is natural to have questions and concerns about a failed root canal, understanding the complexity of the procedure and the possibility of justified failures can help ease anxieties. Open communication with your dental provider and understanding the various factors that can contribute to failure will lead to a more informed and empowered approach to your oral health.
Final Thoughts
Recognizing the signs of a failed root canal is crucial for timely intervention and proper care. While most root canals are successful, understanding that failures can occur and knowing what to look for will empower you to take appropriate action if needed. Consult with a dental professional if you experience any concerning symptoms.
Frequently Asked Questions (FAQs)
Can a root canal be redone? Yes, depending on the cause of failure, a root canal can often be redone.
How long does it take for a root canal to fail? It can vary widely, from days to years or even decades.
Is a failed root canal an emergency? It may not always be an emergency, but prompt evaluation by a dental professional is essential.
How can I tell if my root canal is infected? Symptoms like pain, swelling, and foul odor can indicate an infection.
What are the risks of leaving a failed root canal untreated? Leaving a failed root canal untreated can lead to further infection, pain, and potential loss of the tooth.
* Though the author of this post is a licensed dentist in the state of Kansas, this information is provided for informational and educational purposes only. Please use your best judgment and contact emergency medical services in the event of an emergency.