A Failing Root Canal

Never pull a tooth because you were told that a root canal is infected. The root canal is still infected; unknown to the previous dentist, the tooth may have been more complicated than realized.

How do you know the root canal is failing?

a. A pimple on the gum
b. Your dentist noticed a shadow on the x-ray
c. Having swelling
d. Your having on/off pain

There are still bacteria in the tooth coming out, infecting the bone.

Wait a minute! If the nerve was removed, why am I having pain? The pain is coming from the nerves that attach to the outside of the tooth in the surrounding jaw bone.

Where in the tooth are these bacteria? Not all teeth are created equal! There may be an extra root or canal hiding. Something could have gone astray with the original sterilization process of the root canal. There could be an accessory branch to a canal, like a tributary in a river, containing bacteria. Our 3-D imaging helps with that!

What are your options?

  1. Retreat the root canal                                         ( least expensive)
  2. Root canal Surgery (Apicoectomy)                     ( slightly more expensive)
  3. Extract the tooth replace with a bridge                ( more to most expensive )
  4. Extract the tooth replace with an implant             ( more to most expensive)
  5. Extract the tooth and leave the space                  (most expensive)

Retreat the Root Canal

This procedure entails going back into the tooth. The root canal filling is easily removed. The inside of the root is properly sterilized. A root canal filling is properly placed back into the root. There are pros and cons to be considered. Take the time and consult with our doctors. Remember, it is not whether it is easier or harder, longer or faster, but what will give you the best prognosis (outcome) for the tooth to be tested by time. Most of the time, we make a small opening through the existing crown. That saves the patient from getting a new crown.

Root Canal Surgery (Apicoectomy)

This procedure entails making a cut (incision) in the gum area near the end of the root. The very tip of the root is removed. A small filling is placed into the end of the existing root to seal it off.

Why would I want to consider this? If you cannot retreat the tooth conservatively, this would be your second option. Now, depending on where the tooth is, this may not be an option. Molars are more difficult, and may have a decreased prognosis or chance of success.

Rule of thumb:

The farther you go back in the mouth, the more the difficulty increases and prognosis decreases. Take the time and send us an email.

Extract the tooth replace with a bridge

In order to fill the spot with a tooth, the dentist will have to crown (cap) the teeth on both sides. This will give you the cost of an extraction plus a minimum of 3 new caps. Sometimes the newly capped teeth may need root canal from the new bridge procedure.

Extract with an Implant

After the tooth extraction, the socket may need a bone graft before the implant goes in. So, there are the fees of the extraction, graft, implant and then the crown. This may be a process that takes months. Many people think implants are forever, but not so. Nothing is better than your natural tooth.

Extract the Tooth

Out of sight, out of mind! The tooth can be removed (extracted). Remember, once it is gone, it is gone! Many patients leaving the space will compromise the teeth adjacent over time. The most important step that you can do is to be informed of what to do with the space before the tooth comes out. Have a treatment plan, (game plan) with all your options laid out by your dentist. You may need to be consulted by the oral surgeon or the periodontist. The tooth can be replaced with an implant or a bridge. This may be a more sound treatment plan. How much will it cost to replace the tooth? Can the tooth be replaced?

But I am in pain now! Tooth pain is easily controlled with medication. This will allow you the time to make a decision without being influenced by the pain factor. Replacing a tooth may involve work on other surrounding teeth and be more costly, even though it is out of sight for the short term; it may not be out of mind for the long term.