Can Root Canals Be Re-Treated?

Can Root Canals Be Re-Treated?

By Mina Levi, DDS, 08/28/2015

In a root canal procedure, the roots or nerves of the tooth are removed, so there shouldn’t be any pain coming from that tooth anymore. However, every now and then some patients have residual pain that is immediate, or years after the root canal is performed and they need a second root canal. This isn’t a second root canal so much as it is a re-treatment of a root canal. In this week’s article, San Francisco Dentist Mina Levi, DDS discusses what it means when a root canal needs to be re-treated.

What happens during a root canal re-treatment?

The endodontist will re-open the tooth or drill through the placed restoration and remove the filling materials that were placed in the canals of the tooth during the first root canal procedure. Then, the endodontist will look for signs of new infection or additional canals that need to be treated. The endodontist will then remove any infection or clean out the missed canal, clean and reshape them, and place new filling materials. Another crown or restoration will need to be placed on the tooth after the retreatment.

Why would I need a second root canal procedure?

A tooth may not heal as expected after the initial root canal for a number of reasons:

1. Complicated canal anatomy went undetected in the first procedure. Some people have a complicated root system like an extra root that is directly behind another root, so an x-ray may not have shown this in the initial treatment.

2. Narrow canals were not treated during the initial procedure.

3. The restoration (filling or crown) did not prevent saliva from contaminating the inside of the tooth.

4. The placement of the crown was delayed after the endodontic root canal treatment. If you wait more than 30 days after a root canal to have the crown placed, it can cause problems with the initial treatment.

If you have tooth pain or a root canalled tooth that is bothering you and you think you may need re-treatment, visit San Francisco Dentist Mina Levi, DDS on the web at www.minalevidds.com or give us a call at (415) 513-5066.

Topics: San Francisco Dentist, root canal, root canal pain, retreat, root canal retreat, root canal retreatment, second root canal, second root canal treatment, why do I need a root canal retreatment 

Why Would My Tooth Hurt After a Root Canal?

Why Would My Tooth Hurt After a Root Canal?

By Mina Levi, DDS, 01/08/2015

At the San Francisco dental office of Mina Levi, DDS, we refer a number of patients to endodontists if there is nerve pain that requires a root canal. After a root canal, the root is gone; so many people think that there should be absolutely no pain after a root canal, which sometimes is not the case. In this article, Dentist San Francisco Mina Levi, DDS explains what a root canal is and why someone may have pain after a root canal is performed.

What is a root canal?

Inside of a tooth, under the white enamel part and under the next  hard layer called dentin, there is a soft tissue which is the pulp of the tooth. The pulp contains blood vessels, nerves and connective tissue. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it. When the pulp becomes infected or inflamed, caused by deep decay, repeated dental procedures, faulty crowns, crack in the tooth, etc, then endodontic treatment may be necessary to remove it. If the pulp infection is left untreated, it can cause pain or lead to an abscess. This pain is a sign that the dentist uses to decide if the tooth will need a root canal or not.

A root canal removes the infected pulp and the inside of the tooth is cleaned out and disinfected, then filled and sealed with a rubbery material. After this, the tooth is restored with a crown or filling for protection. After the tooth is restored, the tooth continues to function like it did before.

What would cause pain after a root canal?

There are a number of possible causes of pain after the completion of a root canal. After a root canal is completed no living pulp tissue remains inside the tooth, but nerve endings remain in the ligaments that attach the tooth to the surrounding bone. These ligaments have nerve fiber associated with them that can feel pain.

Another cause could be inflammation of the periapical tissues post root canal. This inflammation may be due to extruded sealer or “over instrumentation” during the endodontic procedure. Sometimes the root canal files go past the apical terminus and can either inject some debris periapically or just damage the ligaments. This inflammation usually resolves by itself given enough time.

Another source of post root canal discomfort is a high bite and this can easily be corrected by a dentist. If a patient bites down, with no food in their mouth and their root canalled tooth hurts, then the bite should be adjusted.

Other possible causes of pain are a persistent infection or a root fracture. If a root canal is completed, but an infection still is present around the periapical area then a retreatment may be indicated especially if significant time has gone by without a resolution of the infection.

If you have tooth pain or think you require a root canal, or if you are having post-root canal pain, visit Dentist San Francisco Mina Levi, DDS on the web at www.minalevidds.com or give us a call at (415) 513-5066.

Topics: San Francisco Dentist, root canal, root canal pain, root canal dentist, endodontics, endodontist, endodontic treatment, endo, pulp, dentin, enamel, tooth structure, inflammation, infection, pulp infection, root infection, pain, tooth pain, achy pain