By Dr. Abhi Singh Root canal treatment treats tooth decay by removing the infected pulp from inside the tooth. Given the high success rate of root canal therapy, failures do occur in many instances, and the majority of the time, they can be related to the previously stated causes of failure. Many people have heard about unsuccessful root canal treatments, but not many know what causes them to fail.
Here, we will discuss some of the most common reasons why root canal treatment fails, so you know what to look out for!
The term “root canal” is not a treatment but rather a part of the tooth structure. It is the part of the tooth made up of blood vessels, nerve tissue, and other cells that help in its development and function. A root canal is also called tooth pulp.
The soft tissue, the pulp, is found deep within your tooth, underneath the white surface enamel and a hard layer known as dentin. Trauma, tooth decay, and bacterial infection can cause damage to the dental pulp, and your dentist may recommend root canal treatment, also known as endodontic therapy.
Root canal therapy aims to remove bacteria from the infected root canal, protect the tooth from becoming infected again, and save the original tooth. A root canal is a procedure in which the inflamed or infected pulp of the tooth is removed, and the inside of the tooth is thoroughly cleaned and disinfected before being filled with a filling and sealed.
Advanced technology has helped dentistry by offering simple but effective dental treatments. Today, the current root canal therapy has become less invasive and virtually painless. Depending on the condition of your tooth, the procedure may be done with only one to two appointments to complete. In no time, you’ll be back to smiling, biting, and eating with ease.
According to a recent study, the endodontic procedure is generally an effective and safe treatment with a high success rate ranging from 86 to 98 per cent. However, like other dental procedures, there are potential complications that need to look at.
The number of roots and root canals in different types of teeth (molars, premolars, canines, and incisors) varies depending on the tooth type. Our dentist will take all possible measures, like a dental x-ray, to have a clear picture and examine your tooth’s structure. However, there are instances that root.
If the dentist is unable to reach the end of the root or if a canal is missed, the tooth may become problematic following treatment. This is usually common in back teeth or molars.
Untreated canals cause root canal failure. This usually means that a canal is not treated to the root. “Being short” increases the risk of failure because untreated or unfilled root canal space allows bacteria to grow and cause infection.
A root canal treatment takes longer than expected because of natural anatomies like sharp curves, calcifications, or dentist errors like mismeasurement.
Another cause of root canal failure is diseased tissue that remains in the tooth following root canal treatment. When this happens, the unremoved infected tissue can provide a source for bacteria to grow and reinfect the root canal system.
A root fracture is a less prevalent cause of endodontic treatment failure. In other cases, this may not be related directly to root canal treatment. Root cracks allow bacteria to enter the canal system and induce symptoms similar to those of an infected tooth. Some cracks can be caused by trauma, extensive and deep fillings, or tooth grinding. Sometimes cracks are unavoidable.
A root canal treatment aims to remove the canal tissue, eliminate bacteria, and seal the canal system to prevent re-infection. It is also critical that a filling or crown is correctly placed over the tooth to guarantee no leaking following the treatment.
The best way to decrease the risk of bacterial leakage is to have a permanent filling inserted at the same time as the root canal treatment is completed. A dental crown, which is then fitted at a later visit, will ensure that the tooth is as well-sealed as possible against bacterial leakage.
Endodontic failure is more likely in cases where the materials used to fill and seal a root canal system extend beyond the tip of the root. This is also known as overfilling or overextension.
In a study of 1001 endodontically treated teeth, the quality of root canal obturation was the most critical determinant in endodontic treatment efficiency.
The condition of a tooth can influence the outcome of endodontic treatment. A “periapical radiolucent lesion” is one such issue.
These lesions may harbour bacteria even after a tooth’s root canal treatment is completed. If so, the infection will be a chronic irritation to the surrounding tissues.
It is typical for the tissue surrounding the root of your tooth to be affected following root canal therapy (RCT), making the surrounding area painful and unpleasant.
A root canal can be an unpleasant experience. But while a qualified dentist can reduce root canal discomfort and pain, there is no way to avoid it entirely. When a root canal goes wrong, the issue worsens. If you are coping with this issue and need help, you can receive a free consultation at Prospect Road Dental in Western Australia.
The symptoms of root canal failure may vary from person to person. Your symptoms may be comparable to what you had before treatment, or you may not have any symptoms at all. Here are some of the most prevalent signs of root canal failure.
The tooth should no longer be sensitive after the root canal process. If you experience tooth discomfort following a root canal when applying pressure to the tooth, such as biting, your root canal may have gone wrong. Inflammation in the surrounding tissues generally causes this issue. Pus and other infectious debris leaking from the tooth typically cause this inflammation.
The area around the damaged tooth should not be inflamed after healing is complete. If you see any swelling, you should consult your dentist immediately. Infections can be fatal if not treated early, and swelling is usually a sign of a severe illness (or re-infection).
Swollen tissues are always painful and tender, and they may also start to discharge pus. In some instances, an infection will develop near the tooth’s root. When it grows large enough to penetrate the layer on the surface of the gums, it swells up like a giant pimple and begins oozing pus into your mouth.
Pain after root canal therapy is a common side effect, but you should consider it a warning sign if it persists after the treatment. You should be especially worried if you have recurrent discomfort with no apparent explanation or if the pain worsens with time.
It may help set your mind at ease to know that most root canal patients do not have this issue. According to this study, 95 percent of individuals treated had no lasting pain after having a root canal.
A faulty root canal symptom can sometimes cause a person to have conditional sensitivity in their teeth. That is, you may experience tooth pain and discomfort following a root canal, but only under specified situations—for instance, cold or hot sensitivity.
This is not a common symptom of unsuccessful root canals, but it is a warning indication. Because a root canal removes the tooth’s nerves, it means you shouldn’t feel anything. If you are sensitive to hot or cold in that tooth, a nerve has been missed. Temperature sensitivity is a reliable sign of re-infection (pulp necrosis).
Other signs of poor root canal treatment may include the following:
- Increased tooth mobility.
- Discharge from the treated tooth.
- Tooth discolouration.
- Sinus problems.
- Biting causes pain.
The root canal procedure can prolong the life of even the most damaged teeth. There are also times when a tooth that has been treated doesn’t heal correctly and can become infected or painful months or even years after it has been treated. It is not too late if your tooth does not heal completely or develops new problems. A further procedure might be needed to help you heal and maintain your tooth. An endodontist can perform retreatment on a previously treated tooth if you experience pain or discomfort.
Recognising the symptoms of a failed root canal is the first step toward retreatment. Whether your treatment was recent or several years ago, identifying the indicators of deterioration can contribute to the preservation of your tooth. Seeking retreatment as early as possible will prevent you from getting another infection and further suffering.
If you observe any signs of root canal treatment failure, contact an endodontist soon. At Prospect Road Dental, we provide treatment alternatives that can get you back on track to good oral health without extracting the damaged tooth.
Our endodontist has received advanced training, so you may be confident that you will receive the most excellent root canal retreatment outcomes available.
If retreatment has been approved as a solution, we will reopen your tooth to access the root canal filling material. To gain access to the root canal, this restorative material will be removed. Our dentist will now thoroughly clean your canals and check the inside of the affected tooth. After the canals have been cleaned, they will be filled and sealed, and a temporary filling will be placed in the tooth.
In most cases, root canals are effective with high rates of success, and retreatment is the most frequent recommendation in the event of failure. There are, however, various options for treating a failed root canal.
Endodontic surgery
Traditional root canal retreatment might not be enough to save your tooth, and your dentist may advise you to undergo surgery. One of the most common types of endodontic surgery is apicoectomy (resection of the root end). Surgery involves opening the gum tissue to expose the bone and removing infected or inflamed tissue. Also, the tip end of the root is removed.
Endodontic surgery may be advised in combination with or as an alternative to retreatment. Your endodontist will go over your options with you and propose the best course of action.
Tooth Extraction and replacement
Extraction of the tooth is the only option if you want to avoid both root canal retreatment and endodontic surgery. Even if it is generally recommended that you keep your natural teeth whenever possible, extraction may be the best or last option in some cases.
The extracted tooth must be restored with a dental implant, bridge, or removable partial denture to restore chewing function and prevent neighbouring teeth from moving. These alternatives are generally more expensive and time-consuming than retreatment and restoration of the natural tooth since they require extensive surgery or dental procedures on surrounding healthy teeth.
When looking for alternatives to root canal treatment, the dental professional must make sure there isn’t an underlying problem with your tooth. If signs of a failed root canal are present, they should be treated immediately to avoid future problems.
Reasons for root canal failures may include leaking, overfilling, repetitive dental work, dental decay, incomplete removal of diseased tissues, curved or narrow root canals, cracks, and missed canals.
Pain and discomfort are natural reactions after root canal treatment. However, it is important to look out for any indications of failed treatment and have immediate retreatment. Signs and symptoms of a faulty root canal may appear a few days or a year after the treatment. Hence, proper care and routine dental check-ups are necessary to maintain your oral health.
At Prospect Road Dental, our priority is your oral health and helping you achieve a beautiful smile. Please talk with us at (08) 9399 2037!
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