Re-treatment? What is the next step?

Got a root canal done for the same tooth multiple times? Has the pain not gone yet, or is the gum boil still there? What is to blame? Curved roots? Improper care? Or an IMPROPER DIAGNOSIS or TREATMENT?

A root canal treatment termed as a failure if

Reasons your root canal failed

1. Incomplete removal of the bacteria:

For a root canal treatment to be successful the entire infected tissue (present inside the tooth) needs to be removed. This involves mechanical as well as chemical disinfection. If the infected tissue isn’t completely removed there are chances of the tooth getting re-infected leading to failure of the root canal.

2. The root was fractured:

If the root is broken due to excessive cavity damage the root canal generally fails Another reason of a root fracture is biting on something hard suddenly while chewing on soft food. This kind of root fracture (depending on the level of the fracture) can be treated, and the required treatment should be undertaken before the root canal is undertaken.

3. A root canal filling was done before the entire infection (pain) was resolved

With tooth infection being the most common cause requiring a root canal treatment, while the treatment is undertaken the entire infection should be resolved before the final filling is done.

The resolution of the infection involves 2 steps

Incomplete resolution of infection is a common feature of “single sitting root canals”. In this method (if used infected teeth) the infection doesn’t resolve entirely and thus may lead to a failure typically after a few months/years

4. There was a large infection in the bone due to the tooth infection which wasn’t treated

Sometimes, when the infected tooth and the resulting pain has been ignored multiple times, the underlying bone gets damaged and infected. In this scenario when the treatment is finally undertaken, just a root canal might not be adequate and the infection in the bone would also be required to be removed. If the long standing infection in the bone infection isn’t resolved, it can result in root canal failure.

5. The filling was inadequate not providing resistance from re-infection

When the filling is done in the root canal, it needs to seal off the canal from the underlying bone (which is living) An inappropriate seal in the canal can cause the bacteria to enter from the bone into the canals causing reinfection and tooth pain, finally leading to the failure of the treatment.

6. The reason for tooth pain was not the tooth

There can be multiple reasons for tooth pain , other than that caused by tooth infection. The most common reason for tooth pain that can lead to a root canal treatment is gum disease. Gum diseases can occur in conjunction or separate from a tooth infection. In either case, just a root canal cannot resolve the pain and, complete treatment involving the treatment of gums is also required. Only root canal done in such a case can lead to treatment failure.

The next step

So you now know that your root canal treatment failed. What are the treatment options available to you? The treatment depends on the condition of the tooth and the reason for failure. Thus, a proper evaluation of the past condition as well as the present symptoms needs to be done in order to come to the correct treatment option that would be required to resolve the issue.

The treatments involved in the failure of a root canal include

The most important factor is to determine what cause the failure in the first case and then go ahead with the treatment. Mindlessly undertaking any of the above mentioned procedures, can result in the failure of the treatment repetitively. Finally, it would result in the removal of the tooth after a lot of frustration of both the doctor and the patient.

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