What To Do When a Root Canal Fails

What is Root Canal Failure?

A root canal fails when a tooth that has been previously treated with a root canal procedure becomes infected at the root. If this infection is allowed to continue to develop without proper treatment, the infection can potentially spread to other teeth in the area or cause illness in other parts of the body.

What Causes a Root Canal to Fail?

  • Undetected canal branches: Depending on the circumstances and the patient, a root canal procedure can be an intricate process. Sometimes, a patient’s tooth (such as a lower incisor, for example) may have more canals within it than are expected. Molars that have three roots may have as many as four canals, some of them hidden behind others. If one of these canals is missed and not treated, an infection will ultimately develop and can potentially form a painful abscess.
  • Obstruction: An obstruction (such as another tooth, filling material, etc.) may make it impossible for the dentist to reach and thoroughly clean the entirety of the canal affected.
  • Cracks in the root: The root of the affected tooth may develop a fissure or fracture deep beneath the gum, making it impossible to fully seal the canal. This allows for the possibility of an infection that leads to increased sensitivity, pain and the need for retreatment.

What are the Treatment Options for Failed Root Canals?

There are a number of options available for dental patients affected by a failing root canal. These include:

  • Retreatment
  • Apicoectomy (or surgery at the apex of the tooth)
  • Extraction of the affected tooth

Retreatment is the most common option and has the highest rate of success. It involves removing the original filling, disinfecting the canal and then resealing it to prevent further irritation and exposure to bacteria.

Apioectomy is the procedure most often chosen when a blockage of some sort prevents access to the canal or if the original procedure included a post and crown restoration. The process includes the creation of a small flap in the gum through which the root is accessed. The infected portion of the root may be completely or partially removed and a new seal is placed.

Extraction is the option chosen if retreatment is not effective or if the affected tooth cannot be successfully restored in any other way. If there exists sufficient bone at the site of the extraction, an implant may be used to fill the empty space.

Depending on the nature and the severity of the root canal failure, the dentist will consider all options available in order to make a decision regarding treatment and further surgery.

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