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FAQ:  Root Canal Therapy RCT



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Question:
I had a root canal performed about 2 years ago and recently had an absess at the base of the gum on the same tooth. I went to a new dentist who did x-rays and said the the root canal wasn't done all the way.

He then took x-rays of the rest of my mouth and saw 3 other root canals that he said weren't done right either. Should I get a second opinion? Should I have gotten an absess on a tooth that already had a root canal?

Please help ... I am really upset and don't want to go through the pain again. ...Visitor from NJ

Answer:
The reason why root canals are not successful is due to many reasons. First let's explain what a root canal is and why we perform them.

Root canals are the removal of the nerve and blood vessels from within the tooth. This is performed because the tissue has died for some reason and may or may not be infected with bacteria. The body is seeing the tooth and the bacteria as a foreign body and is trying to dissolve (eat it up) the tooth. This is what then will become an abscess.

After the nerve tissue is removed the remaining area of the tooth is then shaped to further remove any bacteria on the side walls and to accept the filling material better.

The problem with root canals are that they do not always look like the straight canal which is seen on the x-ray or in the diagrams. A closer representation is as if you had pulled a weed out of the garden and saw the tap-root with the associated root hair with it. It is the root hairs which will often retain the bacteria and cause the subsequent infection.

Also the x-ray is a 2D picture of a 3D object. This means that what looks like the end of the tooth may not really be the end of the tooth but really the side which has been superimposed upon the end.

It would seem that from your description that the tooth has had a problem and if possible should be retreated. If this does not cure the problem the next procedure to save the tooth would be an apicoectomy. This is a procedure which removes the infection from the base of the tooth and then seals the root end of the tooth.

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