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FAQ:  Root Canal Therapy RCT



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Question:
Failing Root Canals:
I've had quite a few root canals, 4 have failed. I had an abscess after the root canal. The infection drained into my left lymph node and under my tongue. It is very painful when I chew.

I scheduled for the affected tooth to be extracted and I just started antibiotics. What to do? I can't waste money putting another cap just so they can take them out in about 6 months.

Why aren't they healing in my body. Or is there something stronger to take for people like me? What would you suggest I do from this extraction - should I get a bridge and will they treat this site after the tooth/cap is out or does it just drain? ...Visitor from NY

Answer:
Your concerns are valid and unfortunately common to many. First let me explain that the information given is generalized and may not be specific for you individual situation.

Root Canals do sometimes fail even with the best Doctor performing them.

Lets look at how the tooth was formed. There are cells which live inside the tooth called odontoblast that make up the inner hard part of the tooth (Dentine). These cells continue to make dentine through-out the life of the tooth.

There are fed by blood vessels which enter from the base of the root of the tooth (apex). Often in an x-ray or in drawings these blood vessels are seen as coming from a single opening (foremen). But closer examination would revel something that looks closer to a tap root with root hairs emerging from it, as seen when weeding a garden (the main canal with Lateral Canals coming off of it).

When a root canal procedure (endodontic procedure) is done the main "tap root" is removed physically with the endo-files and the "root hairs" are removed by chemical means, such as soaking the tooth in Sodium Hypochlorite.

Sometimes the Lateral canals will still have a small amount of organic material in it which can cause a small infection. The body can often fight off this small infection, however if the defense of the body gets low then a larger infection may emerge and the root canal is considered a failure.

Procedures to fix this include retreating the root canal, an apicoectomy (where the infection is removed from the apex of the tooth) or an extraction (the removal of the tooth).

Lymph Nodes are ares of the body which holds infection and foreign material to present it to the immune system. They keep the infection from spreading and tells the body what it needs to fight against.

If the lymph node has a large job to do then it may become damaged and will scar down after the infection is over. This will be felt as a lump in the skin around the lymph node.

Brides (in dental terms) often mean two or more teeth crowned (capped) and joined together with a fake tooth which replaces a missing tooth in between them. This prosthesis (replacement of a body part) does get removed by the patient. Sometimes if the two neighboring teeth are free of any restorations and the area to be replaced has good bone a Dental Implant may be placed instead of the crown and bridge. The implant will hold the new tooth and serves as a replacement to the root of the tooth removed.

On a more specific note, you may need to be tested for a systemic (whole body) disorder and/or immune concerns, since so many root canals have failed. The infection should clear up after the extraction and there should not be any draining in the surgical site.

A change of antibiotics may be indicated after a culture is obtained at the time of the extraction. Your bridge should be well fitting and last for many years.

Editorial Staff

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