Reinfected Root Canal: How This Happened & What To Do

As endodontists, we sometimes treat patients who have a reinfected root canal. Often those patients ask how this happened and what to do about it. Whether we are retreating from work done by a different dentist or our work, we strive to restore the patient’s well-being.

It’s vitally important for optimal dental health that we understand the causes, symptoms, and treatment options available for reinfected root canals. In this article, we explore these intricacies as well as offer strategies for effectively dealing with reinfected root canals.

The vast majority of root canals Charlotte NC are successful and provide relief from pain. Each year endodontists and dentists perform over 15 million root canals in the United States. Over 95% of those root canals are effective.

A successful root canal saves the natural tooth and extends its life to match the other healthy teeth. However, once in a while, a root canal isn’t successful and needs retreatment.

Root canals are highly effective, but any treatment runs a small risk of complications. The European Journal of Dentistry found that the overall success rate of a root canal and other endodontic treatment ranges from 86% to 98%. According to the study, various factors can contribute to failure, including the persistence of bacteria, untreated canals, or other complications.

Understanding why a root canal might fail or become reinfected is essential for ensuring future success. Several factors can contribute to reinfection, and they may stem from the initial procedure or develop afterward. If bacteria weren’t fully removed during the initial root canal treatment, or if there were untreated canals within the tooth, the infection can resurface. This highlights the complexity of the root canal system, with its intricate network of tiny canals that may harbor bacteria if not entirely clear.

About Reinfected Root Canals

Root canal procedures are performed to save severely infected teeth from extraction. Learn what is the difference between a root canal and extraction to make a better decision. However, in some instances the treated tooth may be re-infected, necessitating further intervention and treatment options.

When a root canal is unsuccessful, symptoms may return anywhere from a few months to a few years later. Sometimes endodontic retreatment in Charlotte NC offers relief and helps restore balance and health.

Endodontic retreatment is a procedure where an endodontist removes the original root canal fillings and then cleans and disinfects inside the tooth. Next, the dental professional refills and reseals the canals. The goal is to save the natural tooth, just like with any other root canal.

Although general dentists also perform root canals, many patients feel more secure turning to a specialist. A top endodontist endodontist in Charlotte NC specializes in root canals and retreatment.

According to the American Association of Endodontists (AAE), an endodontist typically performs 25 root canals weekly, while a general dentist usually performs just two. In addition to earning a general dentistry license, an endodontist also completes an additional specialized training program.

In some cases, the sealing of the tooth may not have been sufficient, allowing bacteria to reenter the tooth. Another scenario might be damage to the tooth after the root canal, such as a crack or fracture. Teeth that have undergone trauma are more susceptible to reinfection as bacteria can penetrate through the cracks.

Delayed restoration can also play a role in reinfection. If the permanent filling or crown wasn’t placed soon enough after the root canal, the tooth remains exposed to bacteria. Lastly, patient-related factors such as poor oral hygiene or recurring decay can contribute to reinfection.

Why Retreatment is Sometimes Necessary

The success of any root canal treatment largely depends on effectively eliminating harmful bacteria from the root canal system and then sealing it to keep more bacteria from getting inside the tooth or roots. That description oversimplifies the process due to the unique nature of each individual’s teeth and roots.

As you may know, teeth are not solid. The inner layers contain dentin which is a porous tissue and soft tissue known as pulp. The nerves and blood vessels are in the pulp, and infected pulp leads to pain. The endodontist removes the pulp from the infected tooth, disinfects it, and reseals it during a root canal.

Now that you understand why retreatment is sometimes necessary, it may help recognize signs when it may be needed.

Signs of a Reinfected Root Canal

Reducing the risk of reinfected root canals requires knowing the signs. Common indicators may include:

• Persistent Pain: Any discomfort felt after treating a tooth that persists or worsens may indicate reinfection.

• Swelling and Sensitivity: Any swelling, tenderness, or sensitivity around a treated tooth could be an indicator of reinfection.

• Gum Pus or Drainage: Pus or drainage around a tooth or gums could indicate an infection in its root canal system.

• Loose Restoration: If a dental crown or filling feels loose or becomes dislodged, this could allow bacteria back into the tooth and lead to reinfection.

• Taste or Odor in the Mouth: Persistent bad tastes or smells in the mouth may indicate bacteria growth and infection in an affected tooth, suggesting possible further health complications.

Keep in mind that reinfection might happen weeks, months, or even years after the original root canal. Sometimes non-surgical retreatment isn’t an option. In those cases, endodontic surgery might be the best alternative to an extraction.

Contact your dentist or endodontist for an examination. The sooner the diagnosis, the sooner the problem may be fixed and the pain relieved. Prompt attention may result in saving the tooth and ending the pain and infection. Sadly, if the root canal fails and the tooth becomes reinfected, that infection will not just go away on its own. Either some form of retreatment or extraction is necessary to restore health after reinfection

What Should You Do About It?

If you suspect that your root canal is reinfected, it is crucial to act quickly to address the issue. Delaying treatment can result in worsening pain, swelling, and potentially the need for extraction. The first step is to schedule an appointment with your endodontist or dentist, who will conduct a thorough examination to confirm whether reinfection has occurred. In many cases, the earlier the reinfection is caught, the better the chances of saving the tooth.

For reinfected root canals, the most common treatment option is endodontic retreatment. This involves reopening the tooth, removing the old root canal filling, and thoroughly cleaning and disinfecting the canals. Retreatment can be highly effective, especially when performed by a specialist like an endodontist who has advanced training and tools to address more complex cases.

In situations where retreatment may not be sufficient, an apicoectomy could be recommended. This surgical procedure targets the tip of the tooth’s root and removes it along with any surrounding infected tissue. The end of the root is then sealed to prevent reinfection. This is often the next step if retreatment doesn’t fully resolve the issue or if the infection is localized near the root tip.

In some cases, antibiotics may be prescribed in conjunction with retreatment or surgery to help control the infection and prevent it from spreading. However, antibiotics alone cannot resolve a reinfected root canal and should be seen as a temporary solution.

Finally, in severe cases where reinfection cannot be adequately treated, the tooth may need to be extracted. This is typically a last resort when other treatments have failed or the structural integrity of the tooth is compromised. After extraction, the missing tooth can be replaced with a dental implant, bridge, or other prosthetic to restore function and aesthetics.

Root Canal Reinfection Risks

Reinfection of a root canal can result from several causes, most commonly related to inadequate cleaning and sealing during its initial procedure.

Common reasons include:

• Failure to Remove Bacteria Entirely: If bacteria remain within a root canal system after initial treatment, they could resurface and reinfest. This can increase the risk of reinfection.

• Unsafe Restorations: Poorly fitted or compromised dental crowns or fillings may allow bacteria back into the root canal system.

• Cracked or Fractured Tooth: Cracks or fractures in teeth provide entryways for bacteria to gain entry and re-infiltrate the root canal system.

• Delayed Restoration Placement: Delaying permanent restoration after root canal therapy may leave your tooth vulnerable to reinfection.

• Trauma or Decay: Any trauma to the tooth or new decay increases the risk of reinfection, jeopardizing previous root canal treatments.

Treatment Options for Reinfected Root Canals

As soon as your root canal becomes reinfected, immediate treatment must take place to reduce further complications and protect its integrity. Potential remedies could include:

• Root Canal Retreatment: When necessary, dentists may perform a root canal retreatment procedure to address an infection, thoroughly clean out, and seal off the canal effectively.

• Apicoectomy: When retreatment fails to provide desired results, an apicoectomy may be recommended to prevent reinfection. This surgery entails extracting the root tip from your tooth’s root system and sealing the canal to protect it from reinfection.

• Antibiotic Therapy: When undertaking root canal retreatment or other procedures, antibiotics may be prescribed to control an infection and stop its spread.

• Tooth Extraction: In severe infections where treatment cannot effectively address it, extracting the tooth may be necessary to stop its spread to surrounding teeth and tissues.

Reinfection of a root canal can create considerable challenges and discomfort for patients. Yet with timely intervention and appropriate treatment most reinfected root canals can be successfully managed, saving the tooth while improving oral health.

Preventing Future Issues

Preventing reinfection starts with ensuring that your root canal is performed and restored properly the first time. This includes choosing a skilled dental professional, particularly an endodontist, for your root canal procedure. Endodontists are better equipped to handle complex cases and reduce the risk of complications.

Maintaining good oral hygiene is essential to prevent reinfection. Regular brushing, flossing, and routine dental checkups will help protect your treated tooth from decay and infection. If you notice any symptoms such as pain, swelling, or sensitivity around a treated tooth, contact your dentist immediately.

Contact a Skilled Dental Professional

If you believe you may need retreatment, please do not hesitate to contact a skilled endodontist. The specialists at Ballantyne Endodontics know firsthand the importance of prompt treatment. Ballantyne’s own Sonia Chopra, DDS, describes herself as not just an endodontist but also as “the ultimate dental patient.” After failed treatments, a compassionate endodontist effectively provided treatment and relief.

The entire team at Ballantyne Endodontics shares Dr. Chopra’s passion for saving teeth and ending pain. They balance this passion with cutting-edge endodontic technology and best practices in endodontics, leading to the best patient experience possible.

Some patients worry that if the root canal they had years ago was unsuccessful, the same is likely to happen again. Endodontics continues to advance, so new, improved techniques and tools may not be available to your previous dentist. However, your endodontist will need to examine you to determine whether you are a good candidate for retreatment.

Charlotte-area residents trust Ballantyne Endodontics to save their natural teeth and restore balance and well-being to their mouths. Contact us today to schedule a consultation or learn how you may request a referral from your general dentist.