A dentist completed a root canal on my top right premolar in 2018. I had no problems with the tooth until last month. Now the tooth hurts daily, although the pain is not nonstop. How long do I have before I need to see a dentist? Will I need a second root canal on this tooth? Thank you. Mark from Helena, MT
Thank you for your question. Dr. Thomas would need to examine and x-ray your tooth to determine if it is reinfected and needs further treatment, but we will explain why a root canal tooth may hurt years after treatment.
Why Does Your Root Canal Tooth Hurt Again?
If your root canal tooth hurts again, it probably means that the tooth did not heal completely, and the infection flared up again. When a dentist does not remove all the infected pulp from a tooth or misses a hidden canal, you can experience future complications. According to the Journal of the American Dental Association, other factors that can contribute to root canal failure include:
- Under- or over-filling a tooth with dental filler material
- Perforations in the root canal systems
- Dental instrument separation, or break off, into the root canal system
How Common Is Root Canal Failure?
Root canal failure occurs in about one in ten procedures. Infection may take months or years to flare up if a tooth does not heal completely. The infection lingers when a dentist cannot see deep inside tooth canals or reach curvy channels. Only dentists with advanced training and endodontists (root canal specialists) have the instruments needed for challenging tooth channels.
What Is the Treatment for Root Canal Failure?
Repeat root canal treatment or root canal surgery is the treatment for root canal failure. If your dentist does not have advanced root canal therapy training, they will refer you to an endodontist. The endodontist will take these steps:
- Find the infected root
- Remove the infection
- Fill the tooth
- Seal the tooth
During root canal surgery or apicoectomy, a dentist or endodontist will access the tooth through the bone and the root tip instead of the crown.
Schedule an appointment promptly. After an examination and x-rays, an endodontist or dentist trained in root canal therapy will determine whether your tooth is savable. Otherwise, they will recommend tooth removal and a dental implant.
Sugar Land, Texas, dentist Dr. Siny Thomas sponsors this post.