Baton Rouge Dentist

What’s Next If I Had a Root Canal Fail?

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Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.What’s next if I had a root canal fail? A toothache that has been bothering me for the past two months got so bad last weekend that I saw a nearby dentist for a same-day appointment. I did not want to return to my previous dentist because I didn’t like the customer service at the practice, and the hygienist is quirky. The toothache was in an upper left first molar tooth that my dentist did a root canal on two years ago. The dentist I saw most recently said she would need to refer me to an endodontist for a procedure called an apico? I have been a little slack about going to the dentist, and I haven’t seen one since I quit my last dentist, so maybe I could have avoided this. What is this apico procedure, and do I really need it? Thanks. Malachi

Malachi,

It’s good that you made a same-day appointment with a dentist. If you have a lingering toothache, you need treatment. Whether you need an apicoectomy depends on the X-ray results. You can get a second opinion from another dentist or an endodontist (root canal specialist). If you have problems with a root canal tooth, you will probably still need to see an endodontist.

What Is an Apicoectomy?

An apicoectomy is a minor surgical procedure that accesses the tooth root through an opening in the gum tissue and bone. An endodontist will remove the inflamed or infected tissue and remove the root tip. The endodontist will fit the root with a special material and seal it. Stitches will close the area and help it heal. According to the American Association of Endodontics, your jawbone will heal around the tooth root in a few months.

Why Do You Need an Apicoectomy?

If a dentist or endodontist cannot access a tooth infection near the root tip by opening the crown, they will recommend an apicoectomy. Sometimes after root canal treatment, infection in the tooth’s canals in the tooth can remain, particularly in areas that are difficult to reach. Then, you may need a second root canal or an apicoectomy.

You can get a second opinion from another dentist or an endodontist, a specialist who can provide the most accurate diagnosis and precise treatment.

 

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

What to do about a repeatedly rude dentist

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After the anesthetic wore off from a root canal, the pain was horrible. Swelling and terrible pain lasted three days. My dentist prescribed Flagyl. I saw my dentist a week later, and he told me to keep staying the medication because the root looks fine.

My pain didn’t stop, so I had an emergency appointment with another dentist. They recommended that I see a neurologist. The neurologist says I have trigeminal neuralgia and should let my dentist know. I called my dental office, and they said that the dentist wanted to talk to me in person. He spoke rudely and told me that he had nothing to do with my nerve pain.

When I scheduled my dental crown appointment, the nurse said I need clearance to see the dentist, and without it, I won’t get a crown from their office. I’m waiting to hear from my dentist, but I wonder why I’m being treated so rudely. I didn’t accuse my dentist of anything. Should I trust him to place the crown? Thank you. Heather

 

Heather,

What you describe is odd and rude behavior from your dentist. We suggest that you switch to another dentist and ask for a refund for incomplete work. Although emergency dental visits are appropriate in many cases, you need a doctor who will take time to identify the source of your pain.

Doctors usually prescribe Flagyl for the lower GI tract and vaginal infections. It is an alternative antibiotic when other types won’t work for oral infection. Flagyl has a limited spectrum and is usually combined with amoxicillin or another.

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.
Sometimes, an emergency dental appointment isn’t enough

Trigeminal neuralgia causes extreme facial pain when an area of the face is touched or stimulated. Strangely, a neurologist diagnosed your case based on your dental incident alone. But why would your dentist become rude and defensive? We can’t answer that, but your dentist’s office doesn’t seem like a trustworthy place to get a new crown.

You can report the “non-visit” to your dental insurance company. You can ask for a refund. If your dentist doesn’t cooperate, you can report the incident to the state dental board.

 

Ryan Perry DDS, a Baton Rouge family dentist, sponsors this post.

Root canal tooth hurting again?

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Almost three years ago, I had a root canal on an upper right molar. In May, the tooth started hurting on and off. I hesitated to do anything about it because I didn’t want to go to the dentist during the pandemic. But now the pain isn’t on and off. It’s just on and getting worse. I don’t want to lose the tooth. I’m not an established patient with any dentist. Part of my hesitancy is that after a dental cleaning and exam last October, I became very ill the next day with what resulted in a month-long respiratory infection. I still have some chest congestion from it. I’m convinced that I got the infection from the dental office. I decided not to return to that office, but now with a throbbing toothache, I’ll have to find a new dentist. In the middle of Covid-19, I don’t want to keep switching dentists. I want an idea of what’s going on. And can you tell me what to expect from a dentist for treatment options? What’s the best treatment is for a root canal tooth that’s aching? Thanks for your input.  Demetrius from Montgomery, AL

Demetrius,

We understand your hesitancy about going to a dentist. Your failed root canal treatment and illness after a dental appointment can create anxiety. But you likely realize that your throbbing tooth won’t improve without help from a dentist. So what’s causing your pain?

What Is Root Canal Failure?

Diagram of tooth with needing a root canal treatment
Although root canal treatment is usually successful, it sometimes fails

Root canal failure is a condition that occurs when a tooth doesn’t heal completely after root canal treatment. Symptoms eventually resurface and get worse. About one in ten teeth experience root canal failure.

Although Dr. Perry has extensive experience in root canal treatment, he would need to examine your tooth for an accurate diagnosis, it seems that root canal failure is causing your pain.

Why Are the Causes of Root Canal Failure?

Root canal treatment can sometimes fail for several reasons:

  • It’s impossible to see deep inside a tooth.
  • Some teeth have curved, branching roots that are difficult to clean.
  • If a dentist misses some of the infection in curved roots, symptoms will resurface.
  • Curvy, challenging roots require specialized rotary instruments to clean them out. Many general dentists don’t have those tools, so they may not completely clear the tooth. You may be referred to a specialist to complete root canal treatment.

What Is the Treatment for Root Canal Failure?

Treatment for root canal failure is either to perform another root canal treatment or root canal surgery. Most general dentists don’t have advanced training in this area, so an endodontist, or root canal specialist, usually completes the work. The specialist will identify the location of the infection that the dentist missed the first time and remove it or seal it off. Many root canal specialists say that retreatment has a 50% success rate, but the results are often better.

A specialist will also examine the condition of your tooth. If it’s cracked, the chances of saving your tooth decrease. Don’t delay treatment. Search online for a dentist with experience in root canal treatment who will see you right away, examine your tooth, and refer you to a specialist if needed.

Ryan Perry, DDS, of Baton Rouge sponsors this post.