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?

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.