Tag Archives: root canal

Root Canal Treatment

Will I Need Root Canal Retreatment?

I had a root canal on my upper right canine almost a month ago, but the temporary filling came out. An abscess developed on the gum near that tooth. When I returned to my dentist’s office, he said I needed the root canal redone to treat the infection.

The abscess doesn’t hurt unless I press on the area. Should I be concerned about the abscess even if it isn’t painful? Would antibiotics clear the infection, or is root canal retreatment necessary? – Thanks. Marceline from ATL

Marceline,

Based on your description, a dentist or endodontist should evaluate the tooth for retreatment. The temporary filling came out, which may have allowed saliva and bacteria to contaminate the inside of the tooth.

During root canal treatment, the dentist removes infected tissue and bacteria from inside the tooth and seals the root canals with filling material and cement. That seal needs protection from saliva to help prevent bacteria from getting back into the tooth.

At the end of the root canal appointment, the dentist usually places a temporary filling to protect the tooth until the final restoration is completed. Depending on the tooth and its condition, that final restoration may be a crown or, in some cases, a permanent filling.

Temporary fillings are designed to be removed easily. If one falls out and the tooth remains open, saliva can seep into the root canal filling. Over several days, bacteria may contaminate the root canal system and compromise the seal.

Can Antibiotics Clear the Infection Without Retreatment?

Antibiotics alone cannot eliminate bacteria that have contaminated the inside of a root canal tooth. Antibiotics travel through the bloodstream, but a root canal-treated tooth no longer has normal blood circulation inside the cleaned canal space.

Antibiotics may reduce an infection that has spread into the gum and surrounding bone, so swelling or an abscess may temporarily improve. However, they do not remove the source of infection inside the tooth. Once you stop the antibiotics, the infection can return if the source remains.

Unnecessary or repeated antibiotic use can also contribute to antibiotic-resistant bacteria. For these reasons, antibiotics are not a substitute for treating the source of a dental infection.

Is It Safe to Leave the Tooth Alone If It Does Not Hurt?

The absence of pain does not mean the infection is harmless or has resolved. A dental infection can remain relatively quiet while still affecting the tooth and surrounding bone.

Leaving the tooth untreated can create several concerns. Although serious complications are uncommon, dental infections can sometimes spread beyond the immediate area. An untreated tooth may also continue to deteriorate from within.

Possible consequences include:

  • Continued infection around the tooth or in the jawbone
  • Loss of supporting bone around the root
  • Spread of infection into nearby facial spaces
  • Further decay and weakening of the tooth
  • Eventually reaching a point where the tooth can no longer be restored

Because this involves an upper tooth, we don’t recommend monitoring it and waiting for symptoms. A dentist or endodontist can evaluate the tooth, determine how much contamination has occurred, and advise whether root canal retreatment can preserve it.

Plano, Texas, female dentist Dr. Miranda Lacy sponsors this post. She caters to anxious patients.

Root Canal Treatment

Can Root Canals Save My Broken Front Teeth?

My center front tooth and the one behind it broke in an accident. The tooth roots are fine. Could I get a root canal on each tooth instead of a partial denture or a bridge? – Thanks. Kamryn from LA

Kamryn,

Saving a fractured front tooth through endodontic treatment (root canal), a tooth post, and crown restoration may be possible. However, several factors influence treatment success.

The extent of the fracture, your occlusion (bite), and the dentist’s preference significantly impact treatment decisions. With dental implants’ increasing reliability and popularity, some dentists may favor implant-supported restorations over saving the tooth.

The mechanics of restoring a fractured front tooth are complex. A critical consideration is the resistance to rotational forces. A tooth root’s anatomy and the placement of a single post in the tooth can lead to the post loosening over time. Some dentists insert two posts, which can enhance rotational stability.

Another crucial factor is the risk of root fracture. Rigid posts can transmit excessive force to the root’s thinner areas, increasing the fracture risk. Therefore, flexible posts, such as carbon fiber or fiberglass, are generally preferred for anterior teeth to reduce this risk.

Consult an experienced root canal dentist or an endodontist (root canal specialist) to discuss your options.

Plano, Texas, female dentist Dr. Miranda Lacy sponsors this post.

Root Canal Treatment

Can I Get a Root Canal at Six Months Pregnant?

In early September, my dentist filled a small cavity in my top right first molar. The tooth began to hurt about three weeks later, and now my dentist says I need a root canal. However, I’m six months pregnant. Is it safe to get a root canal? – Thanks, Kaylynn from MS

Kaylynn,

While we cannot provide a definitive diagnosis without a physical examination and seeing your X-rays, based on your description, a root canal treatment may not be necessary. It is unlikely that a minor cavity would develop into deep decay in less than two months and need root canal treatment.

It’s wise to seek a second opinion from a qualified dentist to evaluate your tooth’s condition.

Regarding your pregnancy, avoiding major dental procedures during the last trimester is advisable. However, if the tooth is infected, prompt treatment is essential to protect your and your baby’s health.

If an X-ray is necessary for accurate diagnosis, wearing a lead apron can shield your abdomen from radiation exposure.

Ultimately, the decision to proceed with dental treatment during pregnancy should be made in consultation with your dentist and healthcare provider.

Dr. Miranda Lacy, a Plano, Texas dentist, sponsors this post. She makes dental care affordable.

Tooth Infection

Do I Have a Tooth Abscess or a Cyst?

The gums around my upper left premolar have been swollen since the summer of 2022. The gum tissue is tender, but it doesn’t hurt. My dentist said I have a chronic abscess, and I would keep the tooth or get it extracted. During my last visit, I expressed concern about the lingering swelling, so my dentist referred me to an endodontist. The specialist said she could do a root canal with 70 percent success, but she is unsure whether I have a cyst. She took an x-ray, so I’m unsure why she couldn’t see a cyst. She showed me a dark shadow on the x-ray where my gums were sore.

My dentist and the specialist mentioned a procedure to access the tooth root through my gum tissue and bone. I could choose that procedure first and a root canal later if it doesn’t work. I understand how I went from my dentist saying that I could keep the tooth or get it extracted to cutting through my gums and bone to see if there is a cyst or an abscess. Are there questions that I need to ask my dentist? Thanks. Sarai

Sarai,

Although dental schools teach about cysts, they are rare, and the risks of having one are small. An infection causes swelling in the gum tissue around a tooth. Root canal treatment will remove the infection. Afterward, you will see and feel relief.

An apicoectomy is a dental procedure that involves cutting through your gums and bone to access a tooth’s root(s). The suggestion of an apicoectomy for your tooth sounds like over-treatment. Additionally, it concerns us that your dentist allowed the swelling to continue without investigation and treatment. An abscess can leak bacteria and affect neighboring teeth and your jawbone, even spreading into your bloodstream.

Like other infections, tooth infections can drain your energy and cause malaise. Root canal treatment has at least an 85 percent success rate. The skill of a root canal specialist (endodontist) decreases the risk of root canal failure. The specialist has the latest technology and understands which techniques work best, even in complex cases. Afterward, your dentist will protect your tooth with a custom dental crown.

We recommend treating the infection promptly. If you are uncomfortable with your dentist’s and endodontist’s recommendations, you can see another dentist or specialist for a third opinion.

Dr. Miranda Lacy, a Plano, Texas dentist, sponsors this post.

Porcelain Veneers

Will Root Canal Treatment Ruin a Porcelain Veneer?

I have eight porcelain veneers on my upper front teeth. After seeing an ENT for what I thought was a sinus infection, my dentist found the problem. I have a periapical abscess. My dentist referred me to an endodontist for a root canal, but I’m concerned because the abscess is between my right lateral incisor and the tooth behind it. Will I need a new veneer for the tooth with an abscess? Thanks. Abbie from Arlington, VA

Abbie,

Without root canal treatment, the infection can spread deep into your jawbone. However, it is uncommon to have an infection in a porcelain veneer tooth.

Will Root Canal Treatment Ruin a Porcelain Veneer?

If your dentist placed and bonded your porcelain veneers well, you should not lose them during root canal treatment. The endodontist can access the infection without damaging the veneer. You can ask the endodontist about the procedure and how he will avoid damaging your veneers.

Why Might a Porcelain Veneer Tooth Need a Root Canal?

Aggressively preparing a tooth for porcelain veneers increases the risk of stress and infection that requires root canal treatment. We hope that over-preparation of your teeth for veneers is not the cause of your tooth infection. However, we won’t linger on what may be the cause of the infection because you need root canal treatment.

A tooth turns dark after a root canal procedure because a dentist replaces the tooth pulp with root canal filler material after removing the infection. The material and cement left in the tooth make it look darker.

Ask your dentist to clean the filler material and cement from the portion of your tooth above the gumline. After removing the material, your dentist can place a fiberglass post into the tooth root and fill the space with a tooth-colored composite. This intervention can help your teeth retain its color for five to ten years.

Dr. Miranda Lacy, a Plano, Texas dentist, sponsors this post. Dr. Lacy makes treatment affordable through payment plans and offering treatment alternatives when appropriate.