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Dental and Oral Health (Adults)

Root Canal 10 Years Ago, Pain Resumes

04/27/2006

Question:

I`m 36. At 11 I chipped my left front tooth and it was fixed. The tooth abscessed at 18, I took antibiotics, there was no more abscess, but I didn`t get my root canal. At 24, problems again. I had a root canal completed and repalced the chip with a clean fix.

Now, 12 years later, my gum has minor swelling and feels as if it has abscessed again and is tender to the touch with low grade pain, manageable by ibuprofen.

Question: Will another root canal fix the problem or will they need to replace the tooth this time? It has not started to look dead (grey color, etc) and it feels secure. I`ve not consulted a dentist yet, but was wanting to know the normal procedure so as to know and be able to judge the dentist`s diagnosis and remedy. I really want to keep the tooth.

Answer:

I would suggest you start with your general dentist. He or she may want to x-ray your tooth, check your bite and gums to be sure that the tooth is not fractured (cracked through the root) and that the gums are strong. It is possible that the root has fractured or periodontal disease has caused bone loss around the tooth.

If the tooth and gums are weak, the general dentist might treat your gums or refer you to a gum specialist (Periodontist). If the tooth has not already been capped (crowned), your dentist may reccommend it.

It is also possible that the root canal might be retreated, if needed, by the general dentist or a root canal specialist (Endodontist). There is a chance that the filling placed after the root canal has leaked. This could be due to recurrent decay or natural wear over ten years. Once a filling leaks in a tooth with a root canal, it does not take long for the bacteria in the oral cavity to find their way to the tip of the root of the tooth. When this happens, a re-treatment of the root canal is necessary and should solve the problem unless the filling would leak again. You did not state whether you get regular six month check-ups at the dentist's office. This would preclude further problems with decay or leakage as the filling can be replaced if it starts to break down.

The best thing to do is go to the dentist and have an x-ray taken. This will aid the dentist in determining the cause. If the tooth cannot be saved, your dentist might suggest removal and replacement with a bridge or possibly an implant.

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Response by:

David Lee Hall, DDS David Lee Hall, DDS
Clinical Associate Professor of Primary Care
College of Dentistry
The Ohio State University

D Stanley Sharples, DDS
Clinical Assistant Professor of Primary Care Dentistry
College of Dentistry
The Ohio State University