• Dental Phobia Support

    Welcome! This is an online support group for anyone who is very afraid of dentistry or who suffers with dental phobia. Please note that this is NOT a dental problems forum! You can find a list of them here.

    Register now to access all the features of the forum.

Root canals just don’t work

P

Pearly77

Member
Joined
Feb 5, 2020
Messages
49
Location
Virginia
Is this possible? Dentists, have you ever had a patient that they didn’t work on?

I have had two root canals in the past — both on teeth that were never infected but had old fillings too close to the nerve. Upper left—premolar and canine. Both root canals never settled and ended up needing apico s.

Last week I had a new crown placed on my #30. It doesn’t seem to be settling and Im worried it’s heading into that root canal territory. But I’m also terrified that it’ll be another situation when the root canal just won’t work.

Am i crazy? Or is this a real possibility?
 
Gordon

Gordon

Administrator
Staff member
Verified dentist
Joined
Oct 25, 2005
Messages
7,986
This is going to be a long answer, just what I need on a Saturday morning :)

A root canal is always a slight compromise, it's completely impossible to remove all of any infected material from every single root canal, some canals have little accessory branches from them and others have tight kinks and curves in them which our files and chemicals simply can't access.

Other canals have a sort of delta at the apex rather than a single large (relatively!) opening where the pulp enters.
Even with the best technique there are always going to be a few small amounts of bacteria able to colonise these areas.
There is also the question of the seal at the mouth end of the canal, a slightly compromised final restoration of the tooth can allow new bacteria into the canals and away it all goes again :(

HOWEVER, the idea behind root treatment is to reduce the bacterial load to such an extent that the host's own defences can mop up any bacteria which get out into the space between the tooth and the bone.
There are 2 things which can mess this up, 1; if the bacteria are particularly aggressive and reproduce quickly enough to overcome the host response and 2; if the host response is a bit compromised so the bacteria don't get killed off quickly enough. Or more likely a mixture of the two.

So that's a long way of saying that you're not crazy, but you also can't assume that every single root canal on all your teeth will be the same :)
 
Enarete

Enarete

Super Moderator
Staff member
Joined
Sep 18, 2017
Messages
3,255
What a great explanation, @Gordon, thank you! :respect:
 
Lioness

Lioness

Member
Joined
Jul 10, 2016
Messages
47
Location
Poland
There are 2 things which can mess this up, 1; if the bacteria are particularly aggressive and reproduce quickly enough to overcome the host response and 2; if the host response is a bit compromised so the bacteria don't get killed off quickly enough. Or more likely a mixture of the two.

And @Gordon - if I've understood you correctly - can those two facts cause that also my tooth still hurts (sometimes stronger, sometimes weaker) after almost 5 years after root canal treatment?
And it also hurts stronger recently when I lie down or when I change my position from sedentary to recumbent...
Or maybe can it be just because of the changes of the weather? I suppose my tooth after root canal reacts to each of them... :(
 
Gordon

Gordon

Administrator
Staff member
Verified dentist
Joined
Oct 25, 2005
Messages
7,986
Thanks for the kind words.
@Lioness, yes that would explain it, it's a balancing act, so if something throws the balance off, it can cause symptoms to appear. I'm not sure that changes of the weather has much effect :)
 
Lioness

Lioness

Member
Joined
Jul 10, 2016
Messages
47
Location
Poland
Hmm... I'm not sure what to do if the tooth will be still quite painful in the future... Have it taken out...?:unsure:
 
Gordon

Gordon

Administrator
Staff member
Verified dentist
Joined
Oct 25, 2005
Messages
7,986
Seems a bit drastic if it's been going for 5 years already?
 
S

Sarah77

Junior member
Joined
Jun 18, 2020
Messages
15
Location
Us
Gordon, probably a silly question but is there anything a person can do to help their body accept a root canal — better their bodies response?
 
Lioness

Lioness

Member
Joined
Jul 10, 2016
Messages
47
Location
Poland
Seems a bit drastic if it's been going for 5 years already?

Yes, but... What else can you do? I'm more and more tired with quite often twinges or - sometimes - pain...
 
Gordon

Gordon

Administrator
Staff member
Verified dentist
Joined
Oct 25, 2005
Messages
7,986
Gordon, probably a silly question but is there anything a person can do to help their body accept a root canal — better their bodies response?
Nothing specifically, don't believe all the "woo" out there about boosting the immune response :) Obviously, eating a reasonably balanced diet and keeping as healthy as possible is likely to help a bit.

Lioness, need to see some x-rays, it might be that re-doing the root canal would help. Which tooth is it?
 
Lioness

Lioness

Member
Joined
Jul 10, 2016
Messages
47
Location
Poland
It's number 7, bottom, on the right side of my mouth. OK, maybe I will have an OPG taken in some time. I suppose that having an X-ray taken with my gag reflex would be very problematic...
Besides, I guess, the OPG would be more exact and useful - it's the whole mouth shown at once, isn't it? It is also the same as panoramic radiograph, am I right?

Well, we'll see what will be... Anyway, thank you a lot for your interest and time, @Gordon.
 
A

Acheygirl

Member
Joined
Jan 20, 2020
Messages
92
Location
USA
Thank you for asking this question and Dr. Gordon you are amazing for answering. Pearly77, I had a premolar as well and that has given me tons of trouble. The only time in my life I have experienced unresolved dental pain is with root canals. I had one 16 years ago and it took some time to settle. I swore I would never get one again then in 2019 I had another. That did not do well, then the one next to it, that seems not to have done well. All done by an expert in the field. Very skill Endo.

I'm healthy, fit and in good shape all round. Could some of us have strange curvy complex root systems and that is why some of us are root canal failures? I can see one failing but having issues with many does not make sense.
 
Gordon

Gordon

Administrator
Staff member
Verified dentist
Joined
Oct 25, 2005
Messages
7,986
It's number 7, bottom, on the right side of my mouth. OK, maybe I will have an OPG taken in some time. I suppose that having an X-ray taken with my gag reflex would be very problematic...
Besides, I guess, the OPG would be more exact and useful - it's the whole mouth shown at once, isn't it? It is also the same as panoramic radiograph, am I right?

OPG is handy for a quick snapshot of the mouth but less useful for precise stuff like checking on a root canal, but if it's all you can manage then it's better than nothing.
 
Gordon

Gordon

Administrator
Staff member
Verified dentist
Joined
Oct 25, 2005
Messages
7,986
I'm healthy, fit and in good shape all round. Could some of us have strange curvy complex root systems and that is why some of us are root canal failures? I can see one failing but having issues with many does not make sense.

Absolutely some people have strange root canal systems, I think I wrote that already? The statistics are based on pretty wide experience, it's only very small numbers that seem to fail, but like everything else biological there's a wide variation. I've seen x-rays that look pretty rubbish (especially if I've done the RCT!) but the teeth are fine and others where the x-ray looks perfect but the tooth never settles.
 
Top