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Redoing Root Canal Treatment

A root canal is a dental treatment aimed at removing infected tissue from within the inner pulp of the tooth, a procedure which is performed to prevent the spread of infection. The elimination of infection via root canal treatment is not the final choice to save a tooth, but it does remove the infected tooth root tissue effectively to restrict the development of infection.

The idea of root canal treatment may make some people feel apprehensive about the surgical nature of the treatment, pain-related stigma associated with treatment, the fear of tooth loss or the thought of tooth extraction. However, modern technologies, materials and procedures provide patients with the means to experience pain-free treatment with a quick, healthy recovery.

What causes an infection in the root canal?

Teeth are made of outer enamel and dentin layers covering an inner dental pulp, in which there are blood vessels circulating nutrients for anatomical function and nerve endings transmitting nerve signals.

An infection of the inner tooth pulp is caused by tooth decay, bacterial infection, mycosis fungal infection, poor nutrition, excess sugar and acid diet, smoking, medication and serious health conditions including diabetes.

Damage to the outer enamel and dentin layers means that infection can enter the inner tooth. Once a tooth's pulp is infected the infection can travel via the root canal system to other tooth roots and pulp inflaming oral tissue.

Who is at risk of infection?

Individuals most at risk of infection are patients with tartar and plaque build-up on their teeth and those who do not maintain good oral hygiene or visit a dentist regularly. Bacterial and fungal growth can set in when food becomes trapped between the teeth from a lack of teeth brushing and flossing. These cause the start of infection and tooth decay, which breaks down the enamel and dentin layers and infects the inner tooth pulp.

People who consume excess sugar and high acid concentrations may experience enamel erosion and damage, exposing the dental pulp to infection. Poor nutrition and smoking are also linked to tooth decay. Certain medications may also trigger bleeding gums and erosion of tooth enamel. Side-effects are often listed on medication leaflets. Those on medication and with health conditions which impact oral health should notify their dentist to ensure proper care can be put in place.

What are the symptoms?

Patients with dental pulp infection may experience incessant tooth pain and sensitivity as the oral inflammation increases. If left untreated the toothache escalates with throbbing teeth, mouth and facial aches. Along with prolonged oral pain, bleeding and swelling gums, other symptoms include receding gums, loose teeth and bad breath.

Nerve endings in the pulp may also be traumatised, resulting in neurological symptoms of migraine or severe headaches, particularly if abscesses develop. People can also experience associated symptoms such as high temperature, fever and nausea. Chronic gum disease, periodontitis and/or necrotising ulcers may also form in the mouth.

What procedures are involved in Root Canal Treatment?

An oral examination is initially carried out with diagnostic testing tools, such as X-rays, imaging and biopsy to isolate the cause of infection. The spread of dental pulp infection is tracked, so that the exact location of infected root canals can be identified. Once a patient consents to the root canal procedure a treatment date is set. The patient's teeth will first be cleaned and a local anaesthetic is given to numb the treatment area for pain-free root canal treatment.

The oral surgeon then uses a dental drill to gently access the inner tooth pulp. A dental instrument is used to carefully scrape away the infected tooth root tissue. Based on the severity of infection and treatment required, the patient may need time to recover from the initial procedure before receiving further root canal treatment.

Once the infected dental pulp and tooth root tissue are removed, a dental substance known as gutta percha is inserted into the space to secure the tooth within the jawbone and prevent the return of infection. A dental crown may then be placed over the tooth surface to solidify structure and improve dental bite function.

What will happen if dental pulp infection is left untreated?

When infection spreads through the dental pulp and root canals, the tooth structure is weakened and teeth are at higher risk of fracture. Some people experience bone or tooth loss and may require a bone graft. The infection can spread through the blood stream via the blood vessels in the dental pulp. Such infection can cause complications within the body for the autoimmune, circulatory and metabolic systems.

Physical infection may trigger high blood pressure resulting in an increased risk of stroke, heart attack and cardiac or vascular disease. Others may experience neurological conditions if the infection causes nerve damage. When infection spreads oral function, such as the ability to eat and bite, and nerve function deteriorate. The whole body is placed under pressure and weakens, leading in a rise of susceptibility to illness and disease.

Are there complications associated with Root Canal Treatment?

Although all surgical procedures may result in bleeding and bruising or other side-effects, root canal treatment is designed to remove tooth infection and is less complicated than other procedures. Oral surgeons perform the procedure with expertise gained through experience and patients have pain-free treatment options. A patient's medical history and health are always considered for risk management during the procedure.

Complications likely to arise due to ignoring dental pulp infection are far more damaging to your oral and overall health, particularly if there is damage to the immune system and neurological function. Painkillers are prescribed following the root canal procedure to ease any discomfort, with all risks and benefits discussed prior to treatment.

What alternative treatments are there?

If root canal treatment is not appropriate a dental surgeon may recommend apicectomy as a means to remove infected tooth root tissue. Tooth extraction is also a possibility but only in severely advanced cases. Dentists will try to preserve natural tooth structure where possible.

Prevention of dental pulp infection is the best alternative treatment. Eating a balanced diet with moderate sugar or acid intake, maintaining oral hygiene and attending regular dental check-ups are all vital for good dental health. You are also recommended to quit smoking if this is something you do.

How successful is Root Canal Treatment?

Root canal treatment carries a 70 to 90 percent success rate, though further infection may not be totally eliminated. Individuals are responsible for their oral health condition and need to actively engage with dentists to maintain the health of their teeth and prevent damage to the tooth structure.

Redoing Root Canal treatment

There are cases where root canal treatment is performed and re-infection sets in. In such cases carrying out the root canal procedure again may be an option, or an apicectomy may be more appropriate. Those who have received root canal treatment should regularly visit a dentist for check-ups and report any symptoms that could be an indicator of oral infection.

Baker Street

Dental Clinic

Dr Watson Chambers 102 Baker Street London, W1U 6FY

020 8563 8063

Liverpool Street

Dental Clinic

9 Artillery Lane, London E1 7LP

0207 247 7151

Earls Court

Dental Clinic

221 - 225 Old Brompton Rd, Earls Court, Kensington London SW5 0EA

020 7370 0055

Kings Cross

LDN Dental

34 Caledonian Road, London N1 9DT

0207 278 6362