AboutGary Backlund, DMD, MSD Expertise I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.
Experience 25 years practicing as a specialist
Organizations American Association of Endodonists, Past President Washington State Association of Endodontists.
Question QUESTION: Hi Dr. Backlund, I'm wondering for people who need root canals because they have an infection going on around the bone area, after the root canal, is it guaranteed that the bone on the infection will go away?
Are there cases where the root canal is done beautifully, but the infection is still in the bone?
And also, if the dentist or endodontist see on the x-ray that the root canal is done beautifully, is retreatment usuaully recommend anyway if symptoms persist, such as pain or swelling?
ANSWER: Hi Jane,
Unfortunately, when you are dealing with the human body, nothing is 100%. While root canals have a very high success rate, actually they have a higher success rate than a silver filling in terms of percentages, about 2-3% fail for no reason that dentists can discover.
When a situation like this happens, the treatment depends on the "suspected" cause. If we have done the root canal and can't see a reason why there is a problem, we would probably not do a retreatment. We would most likely move right to a surgical option. In some cases, no matter what we do, we can't resolve the problem and the tooth needs to be removed. This is a VERY infrequent occurrence, but it does happen.
I hope this answers your question.
Gary Backlund DMD, MSD
---------- FOLLOW-UP ----------
QUESTION: So, let's say if the dentist see that everything is alright on the x-ray. X-ray can determine if the root canal is done properly, correct? I want to make sure that is true.
So, if done correctly as seen on x-ray, but symptoms persist, then retreatment is not needed, but then the next move would not be reteatment but moving on to the apicicoetemy (sp?) right? i want to make sure I got that correct.
So, are you saying that even if root canal is done successfully, the infection on the bone can still cause pain and can still be there on the bone?
And after the root canal if infection is still there, and if the patient has the option to go for stronger antibiotics, is that recommended?
Answer Hi again Jane,
X-rays do not tell the whole story. They are a 2 dimensional picture of a 3 dimensional root, so even if it looks OK on an Xray, that doesn't mean it is.
What I said was if WE did the root canal, we would not retreat. If a general dentist had done it, we MIGHT retreat, depending on what we saw on the Xray and the symptoms the patient presents. We feel very good about our quality and are less likely to redo something done as well as we could the first time.
Pain is an indication that something is wrong. It is impossible to have a successful root canal and still have pain unless that pain is coming from something else, like gum problems, but then that isn't the fault of the root canal.
As for antibiotics, it depends on how recent the root canal was done. If it was last week, then antibiotics might be reasonable. If it was last month, there are problems.
What you really need is a good diagnosis of your problem. Obviously I can't do that. If you haven't seen an endodontist, I would suggest that you see one for a 2nd opinion. Once you know what the problem is, you will have some options. Right now, everyone is only guessing.....including me.
