AboutHoward Finnk, D.D.S. Expertise I am a Family and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Society, Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Academy of General Dentistry, Vedder Honors Society, Broward Dental Research Clinic, Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.
Experience After having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. In addition, I am now a member of the Florida Dental Association, Broward County Dental Association, and the Atlantic Coast District Dental Society. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center. Over my lifetime career, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.
I am wondering, how does a dentist know if a root canal is failing or not? Does x-raying the tooth show if the root canal is properly filled up or not? Can it also show if it is successful? What if the patient still has symptoms such as pain, and such? Is that an indication a root canal is failing?
Secondly, I want to ask, if a root canal was successful, whatever infection that was on the bone prior to the root canal, will heal and go away, correct? So there shouldn't be any reason why the infection would still be there if the root canal was successful?
Now, what is this concept about, is it one of those deals where even if the dentist gives the tooth their best effort, the root canal can still fail? How can that happen, because I thought if the dentist did it correctly, it should have no reason to fail.
Thanks, hear from you soon.
Answer Dear d: A tooth with a root canal should experience no pain and no swelling around it. On xray, a failed root canal might have dark areas surrounding the ends of the roots, or a dark area between the roots. This indicates probable infection in the bone surrounding the roots, likely originating from the failed root canal.
Following a successful root canal, the infection in the bone should go away, having been worked on by your immune components and bone-forming cells. Dark areas in the bone should disappear over a period of several months, showing that new bone has been created where once bone was lost to infection.
Sometimes the canals are so complex, having accessory areas that are neither visible nor accessible to the dentist, that by the fact that the dentist cannot clean and shape them, they continue to house infection that feeds into the bone. Example: The managing partner of our Dental Centers (a dentist; let's call him M) had a root canal done several years ago by the founding chairman of the Endodontics Department at a nearby University Department of Dentistry. A widely respected, smart and very effective endodontist. The root canal result was excellent, visibly and radiographically, and the tooth was fine for several years, after which M began to experience pain and swelling from the same tooth. He went back to the same endodontist, now retired from his chairmanship and in private practice. The endodontist remade the root canal, and M was fine for about one year, after which the booth became sore and infected once again. I had the good fortune to extract this tooth, and upon viewing it outside the mouth, under magnification, with good lighting, we discovered a very small accessory canal running from the nerve chamber, straight down into the furcation (separation) between the roots. This was not visible on xray, nor was it visible to the endodontist either time, even when using a 10-power endodontic microscope while doing the second procedure. I think this example may be the best explanation of how a root canal, provided under the best of circumstances, twice, can still fail. dd
