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Question

I had root canal done on one of my lower front teeth about 20 years ago.  However, on and off I have been  feeling some dull pain in and around that tooth.  As I can recall, two general dentists looked at it, but they could not explain the pain since the X-ray appeared normal.  Now, since last Friday, I have noticed the the pain is definitely increasing. I have also noticed that when I apply pressure on the tooth or at the gum line, I don't feel any difference, but when I apply pressure on the gum about 5-6mm below the gum line I notice an increase in pain.  

Can you tell me what might be going on and causing a pain?
Can root canal fail after many years?
What specialist should I seek to have the treatment? I am afraid that if I go a general dentist, he/she may not be able to treat.

Answer
Hi Bob,
Good questions.  The symptoms you describe indicate that there may be an endodontic problem with one of you lower front teeth.  Those teeth are particular small and the roots are very close, so it may not necessarily be the tooth that had the previous root canal.

To answer your questions:
1.)  The pain is caused by some degree of inflammation around the base of the tooth (5-6 mm below the gum line), which is indicative of root canal pathology.
2.)  Root canals do at times require retreatment.  Often if the permanent restoration (filling or crown) leaks then the root canal space will get reinfected.  However, the success rate of root canal treatment is about 94%.
3).  You should see an endodontist (root canal specialists).  You can ask your general dentist for a referral or use the website www.rootcanalspecialists.org to find one and learn more about root canals.  The endodontist will be able to evaluate the past root canal, make sure it's not another tooth or multiple teeth, and treat accordingly.

Best of Luck,
Ketan Amin, DMD
Austin Center for Endodontics (Root Canal Specialists)
Austin Center for Endodontics

Dentistry

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Ketan Amin, DMD

Expertise

Graduating from Harvard School of Dental Medicine, I received a broad understanding of both medicine and dentistry. I continued my training at New York University, as a dental specialist in endodontics, which concerns root canal therapy, related surgeries, as well as diagnosing and managing various forms of pain occurring in the head and neck

Experience

Dentistry; Specialist in Endodontics (Root Canal Therapy).

Organizations
American Association of Endodontics American Dental Association American Academy of OroFacial Pain

Education/Credentials
Harvard School of Dental Medicine-Doctorate in Dental Medicine (DMD) New York University College of Dentistry-Certificate, Endodontics

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