Prof Dr Christian Mehl
Root canal treatments are usually successful for our valued patients but be aware that statistically-speaking, in at least 10% of cases, the inflammation can flare up again after the procedure. Let us explore the reasons why this can happen, which treatment options are possible should this occur and just how we can increase the original chances of success.
Why do some Root Canal Treatments fail?
As dentists, we consider that a Root Canal Treatment is deemed as a success when the pain or inflammation has subsided and the healing of the tooth infection can be verified with an X-ray. Quite simply, if one of these two requirements is not met or if root resorption has taken place, then the Root Canal Treatment is deemed to be unsuccessful.
Rest assured that due to the highest standards of meticulous preparation we conduct pre-treatment including the precise measurement of the root canals affected plus a thorough cleaning during the procedure; pain after a Root Canal Treatment can be minimised effectively.
Should the dentist overlook fine root canals or if bacteria remain inside the tooth for other reasons; pain may re-occur post-procedure. This level of pain can continue for several weeks depending on the circumstances of the individual patient case. Please also realise that the renewed inflammation in the affected root canal can spread without symptoms. Should this arise, the issue is usually discovered by a member of your expert dental team during a routine examination or when an X-ray of the oral cavity is taken for other reasons.
When a tooth nerve dies due to trauma (decay, impact, grinding, etc.), inflammation occurs at the root tip of the tooth, which can have an impact on overall health. It is then important to clean the tooth and disinfect the root canals all the way to the tip. Here you can see a four-canal lower posterior tooth with cleaned canals.
The cleaned canals are sealed with a cement and rubber-like pins.
The tooth is then given a filling to stabilise it again. To achieve long-term stability, restoring the tooth with an all-ceramic partial crown or crown is suitable.
Here is the exemplary X-ray image of a root canal-filled tooth. The rubber tips ideally reach the end of the tooth root.
What is a Revision or a Retreatment?
Your dentist will now seek the optimal way to remedy the resulting inflammation present in the affected area plus eliminate the current level of suppuration (the discharge of pus) spreading from the tip of the tooth root – both common issues arising after an unsuccessful Root Canal Treatment. It is particularly vital to address the pus discharge to prevent it developing inside the bone and so causing further damage. In such a situation timing is everything – the faster the procedure takes place the easier it is to deliver the necessary treatment. This is called a Root Canal Revision or a Retreatment.
During this procedure, your dentist removes the problematic root filling, rinses and disinfects the inside of the tooth from bacteria and introduces a new filling to the affected site. The success of the treatment is around 60 – 80% depending on the initial situation as presented in the individual patient case.
If the Revision is also deemed to have been unsuccessful, then you may be considered for an Apicectomy (a minor dental surgery) which can be performed if recommended as the next necessary step for you, regarding your root canal. An apicectomy is sometimes called a ‘root end surgery’ and involves the surgical removal of an anatomical apex (the end of the root of the tooth) and any diseased tissue surrounding it.
If, when the affected tooth is evaluated it is viewed as unsustainable, then a tooth restoration utilising a dental implant or a dental bridge is the better option for you to consider, should this particular situation arise for you. Consult your dentist at your booked appointment to recommend which procedure will be the most successful choice for you to proceed with in your own individual case and as presented, in clinic.
Clinical factors which can increase the success of a Root Canal Treatment
As dentists we fully appreciate that the presentation of some Root Canal Treatments are more straightforward to perform and yet some are more complex, too. Example complexities include the discovery of exceptionally fine or curved root canals which must be treated in order to achieve optimal clinical results. A Root Canal Revision is also a challenging procedure to undertake. The chances of success of the treatment are higher if the Endodontist is highly skilled and experienced and can work without time pressure.
Additionally, the equipment supporting your dentist in this type of minor dental surgery is also a particularly important clinical factor. Practices such as Wimpole Street Dental Clinic, who specialise in Endodontics have, for example, an operating microscope and a three-dimensional X-ray machine for 3-D imaging; enabling us to conduct the meticulous preparation seen as an essential pre-requisite to delivering the highest standards of modern dentistry, prior to scheduling this procedure.
Should you have any concerns regarding your forthcoming Root Canal Treatment or even about how best to care for yourself and your teeth post-procedure, contact us for the best professional advice, today.
|Root canal treatment fees|
|Emergency root canal treatment||£250|
|Front tooth retreatment||from £800|
|Premolar retreatment||from £1,100|
|Molar retreatment||from £1,400|
Are you ready to restore your smile?
We know that no patient looks forward to root canal treatment, so our dental team always work hard to deliver the highest quality care.
Treatment for root canal differs in cost from £95 up to £1,400. Costs depend on patient circumstances and oral health. Every one of our patients receives a bespoke personal treatment plan from our specialist team.