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Root Canals

Root canal failure on 3 teeth? Need advice

05/23/2007

Question:

Hi, I had root canals Dec. of 06 on teeth #12 and #13 by an endodontist on the same day. One was infected, one he said had a lesion. I also had a root canal in Jan. 07 on tooth #4 by my dentist as it had been hurting badly even after the restoration of an onlay but he said when he was doing that root canal, he saw no signs of infection while in there. He said it was probably the restoration was right up against the root causing irritation.

In Feb. 07, all permanent restoration were complete on all my teeth including crowns on tooth #12 and #13. In Feb. teeth #12, #13, and #4 the only teeth that I`ve had root canals on all started acting very slightly sensitive. By the end of Feb. all 3 root canaled teeth had a low to moderate dull ache, similar to a headache, only concentrated in the teeth. Now here in May, they are more sore rather than a dull ache. Especially tooth #13 moreso. It is slightly sore pressing on the sides of these teeth. Chewing on them is mildly sore but barely. Above teeth #13 and #14 the upper gum area is more bothersome than the actual tooth most of the time with aching, burning.

I have had these teeth checked by my endodonist and nothing shows in a x-ray, and my response to tapping showed inconclusive evidence. When tapped tooth #12 feels the worst. But on any given day, tooth #12 does not hurt at all, but #13 is most noticable.

I had it checked again this week by the endodontist and still no conclusive evidence as I said different ones hurt after 3 times of tapping. He suggested getting them pulled if they hurt bad enough without even offering a re-do or apio.

I have reason to believe, something is wrong with my bite on all 3 of these root canaled teeth and feel I am hitting on them with too much intensity and sometimes not straight on. I am seeing a tmd specialist to see if they can come up with anything on that as my dentist has tried to adjust my bite and concluded to take a wait and see approach and/or see the tmd specialist he recommended.

Anyway, my main question is I have exhausted my financial resources in getting the restorations done. If I were to see another endodonist and they gave me the chance to correct the problem, I don`t have the money to pay to re-do a root canal, then turn around pay to do an apio. if needed, then turn around and maybe need the teeth pulled anyway. I also don`t have the money to pay for restorations on pulled teeth. I don`t have the money to pay a tmd specialist for all their techniques and procedures to determine a bite issue. If I got the teeth pulled, and left them they would be noticable to others and in not being able to replace them if my other teeth shifted, all the money I spent on restorations would be all for not. I don`t know which direction to go if it turns out I need the root canals redone. I feel as though I just dumped $10,000 into an already sinking ship. Any advice? - Also, what is the likelihood that 3 root canaled teeth done in the last 6 months by 2 different people would all fail at once?

Sorry for the length. I`ve been sitting here with aching teeth for almost 4 months and no answers. I may end up having to just take a wait and see approach longer than I would have liked to.

Oh, also, if a root canal had failed and there was infection sitting in there, what is the longest it would take until it would show up on x-rays or become obvious some other way?

Sorry for the length. I don`t want to lose the teeth but can`t hardly afford to fork out money in the thousands to find the answer.

Answer:

To answer your 1st question, it would be rare for all the root canal treated teeth to "fail" at once. Having continued problems with infected teeth is not necessarily something you have to see on a radiograph. Other things can be apparent like swelling, certain types of pain, etc.

I also noticed that you described your pain in the gum area as aching and burning. Usually that type of burning pain is not related specifically to an infection in the tooth.

Your case is too complicated for me to comment on exactly what is wrong or what specifically should be done. However, I would continue to seek care and not make any decisions that you are uncomfortable with. I know you are concerned about the costs associated with getting another consult, but if you are not confident in your choices, it doesn't hurt to get a second opinion. You are assuming what would be said at another consult (retreatment, apicoectomy). Instead, this could be related to many other things such as muscular, joint, or neurologic. You need to seek care to determine the cause.

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Response by:

Melissa McCartney Drum, DDS, MS Melissa McCartney Drum, DDS, MS
Assistant Professor of Endodontics
College of Dentistry
The Ohio State University