Theriot Family Dental

Root Canal Failure

I had a root canal treatment a couple of years ago and then the tooth flared back up. My dentist did a re-treatment and gave me penicillin and pain killer. It’s been almost two weeks and I am still in massive pain.  I called the dentist back a few days after treatment and he said some patients just take longer to heal than others. I called him back yesterday and he said to give it two weeks and then if I am still hurting we’ll do another round of antibiotics. I don’t think I can wait that long. Is this normal?

Pamela

Dear Pamela,

woman grabbing her jaw in need of an emergency dentist

I think you need to see an endodontist. I don’t think your dentist is handling this infection correctly. There are a few things going on here. First, penicillin is not a good choice for an antibiotic, especially for a root canal retreatment. There is a high resistance to penicillin in these situations. Second, your dentist should have recognized this antibiotic wasn’t working and prescribed another one. My recommendation is clindamycin, which is a good choice for dental infections.

You should be aware that when a root canal treatment fails, each retreatment has less and less of a chance of succeeding. This is another reason he should have been taking the fact that you weren’t improving more seriously.

You will likely need another retreatment if you want to try to save the tooth. Be aware that there is only about a 50% chance the next root canal will work. Going to an endodontist will give you your best chance. When you call them, let their office know what has been going on. They will get you on the right antibiotic. I don’t think you will put this off with the amount of pain you are in, but I want to make sure you know this is considered a dental emergency. They should get you in right away.

If the tooth cannot be saved. After your extraction, you will need to discuss tooth replacement options with your dentist. The best replacement will be a dental implant. Just make sure whoever does it has extensive post-doctoral training in the procedure. This isn’t something adequately taught in dental school, nor is it a specialty. If I were getting a dental implant placed, I would look for someone who is a fellow with the International Congress of Oral Implantologists. They have extensive training and a proven track record.

This blog is brought to you by  Lafayette, LA Dentist Dr. John Theriot.