Incomplete Root Canal Treatment: What to Do Next?

The nerve conduction study was not clean?

Hello Dr.
Tsai,
I apologize for bothering you, but I would like to ask you about my upper left third molar.
I had a root canal treatment done in April and received a crown, and everything went smoothly (as I had previously had my upper left second molar treated at the same clinic).
However, on May 22, a colleague referred me to another clinic for a dental cleaning, where the dentist's technique was even better.
After the cleaning, I felt really good, but in June, I started to feel some sensitivity in the upper left third molar, especially when eating hot pot; it felt uncomfortable! Since I had already undergone root canal treatment, I was surprised to experience sensitivity.
I went to the new clinic for an examination, and the X-ray showed that the upper left third molar had some residual nerve tissue, but it was not to the extent that a retreatment was necessary.
I would like to ask you, Dr.
Tsai, would you recommend retreatment for the upper left third molar, or should I just pay attention to my diet? Thank you!

Miss Su, 30~39 year old female. Ask Date: 2018/06/25

Dr. Cai Shangwu reply Dentistry

Hello,
1.
Currently, you can search for relevant medical information online by entering keywords.
(Our dental department does not provide online information services at this time.)
2.
However, regarding the issue you mentioned, without a visual examination, it may be flawed to judge solely based on the literal meaning of the words.
Therefore, I recommend that you visit the outpatient clinic for an in-person examination and diagnosis to obtain a clearer and more accurate response.

Reply Date: 2018/06/25

More Info

When it comes to incomplete root canal treatment, especially in cases where there is lingering sensitivity or pain after the procedure, it is essential to understand the underlying issues and the potential next steps. Based on your description, it seems that you have undergone root canal treatment on your upper left third molar (tooth), and while the initial treatment appeared successful, you are now experiencing discomfort, particularly when consuming hot foods.

Understanding the Situation
1. Incomplete Cleaning: The X-ray results indicating that the nerve was not entirely cleaned out suggest that there may still be some infected tissue or debris within the root canal system. This can lead to ongoing sensitivity or pain, especially when exposed to temperature changes.

2. Post-Treatment Sensitivity: It is not uncommon for teeth that have undergone root canal treatment to experience some degree of sensitivity, particularly to hot or cold stimuli. This can be due to several factors, including inflammation of the surrounding tissues, incomplete cleaning of the canal, or even the presence of a crack in the tooth.

3. Possible Need for Retreatment: If the discomfort persists, it may be necessary to consider retreatment. This involves reopening the tooth, cleaning out the remaining infected tissue, and properly sealing the canal. The success rate for retreatment is generally favorable, especially if the initial treatment was performed correctly but left some issues unresolved.

Next Steps
1. Consultation with Your Dentist: It is crucial to have a thorough discussion with your dentist about your symptoms. They may recommend further imaging or a clinical examination to assess the situation more closely.

2. Consider Retreatment: If your dentist confirms that there is still infected tissue or if they suspect that the canal was not adequately cleaned, they may suggest retreatment. This process can help alleviate your symptoms and prevent further complications.

3. Monitor Your Symptoms: In the meantime, keep track of your symptoms. If the pain worsens or if you experience swelling, it is essential to seek dental care promptly.

4. Dietary Adjustments: While waiting for further treatment, you might consider avoiding extremely hot or cold foods that could exacerbate your sensitivity. Soft foods that do not require much chewing can also help minimize discomfort.

5. Pain Management: If you are experiencing significant discomfort, over-the-counter pain relievers may provide temporary relief. However, it is important to consult your dentist before relying on pain medication for an extended period.

Conclusion
In summary, while it is possible that your tooth may require retreatment due to incomplete cleaning during the initial root canal procedure, it is essential to work closely with your dentist to determine the best course of action. They will be able to provide tailored advice based on your specific situation and ensure that your tooth is treated effectively to prevent further complications. Remember, addressing these issues sooner rather than later can lead to better outcomes and a healthier smile in the long run.

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