Can a Tooth with Years of Root Canal Treatment Be Saved?

Q: Can a Tooth with Years of Root Canal Treatment Be Saved?

Dear Ms. <br>Anonymous： Hello! If there is a shadow on the tooth root, treatment is necessary! If you suspect a tooth fracture, a CT scan can confirm it! Otherwise, you can place a crown for protection and observation! Take care! Wishing you peace and success! Sincerely, Dr. <br>

Is it possible to save a tooth that has had a root canal for many years but is now experiencing biting pain?

Hello, Doctor.
I have some questions I would like to ask you.
My upper left molar had a root canal treatment several years ago due to deep decay.
The dentist who performed the procedure mentioned that my dental nerve was the thinnest and longest she had ever seen in her career, making it very difficult to extract, so it took multiple attempts to clean and fill it.
After that, I unfortunately forgot to get a crown to protect it.
Three years ago, one day, that tooth suddenly started to hurt severely when biting down, but the dentist who performed the root canal was no longer at the clinic, so I had to switch to another dentist.
When I finally managed to see the new dentist after two or three days, the pain had subsided.
After reviewing the history of that tooth, the new dentist took X-rays and conducted an initial examination.
He diagnosed that the root canal was done quite reluctantly, but he believed the previous dentist did a good job technically and cleaned the nerve thoroughly.
However, he noticed a dark shadow at the tip of the root on the X-ray, which he suspected might be an apical cyst.
Since I was not in pain at that time, he suggested monitoring it, and it has now been two years.

During these two years, I have noticed some issues.
First, whenever my depression worsens or I experience significant work-related stress that affects my sleep, that tooth feels "floaty," almost like it has a pulse.
If I try to bite down hard on it, I experience a dull pain, but I do not feel pain when eating.
Additionally, due to my depression, I often have headaches or unconsciously clench my jaw, making it difficult to distinguish whether my head or tooth is hurting.
I frequently feel pain in the area where my upper teeth connect to my ears, which has led me to return to the clinic multiple times for check-ups, but the dentists have consistently said there was no issue.
So, I only received cleanings without any other treatments.

Just the day before yesterday, I returned to the clinic for a cleaning and examination.
The dentist mentioned that since I had been monitored for two years without any pain, I could get a crown to protect that tooth.
However, since that cleaning, I have started to feel that "floaty" sensation again, and when I try to bite down in certain areas, I experience dull pain, although it does not affect my ability to eat.
I just feel something is off, and my cheek feels sore.
I am a bit concerned that there might be a crack in the tooth, but the dentist took full-mouth X-rays that day and said the X-rays looked good.
Therefore, the appointment ended with just a cleaning.

I would like to ask if there is indeed a crack, can a crown be placed directly on it? If the issue is due to an apical cyst causing the floaty sensation, would that mean the tooth would need to be extracted? The dentist mentioned that if this tooth is extracted, I would only have the option of an implant, so I hope to preserve it if possible.
I appreciate your help in clarifying my concerns.
Thank you very much!

Niming, 20~29 year old female. Ask Date: 2020/04/29

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Anonymous: Hello! If there is a shadow on the tooth root, treatment is necessary! If you suspect a tooth fracture, a CT scan can confirm it! Otherwise, you can place a crown for protection and observation! Take care! Wishing you peace and success! Sincerely, Dr.
Huang Ting-Fang, Dentistry.

Reply Date: 2020/04/29

More Info

When it comes to the longevity and potential for saving a tooth that has undergone root canal treatment, several factors must be considered. Your situation, involving a tooth that has been treated years ago and is now presenting with symptoms such as a "floating" sensation and occasional dull pain, raises important questions about the health of the tooth and its surrounding structures.

Firstly, it is crucial to understand that root canal treatment aims to remove infected or damaged pulp from the tooth, sealing it to prevent further infection. However, the success of this treatment can be influenced by various factors, including the quality of the initial treatment, the tooth's structural integrity, and any subsequent complications such as the development of a periapical abscess (root tip cyst) or tooth fracture.

In your case, the presence of a "black shadow" at the root tip on X-rays suggests a possible periapical lesion, which could indicate ongoing infection or inflammation. While the absence of pain is a positive sign, the symptoms you describe—especially the "floating" sensation and discomfort when biting—could suggest that there is still some underlying issue that needs to be addressed.

If there is a fracture in the tooth, it can complicate the situation significantly. A cracked tooth can lead to further infection and may compromise the tooth's ability to function properly. If the fracture is extensive, it may necessitate extraction. However, if the fracture is minor and the tooth is otherwise healthy, a dental crown can often be placed to protect the tooth and restore its function.

Regarding your concerns about a potential root cyst, if this is confirmed, treatment options may vary. In some cases, a retreatment of the root canal may be possible, or an apicoectomy (surgical removal of the root tip) might be indicated. These procedures aim to remove the infected tissue while preserving the tooth. However, if the tooth is deemed non-restorable due to extensive damage or infection, extraction may be the only viable option.

Your dentist's recommendation to place a crown on the tooth is a common approach to protect a tooth that has undergone root canal treatment, especially if there are no significant signs of fracture or infection at the time of evaluation. However, if you continue to experience discomfort or unusual sensations, it is essential to communicate this with your dentist. They may need to conduct further diagnostic tests, such as additional X-rays or even a 3D cone beam CT scan, to assess the tooth's condition more accurately.

In summary, while it is possible to save a tooth that has undergone root canal treatment, the success largely depends on the tooth's current condition and any underlying issues. If there are signs of fracture or persistent infection, the prognosis may not be favorable. It is crucial to maintain open communication with your dental care provider, seek second opinions if necessary, and ensure that any treatment plan aligns with your desire to preserve your natural tooth as much as possible. Regular follow-ups and monitoring will also be key in managing your dental health moving forward.

Similar Q&A

Can a Root Canal Tooth Remain Untreated for 8 Years? Risks Explained

Doctor: Hello! I had a root canal treatment on my lower last tooth 8 years ago. After the nerve was removed, there was some pain for about six months due to drilling into the gum. I temporarily filled it in because I went abroad and did not get a prosthetic tooth. Can a tooth tha...

Dr. Wu Jinjun reply Dentistry
Hello: Teeth that have undergone root canal treatment can become brittle and are more prone to fracture under biting forces. If a complete root canal treatment has been confirmed, it is still recommended to place a crown on the tooth. This will not cause oral cancer; however, if ...

Can I Continue Root Canal Treatment After Two Years?

Hello, doctor. I had a root canal treatment about two years ago, but I couldn't continue the treatment because I was in the military. Now that more than two years have passed, can I still continue the treatment, or is it too late? Thank you.

Dr. Lin Jiayong reply Dentistry
Hello: An X-ray can be taken for confirmation. It is not uncommon for root canal treatments to be interrupted and then redone, so there is no need to worry excessively. Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Can a Missing Resin Filling After Root Canal Treatment Be Repaired?

Hello, I had a root canal treatment on my tooth and it has been filled with resin for at least 4-5 years. A few days ago, a piece of the resin broke off while I was eating, and now there is a missing corner on the tooth. I temporarily visited a dentist I had never been to before,...

Dr. Lin Jiayong reply Dentistry
Hello: It is recommended to return to the original clinic where the root canal treatment was performed to schedule a follow-up appointment for observation and filling. If you do not remember which clinic it was, you can consult with a nearby medical center's restorative dent...

Root Canal vs. Dental Implant: Which is the Best Choice for Your Tooth?

I consulted with a dentist regarding my lower right first molar, which underwent root canal treatment over ten years ago but has not been fitted with a crown. Recently, a corner of the tooth fractured due to biting on a hard object, and the deeper fracture is nearly level with th...

Dr. Lin Jiayong reply Dentistry
Hello: Since you are 41 years old and still relatively young, you might consider completing the treatment with microscopic root canal therapy before getting a dental crown. This should last at least 10 years. If the tooth still has issues in the future, it can be extracted and re...