Is Tooth Extraction Necessary After Failed Root Canal Treatment?

Q: Is Tooth Extraction Necessary After Failed Root Canal Treatment?

Hello： If there is a risk of infection in that tooth, which could potentially lead to sinusitis, it is advisable to have it extracted. <br>If the tooth no longer has any functional occlusion and you are facing financial difficulties, you may consider postponing the placement of d

It seems that the second root canal treatment has failed. Should I consider tooth extraction?

I would like to ask about my upper right second molar, which has undergone root canal treatment twice.
The dentist filled it with resin or a filling material after the root canal, but I have experienced discomfort intermittently since then.
When I visited the dentist again, they cleaned the root canal and mentioned that this tooth is difficult to clean, advising me to maintain good oral hygiene.
They also suggested that if the discomfort persists, extraction might be necessary.
Recently, while using dental floss, I noticed that only this tooth, which has undergone root canal treatment, bleeds and feels uncomfortable.
This tooth is misaligned and does not occlude with the opposing tooth at all.
I would like to know if I need to consider dental implants if I extract this non-occluding tooth, as my financial situation is not very good.
Thank you!

Cai, 20~29 year old female. Ask Date: 2021/06/10

Dr. Lin Jiayong reply Dentistry

Hello: If there is a risk of infection in that tooth, which could potentially lead to sinusitis, it is advisable to have it extracted.
If the tooth no longer has any functional occlusion and you are facing financial difficulties, you may consider postponing the placement of dentures or implants.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/06/10

More Info

Tooth extraction after a failed root canal treatment is a complex decision that depends on several factors, including the condition of the tooth, the surrounding tissues, and your overall oral health. In your case, it seems that you have undergone root canal treatment twice on your upper right second molar, and you are experiencing discomfort and bleeding when using dental floss. This situation raises important considerations regarding the necessity of extraction and the potential need for dental implants.

Firstly, it's essential to understand that root canal treatment aims to remove infected or damaged pulp tissue from inside the tooth and seal it to prevent further infection. However, in some cases, the treatment may not be entirely successful, leading to persistent symptoms such as pain, discomfort, or bleeding. If your dentist has indicated that the tooth is difficult to clean and has suggested extraction if discomfort continues, it may be a sign that the tooth is not responding well to treatment.

The bleeding you experience when using dental floss could indicate that there is still inflammation or infection present in the area surrounding the tooth. This situation can complicate the healing process and may necessitate further intervention. If the tooth is not restorable or if it continues to cause problems, extraction may indeed be the best course of action.

Regarding your question about whether you would need an implant after extraction, it is important to consider the role of the tooth in your bite and overall dental function. If the extracted tooth is not a functional part of your bite (as you mentioned it does not contact the opposing tooth), you might choose to forgo an implant, especially if financial constraints are a concern. However, keep in mind that missing teeth can lead to other dental issues, such as shifting of adjacent teeth, changes in bite alignment, and potential jawbone loss over time.

If you decide to extract the tooth, here are some options to consider:
1. Immediate Implant Placement: If you have sufficient bone density and health, your dentist may suggest placing an implant immediately after extraction. This can help preserve the bone structure and maintain the space for future dental work.

2. Bone Grafting: If there is significant bone loss, your dentist may recommend a bone graft to build up the area before placing an implant later.

3. Partial Dentures: If an implant is not feasible, a removable partial denture could be an option to fill the gap left by the extracted tooth.

4. Monitoring: If you choose not to replace the tooth, regular dental check-ups will be crucial to monitor your oral health and address any potential issues that may arise from the missing tooth.

In conclusion, the decision to extract the tooth should be made in consultation with your dentist, who can assess the specific condition of your tooth and surrounding tissues. If you feel uncertain about your dentist's recommendations or want a second opinion, it is perfectly reasonable to seek another dental professional's evaluation. They can provide additional insights and help you weigh the pros and cons of extraction versus retention of the tooth. Ultimately, your comfort, health, and financial situation should guide your decision-making process.

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