Root Canal Treatment Complications: When to Seek Further Care

Q: Root Canal Treatment Complications: When to Seek Further Care

Hello： A root canal that has already been filled and shows no obvious symptoms can indeed be considered for observation only. <br>Repeated re-treatment of the root canal can lead to loss of tooth structure and affect the integrity of the tooth, potentially resulting in conditions

Root canal treatment

The apex of the first upper premolar's root has become inflamed, which has also affected the first upper molar (natural tooth).
Both teeth underwent root canal treatment, and after the procedure, crowns were placed.
However, within a month, the molar still experienced pain upon biting and tenderness.
Seeking a second opinion at another clinic, a CT scan revealed that the molar had a missed MB2 canal, which was still inflamed and encroaching upon the maxillary sinus.
The dentist utilized a microscope to locate the canal successfully.
After two cleaning sessions, the canal has not yet been filled, and the dentist suggested monitoring for a month before taking another CT scan.
The dentist informed me that they would only address the missed canal for now, as they believe the other three canals were adequately filled by the previous dentist.
However, it has been two weeks since the last cleaning, and I still feel discomfort.
I experience pain when tapping on the occlusal surface or pressing on the lingual side of the tooth (the buccal side pain I had before treatment is no longer present).
Occasionally, I feel a sensation of pressure or a foreign body.
Should I suggest that the other three canals be opened as well? Or does the dentist have a reason for not addressing them yet? Could the presence of bacteria in the other canals be causing the ongoing symptoms? Thank you for your advice!

Mr. Li, 30~39 year old female. Ask Date: 2024/05/06

Dr. Lin Jiayong reply Dentistry

Hello: A root canal that has already been filled and shows no obvious symptoms can indeed be considered for observation only.
Repeated re-treatment of the root canal can lead to loss of tooth structure and affect the integrity of the tooth, potentially resulting in conditions such as root fracture.

Reply Date: 2024/05/06

More Info

Understanding the complexities of root canal treatment and its potential complications is crucial for maintaining oral health. In your case, it appears that you have undergone root canal treatment on both your first premolar and the first molar, with subsequent complications arising from an overlooked canal in the molar tooth. This situation is not uncommon, as the anatomy of teeth can be quite complex, and sometimes additional canals, such as the MB2 canal in molars, can be missed during initial treatment.

When it comes to root canal therapy, the primary goal is to eliminate infection and preserve the tooth. However, if any part of the root canal system is left untreated, it can lead to persistent infection, which may cause pain, swelling, and further complications. The symptoms you are experiencing, such as pain when biting or pressure sensitivity, suggest that there may still be inflammation or infection present, even after the initial treatment and cleaning of the MB2 canal.

Your dentist's decision to monitor the situation after cleaning the missed canal is a reasonable approach. They may believe that the other canals are adequately treated and that the inflammation is primarily due to the previously untreated canal. However, if you continue to experience discomfort, it is essential to communicate this to your dentist. Persistent symptoms can indicate that there may be residual infection or that the other canals could also be contributing to the problem.

In terms of whether to open the other canals, this is a decision that should be made based on clinical judgment and imaging results. If the dentist believes that the previously treated canals are sealed properly and not contributing to the current symptoms, they may opt to wait. However, if there is any suspicion of infection in those canals, it would be prudent to address them sooner rather than later to prevent further complications.

It is also worth noting that the sensation of pressure or a feeling of a foreign body in the tooth can be indicative of inflammation or the body’s response to infection. This can sometimes take time to resolve, even after the offending canal has been treated. Regular follow-ups with your dentist, including imaging studies like CT scans, can help monitor the healing process and determine if further intervention is necessary.

In conclusion, it is vital to maintain open communication with your dental care provider regarding your symptoms. If your discomfort persists or worsens, do not hesitate to seek further evaluation. It may also be beneficial to consider a consultation with an endodontist, a specialist in root canal treatment, for a second opinion. They can provide additional insights into your treatment options and help ensure that all potential sources of infection are adequately addressed. Remember, timely intervention can prevent more severe complications and help preserve your dental health.

Similar Q&A

Managing Pain and Complications After Root Canal Treatment

Hello, Doctor. I would like to ask about my situation. On March 8th, I experienced acute tooth pain and went to see a dentist. The dentist took X-rays and found that my lower right molar had root inflammation due to a cavity, and recommended root canal treatment. They administere...

Dr. Zeng Guanghui reply Dentistry
It is recommended to seek immediate medical attention for a follow-up examination. Dr. Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Understanding Complications After Root Canal Treatment: Causes and Solutions

My mother underwent root canal treatment on her molar three months ago, which resulted in gum issues and facial nerve paralysis. After consulting various specialists, most attributed the symptoms to nerve damage. She is currently following the doctor's instructions for medic...

Dr. Xu Zhenglong reply Dentistry
1. If there is already an apical infection before root canal treatment, it can lead to complications such as cellulitis. Additionally, viral infections and prolonged exposure to cold air can potentially damage the facial area and even the nerves. 2. During root canal treatment,...

Understanding Complications in Root Canal Treatment: A Patient's Journey

Clinical Description: The upper canine tooth was treated with an observational dental cast restoration, which partially fell off after a year and a half. The patient presented without significant symptoms, so the dentist performed a permanent filling. However, a few days later, p...

Dr. Zhang Xiangyuan reply Dentistry
Dear online user, Based on your description, your upper canine tooth has undergone root canal treatment. During the course of the root canal treatment, a temporary filling material was used. The root canal treatment is completed in multiple appointments as determined by the den...

Understanding Root Canal Treatment Failures and Medication Blockage

Hello Doctor: About a year ago, during a routine dental check-up, it was discovered that I had a cavity in one of my teeth that could not be filled. Following the dentist's advice, I underwent root canal treatment and had a crown placed. After several treatments, the crown w...

Dr. Zeng Guanghui reply Dentistry
If, after evaluation by the physician, it is determined that the inflammatory material in the root canal cannot be removed using traditional methods, then a microsurgical procedure may be necessary to thoroughly clean the root canal. Following this, a crown can be placed to resto...