{"id":4305,"date":"2022-04-30T22:51:10","date_gmt":"2022-04-30T22:51:10","guid":{"rendered":"https:\/\/myholisticdentist.com\/?p=4305"},"modified":"2022-09-19T20:57:38","modified_gmt":"2022-09-19T20:57:38","slug":"what-to-do-about-old-root-canal-infections-a-case-study","status":"publish","type":"post","link":"https:\/\/myholisticdentist.com\/2022\/04\/30\/what-to-do-about-old-root-canal-infections-a-case-study\/","title":{"rendered":"What To Do About Old Root Canal Infections – A Case Study"},"content":{"rendered":"

[et_pb_section fb_built=”1″ _builder_version=”4.16″ global_colors_info=”{}” da_is_popup=”off” da_exit_intent=”off” da_has_close=”on” da_alt_close=”off” da_dark_close=”off” da_not_modal=”on” da_is_singular=”off” da_with_loader=”off” da_has_shadow=”on” da_disable_devices=”off|off|off”][et_pb_row _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_padding=”0|0px|0|0px” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]I’m often asked what to do about old root canal infections.\u00a0 Should I try to save the tooth by doing a root canal, or extract the tooth and replace it with an artificial tooth?\u00a0 The short answer is, it depends on the situation and history of the tooth.\u00a0 But it also depends on the health of the bone around the tooth, as well as the overall health of the patient.\u00a0 When I have a question about the health of the patient and their ability to heal, I will usually recommend a blood test to look at the inflammatory markers: blood sugar, CRP, Vitamin D levels, etc.\u00a0 This is a good idea whenever surgery is done, especially when the bone is involved and you need good bone healing around your treatment.\u00a0 This is specifically relevant when you are doing root canals, extractions and implants.\u00a0 More on this in a future post.<\/p>\n

In the coming weeks I will be discussing different situations involving infected root canal teeth and reviewing how we handled each one.\u00a0 What will become clear is that different situations call for different solutions.\u00a0 In one scenario the patient may choose to keep the tooth by doing a root canal.\u00a0 In another situation, the patient may opt to extract the tooth and replace it with a bridge or implant.\u00a0 A third patient may choose to do nothing and monitor the tooth with ongoing support.\u00a0 When we are dealing with infected or compromised teeth, the old adage ‘One size does not fit all’ applies. \u00a0Our bodies, our teeth and every patient is indeed unique<\/p>\n

When to Extract Old Root Canal Teeth<\/h2>\n

For those of you who were told that your root canal should last a lifetime, this has not been my experience.\u00a0 The fact is root canals fail and they usually fail more often than is realized by both doctor and patient.\u00a0 How do I know this?\u00a0 Because 3-D imaging called cone beams show more infection with old root canals than has been previously known.<\/p>\n

\"Xray<\/a>This is because normal Xrays taken in dental offices don’t reveal the infection that’s sometimes there.\u00a0 After all, they are two dimensional and shot through the bone, so many times infection can go undetected, as it is hidden in the center of your jaw bone.\u00a0 Remember that during root canal treatment the nerve is removed from the tooth, so you will no longer feel that something is wrong, even if there is infection.<\/p>\n

To the right is a normal Xray of a root canal tooth.\u00a0 The bone around the tooth looks fairly normal, certainly within normal limits for a root canal tooth, as shown with the arrow.\u00a0 Most dentists would say that this tooth looks to be healthy, as there is no evidence of infection and the canals look well filled.\u00a0 If there is no pain and no clear indication of an infection on the xray, as is the case with here, most dentists would say the tooth is fine and does not need any further treatment.<\/p>\n

\"Infected<\/a>However, when we take a cone beam image, which is a three dimensional study similar to a cat scan, the true condition of this tooth is revealed.\u00a0 No longer can the infection hide because we can see deeper into the bone and with better resolution.\u00a0 The cone beam has little difficulty revealing that there is a problem.<\/p>\n

How many previously treated root canals have similar problems that are being missed with normal Xrays?\u00a0 For me as a dentist, it is frightening to contemplate.\u00a0 The good news is that advances made in cone beam technology now make it possible to catch many infections in the jaws around these old root canal teeth that have previously gone undetected.<\/p>\n

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So What’s the Treatment for Infected Root Canal Teeth?<\/h2>\n

There are only 3 choices once an old root canal infection is diagnosed:<\/p>\n