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Diagnoses

Failing endodontic treatment

Establishing this diagnosis

Establishing a diagnosis involves examination, review of medical and dental history, clinical data analysis, and tests that are specific to your condition. Only a dentist can evaluate your signs and symptoms to establish a diagnosis.

Generally, teeth which require endodontic re-treatment will have an area of chronic infection at the root tip, which is visible on an X-ray image of the tooth as an obvious dark lesion. The lesion will generally lack a white ("corticated") margin, which makes it appear diffuse and "active". Presence of a white margin around the lesion suggests there has been healing of the original lesion, and in the absence of other signs and symptoms, is not an indication for endodontic re-treatment.

Teeth with failing endodontic treatment may be accompanied by symptoms, such as swelling, drainage and pain to biting. Frequently the tooth restoration (crown, filling, etc.) will be broken or leaking.

If a root canal filling has been exposed to the mouth more than a day or two due to loss or failure of the crown or filling on the tooth, your dentist may recommend endodontic re-treatment prior to placing a final restoration on the tooth (even in the absence of signs or symptoms). This is because evidence has shown that exposure of root canal fillings to the oral environment for much longer than that has produced a significant number of secondary root canal infections. It is undesirable for all parties involved when the dentist has to drill through a brand new crown to re-treat the root canals.