Upper front teeth: root canal re-treatment fifteen years on
Two upper front teeth root filled after a cycling injury more than fifteen years earlier, comfortable until recently. Re-treated in a single visit.
Presentation
A woman in her thirties came to see us about the appearance of her upper front teeth. The colour was what concerned her most.
She had also started to notice discomfort from the upper left central incisor.
Both teeth had been root filled more than fifteen years earlier, after a fall from her bike. Neither tooth had given her any trouble in the years since.
Assessment
The X-ray showed both root fillings stopping well short of the end of the root. There were also clear gaps within the filling material itself.
Space left inside a canal is space bacteria can occupy. Both teeth showed changes in the bone at the root tip, consistent with long-standing infection.
A root filling can sit quietly for many years before anything is noticed. The recent discomfort from the central incisor was the first sign that something had changed.
The original root fillings: both stopping short of the end of the root, with clear gaps in the filling material.
Before treatment
Treatment
Both teeth were re-treated in a single appointment, under rubber dam and the dental operating microscope.
- The original filling material was removed from both canals under magnification
- Each canal was cleaned and disinfected along its full length, including the portion the first treatment had not reached
- Both canals were sealed to the end of the root at the same visit
She was returned to a restorative colleague to rebuild both teeth, and to consider whitening if she wished.
After treatment
Review
Questions patients ask
Why has an old root canal started hurting years later?
A root filling that leaves part of the canal uncleaned can stay quiet for a long time. Bacteria remaining inside continue to affect the bone around the root, often without any symptoms. Discomfort tends to appear only once that balance shifts.
Will root canal re-treatment change the colour of a front tooth?
Re-treatment deals with what is happening inside the root, not with colour. Whitening a discoloured front tooth is a separate piece of work, carried out by the restoring dentist.
Does an old root filling always need redoing?
No. A root filling that falls short but is causing no problem, with healthy bone around the root, can reasonably be left and monitored. Re-treatment comes into the discussion where there are symptoms, or changes visible on an X-ray.
Published with the patient’s written consent and fully anonymised. Every tooth is different and outcomes vary from case to case, so this case should not be read as a promise of a particular result.
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