I am afraid that I will lose my root canal tooth and need a dental implant. My dentist completed a repeat root canal on my upper left first premolar in October 2022, but I think the tooth is infected again. Is that possible? The left side of my face is puffy beneath my eye and around my cheek. It’s not painful yet, but it is uncomfortable. Will I need an extraction and dental implant? Thank you. Kamal from Honolulu
Thank you for contacting Pumphrey Periodontics of Atlanta. We understand your concerns about your tooth and whether a dentist can save it.
Is Your Root Canal Tooth Infected Again?
Your root canal tooth may be infected again if it hurts and you have swelling in your gums or face. You may also feel discomfort when you put pressure on the tooth or use it for biting or chewing.
Can a Dentist Save a Repeat Root Canal Tooth?
Whether or not a dentist can save a repeat root canal tooth depends on the tooth’s condition and the extent of the infection. Your dentist may refer you to a root canal specialist if the tooth’s canals are curved and challenging to reach.
Why Would You Need Another Root Canal?
You might need another root canal if your dentist missed a canal while removing the infection or if the canals are challenging to reach. After root canal treatment, your dentist or specialist will prescribe an antibiotic to help your body get rid of the infection.
What If Your Root Canal Tooth Is Not Savable?
If a root canal tooth is not savable, your dentist may refer you to a periodontist for tooth removal and a dental implant. If your jawbone around the tooth is healthy, you may get a tooth extraction and an implant on the same day. The advantages of same-day implant placement include:
- Preserves the jawbone
- Prevents the need for bone grafting later
- Reduces overall treatment time
A June 2022 Journal of Periodontology article published results from a two-year study of immediate placement for 63 first premolars in patients. Forty-one of the implants that dentists restored were still functional after two years. The long-term survival rate for first premolars requires further studies.
Consult with a Periodontist
If you require tooth removal and a dental implant for your first premolar, we recommend scheduling a consultation with a periodontist (a specialist in teeth, gums, and the jawbone). After an exam and 3-D x-ray, the specialist will explain your treatment options for a dental implant. Each patient’s case is unique.
Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.