Root Canal Failure – What Are The Options?

Bob recently asked this question about a root canal failure.


I just had a root canal because of extreme sensitivity to hot and cold on a tooth that also hurt when I chewed and flossed (it had multiple fillings on it ). The root canal seemed to solve all that but I still feel the “throb” or whatever, when I shake my head or jump up and down or even pat myself on the head. It is only in that tooth, on the one side even maybe, and it was there before the root canal with the other symptoms. I don’t want this to persist after they put a permanent crown on it it would drive me crazy. Can you help me to tell them what is wrong so they can finally fix it.



Bob, sorry to hear that you are having these problems. This is certainly a very annoying problem for you, especially having gone through the treatment. As you may know, a root canal is a procedure used to treat teeth with inflamed or dead pulpal tissue. For more info on root canal see our guide here.


General Causes of Root Canal Failure

Unfortunately there is no way to know what is causing your pain specifically, without examining you and seeing your x-rays. But here are some possible causes for root canal failure in general:

What causes root canal failure?

What causes root canal failure?

  • Incomplete root filling, leaving some space for bacteria to proliferate, or leaving behind some diseased pulpal tissue. Some teeth have very complicated canal systems that are very difficult to completely clean out and fill.
  • Infection (abscess) or inflammation at the root tip, often as a result of the above. The infection will battle (so to speak) with your immune system and when it is allowed to build up this will increase the symptoms.
  • Root filling material extended out beyond the root tip, irritating the bony tissue.
  • A fracture of the tooth or leaking filling. These can indirectly cause failure of the treatment. By allowing the ingrowth of bacteria/substrates, a crack in the tooth or filling may tip the balance in favor of infection recurring in a tooth.

Again, these are only some basic notes on the causes, and for specific advice one would need to examine your tooth.
See this article for more advice on pain after root canal. The article also explains the treatment options with failed treatment. In brief, the options boil down to re-treatment of the root canal or extraction and replacement of the troublesome tooth.

One point that stands out is that you say the pain is worse on shaking your head. This is a common symptom with sinus problems. If the tooth is on the top jaw, near the back, this may be an issue.

Again, there is no way to know for me to be sure what is causing the failure of the root canal to settle. It is unlikely that your dentist will put a crown on a tooth that is problematic. If the problem persists your dentist may refer you to an endodontist (a specialist in root treatment).

Let us know how you get on Bob.

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