erinbard,

I know this information is a lot to take in especially since it is not coming directly from your treating dentist. But if you read through some of the threads on this forum you will notice that the problems people are having with root canaled teeth are very common and fairly similar. Which means dentists see these problems on a daily basis.

I am going to re post your thread and clarify it a bit better for you. I will reply in bold type.

<<Once you get pain in your tooth and it requires a root canal that is the 1st point of infection.>>

NOT EXACTLY. THE TOOTH IS PROBLEMATIC AND LIKELY INFECTED PRIOR TO ANY SYMPTOMS. THE SYMPTOMS OF INFECTION ARE OFTEN DELAYED UNTIL THE INFLAMMATION CAUSES UNDUE PRESSURE INSIDE OF THE TOOTH. DOING THE ROOT CANAL DOES NOT CURE THE INFECTION. IT IS DONE TO ATTEMPT TO TEMPORARILY RETAIN AN UNHEALTHY TOOTH.

<< The root canal helps the infection but does not actually get rid of the infection completely. So all teeth that are root canaled are 'infected'.>>

THE RC AIMS AT REMOVING THE VISIBLE NERVE TISSUE INSIDE THE LARGE VISIBLE CANALS. THE STATUS OF THE INFECTION AND INFLAMMATION MAY BE TEMPORARILY REDUCED. BUT THE INFECTION BREWING INSIDE THE DENTIN TUBULES IS VERY ACTIVE AND EVENTUALLY SPREADS BEYOND THOSE AREAS. THIS RENDERS ALL ROOT CANALED TEETH CHRONICALLY INFECTED.

<<The problem is when the pain re-starts - that means thats the infected tooth has become 'abscessed'? >>

NO. THE PROBLEM IS ONGOING IRRELEVANT OF THE SYMPTOMS. PAIN AFTER A ROOT CANAL PROCEDURE IS A GENERAL INDICATOR THAT THE INFLAMMATION HAS INCREASED AN THERE IS NOW MORE PRESSURE BUILDING UP INSIDE OF THE TOOTH. NOT ALL TEETH WILL ABSCESS.

<<So a tooth can be infected for years and years and nobody notices?>>

CORRECT. OFTEN THERE CAN BE INTERMITTENT OR VAGUE SYMPTOMS WITH EITHER THE INFECTED TOOTH, THE ADJACENT TEETH, THE SINUS, THE JAW, THE EARS, ETC.

<< Its just in an x-ray that you notice.>>

SOMETIMES THE SYMPTOMS ARE NON EXISTENT OR VAGUE BUT THE INFECTION IS PICKED UP ON AN XRAY. THE BACTERIA INSIDE OF THE TOOTH HAS TO BECOME VIRULENT TO BE PICKED UP ON A 2 DIMENSIONAL XRAY. HOWEVER, THE INFECTION IS OFTEN BREWING LONG BEFORE IT APPEARS ON THE XRAY.

<< It is then basically a wait and see game to see if it develops into an abscess?>>

DEPENDS HOW YOU LOOK AT IT. IF YOU UNDERSTAND THAT ALL ROOT CANALED TEETH HAVE SOME DEGREE OF A CHRONIC INFECTION INSIDE OF THEM PRIOR TO OR AT THE ONSET OF THE RC PROCEDURE AND YOU ARE COMFORTABLE WAITING FOR THE INFECTION TO BECOME SEVERE, THEN THAT WOULD BE CONSIDERED A WAIT AND SEE APPROACH. WHICH IS THE APPROACH THAT MANY CONVENTIONAL DENTISTS WILL TAKE. IF YOU ARE NOT AWARE THAT RC TEETH ARE CHRONICALLY INFECTED AND HAVE BEEN TOLD THAT THE RC CURES YOUR TOOTH, THEN YOU WOULD NOT EVEN THINK THE TOOTH WOULD EVER GIVE YOU A PROBLEM AND WOULD BE SURPRISED TO HAVE PAIN IN THAT DEAD TOOTH AT ANY POINT IN TIME. MOST PEOPLE WOULD THEN GAUGE THE SEVERITY OF THE INFECTION BY THE AMOUNT OF PAIN THEY HAVE. WHICH FROM A PATHOLOGICAL VIEW, IS NOT A GOOD INDICATOR OF THE SEVERITY.

<<So effectively If i have no pain but know that it is 'infected' I could be waiting months before it actually 'abscesses?>>

CORRECT. DURING THAT TIME, THE INFECTION BECOMES MORE VIRULENT AND THE CHANCES OF IT SPREADING TO THE JAW BONE, ADJACENT TEETH, THE SINUS (IF AN UPPER TOOTH) AND BEYOND INCREASES. AS DOES THE POSSIBILITY OF PERMANENT BONE LOSS IN THE SURROUNDING AREA OF THE TOOTH.

I know this is not what you want to hear and I am really sorry.
What are your thoughts after you look at the diagram of the anatomy of the tooth showing all the dentin tubules?

Bryanna