Hi celeste,

Tooth pain does not always occur when a tooth is infected. Pain, swelling or discomfort in adjacent areas such as the ear can be related to a tooth infection. Traveling nerve type pain as you have described can also be attributed to an infected tooth as the inflammation from the infection causes inflammation and irritation to the alveolar nerves that the tooth is attached to. Those alveolar nerves are intricately connected to other branches of nerves that move throughout the body.

Root canaled teeth are chronically infected. These infections do not always show up on radio-graphs until they are very severe. There are several reasons why rc teeth stay infected but the easiest reason to understand has to do with the microscopic canals. There are literally many hundreds of these canals in every tooth. They all contain nerve tissue but they are not accessible like the larger canals. So the nerves in these tiny canals is never removed and it quickly becomes necrotic infected nerve tissue. It is just a matter of time as to when the tooth becomes overwhelmed with infection. In the mean time, the bacteria seeps from the tooth and goes into the periodontal ligament, the jaw bone and beyond.

It does not matter how many times a tooth is root canaled, the status of the infection inside of the tooth will not change. The microscopic canals will remain infected. I will attach a diagram of a tooth that shows the microscopic canals called dentin tubules. This will give you an idea of how many there are in the tooth and why the tooth stays infected.

Sometimes a dentist will suggest to do a surgical root canal called an apicoectomy. The main difference between a surgical root canal and a conventional root canal is the site of entry into the tooth. Otherwise, both procedures serve the same purpose and cannot favorably alter the status of the infection in the tooth.

To keep the rc tooth means is to keep the infection. The only means of eradicating the infection is to remove the source of the infection, which is the tooth.

I will attach the diagram of the microscopic canals, dentin tubules.

Attached Thumbnails