Hi Thomas,

Your dentist should have informed you more thoroughly.

Root canal treatment does cure an infected tooth. It does not matter if there were large canals that were missed with the previous treatment or how many times the tooth is treated. It will remain infected because there is no access to the many hundreds of microscopic canals which will continue to harbor infected nerve tissue. I will post a diagram of the anatomy of a tooth so you can see how the tooth is full of these microscopic canals called dentin tubules.

The fistula forms when the tooth becomes overwhelmed with infectious bacteria. The fistula is the body's way of trying to find a way to drain some of that bacteria. The infection moves beyond the tooth, burrows a hole in the jaw bone and creates an opening through the bone and gum tissue. This opening is the fistula.

Because the tooth will remain infected, even after another root canal treatment, the fistula will keep coming back.

Your dentist may also give you the option of doing a surgical root canal which is called an apicoectomy. This root canal is done through a surgical opening in the jaw bone rather than through the biting surface of the tooth as in a conventional root canal. It is irrelevant which way the procedure is done as the end result will be the same.... the tooth will remain infected.

The other problems with root canaled teeth or any chronically infected tooth is that the infection will burrow through the tooth and make it's way into the jawbone. It can then travel into the bloodstream and so forth. You may already have this occurring to some degree since the tooth has been infected for 7 years.

If you extract this tooth, it should be done by an oral surgeon and the surgeon should thoroughly debride the socket clean of any visibly diseased tissue and bone. If this debridement is not done then the infection will continue to brew as if the tooth were still present. Not all surgeons do this automatically even though they have all been taught to do this with each extraction. It would behoove you to let the surgeon know that you WANT him to do a thorough debridement.

Putting a dental implant in the jaw bone where a root canaled or long term infected tooth has been carries a high risk of infection and failure because that bone is usually not stable enough to hold an implant. The long term success of these implants is compromised.

Depending on which tooth this is, you may not have to be concerned about replacing it should you decide to extract it. If it does need to be replaced, ask your dentist what your replacement options are... example... removable partial denture... nesbit partial... fixed bridgework... etc.

FYI... There are some new protocols being utilized (by some integrative and biological dentists) during root canal therapy to help reduce the bacterial count within the tooth. Things like direct ozone therapy and the erbium laser along with less toxic antiseptics to irrigate the canals. Yes, these things do kill bacteria. However, they cannot reach the microscopic canals nor make an infected tooth healthy again as it is not possible to sterilize a tooth. They also cannot restore the vitality to the tooth which is essential in order for the tooth to be healthy and not rejected by the body.

I'm sorry this is not the news you had hoped to hear... unfortunately, dental infection can be a serious problem and holding onto an infected tooth is not healthy. If you want to do your own research for accurate and truthful information .. you can google The Root Canal Coverup, Dr George Meinig. Stay away from sites like quackwatch as that is only there to stir up additional skepticism about issues that the founder knows little about.

Please see the attached diagram of a tooth.. the tan lines marked dentin tubules will give you a clear view of just how many inaccessible microscopic canals are in each tooth.

I hope this is helpful to you...
Bryanna

Attached Images

dentin tubules.jpg (84.3 KB, 43 views)