Dr. Paul Northup, DDS

Not necessarily but you should have the abutment teeth thoroughly pulp tested and evaluated to ensure they are healthy first to avoid getting an expensive new bridge and then having to access "cut a hole" through your new bridge. This will also allow you to avoid the pain that may ensue by bridging a tooth with an unhealthy pulp.

This varies significantly based on the tooth location and anatomy of the tooth. In the hands of an experienced endodontist, a molar without significant calcification or other anomalies will take approximately an hour to an hour and a half.

This all depends on the location and the extent of the cavities. If it is into the pulp of the tooth it will require a root canal to save the tooth, however the tooth needs to be deemed restorable. Sometimes the cavity will encroach upon the bone or destroy so much tooth structure it will not be able to be properly restored. Generally, after a root canal, it will require a full crown.

Studies show about 25% of teeth that get crowned at some point will require a root canal. One should have the tooth thoroughly pulp tested and evaluated prior to getting a crown to ensure that the pulp is currently healthy. If it is found to test abnormal then a root canal is likely indicated and should be done prior to getting the crown done.

I would recommend Peridex Rinse aka Chlorahexadine Gluconate. It is a prescription mouth wash and very effective. Since you will need a crown after your root canal it will make the gum much healthier and allow for a superior impression for your new crown. It may cause some temporary staining on your teeth that will easily polish off.

Actually yes it can. A crack can be a direct path to the pulp of the tooth. You should get it evaluated to see if a crown alone will remedy the situation or will the tooth requires a root canal or even extraction.

Generally, a good anti-inflammatory like Ibuprofen is best. If you have any kidney disease or significant gastric issues you should avoid this. Tylenol will help but it does not reduce inflammation. If you have any liver disease you should avoid Tylenol. In the past narcotics were routinely used however due to an epidemic of deadly addictions the dental community has steered away from this. Avoid using a heating pad as it will help the infection increase rapidly.

Gum pain can be normal after a root canal. It can be a result of the clamp for the rubber damn placement pinches the gum leaving it temporarily inflamed.
Another reason can be that infection from within the roots spreads to to apical tissues around the root and into the gum creating gum tenderness and pain.
This situation may require and oral antibiotic to help resolve.

Root canals can fail. When diagnosed and performed well, it is in the range of 90% success. However, cracks or missed canals or leaking crowns and restorations can lead to failure. Failure is generally recognized by soreness to biting and/or tenderness to pressure with touching the gum over the root or actual swelling episodes.

You must have the Maxillary teeth checked for vitality. It is possible the tooth is causing the sinus infection. If it is truly just a sinus infection, the teeth will all test normal and vital.

Any injection can cause a pinching and tenderness during the injection. It is generally very short and the pain is over very quickly.

See your dentist asap. When it is let go for too long the tooth may require a root canal due to the cavity infringing upon the nerve or to a point the tooth can no longer be restored.

On occasion proper recovery and healing can be delayed. Sometimes this is the result of systemic issues of the patient. For example a patient with Diabetes or Lupus or Fibromyalgia may experience delayed healing. If the original infection was advanced involving a significant amount of bone around the roots it may take much longer for total resolution.

A properly diagnosed and well treated tooth with a root canal is generally about 90% successful. Reoccurrence can happen from a leaking crown and/or filling. Also, an unforeseen crack or missed canal during treatment can result in failure requiring further attention or even extraction.

As with any surgical procedure, there is always a risk of bleeding, swelling, nerve damage, or infection. In general, with proper case selection, these are usually minimal. Since you have diabetes, post-op infection is always more likely, so you must be sure to watch your sugar levels and take your antibiotic regimen religiously. There are always other options, however, those carry risks as well. Those might include extraction followed by implant replacement, etc. Each case is individual, so I highly recommend that you consult with a skilled and experienced endodontist who can review radiographs and your own unique clinical situation.
Best of luck with your decision. I hope this helped somewhat.

Paul Northup, DDS

An endodontic re-treatment is indicated when there is an existing root canal that is failing either clinically with symptoms or radiographically showing a radiolucency that appears to be increasing in size. Re-treatment cases must be thoroughly evaluated and a 3-D cone beam X-ray would be indicated to look for reasons for possible failure prior to commencing with treatment. A clinician would want to look for evidence of inadequate instrumentation and root canal sealing "obturation." In addition to any missed canals or leakage at the crown margins or restoration failure. One final concern is the possible presence of a crack or fracture. Cracks and fractures leaves a hopeless prognosis. Once it is decided that re-treatment is a good option, then the tooth must be accessed and all previous root canal filling material must be removed and any missed canals located. Then the canals will need to be thoroughly cleansed and disinfected with the proper medicaments all the way to the apex of the roots. Then completely sealed all the way to this point also. Finally, a PROPER and complete restoration of the crown of the tooth must be completed with NO POSSIBILITY of leakage for the BEST possible prognosis.
Best of luck with your chosen treatment.

Paul Northup, DDS

Success with apicoectomies depends upon case selection and skill of the clinician. In the right hands the prognosis could be as high as 90%. An implant is almost always another option. If you already have a good restoration in place with no pocketing or bone loss and no suspicion of a fracture or crack, an apicoectomy with proper retrofilling in my opinion is the best option.

It could be possible that the clamp from the rubber dam impinged upon your gum and it will take a week or two for it to completely heal. Another possibility is that you have infection coming from the route spreading to the gum area and creating discomfort.
I hope this was helpful.

Paul Northup, DDS

It is a little more complicated retreating a previous root canal. One must remove the previous root canal filling material and or posts and occasionally repair damage that may have occurred during the original root canal. And look for potential missed canals. First you need to rule out situations that may leave a poor prognosis such as a crack in a route or external or internal resorption of the route. So a good evaluation first to determine the prognosis and weather the tooth indeed does need to be re-treated is the place to start.
I hope this has helped you Paul Northup DDS