The last reason why root canals have a bad rap is because they aren't always effective. Even if the dentist does a skilled job, the tooth might always remain painful. This only happens about 5% of the time but it is still annoying. Either the patient has to deal with the pain or the dentist can extract the tooth and replace it with an implant or partial denture.

One reason a root canal fails is because there may be a few extra canals in the bottom of the tooth that the dentist was not able to work with. If there was any partially living or dead tissue in there then it can cause abscesses which will be painful from time to time. Nerve anatomy can be very tricky and sometimes it is just impossible to see all of the issues.

A failed root canal can also be caused by a fractured root. If the teeth have dead nerves in them then they are brittle, especially the parts under the gums. If the root gets fractured it's pretty much impossible to fix.

Another reason might be hypersensitivity to the materials that are used in the root canal. Your body may just reject the tooth. This is pretty rare though because gutta percha is usually inert and is well tolerated. Some patients, however, do get allergies to the cement that is used to seal the apex of the root.

Sargentit Root Canal procedures were popular in the 1950's and 1970's but is not normally used today. This method starts with a regular root canal and then does less canal cleaning and more root filling paste. This is supposed to inactivate the nerve by embalming it. When this technique was first being used it seemed to be working well and was much faster than the other methods. The paste was supposed to deactivate any living or dead nerves in the tooth. Problems seemed to arise years later when the fluid of the embalming started to escape and patients started to get pain and numbness in their teeth.

Because the procedures had been done so long before the only fix was to extract the teeth. Sometimes even this was not enough and they had to undergo some extensive surgery. Most of the people that got Sargenti root canals are not going to have any problems but there are the occasional few that do. No dental schools use this method anymore.

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