Retreatment

Most teeth that have undergone endodontic (root canal) therapy can last as long as other healthy teeth with the right care.

However, an endodontically treated tooth occasionally does not recover. Sometimes, even after a successful procedure, the tooth develops pain or diseased.

You still have time if your tooth has not recovered or if it has developed new issues. Endodontic retreatment is a different procedure that might be able to save your tooth.

Who performs endodontic retreatment?

In dental school, all dentists receive introductory instruction in root canal therapy. However, many dentists refer patients needing endodontic retreatment to endodontists because doing so can be more difficult than doing so for the first time.

Dentists who have completed at least an additional two years of advanced training in diagnosis and root canal therapy are called endodontists. They only practice endodontics, so they deal with issues of this nature every day. Experts in both nonsurgical and surgical retreatment procedures are endodontists. When treating challenging cases, such as teeth with narrow or blocked canals or unusual anatomy, they draw on their specialized training and experience. To carry out these unique procedures, endodontists may employ cutting-edge technology like operating microscopes, ultrasonics, and digital imaging.

What justifies another endodontic procedure for me?

A tooth may not heal as anticipated after initial treatment for a variety of reasons, as is occasionally the case with any dental or medical procedure:

The initial procedure did not include any treatment for narrow or curved canals.

The initial procedure missed complex canal anatomy.

After the endodontic procedure, the placement of the crown or other restoration was postponed.
Salivary contamination of the tooth’s interior was not prevented by the restoration.
In other instances, a tooth that was successfully treated may be in danger due to a new issue. As an illustration, fresh decay can expose the root canal filling to bacteria, which results in a fresh infection of the tooth.

The initial procedure missed complex canal anatomy.
After the endodontic procedure, the placement of the crown or other restoration was postponed.
Salivary contamination of the tooth’s interior was not prevented by the restoration.
In other instances, a tooth that was successfully treated may be in danger due to a new issue. As an illustration, fresh decay can expose the root canal filling to bacteria, which results in a fresh infection of the tooth.

What Happens During Retreatment?

The endodontist will first go over your available treatment options. Your tooth will be reopened by the endodontist in order to access the root canal filling material if you and your doctor decide to retreat the treatment. To allow access to the root canals, complicated restorative materials, such as crowns, posts, and core materials, frequently need to be disassembled and taken out.

The endodontist can thoroughly clean the canals after removing the filling and then carefully examine the interior of your tooth under magnification and illumination to check for any additional canals or unusual anatomy that needs to be treated.

The endodontist will fill and seal the canals after they have been cleaned, and they will also put a temporary filling in the tooth. Your endodontist might advise endodontic surgery if the canals are unusually narrow or blocked. Making an incision during this procedure allows the other end of the root to be sealed.

You must visit your dentist as soon as possible following your endodontist’s retreatment so that the tooth can receive a new crown or other restoration that will protect it and give it back its full functionality.

Is retreatment the best option for me?

It is preferable to preserve your natural tooth whenever possible. Retreated teeth can continue to function properly for a very long time.

Your endodontist may employ new methods that weren’t available when you had your initial procedure because technological advancements are constantly changing how root canal therapy is carried out. With retreatment, your endodontist might be able to solve your issue.

There are no guarantees with dental or medical procedures. Before starting retreatment, your endodontist will go over your options and the likelihood of success.

How much will it cost?

The price varies according to how difficult the process will be. Because your restoration and filling material might need to be removed in order to complete the new procedure, the process will likely be more complicated than your initial root canal treatment. Your endodontist might also have to spend more time looking for unusual canal anatomy. The cost of retreatment will therefore typically be higher than that of the initial endodontic procedure.

While dental insurance may partially or fully cover the cost of retreatment, some policies only cover one procedure on a tooth over the course of a certain amount of time. Prior to retreatment, confirm your coverage with your employer or insurance provider.

Are there alternatives to retreatment?

Endodontic surgery should be taken into consideration if nonsurgical retreatment is not a possibility. Making an incision during this procedure is necessary to gain access to the root’s tip. Endodontic surgery may also be suggested as an alternative to or in addition to retreatment. Your endodontist will go over your options with you and suggest the best course of action.

What are the alternatives to endodontic surgery or retreatment?

The tooth extraction is the only other option. To restore chewing ability and stop adjacent teeth from shifting, the extracted tooth must be replaced with an implant, bridge, or removable partial denture. These options can be significantly more expensive and time-consuming than retreatment and natural tooth restoration because they involve extensive surgery or dental procedures on healthy adjacent teeth.

Nothing compares to a natural tooth that you have. Your investment in maintaining your tooth has already been made. A healthy, functional natural tooth for many years could result from choosing retreatment.

Frequently Asked Questions

Why do i need root canal treatment?

Root canal treatment is very successful but in some cases a patient may need a root canal re-treatment if their previous root canal treatment has failed. This depends on the particular case but it may be because the treatment has not healed correctly or an infection is present in the tooth.

Is it painful?

The nerve has been removed in a tooth that has had root canal treatment. Even though there is no nerve a dentist will still use anaesthetic to numb the area so that the patient will not feel any pain during the procedure. After the numbness wears off there may be slight discomfort for a few days which pain killers can help with. It is recommended that the patient does not chew on anything hard on that side to prevent the tooth fracturing before the permanent crown is placed.

How successful is it?

How successful a root canal re-treatment is, depends on the pervious treatment of the tooth and the reasons of its failure. Usually, the success rate for a re-treated tooth can range from 75% to 88%.

How long does it take?

A root canal retreatment usually takes around the same amount of time as the original treatment. A visit is usually between 30 to 60 minutes but can take longer if the case is difficult. If there is a lot of inflammation or the treatment is complex there may be more than one appointment needed to make sure the treatment heals correctly.

The average root canal treatment is 30 to 60 minutes long. More complex cases may take around 90 minutes. A root canal typically requires one or two appointments to complete.

What does the procedure involve?

An oral examination is initially carried out with diagnostic testing tools, such as X-rays, imaging and biopsy to isolate the cause of infection. The spread of dental pulp infection is tracked, so that the exact location of infected root canals can be identified. Once a patient consents to the root canal procedure a treatment date is set. The patient’s teeth will first be cleaned and a local anaesthetic is given to numb the treatment area for pain-free root canal treatment.

The oral surgeon then uses a dental drill to gently access the inner tooth pulp. A dental instrument is used to carefully scrape away the infected tooth root tissue. Based on the severity of infection and treatment required, the patient may need time to recover from the initial procedure before receiving further root canal treatment.

Once the infected dental pulp and tooth root tissue are removed, a dental substance known as gutta percha is inserted into the space to secure the tooth within the jawbone and prevent the return of infection. A dental crown may then be placed over the tooth surface to solidify structure and improve dental bite function.