When Retreatment of Endodontic Therapy is Necessary

Endodontic Retreatment Dr. Wolfson

A Second Chance to Save Your Tooth...

With proper care most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth. In some rare cases, however, a tooth that has been treated with root canal fails to heal after even the most careful treatment.

Occasionally, the tooth becomes painful or re-infects months or even years after a successful treatment. If your tooth has failed to heal or has developed new problems, you have a second chance. Another endodontic procedure may be able to save your tooth.




Why do I Need another Endodontic Procedure?

Occasionally, as it happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:

  • Narrow or curved canals were not accessible during the initial procedure.
  • Additional canals, known as accessory canals were undetected in the first procedure.
  • The crown or other restoration was not placed soon enough after the procedure.
  • The final restoration did not seal out saliva from entering the inside of the tooth.

In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:

  • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
  • An untreated loose, cracked or broken crown or filling can expose the tooth bacteria that will cause a new infection.

What will Happen during Endodontic Retreatment?

Endodontic Retreatment Dr. Wolfson

Following a complete assessment, Dr. Wolfson will discuss your treatment options. If retreatment is the best suited option for you, Dr. Wolfson will need to evaluate the tooth from the inside. In some cases, complex restorative materials such as a crown or internal support must be removed to allow access to the internal canals.

Dr. Wolfson will clean the canals and carefully examine the inside of your tooth, searching for any additional canals or unusual anatomy that is the cause of the reinfection. Once the site is sterilized, Dr. Wolfson will then fill and seal the canal(s), placing a temporary filling in the tooth (NOTE: There are occasional cases of impossible access to properly sterilize the entire canal. If this is the case, a form of minimally invasive surgery can still save your tooth).

After the completion of treatment with Dr. Wolfson, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to full function.

Is Retreatment the Best Choice for Me?

Retreated teeth can function well for years, even for a lifetime. Retreatment of a root canal will not only save the tooth that nature gave you, it will also maintain the bone levels of your jaw by providing a function through support.

Advances in technology are constantly evolving as to the way root canal treatment is performed, so your endodontist may even be able to use a new technique that was not available when you had your tooth initially treated. If your tooth has unusual anatomy and was not able to be cleaned and sealed during the first procedure, your endodontist may be able to resolve this problem with a second treatment.

What are the Alternatives to Retreatment?

For some patients in need of a retreatment, endodontic surgery is also an option. This involves a minimally invasive small incision near the end of the root to allow the tip of the root to be sealed. Endodontic surgery may be recommended in conjunction with retreatment or as an alternative. Your endodontist will discuss your options and recommend appropriate treatment.

The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore the chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth.

No matter how effective modern tooth replacements are—and they can be very effective— nothing is as good as your natural tooth. You've already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth for many years to come.