Teeth that has been treated with a root canal and properly restored with a permanent restoration last as long as natural teeth. However, there are case when a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the persistent infection or pain may occur months or years after treatment. In these cases, your endodontist will need to complete a follow-up examination to review the case. Radiographs and a clinical examination will be need to determine the proper diagnosis, the cause of the problem, and the treatment plan.
Improper healing may be caused by:
- Curved or narrow canals that were not treated during the initial treatment.
- Complicated canals that went undetected during the initial treatment.
- The crown or restoration was not placed within the appropriate amount of time following the procedure.
- The crown or restoration had leaking margins which lead to recurrent decay inside the tooth
- Persistent infection around the roots of the tooth
- Persistent infection inside the root canal system
After the case is properly diagnosed and treatment plan for retreatment, the endodontist will provide anesthesia for pain control, place a rubber dam to isolate the tooth, drill a hole through the existing crown or restoration, remove the material from the root canal system, properly clean the canals and assess the inside of the tooth and roots for any missed or calcified canals and for any potential fractures. Then the canals are filled with the permanent material. It is common to have a 3D-Cone Beam taken to examine the tooth and surrounding structures.
Alternatives to Endodontic Retreatment
For some patients, endodontic retreatment will not be the treatment option. In such cases, endodontists are likely to recommend they undergo endodontic surgery, also known as an apicoectomy. This may be applicable when the patient has especially complex restorative work or the tooth does not show signs of improvement with a retreatment.
Some patients prefer to opt-out of endodontic retreatment and surgery altogether. The only remaining viable option, then, is tooth extraction. It is crucial to replace an extracted tooth with an artificial tooth after an extraction in order to restore esthetics and functions, prevent resorption, and to keep the adjacent teeth from shifting.
Frequently Asked Questions
I am not experiencing any pain or discomfort. Do I still need a root canal retreatment?
There are cases where you can have infection but no pain associated with it. If you are not experiencing pain or discomfort and you have been diagnosed and treatment planned for retreatment by the endodontist, you should get the retreatment completed to prevent infection from spreading and to retain the tooth. It can be tempting to forget about an issue if it is not constantly reminding you of its existence. However, infections can remain and even spread whether or not you experience pain. Some patients never experience any discomfort from their infected teeth.
I really do not want to undergo endodontic retreatment or surgery. Is tooth extraction not a better alternative?
As mentioned earlier, tooth extraction can be more costly and time-consuming in the long run. Moreover, it is always best to preserve natural teeth whenever possible. Though modern technologies have made artificial teeth better than ever before, they still bring about their own unique set of challenges. Overall, endodontic treatment has a very high success rate. As such, we recommend that you only turn to tooth extraction as a last resort.
Will I need to make a follow-up appointment after my endodontic retreatment?
Yes. It is recommended that you get a permanent restoration placed over the root canal/retreated tooth within 3 weeks of the treatment. Your dentist will discuss with you if you need a crown or a crown replacement on your treated tooth. Failure to get a permanent restoration can leak to reinfection of the root canal system or fracture of the tooth.
How long does a root canal retreatment take?
The complexity of the case will determine the time needed to complete the retreatment. Some cases could require the need for an inter-appointment medicament, while others may have complexities related to the anatomy of the tooth which could lead to the need for two appointments. However, some cases can be completed in one appointment. You endodontist will discuss this with you during the consultation.
Why should I choose an endodontist to perform my root canal retreatment?
Endodontists are specially trained in diagnosing dental conditions and treating complications associated with the inside of the tooth. They are also the only branch of dentist specialty trained to perform all root canal-related procedures. All endodontists are dentists, but not all dentists are endodontists. By choosing to get your root canal retreatment done by an endodntist, you can save yourself the time and trouble of extra office visits and rest assured knowing that you are getting specialized treatment.