With proper care, most teeth which have had endodontic (root canal) treatment can last as long as other natural teeth.
However, in a few cases, a tooth that has received endodontic treatment fails to heal completely. And occasionally, a tooth becomes painful or diseased months or even years after previously successful endodontic treatment.
If your tooth has failed to heal or has developed new problems, you have a second chance. Another endodontic procedure, called retreatment, may be able to save your tooth.
Retreated teeth can function well for years, even for a lifetime. It's always best to save the tooth if your endodontist believes retreatment is the best option for you.
Advances in technology are constantly changing 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 first procedure.
Of course, there are no guarantees with any dental or medical procedure. Your endodontist will discuss your options and the chances of success before beginning retreatment.
Who performs endodontic retreatment?
All dentists are educated in endodontic treatment in dental school. However, because endodontic treatment can be challenging, many dentists refer patients needing retreatment to endodontists.
Endodontists are dentists with at least two additional years of advanced education in root canal techniques and procedures. Because they limit their practices to endodontic cases, they have concentrated experience in endodontic treatment. In addition to treating routine cases, they are experts in performing complicated procedures, such as surgery, and in treating difficult cases, such as teeth with narrow, blocked, or unusually positioned canals. This special training and experience along with the addition of special equipment such as microscopes, can be valuable if retreatment is required.
Why do I need another endodontic procedure?
As occasionally 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 treated during the initial procedure
Complicated canal anatomy went undetected in the first procedure
The crown or restoration was not placed soon enough after the procedure
The restoration did not prevent saliva from contaminating the inside of the tooth
Problems that can jeopardize a tooth that was successfully treated:
What will happen during the endodontic retreatment?
New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth
A loose, cracked, or broken crown or filling can expose the tooth to new infection
Trauma causing root fracturing
First, the endodontist will discuss your treatment options. If you and your endodontist choose retreatment, the endodontist will reopen your tooth to gain access to the root canal filling material
In many cases, complex restorative materials — crown, post, and core material — must be disassembled and removed to permit access to the root canals.
After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth, searching for any additional canals or unusual anatomy that requires treatment.
After cleaning the canal(s), the endodontist will fill and seal the canal(s) and place a temporary filling in the tooth. Post space may also be prepared at this time.
After the final visit with your endodontist, 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.
If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision near the end of the root to allow the tip of the root to be sealed.
What are the alternatives to retreatment?
For some patients considering retreatment, endodontic surgery is also an option. This surgery involves making an 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 chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or prosthetic 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.