With proper care, even teeth that have had root canal treatment can last a lifetime. But sometimes, a tooth that has been treated doesn’t heal properly and can become painful or diseased months or even years after treatment. If your tooth failed to heal or develops new problems, you have a second chance. An additional procedure may be able to support healing and save your tooth.
If you are experiencing dental pain or discomfort in a previously treated tooth, talk to the dentist about retreatment.
Whenever possible, it is best to save your natural tooth. Retreated teeth can function well for years, even a lifetime. Advances in technology are constant and updated techniques may be used to save a tooth, which may not have been available when you had your first procedure. If non-surgical retreatment is not an option, then endodontic surgery may be considered. This involves making an incision to allow access to the end of the root(s). Endodontic surgery may also be recommended in conjunction with retreatment or as an alternative.
The only other alternative to retreatment or failing endodontics ultimately is extraction of the tooth. It will then need to be replaced with an implant, bridge or removable partial denture to restore chewing function and aesthetics and importantly, to prevent adjacent teeth from shifting. Because these options require surgery or dental procedures on adjacent healthy teeth, they can be more costly and time consuming than retreatment and restoration of the natural tooth. But this is a topic for another discussion.
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 placement of the crown or other restoration was delayed following the endodontic treatment.
- The restoration did not prevent salivary contamination to the inside of the tooth.
- An inadequate seal of a restoration (filling) allowed recontamination of 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.
- A loose, cracked or broken crown or filling can expose the tooth to new infection.
- A tooth sustains a fracture.
Some of these issues do not give rise to symptoms, but can give rise to chronic infection, often seen in an x-ray picture as a small black area around the end of an affected root. New problems too, can jeopardize a tooth that initially had successful root canal treatment.
During retreatment, the endodontist will reopen your tooth and remove the filling materials that were placed in the root canals during the first procedure. The endodontist then carefully examines the tooth, looking for additional canals or new infection. The endodontist then removes any infection, cleans and shapes the canals, and places new filling materials. The opening is then sealed with a temporary filling. Once the tooth heals, a new crown or other restoration is placed on the tooth to protect it.