Constantinos D.Laghios / www.endodontic.org

When Retreatment Of Endodontic Therapy Is Necessary

A Second Chance
Occasionally a tooth that has undergone endodontic or “root canal” treatment fails to heal or pain continues despite therapy. Sometimes a tooth responds to root canal therapy but becomes painful or diseased months or years later.
When this happens, the tooth often can be saved with a second endodontic treatment.

Why do I need a treatment?
Your first root canal treatments was performed because the soft inner tissue of the tooth, called the “pulp”, had been damaged. Although this pulp was removed and replaced with a filling material, the tooth remained alive, drawing nourishment from surrounding gums and bone. This living tooth is now experiencing new problems. These could be caused by any of the following:

Incomlete Cleaning and Sealing
For root canal treatment to be successful, the canals must be thoroughly cleaned and sealed. Some canals are so narrow, hardened or curved that the tiny instruments used to clean and shape them cannot completely pass through. Other canals are so small they are difficult to find.

Root Damage
New trauma may have caused the root to fracture or a cyst or infection may have developed around the tip of the root.

New Decay
Severe decay can expose the root canal filling material to bacteria in the saliva, causing a new infection in your tooth. A loose, cracked or broken filling can have the same effect.

Who performs endodontic retreatment?
All dentists receive some endodontic training in dental school. Endodontists are dentists with advanced training in root canal techniques and procedures. They are experts in performing complicated procedures such as retreatments, which are often more difficult than the original treatment.

What will happen during retreatment?
The tooth will be reopened and the canals cleaned, filled and sealed again. In cases of very narrow, curved or hardened canals, an incision may be made near the end of the rootto allow the tip of the root to be sealed. In special cases, the endodontist may even extract the tooth, clean and seal the canals and replace the tooth in order to save it. Your endodontist will be happy to discuss with you what treatment will be necessary in your case.

If the treatment failed, how do I know the retreatment will be successful?
There are, of course, no guarantees. Your endodontist will discuss with you the chances of success before the procedure to help you make an informed decision.

What are the alternatives to retreatment?
Extraction of the tooth is the usual alternative, but you have already made an investment in saving your tooth. It makes sense to have the retreatment to protect your investment. If you have the tooth removed, adjoining theeth may shift, interfering with biting and chewing. Loss of a tooth can also lead to gum disease and loss of additional teeth. You can have a replacement tooth implanted or attached to adjacent healthy teeth, but this is an expensive procedure that requires even more dental work. There is no real substitute for your own teeth, which is more efficient in chewing and biting than an artificial one would be.

If this is a “retreatment”, will I have to pay again?
Generally a fee is required because an entirely new procedure must be performed.

Does insurance cover retreatment?
As with any treatment, insurance policies vary in their coverage. With many policies reimbursement is often limited to a single procedure on a tooth in a given period of time. Check with your employer or insurance company to be sure.


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Next >> Your Guide to Endodontic Retreatment	When Retreatment Of Endodontic Therapy Is Necessary A Second Chance Occasionally a tooth that has undergone endodontic or “root canal” treatment fails to heal or pain continues despite therapy. Sometimes a tooth responds to root canal therapy but becomes painful or diseased months or years later. When this happens, the tooth often can be saved with a second endodontic treatment. Why do I need a treatment? Your first root canal treatments was performed because the soft inner tissue of the tooth, called the “pulp”, had been damaged. Although this pulp was removed and replaced with a filling material, the tooth remained alive, drawing nourishment from surrounding gums and bone. This living tooth is now experiencing new problems. These could be caused by any of the following: Incomlete Cleaning and Sealing For root canal treatment to be successful, the canals must be thoroughly cleaned and sealed. Some canals are so narrow, hardened or curved that the tiny instruments used to clean and shape them cannot completely pass through. Other canals are so small they are difficult to find. Root Damage New trauma may have caused the root to fracture or a cyst or infection may have developed around the tip of the root. New Decay Severe decay can expose the root canal filling material to bacteria in the saliva, causing a new infection in your tooth. A loose, cracked or broken filling can have the same effect. Who performs endodontic retreatment? All dentists receive some endodontic training in dental school. Endodontists are dentists with advanced training in root canal techniques and procedures. They are experts in performing complicated procedures such as retreatments, which are often more difficult than the original treatment. What will happen during retreatment? The tooth will be reopened and the canals cleaned, filled and sealed again. In cases of very narrow, curved or hardened canals, an incision may be made near the end of the rootto allow the tip of the root to be sealed. In special cases, the endodontist may even extract the tooth, clean and seal the canals and replace the tooth in order to save it. Your endodontist will be happy to discuss with you what treatment will be necessary in your case. If the treatment failed, how do I know the retreatment will be successful? There are, of course, no guarantees. Your endodontist will discuss with you the chances of success before the procedure to help you make an informed decision. What are the alternatives to retreatment? Extraction of the tooth is the usual alternative, but you have already made an investment in saving your tooth. It makes sense to have the retreatment to protect your investment. If you have the tooth removed, adjoining theeth may shift, interfering with biting and chewing. Loss of a tooth can also lead to gum disease and loss of additional teeth. You can have a replacement tooth implanted or attached to adjacent healthy teeth, but this is an expensive procedure that requires even more dental work. There is no real substitute for your own teeth, which is more efficient in chewing and biting than an artificial one would be. If this is a “retreatment”, will I have to pay again? Generally a fee is required because an entirely new procedure must be performed. Does insurance cover retreatment? As with any treatment, insurance policies vary in their coverage. With many policies reimbursement is often limited to a single procedure on a tooth in a given period of time. Check with your employer or insurance company to be sure.