Endodontic Retreatment -Your Guide to Endodontic Retreatment
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 cases, however, a tooth that has received endodontic treatment
fails to heal or the pain continues. Occasionally, the tooth becomes
painful or diseased months or even years after 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.
Who performs
endodontic retreatment?
All dentists are educated in endodontic treatment in dental school.
However, because retreatment can be more challenging than providing
initial treatment, 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 can be valuable
if retreatment is necessary.
Why
do I need another endodontic procedure?
As occasionally happens with any dental or medical procedure, a tooth
may not heal as expected after intitial 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 other restoration was not placed soon enough after the
procedure.
• The restoration did not prevent saliva from contaminating 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.
What
will happen during retreatment?
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 and carefully examine the inside of your tooth, searching for any additional canals or unusual anatomy that requires retreatment.
After cleaning the canal(s,) the endodontist will fill and seal the canal(s) and place a temporary filling in the tooth 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.. 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.
Is retreatment the best choice for me?
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. If your tooth has unusual
anatomy that was not cleaned and sealed during the first procedure,
your endodontist may be able to resolve this problem with a second treatment.
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.
How much
will the procedure cost?
The cost varies on how complicated the procedure will be. The procedure
will probably be more complex than your first root canal treatment,
because your restoration and filling material may need to be removed
to accomplish the new procedure. In addition, your endodontist may need
to spend extra time searching for unusual canal anatomy. Therefore,
you can generally expect retreatment to cost more than the initial endodontic
treatment.
While dental insurance may cover part of the cost for retreatment, some
policies limit coverage to a single procedure on a tooth in a given
period of time. Check with your employer or insurance company prior
to treatment to be sure of your coverasge.
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 enodontist 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 dental
procedures on adjacent health teeth, they can be far more costly and
time consuming than retraetment 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.