With proper care, most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth. Root canals performed by endodontists (root canal specialists) and general dentists have a 95% success rate. In some cases, however, a tooth that has received endodontic treatment fails to heal. Occasionally, the tooth becomes reinfected or painful to biting months or even years after successful treatment. The success rate after endodontic retreatment of a tooth decreases dramatically from the initial success rate of 95%; however the other alternative is to remove the tooth and discuss available replacement options.
Why do I need retreatment?
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.
In other cases, a new problem can jeopardize a tooth that was successfully treated.
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 a new infection. The tooth can sustain a fracture. Retreatment can be performed either with an endodontist (a specialist in root canals) or by your general dentist.
- At the retreatment appointment, the dentist will administer local anesthetic to numb the tooth. After the tooth is numb, the dentist 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 canals can be cleaned and the dentist can carefully examine the inside of your tooth searching for any additional canals or unusual anatomy that requires treatment. The root canals will be sealed again with a sealer and filler called gutta percha.
- Your dentist will determine whether a new crown or other restoration placed within the tooth will be necessary to protect and restore it back to full function.
- If the canals are unusually narrow or blocked, your general dentist may recommend endodontic surgery with an endodontist.