When to redo endodontic treatment

With proper care, even teeth that have had a root canal can last a lifetime. But sometimes a tooth that has been treated doesn't heal properly and can become painful or with other pathologies (dental abscess, apical periodontitis) months or even years after treatment. If your tooth has failed to heal or develops new problems, you have a second chance. If you repeat endodontic treatment, it can support healing and save your tooth. If you have pain or discomfort in a previously treated tooth, talk to an endodontist about retreatment.

 

Why you need to redo endodontic treatment

 

As is occasionally the case with any dental or medical procedure, a tooth may not heal as expected after the initial endodontic treatment for several reasons:

• Narrow or curved canals were not completely and properly treated during the initial procedure;
• The complicated canal anatomy remained undetected in the first procedure;
• The placement of the crown or other restoration was delayed after root canal treatment and the root canal suffered bacterial infiltration;
• Post-endodontic restoration did not prevent salivary contamination inside the tooth.

 

In other cases, a new problem can jeopardize a tooth that has been successfully treated. For example:

• The new decay can expose the root canal filling material to bacteria, causing a new infection in the tooth;
• A weak or infiltrated, cracked or broken crown or filling can expose the tooth to a new infection;
• A tooth breaks;

 

What is the restart treatment

 

First, your endodontist will discuss your treatment options. If you and the doctor choose to redo the endodontic treatment, the dentist will reopen the tooth to access the root canal filling material. In many cases, complex restorative materials - the crown, post, and core material - must be removed to allow access to the root canals.

After the root canal filling is removed, the endodontist can clean the canals and carefully examine the inside of the tooth, using magnification magnification through loupes or dental microscope and illumination, looking for any additional canals or unusual anatomy that requires treatment.

After cleaning the canals, the endodontist will fill and seal the canals. If the canals are unusually narrow or blocked, the endodontist may recommend endodontic surgery. This surgery involves making an incision to seal the other end of the root.

After root canal treatment, you will need to return to your dentist as soon as possible to have a new crown or another restoration placed on the tooth to protect it and restore its full mechanical function.

 

The advantage of root canal treatment

 

Whenever possible, it is best to save your natural tooth. Endodontically-retained teeth can function well for years, even for a lifetime. Advances in technology are constantly changing the way root canal treatment is performed, so the endodontist may use new techniques that weren't available when you had your first procedure. Your specialist may be able to solve your problem by retreatment. As with any dental or medical procedure, there are no guarantees. Your endodontist will discuss your options and the chances of success before treatment begins.

 

How much does it cost to redo an endodontic treatment?

 

The cost varies depending on how complicated the procedure will be. The procedure is likely to be more complex than the first root canal treatment, as the restorative and filling material may need to be removed to perform the new procedure. In addition, the endodontist may need additional time looking for the unusual anatomy of the root canal. Therefore, you can generally expect the treatment to cost more than the initial endodontic treatment.

 

What are the alternatives to endodontic treatment and/or endodontic surgery?

 

If non-surgical treatment is not an option, then endodontic surgery should be considered. This surgery involves making an incision to allow access to the root tip. Endodontic surgery may also be recommended along with retreatment or as an alternative. The endodontist will discuss the options and recommend an appropriate treatment.

Another alternative, if endodontic treatment or endodontic surgery can no longer be done, is tooth extraction. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and prevent displacement of adjacent teeth. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be more costly and time-consuming than retreatment and restoration of the natural tooth.

However effective tooth replacement is - nothing is as good as your own natural tooth. You have already made an investment in saving your tooth. The reward for choosing treatment could be a healthy, functional natural tooth for many years to come.