When I see a patient that has undergone a root canal in the past but has since developed pain, they inevitably ask me “Why did the first root canal fail?” Although there are multiple reasons why the original treatment has not been successful, the more important issue is finding a successful outcome this time. In this article I want to address the “Why did my original root canal fail” and more importantly, how retreatment of the tooth can lead to long-term success.
Many teeth are treated with a root canal that will last a lifetime. Unfortunately, there are others that develop pain or disease months or years after treatment. There are multiple reasons why this can occur:
- Complicated canals that were not detected during initial treatment
- Curved or narrow canals that were not treated during initial treatment
- The permanent restoration was not placed within the appropriate amount of time following the procedure
- The permanent restoration did not prevent saliva from contaminating the inside of the tooth
- The infection was not resolved due to a poor immune response
- A tooth sustained a fracture
If your tooth is diseased or has not healed after the original endodontic treatment, you have a second chance…endodontic retreatment can save your tooth.
So, what is endodontic retreatment? The word “Endodontic” comes from two Greek words: “endo” meaning inside and “odont” meaning tooth. Endodontic retreatment treats the inside of your tooth months to years after the original endodontic treatment.
What happens during endodontic retreatment?
First, your endodontist will discuss your treatment options with you. If you both choose endodontic retreatment, your endodontist will reopen your tooth to gain access to the root canal filling material. Quite often, restorative materials that were put in place during the original endodontic treatment need to be removed. These materials could be crown, post, and core materials. Once these materials are removed, your endodontist now has access to your root canal.
After your endodontist has removed the canal filling, your endodontist can clean the canals and carefully examine the inside of your tooth using illumination and magnification. At this point, your endodontist will be searching for additional canals or any unusual anatomy that needs treatment.
After cleaning the canals, your endodontist will fill and seal the canals and place a temporary filling in the tooth. However, if the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This involves making an incision so that the other end of your root is sealed.
After cleaning the canals, your endodontist will fill and seal the canals and place a temporary filling in the tooth. However, if the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This involves making an incision so that the other end of your root is sealed.
Once your endodontist completes retreatment, you will need to go to your dentist to have a new crown or other restoration placed on the tooth to protect it and restore it to its full function.
Often, endodontic retreatment to save your tooth is the best choice for you. Seattle Endodontic Arts specializes in endodontic procedures, and surgery, including endodontic retreatment. Literally, this is all we do, all day long. Our goal is to help you maintain your teeth long-term.
Who performs endodontic retreatment?
While most dentists going through dental school are trained in root canal therapy, endodontic retreatment can be more challenging than providing first-time treatment. This is why most dentists refer their patients to trained endodontists. The latter are dentists with at least two additional years of advanced specialty education in diagnosis and root canal treatment and retreatment.
Endodontists are experts in performing non-surgical and surgical retreatment. They use their specialized training in treating difficult cases, such as teeth with narrow or blocked canals, or then, teeth with unusual anatomy. Endodontists also used advanced technology, such as operating microscopes, ultrasonics, and digital imaging.
One of the alternatives to endodontic retreatment or endodontic surgery, is the extraction of your tooth. We try to save your original tooth using endodontic retreatment. No matter how effective tooth replacements are, we believe there nothing is as good as your own natural tooth.
Hopefully this article has answered many of the questions surrounding endodontic retreatments. My partners and I are always available to discuss this with you more.
For more information on how endodontic retreatment can save your tooth, contact Dr. Mark A. Freeman or any of the partners at Seattle Endodontic Arts at 206-621-9730 or at [email protected]
