When Is Endodontic Retreatment Needed?

Have you ever had root canal procedure, with the hope that the pain would be gone for good, only to find that the same tooth bothers you months or years later? Sometimes, even though the nerve is removed from a tooth, it doesn't heal as anticipated. The discomfort that you feel long after your root canal has healed may be a signal that the tooth needs endodontic retreatment. If this is the case, schedule an appointment with your endodontist for an evaluation, and be sure to ask the following questions.

Why Hasn't My Tooth Healed?

According to the American Association of Endodontics (AAE) many root canal treatments last a lifetime if they're properly cared for. Unfortunately, sometimes endodontic retreatment may be the only way to give your previously treated tooth a second chance if your dentist diagnoses one of the following circumstances:

• Extra, oddly shaped or restricted canals in the root of the tooth that were not originally detected and treated.
• A delay in placing a protective crown on the tooth.
• Failure of the tooth restoration to prevent contamination from your saliva.
• A new infection from new decay or caused by a damaged crown or filling exposing the tooth to bacteria.
• A crack or fracture in the tooth.

What Are My Treatment Options?

When you opted for your original root canal treatment, your dentist probably explained to you that the only other treatment option was to remove the tooth. Now that you are experiencing pain in that tooth, depending on the cause, your endodontist may suggest retreatment or endodontic surgery, where an incision is made at the tip of the tooth's root to surgically remove the infected portion. This procedure is called an apicoectomy. Besides endodontic retreatment or surgery, the AAE explains, the only other alternative is to have the tooth extracted.

What Does Endodontic Retreatment Entail?

The retreatment process begins with your endodontist removing your crown or filling to access the root canal filling material. After removing the root canal material, the endodontist will clean all of the canals, and with the aid of special lighting and magnification, look for extra canals, unusual anatomy, or infection that requires treatment. After removing any infection and reshaping and cleaning the canals, your dentist will refill or restore them. However, if the canals are uncommonly narrow or impassable, the endodontist may recommend endodontic surgery to access and seal a portion of the root tip. The last step in the process involves placing a temporary filling in your tooth, explains the AAE.

What Should I Expect During Endodontic Recovery?

Every situation is different, but your dentist will give you personalized post-operative instructions to follow, and your recovery time may be a bit longer if you undergo endodontic surgery. Over-the-counter pain medication may give you relief for any minimal discomfort due to tissue inflammation. If you experience intense pain or pus is draining from the surgical site, call your endodontist right away. If you had surgery, avoid vigorous brushing around the tooth. Also, avoid chewing hard foods or ice with the treated tooth.

If all goes well, your endodontist will want to see you within a week, and if you had surgery, you may need a stitch or two removed. All swelling and soreness should be gone within two weeks; however, it's important to schedule an appointment with your general dentist as soon as possible to have either a crown or a filling done to protect the tooth and give it full functionality.

Advances in dental technology are happening every day, and the field of endodontics is no exception. So when you decide to go ahead with endodontic retreatment, your dentist may use techniques that weren't available when you originally had root canal treatment. While there are never absolute guarantees, there is no reason to think that you can't keep this tooth for a lifetime.