If you’ve ever had a major infection that’s reached the roots of your tooth, relief probably meant ‘Root Canal Treatment’. A root canal can help get you out of pain and can prevent the need for a tooth extraction. For the most part, root canals are successful and your dental treatment may last a lifetime. But for the five percent of root canals that don’t heal, endodontic retreatment is often necessary to save the tooth.
Endodontic therapy is a complicated procedure that uses files to extract infected pulp from the root. When the infection remains in the root’s canals, the tooth may not heal, causing it to become reinfected There are several ways this can happen:
- Newly formed tooth decay can cause a leakage of bacteria into the root canal.
- The dental crown used to protect the tooth cracks, breaks or is placed too late, allowing new infection to enter the root.
- The roots weren’t cleaned thoroughly or were missed completely -- it can be difficult to remove the infection in curved root canals and some of the canals may be too hard to see, causing them to remain untreated.
- The roots were incorrectly sealed or filled.
- The tooth was contaminated by saliva during the procedure.
While your dentist may be able to retreat the tooth, endodontic retreatment is usually performed by endodontists, or root canal specialists. The first step in endodontic retreatment is non-surgical retreatment, which is performed much like a typical root canal. Your dentist needs to gain access to the roots by either removing the dental crown or drilling directly through the crown itself. The dental crown’s post, which is embedded into the tooth to keep it in place, will need to be removed. Once the tooth filling material is extracted, files are used to reshape the root’s canals, which are then cleaned and filled with gutta percha. Once your endodontic retreatment is complete, your dental crown will be filled or you will be fitted for a new one.
Although the procedure is similar to your original root canal treatment, it requires more precision to better remove what was missed before.
In some cases, your dentist may not be able to remove all of the infection during endodontic retreatment. Your dentist may skip nonsurgical endodontic retreatment altogether if the post that holds your crown in place can’t be removed or if the canals are too narrow, blocked or curved to gain access to them. If endodontic retreatment doesn’t work or isn’t an option, root end surgery may be required.
If you’re experiencing discomfort in a tooth that had a root canal treatment, don’t ignore it. The sooner you see a specialist, the better chance you’ll have of saving your tooth and getting relief from your pain!
