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Root Canal Retreatment


Although endodontic therapy can help you save an infected tooth from extraction, there are a variety of complications that may require root canal retreatment months or even years after your initial procedure. If a previously infected tooth is causing you pain and discomfort, you should consult with your dentist to determine whether you need a secondary treatment. The technology and techniques used by dentists are constantly evolving, and your treatment can be more precise and successful the second time. Your dentist can help you decide whether retreatment or surgery is your best option and will always attempt to save your natural tooth structure when possible.

x-ray of tooth after root canal

If complications such as reinfection affect a tooth following root canal treatment, a subsequent treatment can resolve the issue and help avoid the need for extraction.

Sources of Complications

According to the American Association of Endodontists, root canal treatment has a high success rate. Most teeth treated with root canal therapy can last a lifetime without needing extraction or replacement. However, you may need retreatment if:

  • You have narrow, curved, or complicated root canals that were not diagnosed and treated during your first root canal
  • Your crown or filling was placed too late after root canal treatment and the inside of your tooth has been contaminated
  • You experience new decay or infection due to poor oral hygiene
  • Your restoration is broken and allows infection to enter the tooth
  • You have cracked the roots of your tooth
  • The gutta-percha used to fill the tooth breaks down

These complications can cause pain and discomfort and can occur months or years after your initial root canal therapy. You should visit your dentist immediately to prevent the spread of infection.

Addressing infection early on can also help ensure the success of your first root canal therapy and reduce the risk of retreatment.

Retreatment Protocol

If you and your dentist choose to attempt retreatment on the affected tooth, your dentist will first remove the crown or filling to access your root canals. He or she will then remove the gutta-percha filling from your root canals and clean the infection out. Once the canals are clear, your dentist will be able to look at the inside of your tooth and determine why you need retreatment. If your root canals are blocked or extremely narrow, you may require an apicoectomy, or endodontic surgery. Otherwise, the dentist will simply fill the root canals again and place a temporary filling. To ensure that your tooth is not reinfected, you should return for your new crown or filling as soon as possible.

Retreatment vs. Extraction

Most dentists will try to save your natural tooth whenever possible, and endodontic retreatment can be more cost-effective than an extraction. To replace an extracted tooth, you will need a dental implant and an implant-supported crown or bridge. Implant surgery can be very expensive, and porcelain restorations will need to be replaced approximately every ten years, while a retreated natural tooth can last a lifetime.

toothbrush and floss

Excellent oral hygiene is one of the best ways to avoid the need for root canal retreatment.

How to Prevent Complications

If your complications are due to decay, you can lower the risk of needing root canal retreatment by practicing good oral hygiene. Addressing infection early on can also help ensure the success of your root canal therapy. Studies have shown that early treatment was more successful than procedures performed once the bone had been infected. The quality of your initial root canal treatment can also determine how successful it will be, and choosing an experienced dentist can help lower your risk of complications in the future.

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