Endodontic Retreatment

By Guido E. Costa, DMD, MS

Endodontic Associates

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Endodontic Retreatment

With proper care, most teeth that have had root canal (endodontic) treatment can last as long as other natural teeth. In some cases, however, a tooth that has received endodontic treatment fails to heal.

Occasionally, the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has not healed or has developed new problems, you have a second chance. Another procedure, endodontic retreatment, may be able to save your tooth.

Who Performs Endodontic Retreatment?

All dentists receive basic training in root canal treatment in dental school. However, because endodontic retreatment can be more challenging than providing first-time treatment, many dentists refer patients needing endodontic retreatment to endodontists.

Endodontists are dentists with at least two additional years of advanced specialty education in diagnosis and root canal treatment. Because they limit their practices to endodontics, they treat these types of problems every day. Endodontists are experts in performing non-surgical and surgical retreatment. They use their special training and experience in treating difficult cases, such as teeth with narrow or blocked canals or unusual anatomy. Endodontists may use advanced technology, such as operating microscopes, ultrasonics and digital imaging to perform these special services.

Why Do I Need Another Endodontic Procedure?

As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:

• Narrow or curved canals were not treated during the initial procedure.
• Complicated canal anatomy went undetected in the first procedure.
• The placement of the crown or other restoration was delayed following the endodontic treatment.
• The restoration did not prevent salivary contamination to the inside of the tooth

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

• New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
• A loose, cracked or broken crown or filling can expose the tooth to new infection.
• A tooth sustains a fracture.