Why Would a Tooth Need Retreatment?
Several factors may lead to the need for retreatment, including:
- Persistent or recurrent infection within the root canal system
- Narrow or curved canals that were not fully treated during the original procedure
- Missed anatomy, such as an untreated canal or complex root structure
- Delayed placement of the final restoration, allowing bacteria contamination
- Leaking, damaged or failing restorations (crowns, or fillings)
- New decay that exposes the root canal filling to bacteria
Symptoms that may indicate a problem with a previously treated tooth include:
- Pain or tenderness in the area
- Swelling or gum irritation near the tooth
- Sensitivity to pressure or temperature
- A pimple-like bump on the gums (may indicate a recurring abscess)
- Discoloration of the tooth
- Evidence of infection on X-rays despite lack of symptoms
If you are experiencing any of these symptoms, we recommend scheduling an evaluation. Keep in mind that even if the tooth feels fine, your dentist may still refer you for retreatment based on signs of infection or other concerns visible on radiographic images.
What to Expect During Retreatment?
Root canal retreatment is performed under local anesthesia, with steps similar to the original procedure, but often with added complexities. Here’s what to expect:
- Evaluation and Imaging
We begin with a comprehensive consultation, including clinical examination and advanced imaging, such as digital x-rays and 3D CBCT scans, to understand the cause of the problem and plan the treatment. For retreatment cases, we typically schedule a consultation-only visit first to fully assess the situation. - Access and Removal of Existing Materials
The existing restoration is carefully removed to access the root canal system. In most cases, we are able to access the canals through the existing crowns to preserve it whenever possible. The previous root canal filling materials are then removed. - Re-cleaning and Disinfection
The canals are thoroughly cleaned, re-shaped, and disinfected to eliminate any remaining bacteria or infection. - Inspection for Additional Anatomy or Issues
We inspect the tooth for previously untreated anatomy, anatomical variations, fractures, or blockages that may have contributed to the failure of the initial treatment. - Refilling and Sealing
Once cleaned and inspected, the canals are refilled with fresh biocompatible material and carefully sealed. - Temporary Restoration
A temporary filling is placed. Your general dentist will later complete the restoration with a new crown or appropriate final restoration to protect the tooth.
Is Retreatment More Complex?
Yes, root canal retreatment is often more complex than the initial root canal therapy due to changes in the tooth structure, the presence of existing restorations, and the possibility of hard-to-reach anatomy. However, our team is highly trained and equipped with state-of-the-art technology—including operating microscopes and 3D imaging—to effectively manage these challenges.
What Are the Benefits of Retreatment?
Choosing root canal retreatment offers many benefits:
- Help preserve your natural tooth
- Avoid more invasive procedures like extraction and tooth replacement
- Restore tooth function and comfort
- Prevent the spread of infection or further complications
When Might Retreatment Not Be the Best Option?
In some cases, retreatment may not be the best option- especially if there is significant structural damage, a root fracture, or other complications. If this is the case, we will discuss alternatives such as endodontic surgery (apicoectomy) or tooth extraction with replacement options like implants or bridges.
If you’re experiencing symptoms in a previously treated tooth, don’t wait.
Early diagnosis and treatment improve your chances of saving the tooth and avoiding further complications. Contact our office today to schedule an evaluation—we are here to help you make an informed and confident decision.