Endodontic Retreatment Explained

Root canal surgery is one of the most common major procedures that we perform to save our patients’ teeth here at McDonough Endodontic Center. For some patients, however, the original root canal surgery does not heal properly the first time, and endodontic retreatment may be necessary. In other cases, an entirely new infection arises from a separate issue or injury to the tooth, even years after a successful procedure. If you experience pain and other symptoms in the same tooth where the original apicoectomy was performed, please schedule an appointment as soon as possible with our endodontist for an evaluation.

What is endodontic retreatment?

Most teeth treated by root canal can heal and perform normally for the rest of your life. In cases where the tooth does not heal properly, your endodontist will need to re-open the root, remove the filling and evaluate the situation and re-treat the infected tooth, resolving any issues that continue to cause pain.

The biggest sign that you may need to have a tooth re-treated is intense pain and pressure in the affected tooth, making it hard to chew. Other symptoms include swelling, pimples, and discolored gum tissue around the affected tooth. Your tooth may also be extremely sensitive to heat or cold. Any one of these symptoms should be checked by your endodontist.

When is endodontic retreatment needed?

Endodontic retreatment may be necessary for a number of reasons. For many people who require retreatment, their individual root anatomy may include extremely curved or narrow canals that harbored a tiny amount of infection that was not detected the first time around. Sometimes, tiny amounts of saliva, which harbors a lot of bacteria, can get into the canal before the root canal filling is placed, which can also cause problems. In other situations, a delay in placing the crown after treatment can lead to infection.

Even when the first root canal procedure went perfectly, new problems can develop that may indicate endodontic retreatment. For example, new tooth decay or gingivitis can leave the root vulnerable to new bacteria, and hence, new infection. If the original crown comes loose, gets cracked or broken, this can also allow bacteria to infiltrate and re-infect the tooth. If you fracture the tooth, this also leaves the root exposed to infection.

What is involved in the procedure and healing process?

If endodontic retreatment is indicated in your situation, the endodontist will re-open the affected tooth and take out the root filling that was originally placed during the first root canal. Using advanced imaging and microscopes, our endodontist will examine the root system to discover any lingering infection or any undetected smaller, winding canals. The doctor will thoroughly remove infection, sterilizing and shaping the canals prior to placing a new root filling. A temporary filling will be used to seal the opening, and we will provide you with very specific care instructions to follow to ensure the tooth heals properly. Many patients require a follow-up visit or two to monitor the healing process. As soon as the tooth is healed, a new crown must be placed as soon as possible to keep the tooth safe from further infection.

It is important to follow your endodontist’s post retreatment care instructions exactly to allow your tooth to heal and prepare for any follow-up work that may need to be done for a full restoration of the tooth. This will give your teeth the best chance of healing correctly so that you can keep it.

The Endodontists McDonough Trusts

Dr. Rolin Desir and Dr. Alison St. Paul use the latest technology and diagnostic tools, such as small-volume, cone-beam CT scanning that creates accurate 3D images down to the smallest canals. This enables them to detect even stubborn, tiny pockets of infection so that, for most patients, endodontic retreatment will not be necessary. If you do experience painful symptoms that indicate possible retreatment, however please contact McDonough Endodontic Center right away to schedule an appointment.