What Is a Root Canal Re-treatment, and Why Would I Need One

Let’s talk about this common endodontic surgery performed to resolve a failed initial root canal

Teeth that have undergone root canal treatment following inflammation or infection often last a lifetime with proper care.

However, in some cases, an endodontically treated tooth may not heal properly - potentially becoming re-infected and causing pain months or even years following the initial procedure.

While this can be a rather unfortunate occurrence, the good news is, teeth that had bad root canal dental work in the past can be re-treated with a secondary endodontic treatment procedure if necessary (a procedure simply referred to as a root canal re-treatment).

With a high success rate depending on the circumstance, a root canal re-treatment is designed to save the tooth that has become re-infected once again.

Root canal re-treatment and potential causes explained

Root canal re-treatment is an effective endodontic procedure on a tooth, commonly performed following the failure of an initial root canal treatment.

This failure can be due to a number of potential reasons, including the following:

• Any particularly narrow or curved canals were not properly treated during the initial procedure.
• A patient’s complex canal anatomy was not detected during the initial procedure.
• There was a delay in the placement of the crown or other alternative restoration following the initial treatment.
• The endodontist or dental professional did not take the appropriate steps to prevent salivary contamination that can occur inside of the tooth.

In other situations, the development of new problems in the mouth can put a tooth that was successfully endodontically treated at risk. This includes oral issues such as:

• The introduction of new decay can expose the root canal filling material to harmful bacteria, leading to a new infection in the tooth.
• A crown or filling that has become loose, fractured or cracked can expose the treated tooth to a new infection.
• The tooth suffers a fracture.

How will I know if my initial root canal treatment has failed?

The most common indicator of a failed root canal is pain. This pain can be experienced only when eating or biting down using the affected tooth, or can also be a persistent and recurring pain that does not go away. Moreover, it’s also common to experience swelling and tenderness in the area if your initial root canal treatment has failed.

Lastly, you may also notice a fistula (a pimple-resembling bump located near the affected tooth), or may even notice that the tooth feels loose.

What happens during a typical endodontic retreatment procedure?

During a typical endodontic re-treatment procedure, the tooth will be reopened once again in order to gain access to and clean out the root canal filling material from the initial treatment.

After that, the canals will be thoroughly cleaned out, and the tooth will be carefully examined for any unusual canal structures, as well as any potential cracks and infection. Following this, the canals are sealed. Regarding cases where the canals are too narrow or unusual, it may be necessary to perform further treatment with an apical surgery.

To finalize the root canal re-treatment procedure, the endodontist will place a permanent filling or new crown on the tooth in order to provide protection and support.

What can I expect following a root canal re-treatment?

After an endodontic re-treatment procedure, it’s expected that a patient experiences a recovery similar to that of their initial root canal. This includes common and temporary side effects like mild pain or discomfort, tenderness, and swelling surrounding the treated tooth.

Fortunately, over-the-counter pain medication can relieve these symptoms in the interim, in addition to applying a cold compress to the area. It’s also strongly advised to stick to only soft foods during recovery, and to avoid chewing using the side of the mouth with the affected tooth until the pain subsides.

It’s always wiser to save your natural tooth vs. having it extracted.

If you suspect that you are dealing with a failed previous root canal procedure and are in need of a re-treatment, reach out to our experienced team at Endodontics on Don Mills today.