A root canal involves the removal of soft tissue called dental pulp and infection from a person's tooth. Endodontic retreatment is a second procedure performed on a tooth that has already had a root canal. Retreatment can sometimes save a tooth that would otherwise have to be removed because the first procedure failed or as the result of new decay or injury. If performed successfully, this type of treatment can ensure that a person’s tooth lasts indefinitely. Sometimes, however, people would rather not have another root canal and opt to have surgery instead.
Sometimes unhealed infection or untreated areas of a tooth mean a root canal was not a complete success. For example, bacteria in a person’s saliva may have infected the tooth after the root canal but before the subsequent tooth restoration process was completed. A crack in a tooth may also allow decay in, or the tooth may sustain an injury. In some cases, a dentist may even make a mistake in cleaning diseased pulp out of a tooth, rendering the root canal unsuccessful. When any of these problems occur, a dentist may recommend endodontic retreatment.
To perform this type of treatment, a dentist or root canal specialist must gain access to the previously treated tooth. This typically means removing the crown, which is a protective cap placed over a treated tooth, and any other materials used to restore the tooth after the initial root canal. A dentist will then have to remove the material that was used to fill the tooth and clean the canals, which are channels that house the pulp. After this step, a dentist usually refills the canals and finishes by putting a new filling in the treated tooth. The filling is usually only meant to remain in place temporarily, and the patient typically has his crown and permanent filling replaced at a subsequent appointment.
For many people, the new root canal proves successful, but dentists do not usually guarantee that a retreated tooth will remain healthy for life. Leftover bacteria or new decay could cause problems once again. As such, dentists often warn patients that even a tooth that has undergone endodontic retreatment may someday require extraction. Having a permanent filling and restorative crown applied in a timely manner and practicing good oral hygiene can improve the chances that a restoration will last.
If a patient and his dentist decide that endodontic retreatment isn’t the best option, they may consider surgery instead. In such a case, a dentist surgically accesses the root of the tooth through the gums and treats the root by sealing its tip. Surgery can be used by itself or in conjunction with the typical endodontic retreatment techniques.