With proper care, you’ll keep teeth that have had root canal treatment for a lifetime but it’s possible for those teeth to heal improperly, becoming painful or diseased months or even years after treatment. If this happens to your treated teeth you have a second chance to save the tooth with retreatment. An additional procedure may be able to diminish dental pain or discomfort and to promote healing. If you suspect a tooth that had a prior root canal requires retreatment, visit your dentist or endodontist for evaluation.
As with any dental or medical procedure, it’s possible your tooth won’t heal as expected after initial treatment for a variety of reasons, including:
• 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.
A new problem can also jeopardize a tooth that was successfully treated, such as:
• 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. During retreatment, the endodontist will reopen your tooth and remove the filling materials that were placed in the canals during the first procedure. The endodontist then carefully examines the tooth, looking for additional canals or new infections. The endodontist then removes any infection, cleans, and shapes the canals, and places new filling materials. The opening is then sealed with a temporary filling. The tooth should then be restored with a more permanent restoration to seal and protect it. In some cases, the endodontist may be the one to seal the tooth more permanently in preparation for the general dentist to place a crown.
HOW DO I KNOW IF I NEED AN ENDODONTIST?
If you’re experiencing tooth pain, you have injured your tooth, your tooth is sensitive to hot or cold, you should make an appointment to see an endodontist.
Traumatic dental injuries often occur because of an accident or sports injury. The majority of these injuries are minor – chipped teeth. It’s less common to dislodge your tooth or have it knocked completely out but these injuries are more severe. Treatment depends on the type, location, and severity of each injury. Regardless of the extent of the injury, your tooth requires immediate examination by a dentist or an endodontist. Sometimes, your neighboring teeth suffer an additional, unnoticed injury that can only be detected by a thorough dental exam.
Endodontists are dentists who specialize in treating traumatic dental injuries. With their advanced skills, techniques, and technologies they often can save injured teeth. If you have a cracked or injured tooth, find an endodontist near you right away. Most endodontists offer tremendous flexibility in accommodating emergency cases. You’ll have relief from your pain and likely save your tooth, so act as quickly as possible.
ROOT CANAL TREATMENT
A root canal treatment is a dental procedure to remove inflamed or infected pulp from the inside of the tooth, which is then carefully cleaned and disinfected, then filled and sealed.
Root canal treatment is designed to eliminate bacteria from the infected root canal, to prevent reinfection of the tooth and to save the natural tooth.
ENDODONTIC SURGERY
It’s possible that a nonsurgical root canal procedure won’t be enough to save your tooth and that your endodontist will recommend surgery. Endodontic surgery can be used to locate small fractures or hidden canals previously undetected on X-rays during the initial treatment. Surgery may also be needed to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth.
There’s no need to worry about surgery if your endodontist prescribes this additional measure. Advanced technologies like digital imaging and operating microscopes allow these procedures to be performed quickly, comfortably, and successfully.
There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which may be needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure.
Your endodontist performs this micro surgical procedure first making you comfortable by applying local anesthesia before opening the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. A small filling may be placed to seal the end of the root canal and a few stitches or sutures are placed to help the tissue heal. In the next few months, the bone will heal around the end of the root. Most patients return to their normal activities the next day. Post-surgical discomfort is generally mild.
