A second chance to save your tooth
With proper care, most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth.
In some cases, however, a tooth that has received endodontic treatment fails to heal or the pain continues. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment.
If your tooth has failed to heal or has developed new problems, you have a second chance. Another endodontic procedure may be able to save your tooth.
Why do I need another endodontic procedure?
Endodontic is a word derived from two Greek words (Endo – inside) and (odont – tooth). Therefore, endodontic treatment is the treatment of the inside of a tooth.
Before you can fully understand the features of an endodontic treatment, you should first have an overview of the anatomy of a tooth. There is a soft tissue deep inside the tooth known as pulp. This pulp is located beneath the enamel (white outer covering of a tooth), and the dentin (hard layer beneath the enamel). All the nerves, blood vessels, and connective tissues in a tooth are located within the pulp. During tooth development, the pulp also produces the hard tissues of the tooth.
The pulp is a very important part of the tooth and plays a significant role when the tooth is still growing and developing. It provides support to the growing tooth, until the tooth has completely matured enough to draw nutrition from the surrounding tissues without depending on the pulp. The pulp occupies the region of the crown of the tooth to the root ends, where it merges with the surrounding tissues of the root.
In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:
A loose, cracked or broken crown or filling can expose the tooth to new infection
1) First, the endodontist will discuss your treatment options. If you and your family dentist choose retreatment, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials – crown, post, and core material – must be disassembled and removed to permit access to the root canals.
2) After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth, searching for any additional canals or unusual anatomy that requires treatment.
3) After cleaning the canal(s), the endodontist will fill and seal the canal(s) and place a temporary filling in the tooth. Post space may also be prepared at this time.
4) After the final visit with your endodontist, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to full function.
Retreated teeth can function well for years, even for a lifetime. It’s always best to save the tooth if your endodontist believes retreatment is the best option for you.
Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may even be able to use a new technique that was not available when you had your first procedure. If your tooth has unusual anatomy that was not cleaned and sealed during the first procedure, your endodontist may be able to resolve this problem with a second treatment.
Of course, there are no guarantees with any dental or medical procedure. Your endodontist will discuss your options and the chances of success before beginning retreatment.
What are the alternatives to treatment?
For some patients considering retreatment, endodontic surgery is also an option. This surgery involves making an incision near the end of the root to allow the tip of the root to be sealed. Endodontic surgery may be recommended in conjunction with retreatment or as an alternative. Your endodontist will discuss your options and recommend appropriate treatment.
The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth.
No matter how effective modern tooth replacements are – and they can be very effective – nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for many years to come.