Retreatment of Failed Root Canal Therapy

When to Retreat a Failed Root Canal

Most teeth treated with root canal therapy remain healthy. Occasionally a tooth treated with root canal therapy (RCT) fails to heal or the pain continues. The tooth can become painful or diseased months or even years after successful treatment. The good news is a procedure to save your tooth can be performed. There are many reasons a treated tooth may not heal as expected:

  • Narrow or curved canals which were not treated during the initial procedure.
  • Complicated canal anatomy went undetected in the first procedure.
  • The crown or other restoration was not placed soon enough after the procedure.
  • The restoration did not prevent saliva from contaminating the inside of the tooth.

New decay can also jeopardize a successfully treated tooth by allowing bacteria into the filling material causing a new infection.

If the doctor prescribes retreatment, they will reopen your tooth to gain access to the root canal filling material. After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth with the high-power microscope. During this examination they will be looking for any additional canals or unusual anatomy that requires treatment. The advent of the dental microscope and our endodontist’s specialized training enable them to discover canals that would not otherwise be visible to the human eye. After cleaning the newly discovered canal(s) they will fill and seal the canal(s) and place a temporary filling in the access site. You will then be advised to visit 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.

Is Root Canal Retreatment the Best Choice?

Retreated teeth can function well for years, even for a lifetime! It is always best to save the tooth if possible. Extraction should always be the last option. An extracted tooth should then be replaced with a dental implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. No matter how effective tooth replacements are, and they can be very effective, nothing is as good as your natural tooth. You’ve already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth. Of course, there are no guarantees with any dental or medical procedure. The endodontists will discuss your options and the chances of success before beginning any therapy.

How Much Will a Root Canal Retreatment Procedure Cost?

The fees vary depending on how complicated the procedure will be. The treatment will probably be more complex than your first root canal therapy, because your restoration and filling material may need to be removed to accomplish the new procedure. In addition, the endodontist may need to spend considerable time searching for unusual canal anatomy. While dental insurance may cover part or all the cost for retreatment, some policies limit coverage to a single procedure on a tooth in each period of time. Check with your employer or insurance company prior to treatment to be sure of your out of pocket expense.


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