Root canals are a great treatment option for individuals who want to maintain their natural teeth, as they can provide excellent results at a relatively low cost. On some occasions, though, root canal therapy may not prevent the recurrence of infection inside the tooth. Such infections can bring back pain and other unpleasant symptoms, and the first reaction by many people is to seek an extraction. However, the good news is that teeth that have been treated with root canal therapy can again benefit from second root canals. Known as endodontic retreatment, this second-chance option can help people keep natural teeth, even when they believed extraction was their only option. Below is more information about why and how teeth treated with root canal therapy can fail and how retreatment may be the best option for you:
The causes of root canal failure
In a root canal procedure, the dentist cuts a hole into the top of the tooth and uses tiny instruments to clean out both living and diseased tissue. The tips of these instruments are extended all the way into the roots of the teeth, and the dentist finishes cleaning out the inside of the tooth. Next, the openings inside the roots and inside the tooth itself are filled with a substance designed to add strength and protect teeth from breaking.
In most cases, root canal therapy is overwhelmingly successful and does not need to be repeated. However, there are times when a root canal will need augmentation at the hands of a skilled endodontist. This failure can occur due to a variety of conditions, including:
Crowns not placed - You may be excited and ready to get your tooth repaired fully, but some people delay the time between the root canal and placement of a crown. A missing crown can permit infectious material to enter the top of the tooth and pass into the roots.
Uncleaned roots - Stereotypical diagrams of teeth often show the teeth to have a simple root layout; however, it is not always that straightforward. In fact, teeth often have a complex variety of root patterns, shapes, and sizes. This can permit roots to go unnoticed during the original root canal, thus leaving an area ripe for future infection.
Damage to the repair and teeth - Even if the previous repair is perfect, damage to the affected tooth or site of old repairs can result in a new infectious process. Cracked teeth and broken crowns are just two possible sources of infection.
How a retreatment is performed
Much like when the original root canal was performed, the dentist will clean all of the interior surfaces of the root openings. Before this is done, however, any type of material that was inserted previously will need to be removed to allow access to the interior of the tooth. This requires the dentist to work slowly and carefully and avoid overlooking any residual material. In addition, the dentist may wish to conduct more in-depth analysis of the patient's tooth to be sure there are no missed areas. Once the second treatment is concluded, the dentist will seal all openings and reinstall a replacement crown.
Other options for treatment
If a retreatment still does not improve the situation, then you can always consider extractions under the guidance of a dentist. Extractions will require you to choose a follow-up means of protecting your bite and surrounding teeth, such as the installation of a bridge or dental implants;
In other cases, you may be advised to consider endodontic surgery, which involve sealing the bottom openings of the root in the tooth. By sealing these openings, there is little chance for future infection to arise from the bottom of the tooth. This surgery is safe, effective, and relatively simple in concept, so don't hesitate to ask your dentist about it.