A Root Canal Treatment is a procedure involving the removal of pulp and nerve tissue from within the tooth. It is recommended when a tooth becomes irreversibly infected and inflamed by bacteria gaining access to the root of the tooth, causing pain, sensitivity, and endangering the long-term health of not only that tooth but the surrounding teeth and gums.
When a patient has followed their dentist’s advice regarding sufficient and correct oral hygiene habits and maintenance following a root canal treatment, in the majority of cases their root canal-treated tooth can last in good health as long as their other natural teeth. However in some rare cases, as with all medical procedures, there is a chance either of the body not taking to the treatment or of complications occurring caused by non-ideal circumstances of the original procedure. If this happens, months or even years following a root canal it is possible, although highly unlikely, for the tooth to again become sensitive, painful or diseased.
This is where a Root Canal Retreatment or a different surgical procedure called an Apicectomy comes into play. At Dame Street Dental all consultations of this nature are taken with our specially qualified Endodontic dentist, to assess your specific situation and best advise you, before carrying out the treatment that will give your tooth a second chance to heal and allow you to save your natural tooth.Book online
Although the occurrence is rare, there are a number of reasons why a Root Canal Treatment can fail. It can be due to the tooth not healing fully following the original procedure, or through developing new or related problems following treatment:
If your initial root canal treatment was carried out at Dame Street Dental, your dentist will have emphasised the importance to you of keeping to a regular, 6-monthly check-up and cleaning schedule, to monitor your treated tooth for any issues as well as to maintain your overall oral health. Whether you have booked a consultation with our clinic as a new or an existing patient, your dentist will always first carry out a full and comprehensive examination of your teeth, gums and bone, and will address all specific concerns or issues you are experiencing.
Your need for retreatment may become obvious from symptoms such as pain or discomfort at the site of an old root canal treatment. Alternatively, this may have been an incidental finding of infection or inflammation from your dentist during your examination.
At this stage, your dentist will likely take a detailed X-ray of your tooth to establish the extent of the infection affecting your root, to assess in detail the internal anatomy of your tooth and to allow them to properly plan for your treatment. If your case is more severe or the re-infection extensive, it may be appropriate to carry out an alternative treatment – a minor surgical procedure known as an Apicectomy – and your dentist will be able to discuss this possibility with you at this assessment.
They will be able to answer any questions you may have at this stage, to fully prepare you for the retreatment itself, and to go through all options for restoration procedures following the treatment that are relevant to your case. This detailed treatment plan will include a complete estimate of the time until completion of your full treatment, as well as a breakdown of the total costs involved.
The retreatment procedure
Your dentist will use a highly effective local anaesthetic to numb your mouth prior to treatment. This ensures that the procedure will be completely pain-free, and you will feel little more than some gentle vibration throughout - similar to getting a dental filling. Do speak to your dentist if you have any worries about undergoing treatment due to anxiety, fear, or stress caused by dental procedures, as we make the option of undergoing any treatment under dental sedation available to all of our patients - the ideal solution for any patient who suffers from dental anxiety or severe nerves.
Retreatment of your root canal treated-tooth begins with your dentist drilling a small hole into the tooth to access the root filling material. If you have a crown on your tooth they will either fully remove the crown to expose the filled root or else drill through the crown if appropriate. Your dentist will then proceed to remove the artificial filling material, after which using very fine dental files they will precisely and carefully clean the inside of your root canal system. At Dame Street Dental our endodontic dentist uses our high-tech surgical microscope at this stage to inspect for any unusual anatomy or cracks within the tooth to offset any further complications.
After your tooth has been thoroughly cleaned the interior will be sterilised with an anti-microbial solution to kill any lingering bacteria, before finally the root canals of your tooth will be resealed and filled. Your dentist will have advised you at the treatment planning stage whether or not you will need a new crown placed after this retreatment, or if your previous crown is salvageable and can simply be re-bonded. If your old crown is not offering you sufficient protection and needs to be replaced, then a 3D impression for your new crown will be taken at this stage so that the fabrication process can begin right away. It is vital to have your new crown placed in this instance as soon as possible after your retreatment, to reduce any risk of the procedure failing.
If you would prefer not to undergo retreatment of your tooth, unfortunately, the only other option is the final extraction of your tooth. At Dame Street Dental we will always do our utmost to save your natural teeth whenever possible. However our dentists’ expert recommendation is also patient-led, and we will always listen to your treatment goals, needs, and priorities when advising you on a treatment plan.
During your initial consultation with your dentist, we will always provide you with all the information you need to make an informed decision about all available options and their projected outcomes for your specific case. If you decide to opt for tooth extraction over root canal retreatment, there are many treatment options to discuss in that case to replace the missing space, such as Dental Implants, Bridges, and Dentures.
Failure of an initial Root Canal Treatment can present in a number of ways. While some patients will experience pain and discomfort at the site of the treated tooth, others may notice swelling or an unusual boil or pimple on the neighbouring gumline. In other cases, your dentist may have discovered your need for retreatment as an incidental finding on an X-ray or during a routine examination of your teeth or gums.
If you are at all unsure whether you may be experiencing discomfort or symptoms due to a failed Root Canal Treatment, you can book a consultation today to be examined by our specialist endodontic dentist.
The chance of success does drop for Root Canal Retreatment when compared to initial treatment. However in recent years there have been significant advances made in the techniques and equipment available to specialised dentists – such as dental microscopy, a powerful tool to enhance accuracy and efficacy employed at Dame Street Dental – which have all greatly improved the success rates of Root Canal Retreatment. Your dentist will advise you what the best option is for your individual case and the chance of success during the treatment planning stage prior to committing to retreatment.
No, just as with your initial Root Canal Treatment your retreatment procedure will be entirely pain-free. At Dame Street Dental we use a highly effective local anaesthetic to ensure you experience no discomfort throughout the treatment – you will feel little more than some gentle vibration and pressure during the treatment. While it is perfectly normal to have some mild discomfort for 2 to 3 days following your treatment, this can be effectively managed with over-the-counter pain relief medication.
For nervous, anxious or dentist-avoidant patients we also offer the option to undertake this or any treatment under Dental Sedation. This allows even the most nervous patient to remain completely relaxed and at ease throughout their procedure, while remaining conscious but drowsy and with no unpleasant memories of your treatment afterwards.
Particularly for lengthier appointments, which may have involved stress to your jaw from keeping your mouth open for the duration, you can expect to feel some mild discomfort or tenderness after your treatment, which will usually begin to improve within 2 to 3 days. This discomfort will be mild, and can be routinely relieved by over-the-counter painkillers and by following the aftercare advice given to you by your dentist.
You will be able to eat normally following your procedure, however it is best to avoid all food for at least 3 to 4 hours immediately after treatment to allow the numbness from your local anaesthetic to wear off.
Following this period, it is generally advised to chew on the opposite side of your mouth to the site of your treatment until any tenderness has resolved, and to keep to a soft diet for 2 to 3 days after the procedure if you are still experiencing sensitivity.
At Dame Street Dental we know that it is always best to save your natural tooth whenever possible. Choosing to have the tooth extracted instead can lead to a number of complications down the line, due to the impact the loss of a tooth has on the surrounding teeth, bone density and shrinkage, in addition to the aesthetic impact of a gap in your smile. Your dentist will be able to address any concerns you have regarding Retreatment at your initial consultation, and can advise on the best course of action for your situation, including detailing restoration options post-extraction if that is the path you decide on.
When properly maintained and cared for, a Retreated Root Canal-treated tooth can last just as long as any natural tooth, and making a commitment to good oral health habits and regular dental check-ups and cleanings can prolong the lifespan of your retreated tooth for many years to come, and in some cases may even last for life.
As with all treatments, dental or medical, there is always a small risk of failure – your dentist will be able to advise you on the chance of success before beginning your retreatment, as well as providing clear, thorough aftercare instructions to maximise the effective and long-lasting prognosis of your treatment.
Suffering from recurrent pain, sensitivity or new symptoms at the site of a previous Root Canal Treatment?