What is a Re-Root Canal Treatment?
If you’ve had a root canal, the chances are good that it will be successful and your tooth will remain healed. However, there are occasions when a tooth can fail to heal or become infected again. If a tooth becomes painful or a gum boil appears, it may be necessary to re-treat the tooth to give it a second chance. However, sometimes there are no symptoms and the failure is only detected with an x-ray. If this happens, you may need a re-root canal treatment.
A root canal is a treatment used to save a tooth that is badly decayed or infected. The procedure involves removing the diseased pulp from the center of the tooth and then sealing the tooth. A re-root canal treatment is simply a repeat of the original procedure.
How would you know if you need a re-root canal treatment?
If you have a tooth that has undergone a root canal treatment, it is possible that the tooth may need to be retreated. There are several reasons why this may occur. Sometimes, the original root canal treatment was not successful in sealing off the canals completely. Other times, there may be new decay or an infection present in the tooth that was not there when the initial root canal was done. If you are experiencing any of the following symptoms, it is possible that you may need a retreatment:
- Persistent pain or sensitivity in the treated tooth
- Swelling or tenderness in nearby gums
- A pimple on the gums near the treated tooth
- Discoloration of the treated tooth
If you are experiencing any of these symptoms, it is important to see your dentist as soon as possible so that they can determine if retreatment is necessary.
Failure of a root canal treatment can happen for several reasons:
Most common:
Incomplete canal fillings or missed fillings can result in bacteria remaining in the canals, leading to infection
Bacteria have infiltrated the root canal through a lost or broken restoration, decay, or root fracture. This poses a serious threat to the health of the tooth and must be addressed immediately
Less common:
The root canal infection has spread to the surrounding tissues
The dental filling materials beyond the root canal can cause an inflammatory reaction in the surrounding tissues of the tooth
A cyst has developed at the end of the root, and root canal treatment may be necessary to heal it
Treatment:
First, the dentist will take an xray of the infected tooth to check the severity of the infection. Depending on the condition of the tooth and surrounding bone the dentist will recommend for a re root canal or extraction will be the last option. The re root canal treatment is generally done in 2-3 sessions.
If re root canal is possible the dentist will first break open the existing crown.
Then local anaesthetic may be used to numb the tooth, which is isolated from the rest of mouth with rubber dam. This is extremely important for a number of reasons:-
- It protects you from inhaling/swallowing instruments
- It allows the use of strong disinfectants to clean out root canals
- It also prevents bacteria from saliva getting into the tooth
Access is made through the tooth into the root canal. The previous root filling is removed to allow any infected parts of the canals to be accessed and cleaned. Any other issues, such as missed and blocked canals or broken instruments, can be tackled at the same time. Once the root canals have been located, small files are used to clean and shape them together with copiously rinsing with disinfectants to remove any bacteria. If the cleaning and shaping of canals takes more than one visit, the tooth is dressed using an antibacterial paste within the canals and a temporary filling is placed.
Once the root canals are as clean as possible, they are filled and covered to protect them from bacteria re-entering. In some cases, the tooth will need to be restored with a more permanent restroration, such as a crown, to again prevent bacteria getting back in and causing the root treatment to fail.
Is re-root canal painful?
It will not be painful during the treatment, but you should expect mild discomfort for 2-3 days afterwards. This is best managed with a simple painkiller such as Ibuprofen or paracetamol.
Alternatives to root canal treatment:
There are no alternatives if you wish to retain your tooth. The only other option is to have the tooth extracted. This will leave a gap you might be happy to accept, or you may want to look at options to fill gaps, which could include a denture, bridge or implant.
Factors which increase success:
- Treatment completed by a specialist
- Being able to find all the root canals and clean, shape and fill them to the end of the roots
- Having a good quality permanent restoration placed as soon as possible after treatment. In the case of heavily filled back teeth, a crown is the restoration of choice. This increases the chance of tooth survival by 6 times
Factors which decrease success:
- If there is a radiolucency (dark shadow) on the x-ray associated with the tooth
- If there is a sinus (gum boil) associated with the tooth
- If a large, longstanding perforation (communication through the root into the surrounding gum or bone) is present
- Where the root treated tooth is used to support a denture or bridge
