Root Canal FAQs

The alternative to endodontic treatment is extraction of the tooth. Loss of a tooth could create a functional problem such as chewing or an aesthetic problem. Restoring the lost tooth may involve the provision of a prosthetic replacement such as a denture, bridge or a dental implant the costs of which are variable.

Occasionally a tooth cannot be saved. Endodontic treatment can be performed only if the root canals are accessible and can be adequately cleaned and sealed. The tooth must also have sufficient bone support. We only carry out treatment where we can give a good long term outlook.

Endodontic treatment can fail for a number of reasons: It was not possible to treat narrow or curved canals well enough or the canals were not fully cleaned during the initial procedure. The tooth may have additional complicated anatomy that was not found on the initial treatment.

The final restoration was not placed quickly enough or the final restoration leaked due to a poor fit, fracture or recurrent decay around it.

Retreatment is usually more complicated than initial root canal treatment as the tooth is normally fully restored with a permanent restoration. This can range from a simple restoration to a full coverage restoration such as a crown or as part of a bridge. In addition to this a post may have been placed inside the root prior to a final restoration being placed. This creates difficulty as access to the root canals is more difficult.

Additionally the canals will have been filled with root filling material and hence this has to be removed before they can be instrumented and cleaned again. All of these obstructions make the process more complicated.

All dentists can carry out endodontic treatment, but many prefer not to carry out retreatment procedures as this can be more challenging and may require additional equipment, like a microscope, that may not be readily available.

Your dentist may opt to refer you to another practitioner who either has greater experience and training in the procedure or to a dedicated specialist endodontist for the procedure. This clinician will have additional training and dental equipment that may facilitate the procedure.

If you decide on retreatment the endodontist will gain access to the root canals of the tooth to remove the root filling and clean the canals again prior to refilling the canals. In many cases the restoration on the tooth will have to be removed, including complex restorations such as crowns and posts to allow the procedure to be carried out.

Retreated teeth can function for many years if the reasons for the initial failure can be overcome.

Advances in technology have allowed retreatment to be carried out on complicated problems but like most medical and dental procedures difficulties can prevent some teeth from responding to the treatment. The endodontist can advise on the likely success of the procedure and difficulties prior to the procedure.

Usually, the alternatives would be removal of the tooth or endodontic surgery. Removal of the tooth would then leave a space that may or may not be acceptable functionally or aesthetically and perhaps would require a prosthetic replacement tooth in the form of a denture, bridge or implant. Endodontic surgery involves lifting the gum or gingival tissue after a small incision to allow access to the root tip that is the cause of the persistent problem. This root tip can then be treated and sealed. Endodontic surgery would allow the existing restoration to be retained, however retreating the canals is usually the first and best option. Your endodontist can advise on the particular options for your problem.