Endodontic (Root Canal) re-treatment
If a previously root filled tooth becomes painful, it may be necessary to repeat or refine the previous root canal treatment.
Before planning endodontic re-treatment, the tooth needs to be carefully evaluated to determine the cause of failure. Sometimes, in back teeth especially, if there is no crown on a tooth after the historical root filling, a crack can develop in the tooth. If the tooth has a crack in it, this is a pathway bacteria can re-enter the tooth. If there is a crack in the tooth, the prognosis for re-treatment is not good as if the tooth is re-treated, bacteria can re-infect the space in the tooth again through the crack and the tooth can become symptomatic again.
In addition to a crack allowing bacteria into the tooth, historical root fillings can fail for a number of reasons including,
Missed spaces inside the tooth and extra canals in the tooth
Incomplete disinfection of the canals
Not cleaning the nerve spaces to the end of the root/ blocked canals
Re-infection of bacteria through an incomplete seal at the top of the tooth
At your assessment appointment, a thorough examination of the tooth will be carried out. As well as looking for signs of cracks in the tooth, the tooth will also be assessed to see why the historical root filling has failed and how this failure can be managed. The pros and cons of treatments can then be discussed in addition to alternative treatment options.