Endodontic Retreatment

With the appropriate care, your teeth that have had root canal therapy will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal. Sometimes pain may continue to exist, and may only occur months or years after treatment. If so, Endodontic Retreatment may be needed.

Improper healing may be caused by:

    • Bacteria and diseased pulp tissue that could not be removed during the first treatment.
    • Complicated canals went undetected, or curved and narrow canals were not treated during the initial treatment.
    • The restoration or crown was not placed within the appropriate amount of time following the root canal procedure. Because of this, bacteria in saliva contaminated the root canal system.
    • An injury to the tooth.


In some cases, new problems can influence a tooth that was successfully treated:

    • New decay can expose the root canal filling material, causing infection.
    • A cracked or loose filling or crown can cause leakage into the tooth to new infection.


During retreatment, a rubber sheet is placed over your tooth. The doctor will then reopen your tooth and remove the restorative material to gain access to the root canal filling material. The inside of the canals will be cleaned and inspected. Once cleaned, the doctor will fill and seal the canals and place a temporary filling in the tooth. You will then return to your dentist within a few weeks in order to have a new final restoration or crown placed to resume the tooth’s normal functions.


Is retreatment the best choice for me?

Retreated teeth can function well for years, even for a lifetime. It’s always best to save the tooth if your endodontist believes retreatment is the best option for you.

Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may even be able to use a new technique that was not available when you had your first procedure. If your tooth has unusual anatomy that was not cleaned and sealed during the first procedure, your endodontist may be able to resolve this problem with a second treatment.

Although retreatment can have a high rate of success, there are no guarantees with any dental or medical procedure. Your endodontist will discuss your options and the chances of success before beginning retreatment.

What are the alternatives to Retreatment?

For some patients considering retreatment, endodontic surgery is also an option. This surgery involves making an incision near the end of the root to allow the tip of the root to be sealed. Endodontic surgery may be recommended in conjunction with retreatment or as an alternative. See “Apicoectomy” under “Procedures.”  Your endodontist will discuss your options and recommend appropriate treatment.

The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth.

No matter how effective modern tooth replacements are – and they can be very effective – nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. Retreatment can maintain a healthy, functioning natural tooth for many years to come.

Retreatment Video