Despite the incredibly high success rate of root canal procedures, a tooth that has already received root canal therapy may require endodontic retreatment if the presence of infection is determined to have persisted, or returned after a period of time.
- What Is Endodontic Retreatment?
- Do I Need a Retreatment?
- GentleWave® Retreatment Procedure
- Standard Retreatment Procedure
What Is Endodontic Retreatment?
Endodontic Retreatment is a procedure performed to eliminate infection from a tooth that has already had root canal treatment in order to save the tooth from extraction. To do this, contaminated root canal filling materials and harmful bacteria are removed from inside the tooth, the root canals and nerve chamber are extensively cleansed, and the tooth is filled and sealed.
At Arcadia Endodontics, our board-certified endodontists are highly skilled and experienced in performing endodontic retreatment using state-of-the-art equipment and techniques that maximize the prognosis of your tooth while also promoting optimal patient comfort. Of particular importance, Dr. Kevin Axx and Dr. Collin Clatanoff have distinguished themselves as two of the most experienced providers in the Valley with the GentleWave® System. With this technology, our doctors can maximize the prognosis of your retreatment, all while reducing treatment time, conserving precious tooth structure and reducing postoperative discomfort.
Do I Need a Retreatment?
Endodontic retreatment is typically indicated when an infection persists or recurs inside a tooth that has been previously endodontically treated. Persistent or recurrent infection can occur for multiple reasons, including complex nerve anatomy that complicated the initial root canal disinfection procedures, deteriorating dental restorations that allow for bacterial leakage, recurrent tooth decay, and tooth cracks/damage. Some of the most common signs that indicate you may need a retreatment include:
- Sharp or intense pain when biting or chewing
- Chronic dull pain
- A constant bad taste in the mouth
- Tenderness, swelling, throbbing, and/or discoloration of gum tissue
- Pimples on the gums
- Fever-like symptoms
When left untreated, an infection within a tooth will not heal on its own—and can even spread to other areas, including the jaw, head, and neck. In rare instances, an uncontrolled infection may grow in severity to the point that it leads to life-threatening conditions, such as sepsis.
If you are experiencing any of the symptoms listed above, or if your specific concerns are not listed but you suspect a tooth infection, we encourage you to schedule a consultation with one of our endodontists. Using advanced technologies like Cone Beam CT scanning, Dr. Clatanoff or Dr. Axx can evaluate your teeth and other oral structures with exceptional visualization from virtually every angle, enabling them to diagnose any issues present and develop a customized treatment plan based on your unique needs.
GentleWave Retreatment Procedure
The GentleWave® Procedure is a revolutionary endodontic technique that utilizes advanced fluid dynamics and broad-spectrum acoustic energy to comprehensively disinfect the root canal system of an infected tooth. Unlike the standard retreatment procedure that can require two or more appointments to perform, the GentleWave retreatment procedure is typically completed over the course of just one appointment due to the advanced disinfecting capabilities of this technology. As a result of this enhanced level of disinfection, GentleWave patients typically experience an improved prognosis, quicker healing, and less postoperative discomfort.
Treatment is generally completed using a local anesthetic, although several sedation options are available for nervous or anxious patients. Once anesthetized, the GentleWave® System then propels sanitizing fluid throughout the entirety of the root canal system via broad-spectrum acoustic energy, enabling it to reach and cleanse even the smallest of spaces in which bacteria can hide. Simultaneously, a powerful vortex of procedural fluids are utilized to pull harmful debris, infected tissue, and bacteria from your tooth.
This level of cleanliness is rarely possible with standard endodontic retreatment due to the inability of manual instruments to navigate the intricate anatomies of some root canals where bacteria can accumulate. In addition, traditional endodontic procedures often require the removal of additional tooth structure in order to achieve an optimal level of sanitization, whereas the efficacy of the GentleWave® Procedure allows for maximal tooth structure conservation.
Once the disinfection process of the GentleWave is complete, and the root canal fillings have been inserted, a temporary filling is then placed to close the opening of the tooth. This filling will later need to be replaced with a permanent filling or crown by your primary dentist to help protect and restore full function to the tooth.
Standard Retreatment Procedure
In some instances, a standard endodontic retreatment procedure may be an effective option for successfully disinfecting a tooth with a reinfected root canal. Unlike the GentleWave retreatment procedure, the standard retreatment procedure typically occurs over the course of two separate appointments and employs the use of an antimicrobial paste that works to disinfect your tooth between appointments.
At the first appointment, under local anesthetic, the root canal spaces are emptied, decontaminated, and disinfected. This appointment concludes with the placement of the antimicrobial paste inside of the canals that will work to complete the disinfection of your tooth over the next 1-4 weeks.
At the second appointment, the antimicrobial paste is removed from within the tooth. With the disinfection procedures complete, a biocompatible material is used to fill and seal the root canal system and a temporary filling is placed to close the tooth opening. This filling will eventually need to be replaced with a permanent filling or crown by your primary dentist for optimal long-term tooth function and protection.
Depending on the severity of infection and overall treatment complexity, standard endodontic retreatment typically takes anywhere from two to three visits to perform. Our endodontists do everything possible to make treatment as comfortable and as efficient as possible. For those patients possessing any degree of anxiety or apprehension toward treatment, sedation endodontics options are available and may be of interest.