Having a root canal treatment performed on one of your teeth is one of the more unpleasant procedures in the world of dentistry, and nobody wants to contemplate the thought of having to undergo it twice. However, every medical procedure comes with a chance that it may fail, and occasionally a root canal treatment may fail, or the affected tooth may become reinfected, despite the best efforts of both yourself and your dentist.

What can make root canal retreatment necessary?

• No two teeth are exactly the same, and sometimes the root canals of a tooth may be narrow, sharply curved or unusually shaped. Your dentist will do their best to work around such awkward tooth anatomy, but occasionally pockets of infected pulp may be hidden or too obscured to remove properly. The tissue left behind is therefore an easy vector for reinfection of the tooth.
• A root canal treatment will generally be done in two parts; one to remove the infected pulp and bore out the tooth, and another to fit the protective crown. Although a temporary crown is fitted to protect the tooth between treatments, the affected tooth is very vulnerable to infection if the second treatment is delayed for an extended period of time.
• An improperly fitted filling or crown can leave a gap through which bacteria can infiltrate the tooth, as can damage to the crown or filling. The remaining natural tooth may also be inadvertently cracked or damaged during the treatment procedure.
• Poor dental hygiene after a root canal treatment can leave bacteria and plaque in your mouth, which may cause a repeated infection of the tooth. It can also lead to decay of the remaining natural enamel of a treated tooth, providing another access point for microbial infection.

What does root canal retreatment involve?

If you do require root canal retreatment, exactly what procedure you'll have to undergo will depend upon the extent of the infection and damage:

• Your dentist will do their best to save the natural tooth, as even a heavily damaged and repaired tooth is less likely to incur side effects than an artificial implant. If your dentist attempts to save the tooth, they will remove the crown and bore out the filling material and essentially repeat the root canal treatment, while searching for any abnormalities or damage that may have caused the tooth to become reinfected.
• In more extreme cases of infection, or if the dentist cannot locate to avenue of infection, you may choose to undergo endodontic surgery, a more invasive procedure to examine the tooth thoroughly and find out why it has become infected. Usually, this will involve a small incision being made in the gum tissue below the infected tooth through which the surgeon can closely inspect the roots of the tooth.
• If the tooth is too damaged to save, it may have to be removed and replaced with a permanent implant, partial denture or bridge.

If you have specific questions about root canals, contact a dentist with a practice like Inner West Endodontics.