All dentists are educated in endodontic treatment. Retreatment, however, can be more challenging than the initial treatment. For this reason, many dentists refer their patients in need of retreatment to endodontists.

Endodontists are dental specialists who diagnose and treat oral and facial pain. They specialize in endodontic (root canal) treatment, including any treatment for the soft inner tissues of the tooth, the pulp. In addition to dental school, endodontists receive another two or more years of advanced education. They study root canal techniques and procedures in greater depth, including the area of retreatment.

Occasionally, healing may not occur as expected after an initial root canal procedure. This can happen for a variety of reasons-new decay, a broken or cracked crown, or canals that were not detected during the first procedure. By performing the procedure a second time, endodontists can often save your tooth.

First, your endodontist will remove the restoration or crown and the filling materials inside your tooth to reclean the canals and take a closer look at the inside of your tooth. Examination of the inside of your tooth may determine what caused the first treatment to fail.Next, your endodontist will fill and seal the canals with a rubbery material called gutta-percha, and then place a temporary filling in the tooth.The entire root canal procedure usually requires just one trip to your endodontist’s office. Occasionally, in complex situations, a second appointment is necessary. Talk to your endodontist for information on your retreatment.After retreatment, your family dentist should place a new crown or other restoration on your tooth. Returning to your dentist is very important because the crown will restore your tooth and help protect it from more damage.

The decision to retreat should be made by you, your dentist and your endodontist. While retreated teeth can last a lifetime, there is no guarantee that treatment will be more successful the second time. The treatment option for any particular patient must be chosen on an individual basis.

The cost of retreatment varies depending on the complexity of the procedure. It will probably cost more than the initial procedure because your restoration and root filling materials must be removed before the second treatment can begin. Also, your endodontist may need to spend more time searching for problems that may have caused the initial treatment to fail.The only alternatives to retreatment are having the tooth extracted or having it retreated surgically if the root cannot be accessed through the crown. If the tooth is extracted, it must be replaced with a bridge, implant or removable partial denture. This will restore chewing function and prevent adjacent teeth from shifting. Generally, nonsurgical retreatment and restoration of your natural tooth is the least expensive option. Your dentist will be happy to discuss the various treatment options and their costs with you.