Why Do I Need a Retreat and What Will Actually Happen???

Sometimes – rarely – a root canal doesn’t work the first time. Unfortunately, this ‘not working’ can present itself anywhere from days after the original root canal to years later. And when that happens, a common solution to fix the problem is to perform a retreat root canal. 


What is a retreat root canal and why will I need one?


When we do an original root canal, we go in from the top of the tooth (the crown) to open up and clean out the chambers and canals. During this process, we remove all nerve tissue and all of the bacteria present within the canals and then seal the canals and the tooth so that no additional bacteria can enter. 


Sometimes the canal or chamber can become re-infected. This can either happen from the bottom of the tooth near the root or through the crown of the tooth where we placed the original restoration. Many times, when the infection reenters from the top of the tooth, that is because the restoration originally placed wasn’t sealed perfectly well. 


Either way, when bacteria reenters the canal, you’ll need to either have a retreat root canal or have the tooth extracted. And as we’ll often say that the best solution is to keep as many healthy original teeth in your mouth as possible, Dr. Monica will often recommend a retreat in these cases. 


How will I know that I may need a retreat root canal?


If you are experiencing pain on a tooth that has previously had a root canal or if you have an abscess (a swollen area of your gums), these are tell-tale signs a retreat may be needed. 


It is also important to note that many abscesses start small and can remain unnoticed because they are not presenting with pain in your mouth. This is another reason why keeping your regular 6-month dental visits and monitoring root canal treated teeth with X-rays is so vital to your overall and oral health.


Is a retreat much different than the original root canal?


The process for you – the patient – isn’t much different at all. Dr. Monica does have a slightly different responsibility though. Instead of removing the nerve, like in an original root canal, she’ll be removing the filling material that was placed initially. The one constant is that whether she’s performing an original root canal or a retreat, the goal is to remove all of the bacteria. This is the main reason why your pain (if you have it) will subside. 


Do I need a retreat because my dentist didn’t do a good job the first time around?


Not always. We like to think that root canals are an exact science, however, it’s more like an art form. And as we’ve written about previously, Dr. Monica has even had to have a retreat done in her own mouth (as well as multiple fillings, crowns, root canals, oh and a surgery where they cut off her jaws and reattached them…) So really, it’s nothing that she hasn’t been through before and she’s quick to say that this art form can be a tricky one to perfect – depending on the tooth and its unique anatomy. 


At times, teeth can have more or fewer canals than are expected. Also, canals can branch into multiple other canals. In Dr. Moinca’s case, there was one canal missed during her original root canal, and a few years later when the infection returned and her specialist reopened the tooth, he found the additional canal. 


The number of canals per tooth
This image was shared from https://www.dental-picture-show.com/endodontics/a-how-many-root-canals.html


Did that experience turn her away from her endodontist?


She said, “That was a specialist that I highly trust and have a ton of confidence in. If I need another root canal done, he’d be the one I would schedule with.” So, while these things can happen sometimes, it is not necessarily because your dentist didn’t do a good job. Retreats can happen even to the most highly-trained specialists. 


Is a retreat something we would do at MFD?


While Dr. Monica does perform some retreats at our office, we will refer many retreat cases to a specialist. Endodontists (the specialists) have much more experience in performing both retreats and original root canals and because they do these procedures every day, they can be a great resource when needed. 


If my tooth becomes reinfected and I get a retreat, is there a chance I would need a 2nd retreat at some point?


Dr. Monica answered, “I’m not going to say never because there’s always that possibility but usually if we found the source of why it became infected for a second time (a missed canal, the crown wasn’t properly sealed, or the tooth wasn’t fully filled, etc…) then usually the retreat will be successful.” 


If the retreat isn’t successful, Dr. Monica will typically recommend that the tooth be extracted. 


After the retreat is complete, what will I need to do to keep my tooth strong?


You’ll need a final restoration in the tooth, whether that’s a filling or a crown. Usually, this is a crown but in some cases (normally with front teeth) it can be a filling. If the retreat is performed on a tooth that already has a crown and that crown hasn’t broken during the retreat, we can seal the crown with a filling as your final restoration. 


In some cases, the original crown will break during your procedure, but this is not the most common outcome. If that happens, you will need a new crown to protect your tooth. 


While retreats aren’t the desired outcome after root canals, they are a viable option


As Dr. Monica put it, “I’m living proof… I’ve had it done in my own mouth. It’s been 6 years since my retreat and the tooth is still in great shape. So this procedure can buy you time and help keep your original teeth in your mouth.”

1 reply added

  1. BABS September 24, 2021

    Had root canal approximately 20 years ago, and placed a porcelain crown on #5 tooth.
    Porcelain crown broke (portion).
    Now dentist is telling me I need a Retreat on the Root Canal, because it was done years ago, was the old way of doing it, and I need to have a better root canal.
    My tooth does not hurt, there is no pain — Do I actually need the retreat or is this just generating $$ for another dentist?

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