Root Canal Process & Retreatment
A Complete Guide for Patients by Dr. Glen Mitchell Endodontics
Tooth pain can make even simple tasks feel difficult. If your dentist says you may need a root canal, knowing what happens next can make the visit easier. The root canal process is a dental treatment used to remove infected or inflamed pulp, clean the inside of the tooth, and seal it so the natural tooth can stay in place.
A root canal retreat usually means endodontic retreatment. It is considered when a tooth that had a root canal before does not heal as expected or develops a new problem later. The old filling material is removed, the canals are checked and cleaned again, and the tooth is sealed once more.
At Dr. Glen Mitchell Endodontics in Boca Raton, Florida, Dr. Glen B. Mitchell provides endodontic care that includes root canal treatment, retreatment, and apicoectomy. The practice is located at 900 Glades Road, Suite 3A, Boca Raton, FL 33431.
What Is the Root Canal Process and Why Is It Needed?
The root canal process removes diseased or infected pulp from inside a tooth, cleans and disinfects the root canals, fills the cleaned space, and seals the tooth.
The Pulp and What Causes Problems
The pulp is the soft tissue inside a tooth. It contains nerves and blood vessels. When decay, a crack, trauma, or another problem allows bacteria to reach this area, inflammation or infection can develop.
At first, the symptoms may not seem severe. However, an infected tooth can cause pain when you bite, sensitivity to hot or cold, gum swelling, or a small bump near the tooth. Some infections may cause little or no pain, so an examination is still important when your dentist suspects a problem.
How Does a Root Canal Process Work Step by Step?
The root canal process normally starts with an examination and dental imaging, followed by anesthesia, tooth isolation, removal of infected pulp, cleaning, filling, and sealing.
Step 1: Examination and Imaging
First, the endodontist examines the tooth and reviews your symptoms. X-rays or other dental images may be used to check the roots and the surrounding bone. In some cases, three-dimensional CBCT imaging can provide additional information about the tooth and root anatomy.
Step 2: Anesthesia and Isolation
Next, local anesthesia is used to numb the area. A dental dam can then be placed around the tooth to help keep the treatment area clean and dry.
Step 3: Pulp Removal
The dentist or endodontist makes a small opening in the tooth to reach the pulp chamber. Small dental instruments are used to remove the damaged pulp.
Step 4: Cleaning and Shaping
After that, the root canals are cleaned and disinfected. The canals are then shaped so they can be filled properly.
Step 5: Filling and Sealing
The cleaned canals are filled with a material called gutta-percha. The tooth is then sealed with a filling or another restoration. A permanent crown may be needed, especially when the tooth has lost a large amount of structure.
How Long Does a Root Canal Appointment Take?
A root canal appointment can take about one hour or longer, depending on the tooth and the treatment needed. Cleveland Clinic notes that many root canals take about 60 to 90 minutes, while Toothsavers states that some treatments can take from about one hour to more than two hours.
Factors Affecting Treatment Duration
Front teeth often have fewer canals than molars. Back teeth can require more time because they may have several roots and canals.
Some treatments are completed during one visit. Others require additional appointments. Your endodontist can give you a better estimate after examining your tooth.
The final restoration also matters. A tooth that has received root canal treatment may need a crown or another permanent restoration to protect the remaining tooth structure.
What Happens During Root Canal Retreatment?
Root canal retreatment is performed when a previously treated tooth has not healed properly or develops another infection or dental problem. The endodontist reopens the tooth, removes the previous canal filling, cleans the canals again, checks for missed canals or other problems, and places new filling material.
Why Problems May Occur
A tooth can sometimes develop problems months or years after its first root canal. This does not always mean the first treatment was done incorrectly.
For example, a narrow canal may not have been treated, or unusual root anatomy may have made part of the canal difficult to find. A new cavity, loose filling, damaged crown, or tooth fracture can also allow bacteria to reach the root canal system again.
Why Might You Need a Root Canal Retreat?
You may need a root canal retreat when a treated tooth remains infected, fails to heal, or develops a new infection. Other reasons include an untreated canal, new decay, a damaged restoration, or a tooth fracture.
The Retreatment Process
During a root canal retreat, the endodontist first reviews the tooth and discusses the available treatment choices. If retreatment is selected, the tooth is reopened.
The old root canal filling material is then removed. If a crown, post, or other restoration prevents access to the canals, some of that material may also need to be removed.
The canals are inspected carefully. The endodontist looks for additional canals, infection, unusual anatomy, or other causes of the earlier treatment problem.
The canals are then cleaned and disinfected again. New filling material is placed, and the tooth is sealed.
A permanent restoration is usually needed afterward. The American Association of Endodontists recommends returning to the general dentist as soon as possible after retreatment for the final crown or restoration.
Is Root Canal Retreatment Better Than Tooth Extraction?
Root canal retreatment may be an option when the natural tooth can still be saved. If nonsurgical retreatment cannot solve the problem, endodontic surgery may be considered. Extraction is another option when the tooth cannot be saved.
Choosing the Right Option
Keeping a natural tooth is often considered when it has a reasonable chance of being restored and functioning normally. However, the right choice depends on the condition of the tooth.
An endodontist will assess the tooth before recommending treatment. Factors may include the amount of remaining tooth structure, the condition of the roots, the presence of a fracture, infection, and whether the tooth can receive a proper restoration.
If extraction is required, the missing tooth may later be replaced with an implant, bridge, or removable dental appliance.
What Is an Apicoectomy and When Is It Used?
An apicoectomy is a type of endodontic surgery that removes the tip of a tooth root and nearby inflamed or infected tissue when infection or inflammation remains after root canal treatment.
When Apicoectomy is Considered
An apicoectomy may be considered when regular retreatment cannot reach the affected area. It can also help when a canal is blocked by calcium deposits or when a small fracture or other root problem needs direct examination.
The Apicoectomy Procedure
During the procedure, the endodontist uses local anesthesia to numb the area. A small opening is made in the gum near the tooth so the root and surrounding bone can be reached.
The infected tissue is removed. The end of the root is also removed, and a small filling may be placed to seal the end of the root canal. The gum is then closed with stitches.
How Is an Apicoectomy Different From a Root Canal Retreat?
A root canal retreatment works through the tooth to remove old canal filling material and clean the root canals again. An apicoectomy reaches the root from the outside through the gum and surrounding bone.
Different Approaches
The choice depends on what is causing the problem and whether the affected area can be reached through normal retreatment.
For example, a canal may be blocked by calcification. In another case, persistent inflammation may remain near the end of the root. Endodontic surgery may provide access to that area.
The American Association of Endodontists states that an apicoectomy is the most common type of endodontic surgery. It is also called root-end resection.
This treatment is intended to help save the natural tooth when possible. However, every tooth is different, so an examination is needed before choosing a procedure.
What Should You Expect After Root Canal Treatment?
After a root canal, mild sensitivity or tenderness can occur, especially when chewing. The discomfort should gradually improve, but persistent or worsening symptoms should be reported to your dental provider.
Post-Treatment Care
The tooth may feel different for several days. Your dentist may give you instructions about eating, brushing, medication, and the timing of your permanent restoration.
Avoid placing unnecessary pressure on a tooth that has a temporary filling. Follow the instructions provided by your dentist or endodontist.
The permanent restoration is an important part of treatment. Toothsavers notes that a permanent crown or filling helps protect the treated tooth from fracture and further contamination.
Good oral hygiene also remains important. Brush your teeth, clean between them, and attend regular dental visits.
When Should You Call Your Dentist After Treatment?
You should contact your dentist or endodontist if pain does not improve, swelling develops, symptoms become worse, or you have another concern about the treated tooth. Cleveland Clinic advises contacting your provider if pain lasts longer than expected.
When to Seek Emergency Care
You should also contact your dental provider if a temporary filling or crown becomes loose or falls out.
Do not ignore swelling around a tooth. Dental infections need professional assessment because treatment of the tooth itself may be required. Antibiotics alone do not remove the source of a root canal infection in every case.
Why Choose Dr. Glen Mitchell Endodontics for Root Canal Care?
Dr. Glen Mitchell is a board-certified endodontist in Boca Raton who focuses on endodontic treatment, including root canals, retreatment, and endodontic surgery. The practice states that Dr. Mitchell received his D.D.S. from Northwestern University and his endodontic specialty certificate from Columbia University.
Professional Background
Dr. Mitchell also completed a general practice residency at the VA-associated University of Michigan hospitals and an oral surgery fellowship at the University of Michigan. The practice states that he has taught postdoctoral endodontic residents at Nova Southeastern University.
Practice Information
The American Dental Association lists Dr. Glen B. Mitchell as an endodontist at 900 Glades Road, Suite 3A, Boca Raton, Florida. The ADA listing also identifies the practice as an endodontic office providing root canals, retreatments, and apicoectomy care.
Toothsavers also lists CBCT dental scanning and Waterlase dentistry among its services. CBCT imaging can provide three-dimensional information about a tooth and its surrounding structures, while Waterlase is used by the practice as part of its dental treatment approach.
Frequently Asked Questions About Root Canal Treatment and Retreatment
Is a root canal painful?
Modern root canal treatment is performed with local anesthesia to numb the treatment area. During the procedure, the goal is to keep the patient comfortable while the infected or inflamed pulp is removed. After treatment, some sensitivity or tenderness may occur for several days. Cleveland Clinic notes that most people recover in less than a week, although individual recovery varies.
If pain becomes worse instead of better, contact your dentist or endodontist. Persistent pain may need further evaluation.
How long does a root canal last?
A properly treated and restored tooth can last for many years and may last a lifetime. The American Association of Endodontists states that teeth can remain functional for a lifetime with proper care, although no dental treatment comes with a guarantee.
The final restoration matters because it helps protect the tooth from fracture and bacterial contamination. Good brushing, cleaning between the teeth, regular dental visits, and timely restoration can help protect the treated tooth.
Can a tooth need another root canal years later?
Yes. A tooth that received root canal treatment can sometimes become diseased or painful months or years later. Causes can include a missed canal, new decay, a damaged crown or filling, or a fracture.
In these cases, an endodontist may recommend retreatment, endodontic surgery, or another option depending on the condition of the tooth.
What is the difference between root canal treatment and retreatment?
Initial root canal treatment removes infected or inflamed pulp from a tooth that has not had root canal treatment before. Retreatment is performed on a tooth that already received a root canal but has not healed properly or has developed another problem.
During retreatment, the previous filling material is removed before the canals are cleaned and filled again.
Does every root canal need a crown?
Not every tooth has exactly the same restoration needs. However, many root canal-treated teeth need a crown or another permanent restoration because the remaining tooth structure may need protection. Cleveland Clinic notes that a crown is usually needed after root canal therapy, while Toothsavers also recommends permanent restoration to protect the treated tooth.
Your dentist will decide which restoration is appropriate based on the tooth's condition and remaining structure.
When should I see an endodontist?
You may be referred to an endodontist when a tooth has inflammation or infection inside the root, when a previous root canal has failed, when dental pain is difficult to diagnose, or when endodontic surgery may be needed. Endodontists receive additional specialty training focused on diseases and injuries involving dental pulp and surrounding tissues.
Dr. Glen Mitchell Endodontics provides endodontic care in Boca Raton, including root canal treatment, retreatment, and apicoectomy.
Can a root canal save my natural tooth?
Root canal treatment is intended to remove infection and preserve the natural tooth. The American Association of Endodontists states that root canal treatment, retreatment, and endodontic surgery can all be options for saving a natural tooth when the tooth is suitable for treatment.
However, not every tooth can be saved. Severe fractures, extensive damage, or other problems may make extraction necessary. An examination is needed to determine which treatment is appropriate.
Does a root canal need more than one visit?
Sometimes. Many root canal treatments can be completed in one visit, but some teeth require additional appointments. Treatment time depends on the number of roots and canals, infection, access, tooth anatomy, and other clinical factors.
Your endodontist can explain the expected number of visits after examining the tooth.
What should I do if a previous root canal starts hurting again?
Contact your dentist or endodontist for an examination. A previously treated tooth that becomes painful may have a new infection, an untreated canal, a damaged restoration, or another problem.
Do not assume that extraction is the only option. Retreatment or endodontic surgery may sometimes help save the natural tooth.
For patients in Boca Raton, Dr. Glen Mitchell Endodontics provides consultation and treatment for root canal problems, including retreatment and apicoectomy.
Schedule Your Root Canal Consultation
You can contact Dr. Glen Mitchell Endodontics in Boca Raton to discuss tooth pain, a suspected infection, a previous root canal that is causing problems, or another endodontic concern.
900 Glades Road, Suite 3A
Boca Raton, FL 33431
MondayβFriday: 9:00 AM β 5:00 PM
Saturday & Sunday: Closed
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