Laser Assisted Root Canal Therapy
(non-surgical procedure)
The Food and Drug Administration has approved the use of lasers as devices to remove diseased gum tissues and for other soft tissue applications, in the removal of cavities, as an aid in placing tooth-colored restorations and as an aid in root canal procedures, such as pulpotomies.
Retreatment:
“I had a root canal … and it’s ‘failing.’
Now what?”
Sometimes, a tooth that has been treated doesn’t heal properly and can become painful or diseased months or even years after treatment. If your tooth fails to heal or develops new problems, you have a second chance. An additional procedure may be able to support healing and save your tooth. If you have pain or discomfort in a previously treated tooth, it may be time to talk to a dentist about retreatment.
Why do I need another endodontic procedure?
As occasionally happens with any dental procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:
- Narrow or curved canals were not treated during the initial procedure.
- Complicated canal anatomy went undetected in the first procedure.
- The placement of the crown or other restoration was delayed following the endodontic treatment.
- The restoration did not prevent salivary contamination to the inside of the tooth.
In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:
- New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
- A loose, cracked, or broken crown or filling can expose the tooth to a new infection.
- A tooth sustains a fracture.
What will happen during retreatment?
First, your dentist will discuss your treatment options. If you and your dentist choose retreatment, the dentist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post, and core material—must be disassembled and removed to permit access to the root canals.
After removing the canal filling, your dentist can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.
After cleaning the canals, your dentist will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your dentist may recommend dentist surgery. This surgery involves making an incision to allow the other end of the root to be sealed.
After your dentist completes retreatment, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to its full function.
Is retreatment the best choice for me?
Whenever possible, it is best to save your natural tooth. Retreated teeth can function well for years, even for a lifetime.
Advances in technology are constantly changing the way root canal treatment is performed, so your dentist may use new techniques that were not available when you had your first procedure. Your dentist may be able to resolve your problem with retreatment.
As with any dental or medical procedure, there are no guarantees. Your dentist will discuss your options and the chances of success before beginning retreatment.
Laser Assisted Apicoectomy
(minor surgical procedure)
An apicoectomy is a common dental procedure where inflamed gum tissue and the end of the root of your tooth are removed while the top of your tooth is left in place. It’s often called a root-end resection because it works on the end (or, tip) of your root called the apex.
What’s the difference between a Root Canal and an Apicoectomy?
A root canal is a procedure designed to treat inflammation and infection in the inner pulp tissue of your tooth. Inflammation in tooth pulp causes deep tooth decay and abscesses, which can spread to your bone if they’re not removed.
During a root canal, your dentist opens up your tooth, removes the pulp cleans the root area, and then fills and seals it. This is done to manage disease and decay without pulling your tooth.
An apicoectomy, in contrast, only deals with the tip of the root and is usually performed after a root canal to fix the root or the tissues around the tooth.
Myths About Root Canals
Source: aae.org
Myth 1: Root canal treatment is painful.
That may have been the case decades ago, but with modern technology and anesthetics, you won’t experience any more pain than if you went to have a cavity filled. The pain from a severe toothache, often caused by damaged tissues in the tooth, can be easily remedied when a dentist removes the damaged tissue through root canal treatment. In addition, dentists are experts in pain management, and most cases can be treated quickly and comfortably.
Myth 2: Root canal treatment causes illness.
Information you may find on the Internet or elsewhere, claiming that if you receive a root canal treatment you’re more likely to become ill or contract a systemic disease in the future simply isn’t true. This false claim was based on long-debunked and poorly designed research conducted nearly a century ago, long before modern medicine understood the actual causes of many diseases. There is no valid, scientific evidence linking root canal treatment to cancer or disease elsewhere in the body. Modern research has shown that patients with multiple endodontic treatments had a 45 percent reduced risk of cancer. (Tezal M, et al. Dental Caries and Head and Neck Cancers. JAMA Otolaryngol Head Neck Surg 139(10):1054-60, Oct. 2013.).
Myth 3: It’s better to pull a tooth than have root canal treatment.
Saving your natural teeth, if possible, is always the best option. Nothing artificial can replace the look or function of a natural tooth so it’s important to always consider root canal treatment as an option. Endodontic treatment has a high success rate and many root canal-treated teeth last a lifetime. Replacing an extracted tooth with a bridge or implant requires more time in treatment and may result in further procedures for neighboring teeth and supporting tissue.
Myth 4: Root canals involve removing the roots of the tooth.
When a root canal treatment is performed, the pulp from the inside of the tooth is removed. The roots of the tooth are not removed.
Myth 5: If my tooth doesn’t hurt, there is no need for a root canal.
While a throbbing toothache typically is a telltale sign of a need for root canal treatment, there are times when a tooth can require root canal treatment when there is no pain present. Dentists are specially trained to test a tooth to see if the pulp has been infected or damaged. If this is the case, a root canal would be necessary to save the tooth.