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All the below content has been written by Dr. Sandip Sachar. 

Dentist NYC: Root canal retreatment

What is root canal retreatment? 

In rare circumstances, a root canal may fail.  A failure of a root canal occurs when an infection is noted to the root of the tooth, where the nerve used to be.  When this happens, a root canal retreatment is necessary.  A root canal retreatment is basically repeating the root canal procedure to the tooth that has already undergone a root canal.  The main difference between a root canal procedure and a root canal retreatment procedure, is that during the root canal retreatment procedure the filling material within the canal of the tooth is removed, and the filling or crown on the tooth may need to be removed as well, prior to re-performing the root canal procedure. After filling materials are removed, the procedure is virtually identical to a root canal procedure.

Picture of x-ray old root canal with infection and root canal retreatment

Why would I need a root canal retreatment?

A root canal retreatment becomes necessary when a patient has an infection at the root of the tooth, where the nerve used to be prior to performing the original root canal procedure.  Re-infection of the root of a tooth that has undergone a root canal procedure in the past can be caused by, an old crown that begins to leak and allows bacteria to enter, poor oral hygiene that allows plaque to accumulate around the margin of a crown or filling of the tooth, a fracture of the tooth due to trauma that allows bacteria to enter, and a previous root canal procedure that was not done perfectly, which happens on rare occasions.  A crown that has previously been inserted after a root canal procedure may become loose and leak in patients that clench and grind their teeth.  For these patients, we recommend a nightguard to protect the crown.

What are signs and symptoms that you may need a root canal retreatment?

There may or may not be symptoms associated with reinfection of a tooth that has previously undergone a root canal.  Some patients will experience symptoms, and some will not.  When present, signs and symptoms may include sensitivity to hot, sensitivity to cold, swelling of the mouth, a draining sore on the gums, tenderness with biting and chewing, and discomfort of the lymph nodes nearby.

Dental examination and determination if a root canal retreatment is necessary?

We will perform a clinical examination.  After our extensive clinical examination, we will perform dental x-rays.  When we observe signs of infection on x-ray at the root of the tooth where a previous root canal procedure was performed, a root canal retreatment procedure is determined to be necessary. Many times, we diagnose the need for a root canal retreatment on x-ray during a normal routine six-month examination, although no signs or symptoms may be present.  For this reason, having a six-month checkup are extremely important and should not be missed.

What happens if I do not address a re-infection of a tooth that has previously had a root canal?

Left untreated, a re-infection of a tooth that has previously had a root canal procedure can lead to pain and swelling, and spreading of the infection.  An untreated infection can spread within the jaw bone.  Once the bone is infected, the tooth may need to be removed. And, more importantly, the infection may damage the bone such that the bone is not strong enough to withstand an dental implant in the future.

How is a root canal retreatment procedure done?

A root canal retreatment procedure is very similar to a root canal procedure.  The difference is that sometimes, we need to remove the old crown or filling that has previous been placed in the tooth.  We will remove the old filling material in the canal of the tooth as well.  The canal is then cleaned to ensure there is no more bacteria.  The canal is then filled with new filling material.  If indicated, we may prescribe oral antibiotics. On your next visit, a permanent restoration is bonded to the tooth to seal the tooth and restore the shape, size, function, appearance and strength of the tooth.  In the most severe cases of dental infections, the infection may spread into the blood and other organs of the body.

When should I see a root canal specialist, endodontist, for root canal retreatment?

For the more complicated and complex cases of root canal re-infection we refer these patients out to our trusted network of endodontists.  After root canal retreatment is completed by an endodontist, we have our patients return to our office for a crown or filling.

When to have a root canal retreatment procedure versus having a tooth extraction and dental implant.

When presented with a reinfection of a tooth that has previously had a root canal procedure, it is sometimes an easy decision to make, and sometimes a hard decision to make, whether or not to perform a root canal retreatment.  When the underlying cause is the leaking of an old crown, we will almost always perform the root canal retreatment procedure.  As always at Sachar Dental NYC, we believe in performing the least invasive, and most conservative treatments possible.  We always try to save the natural tooth rather than remove it, and replace it. 

When the underlying cause is more complicated, the decision to perform a root canal retreatment procedure or not, is more complicated. When presented with an infection of a tooth with a previously performed root canal, we first determine what is the underlying cause.  If we suspect a hairline fracture that is not conclusively evident on x-ray, we take into consideration if we think that a root canal retreatment will work or not.  In these cases, our expert dentists will utilize their education and extensive experience to make this decision.  Every patient is different.  In some cases, we may determine that the prognosis of a successful root canal retreatment is poor.  In these cases, we will recommend a tooth to be extracted, and possibly replaced with a dental implant. We always make this decision based on what we would want done in our own mouths, or for our own family.

What are the costs in Midtown Manhattan, NYC for a root canal retreatment?

At Sachar Dental NYC, we have a one-time charge for a root canal retreatment of between $1,400 and $1,800.  Most PPO dental insurances cover this procedure at 80%.  As always, before coming into our office, we will check your insurance benefits and be able to inform you if your insurance covers this procedure, and what your out-of-pocket costs will be.  If covered by your insurance, on the day of your visit, you will only be responsible for your percentage.  We will submit a claim to your dental insurance, and receive insurance payment directly from them.

Due to the complexity of the retreatment root canal procedure, an endodontist specialist’s charge for this procedure may range from $2,600 to $3,100.

Does my dental insurance cover the cost of a root canal retreatment?

Most PPO dental insurances cover root canal retreatment procedures at 80%. Prior to coming into our office, we always check on your insurance benefits.  That way, we will be able to inform you if this is a covered service or not, and what your out-of-pocket costs will be.  To enable you to make informed decision, we always check on your benefits before performing any procedure.  We will submit a dental insurance claim to your insurance and receive insurance payment directly from them.  On the day of your visit, you will only be responsible for your percentage. 

Can I use flexible spending dollars or a medical savings account for these charges?

Yes, you may be able to use your medical savings accounts or flexible
spending dollars to cover charges related to your treatment.  At the
time of your service, we will provide you with all the necessary
documentation and receipts.

Do you offer payment plans for treatment?

At Sachar Dental NYC, we offer interest free financing through Lending
Club and Care Credit.  In 15 minutes, we will let you know if you are
approved for interest-free financing.  These options will enable you to
make payments over the next 12-18 months without any interest charged.

Why are we the best dentists in New York City for a root canal retreatment?

At Sachar Dental NYC, we always perform the most conservative approach and least invasive procedures available.  We always try to save the tooth rather than perform a root canal retreatment procedure if possible.  When a root canal retreatment procedure is necessary, we have the experience and education necessary to do the procedure correctly.  We are also experts in make a diagnosis of hairline fractures within the tooth, that are very difficult to see and diagnosis.  In the case of more complex root canal retreatments, we will refer our patients out to our trusted network of root canal specialist endodontists.  After seeing a root canal specialist, our patients return for us to restore the tooth with a crown.  We always use the least toxic materials available.  We always treat our patients like we would want to be treated ourselves, or how we would treat her family.

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