Redo a root canal i had a root canal that has become abscessed and needs to be redone. general dentists tell me that i need to find a specialist (a many hour drive). my question is why is a specialist needed? if this dentist was just plan old incompetent,

It : It is most definately better to have a specialist look at it. Most general dentists are not equiped to handle these difficult cases. Most won't even think about doing a retreat on a molar. My endodontists have microscopes to help do the rct much more efficiently. As the tooth is treated with redone rct and apical surgeries, the success rate drops. Success rates for intial rcts are in the mid to high 90%. Retreats drop down into the high 80%.

As : As with most things in life, you start out solving problems at the basic level. When complications develop or the case becomes more involved then it is appropriate to enlist the aid of specialists. All general dentists have to show basic competency in performing root canals to graduate. Some dentists have a interest in treating routine cases while others prefer to refer all root canals to specialists. There are many general dentist who are very proficient in treating root canals and have a large number of cases to their credit. When a case becomes complicated, such as when a root canal fails to respond as desired, referral to a special, who has two years additional training and limits this practice to endodontics, is appropriate. These practices may have specialized equipment and advanced training to better handle complicated treatment. I agree that the success rate falls with re-treatment but that is no reason not to obtain a consultation by an endodontist.

I : I don't think the issue is incompetence-actually recognizing the difficulty of retreatment and referring you to a proper specialist with the skill and equipment to give your tooth the best chance for a successful outcome is the correct thing to do. Retreatments can vary in success depending upon the tooth and the situation but 80%+/- is close.

Failures : Failures of root canals or reinfections usually has nothing to do with the skill level of the dentist. You can do everything perfect and still have an unfavorable outcome. Most general dentists don't have the tools or the experience to redo root canal therapies. Retreating a root canal is a completely different process than a tooth that has never been treated before. Sometimes a retreat can't be performed so a surgical approach is needed (this is where the endodontist removes the tip of the root from the tip). It usually saves time, money and pain by seeing the specialist first, as a general dentist may do their best to retreat and the tooth still needs surgery. Re-treatments for root canals do have a low success rate compared to other treatments. For this reason, many practitioners do not do any retreats at all and opt for removal and implant or bridge placement.

See Endodontist: See the specialist that does this and only this every day. They are expertly skilled and needed for any retreatment. More difficult for many reasons, one of which is the removal of all the material inside the canals from the failed treatment. You can find a specialist in santa fe, alburquerque, etc. Well worth the trip. Make the trip for your health.