What is Root Canal Retreatment?
When a Root Canal is not done efficiently, due to incomplete cleaning or sealing or if the infection returns due to filtration of bacteria, then the patient may be recommended a Root Canal Retreatment where an Endodontist has to re gain access to the canal to treat it again.
Root Canal Retreatments are much more complicated since a lot of times the specialist will have to remove Crowns, Resin Build Ups and in some cases metal or fiber posts before they are able to have clear access to the pulp chambers to treat the infection.
After a Root Canal Retreatment an antibiotic is prescribed and a Post and Core build Up and Crown is recommended to prevent fractures or filtration of bacteria to the tooth.
Pre Op Instructions
Please have a read at all the Pre-Op Instructions.
3 WEEKS BEFORE SURGERY
Smoking and Dental Implants don’t go together. Why did you lose your teeth/tooth in the first place. We know smoking can be difficult to quit but we insist that patients stop smoking at least 3 weeks prior to their Dental Implants. In rare cases we might ask you to quit sooner. Smoking can interfere with healing by constricting and decreasing blood flow all over the body which may prevent the wound from healing properly. Do not resume smoking after surgery until you are given permission by our Dental Surgeon.
3 WEEKS BEFORE SURGERY
We know you will be on vacation and the all-inclusive bar might be tempting. Please try and stay away from alcohol consumption for a minimum of 5 days prior to your procedure. Alcohol causes increased bleeding, increases the chances of infection, depresses immune functions and may interfere with wound healing.
3 WEEKS BEFORE SURGERY (over-the-counter and prescribed)
Please check with your Physician about suspending any medication prior to arrival.
You will be instructed by your surgeon or patient counselor to temporarily discontinue certain medications in the weeks ahead.
Drugs containing ASPIRIN, SALICYLATES, SALICYLAMIDES or IBUPROFEN should be avoided for at least two weeks before and after surgery. Brand names are:
- A.S.A. Enseals
- Alka Seltzer Cold Medicine
- Alka Seltzer Effervescent Tablets
- Advil Anacin with ASA
3 WEEKS BEFORE SURGERY
It is important that you maintain a healthy diet. You will be on a soft mechanical diet or some form of a modified diet tailored to your surgery. It is important that you follow these instructions! It is a good idea to stock up on protein supplements like BOOST or Ensure. Various softer foods like well cooked pastas, eggs, soup/broths, and yogurt are also good ideas. We will provide you with a list of dietary suggestions in your post-op packet as well.
2 WEEKS BEFORE SURGERY
- All Aspirin and Ibuprofen products including the drugs listed on the enclosed insert.
- All anti-inflammatory drugs (i.e. Ibuprofen) used for arthritis. (Please consult your physician prior to discontinuing).
- All anti-coagulants.
- Vitamin E taken internally.
- If a medication is in question, call our office nurse.
2 WEEKS BEFORE SURGERY
- Take a Multivitamin tablet daily. Most multivitamins contain some form of vitamin E, however this is acceptable to take prior to surgery. We do ask that you refrain from taking additional vitamin E.
- Take Vitamin A â€“ 8,000-10,000 units, twice a day. This has well-documented beneficial effects on surgical healing and will also fuel your immune system.
- Take Vitamin C â€“ 1,000 mg., twice a day. This is essential for collagen synthesis, which is part of normal wound healing. Your need for Vitamin C will increase after surgery.
- Take Bromelain â€“ 1,000 mg., twice a day. (Pineapple enzyme â€“ from a health food store) This helps to relieve the swelling associated with surgery. Bromelain: This anti-inflammatory promotes healing.
1 week BEFORE until 2 weeks AFTER procedure
- Eat healthy, regular meals.
- Eat 2 fruits and 3 green vegetables daily (per diet instructions).
- Eat a small amount of protein at each meal.
1 WEEK BEFORE SURGERY
- You may begin taking Arnica Montana
- Take every 8 hours as directed and continue for 10 days.
- Continue taking Bromelain as directed every 12 hours between meals. This anti-inflammatory promotes healing. As an alternative, eat fresh pineapple.
Arnica: Arnica Montana is an herb that grows wild in the Swiss Alps. Also known simply as â€śArnica,â€ť itâ€™s been used in Europe for hundreds of years for the reduction of bruising and swelling and to shorten the recovery period after a physical trauma such as an accident, surgery or injury.
Post Op Instructions
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Standards of good oral hygiene are critical for the success and functionality of the implants and restoration. The best way to prevent infection and ensure healing is to keep your mouth clean. Clean your mouth thoroughly after each meal beginning the day after surgery. Use a soft bristle toothbrush and toothpaste after meals and at bedtime. Use of a dental waterpik is highly recommended to irrigate underneath the denture to flush out debris.
Minimal bleeding is expected after this implant procedure. The best way to stop bleeding is to place a damp piece of gauze in the mouth and gently bite for 30 minutes. Rest quietly with your head elevated. If bleeding continues, use gauze for an additional 30 minutes. Pink or blood-tinged saliva may be seen for 2-3 days following the surgery and does not indicate a problem. Suture material may last 2 to 3 weeks and should be left alone. You will be asked to return to the office for a 2 week follow-up appointment. Any sutures remaining at that time may be removed at the surgeonâ€™s discretion. Do not pull or cut the sutures yourself.
Swelling is the bodyâ€™s normal reaction to surgery and healing. The swelling will not become apparent until 24 hours after surgery and will not reach its peak for 2-3 days. After this time, the swelling should decrease but may persist for 7-10 days. Swelling may be minimized by the immediate use of ice packs. Apply the ice packs to the outside of the face 20 minutes on and then 20 minutes off while awake for the first 24 hours.
Unfortunately, most oral surgery is accompanied by some degree of discomfort. If you do not have an allergy to non-steroidal anti-inflammatory medications (Ibuprofen, Motrin, Advil) we recommend taking this prior to the local anesthetic wearing off. More severe pain may require a narcotic pain medication. Narcotic pain medication will make you drowsy, do not drive or operate mechanical machinery while taking the prescription. Alternate Ibuprofen (2 tablets / 200mg each) and the narcotic medication every two hours if needed. Once you feel like you can stop the narcotic, use Ibuprofen or Tylenol. You may also be prescribed an antibacterial mouth rinse which should be used twice daily in the first two weeks following implant surgery. Post-operative antibiotics should be taken as directed and always take entire course of the prescription. All medications should not exceed the recommended dosage.
After General anesthetic or I.V. sedation, start with liquids. While numb, patients should avoid hot liquids or foods. Your food intake will be limited for the first few days, compensate for this by increasing your fluid intake. We recommend high protein shakes/smoothies (Ensure, Special K, etc.) as meal replacement supplements. Patients are restricted to a SOFT CHEW diet for the first 6 weeksâ€¦ if food cannot be easily cut with a forkâ€¦ DO NOT eat it!
For the first 48 hours you should rest and relax with no physical activity. After 48 hours, you may resume activity as tolerated.
- Ice Cream
- Scrambled Eggs
- Cream of Wheat / Oatmeal
- Mashed Potatoes
- Cottage Cheese
- Ice Chips
- Smoothies / Protein Shakes
Add Soft Foods When Numbness is Gone / Increase Diet as Tolerated
- If the corners of your mouth are stretched, they may dry and crack. Your lips should be kept moist with an ointment such as Vaseline.
- Sore throats and pain when swallowing are not uncommon. The muscles get swollen and the normal act of swallowing can become painful. This will subside in 2 to 3 days.
- Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days. Do not force your mouth open. Massage the muscles and apply moist heat.
- With upper jaw implant treatment, you may develop bleeding from the nose. This is usually a temporary finding and will not persist past 2 to 3 days. Avoid blowing your nose for several days.
- An appointment with your general dentist may be needed within a few days of surgery to make any adjustments to your temporary denture.
- Your case is individual as no two mouths are alike. Discuss all questions or concerns with your oral surgeon or implant coordinator.
If you are trying to enhance the color, shape or overall appearance of your smile Crowns and Veneers would be your best bet. Depending on your bite and the position of your teeth, would depend on whether Crowns or Veneers would work best for you.
When a Root Canal Retreatment is not effective or if there are curved roots making it impossible to eliminate infection at the Apex (Root tip) of the tooth, then an Apicoectomy would be the final solution before extracting the tooth. This is a surgical procedure where the Oral Surgeon opens a window in your bone above the apex of the infected tooth to remove the infection and the infected apex. A special sealer is placed to fill the area removed during the procedure.