What Happens if a Root Canal Fails?

Sometimes patients ask – What happens if a root canal fails? Good news: around 95% of all root canals are successful and last for years or the patient’s lifetime.

However, in medicine, as in life, there are no guarantees. If you notice severe pain in a tooth previously treated with a root canal, you may have a failed root canal that requires retreatment. We hope this article helps you make informed choices for you or your family’s needs if this happens to you.

Please remember that this blog post is not a substitute for dental care. Each person is an individual patient, and as we later explain, each person’s teeth have unique anatomy and characteristics. A skilled endodontist who uses state-of-the-art technology has the best chance of successfully retreating failed root canals.

What is a Failed Root Canal?

First, we would like to reassure you that the vast majority of root canals are successful and provide relief from pain and suffering. However, occasionally a root canal procedure fails.

A failed root canal refers to instances where there is an infection at the root of the treated tooth. According to the American Association of Endodontists, there are a few potential causes for a failed root canal, including:

• Complicated root branching: The tooth’s roots have tiny canals that vary by the individual. Sometimes an infected canal may go unnoticed during the initial root canal procedure.
• Curved or especially narrow canals that were not effectively treated.
• Fractures or cracks in the tooth.
• Delayed crown placement or implementation of other restorations to the tooth to protect it.
• New tooth decay has exposed the root.

Whatever the reason for the failed root canal, resolving the problem involves a comprehensive examination. If this happens to you, it’s important we understand exactly what’s going on with your tooth, because every tooth has a story, and each requires its own treatment plan! 

What Happens if a Root Canal Fails?

When a root canal fails, the patient experiences infection or discomfort — either continued from before or new. It is crucial the patient receives appropriate treatment in a timely manner since the infection can spread to other teeth or lead to illness. Plus, the sooner pain can be relieved, the better!

Sometimes patients ask how they will know if their root canal procedure fails. Here are a few symptoms of a failed root canal:

• Discomfort in and around the infected tooth is the most obvious symptom. It is normal to feel tenderness in the treated tooth in the days following a root canal. However, severe and lingering pain is a sign something is wrong.
• Swelling is often a sign of infection or inflammation. A little swelling for a few days after a procedure is normal and expected while you heal. However, if the swelling continues, it may be a sign of continued inflammation or infection.
• Bloody or pus discharge is another sign of infection and possibly an abscess.

If you or a family member experience these symptoms, call your dentist or endodontist for follow-up care. Your endodontist will help identify a path forward. The best retreatment will relieve the pain and restore wellness to your mouth.

Treatment Options for a Failed Root Canal

If you are experiencing a failed root canal, we want to assure you that retreatment or another procedure may allow you to keep your natural tooth and feel relief from the pain. First, be aware there are a few treatment options for failed root canals:

• Retreatment of the tooth with another root canal.
• A surgical procedure is known as an apicoectomy.
• Tooth extraction

At Ballantyne Endodontics, we believe the ideal situation is saving the patient’s natural tooth whenever possible! Restoring health to the natural tooth offers the best chance of long-term success and promoting quality of life for the patient.

Occasionally an extraction is the best option for an individual, but we think it is always worthwhile to assess whether the patient will benefit from retreatment or an apicoectomy before proceeding with an extraction.

While root canals have been practiced for decades, new advances in technology and techniques have resulted in even better treatment. If you need retreatment, see an endodontic specialist who uses the latest techniques. If your initial root canal was years ago, your endodontist might use techniques and technology that weren’t available during your first treatment. You might be amazed by the results!

What Happens During Retreatment?

Often, we find that retreatment is the best option. To make this determination, we will start with a Cone-Beam CT Scan (comprehensive imaging) that allows your doctor to see the full anatomy of the impacted tooth. Every tooth has its own story and this scan allows us to read your story and determine your treatment plan. 

After the thorough examination with comprehensive imaging, your endodontist will discuss your options, as they vary from person to person and tooth to tooth. If you opt for retreatment, here is a brief overview of the process you can expect.

First, your endodontist will need to reopen the affected tooth to regain access to the previous root canal filling. They may need to remove your crown or other restorative materials, so they have access to the interior.

Next, they will remove the previous root canal filling and thoroughly clean inside the tooth. They will use sophisticated imaging tools like magnification and illumination to look at the structure of your root system. Your endodontist may discover your tooth’s anatomy is more complicated than the average person’s and may notice areas that were left untreated previously.

After thoroughly cleansing the area and refilling, your endodontist will re-seal the tooth and add a temporary filling. You will probably need to return to your dentist for a new crown or other state-of-the-art restoration.

Your endodontist and dental team will discuss those specific details with you before your procedure. Be sure to follow your prescribed course of treatment, including keeping follow-up appointments and following any special instructions during your at-home recovery.

Next Steps: Find a Qualified Endodontist

We hope this article answered some of your questions regarding “what happens if a root canal fails?” If you or a loved one are suffering from a failed root canal, ask your dentist to refer you to a skilled endodontist.

If you live in the Charlotte, NC area, we urge you to consider Ballantyne Endodontics. We have had the privilege of treating Charlotte residents since 2008. Our founder, Endodontist Sonia Chopra, D.D.S., knows first-hand what it is like to need retreatment for a root canal, and she has devoted her professional life to restoring health and balance for her patients.

Call us today for information on getting a referral from your dentist or to schedule a consultation.