Dentist Questions Root Canal

What happens if a root canal fails?

I'm going to have a root canal soon, and now I'm just wondering about any negative effects that can happen if the root canal were to fail. What happens if a root canal fails? What are the complications?

3 Answers

If root canals fail, there are generally 4 options: 1) live with it until it becomes too painful or infected to live with, 2) the other extreme is to extract the tooth (replacing it with an implant
is about 90 to 95% successful...similar to root canal therapy), 3) retreat the root canal, or 4) root canal surgery to correct the problem. Success rate by endodontists (root canal specialists) is about 95%. Endodontists are trained to deal with more complicated cases including failed root canal treatments. Most endodontists utilize surgical microscopes that enable them to see what is going on. They also have had intensive advanced training to be able to call themselves specialists and they do not do general dentistry except perhaps certain, limited procedures. Endodontists also do root canal surgery (apicoectomies for example) but the surgery usually has a lower success rate when the canal is infected (about 50% per infected canal). Therefore, surgery on a molar with 3 or 4 canals may very well fail over time. Failure (original infection remaining or reinfection) must be eliminated. Surgery removes infection from the bone, but not the root. Surgery then has to seal the infection into the root. That seal can leak and the problem return over time. The 50% failure per canal on a molar with 3 canals would mean surgery on 1 canal is successful, surgery on 1 canal fails and the 3rd canal may or may not heal. 1 canal not healing means the tooth fails. However, if the canals are retreated, then success can be 90% to 95% success. Then if surgery is needed on a properly retreated tooth, the canals are now already cleaned out and surgery just has to worry about
the bone infection, then success goes up to about 80%.
If your root canal fails: 1. you can have it re done by a specialist, 2. you can have an apicoectomy, 3. you can have the tooth extracted. If the tooth is an upper 1st molar, you should only have it done by an endodontist.
If a root canal fails, it is possible that you may have pain or discomfort in the tooth, swelling in the gum, infection, or it is even possible that there could be no signs or symptoms at all. If a root canal fails, sometimes it can be fixed by retreatment, surgery, or it is also possible that the tooth may need to be extracted. Without knowing more details of your specific case, it is impossible for me to run through all the possible scenarios. You should consult with the dentist who will be doing your root canal and address your concerns with him or her.