Root canal treatment is very good at saving teeth. The American Association of Endodontists (AAE) says that with proper care, even a tooth that has had a root canal can last a lifetime. But sometimes a treated tooth does not heal as expected, or a new problem develops months or even years later. If that happens, you may have a second chance to save the tooth through endodontic retreatment.

What Does "Failed Root Canal" Mean?

A root canal removes infected pulp from inside a tooth, cleans the canals, and seals the tooth. A root canal is considered to have failed when the tooth does not heal, or becomes painful or diseased again later. Our practice notes that this is relatively rare, and that when the tooth heals properly, the results can last a lifetime.

Signs a Root Canal May Be Reinfected

Our endodontic retreatment page says the clearest sign is tooth pain after root canal therapy. You may also notice tooth sensitivity. The AAE says that if you have pain or discomfort in a previously treated tooth, you should talk to an endodontist about retreatment. Do not wait for it to go away on its own.

Why Can a Treated Tooth Get Infected Again?

The AAE and our practice list several reasons a tooth may not heal after the first treatment:

• Narrow or curved canals were not fully treated during the first procedure.
• Complicated canal anatomy went undetected.
• The crown or other restoration was delayed after the root canal.
• The restoration did not prevent saliva and bacteria from reaching the inside of the tooth.

A new problem can also put a treated tooth at risk:

• New decay can expose the root canal filling to bacteria.
• A loose, cracked, or broken crown or filling can let bacteria in.
• The tooth fractures.

What Happens During Retreatment?

During your consultation, our team takes 3D scans of your mouth and examines your teeth. Retreatment typically requires only local anesthesia, and we offer many options for comfort.

Here is how the procedure works, according to our practice and the AAE:

1. The area is numbed.
2. The crown, and sometimes a post or core material, is removed to reach the canals.
3. The old filling material and any inflamed tissue are removed, and the canals are cleaned.
4. The inside of the tooth is examined with magnification and light for extra canals or unusual anatomy.
5. The canals are filled and sealed again.
6. You return to your dentist to have a new crown or other restoration placed.

If the canals are too narrow or blocked, the AAE says endodontic surgery may be recommended to seal the tip of the root. Learn more about endodontic surgery.

Recovery

Retreatment takes about the same time as a standard root canal, which our practice estimates at 30 to 60 minutes per tooth. Gums may be a little sore for several days, and soft foods help until they heal. Most patients recover in just a few days.

What If I Do Not Retreat the Tooth?

The AAE explains that the only other option is extracting the tooth. A missing tooth often has to be replaced with an implant, bridge, or removable partial denture so you can chew well and your neighboring teeth do not shift. The AAE notes these options can be more costly and time-consuming than saving the natural tooth.

Cost and Insurance

The AAE says retreatment can cost more than the first root canal because it is often more complex. Insurance may cover part or all of it, though some policies limit coverage to one procedure per tooth in a set period, so check with your insurer first. Contact our office to discuss payment and financing options.

Frequently Asked Questions

Is retreatment guaranteed to work?

No. The AAE says there are no guarantees with any dental or medical procedure. Your endodontist will go over your options and chances of success first.

Is retreatment painful?

It is done with local anesthesia, and our practice offers options such as nitrous oxide for comfort.

How do I know if my pain is from a failed root canal?

Only an exam and imaging can tell. Pain after treatment is a reason to call.

Schedule an Evaluation

If a treated tooth is hurting, contact Lubbock Dental Specialists to schedule an exam in Lubbock or Amarillo. You can also see all of our endodontic procedures.