Can a Root Canal Be Re-Done More Than Once?

I had a root canal treatment done, and then a few years later had a retreatment done because the infection returned. Now it is back again. Is it possible to re-do a root canal more than once? If not, will I need to pull the tooth? Is my dentist doing something wrong?

Breanne

Dear Breanne,

While a root canal treatment can be redone multiple times, the chances of a successful outcome go down each time it is attempted. It is possible that your dentist could have done nothing wrong each time and it still not succeeded. This happens between 5 and 15% of the time.

This is because the pulp canal has branches that take unique twists and turns. Sometimes it is a matter of them missing a branch, but other times there are some which take a turn that even with the tiny tools a dentist uses the dentist can’t get to them. Some are at 90 degree angles.

If you’ve seen a root canal specialist to have your root canal retreated and it still failed, the chances of a third one succeeding are minimal. If you didn’t see a root canal specialist, then you have a shot that the third time will be the charm.

Let’s say for arguments sake that another won’t work. This does not mean that you will need to extract the tooth. There is something else to try first. Another option, known as an apicoectomy, a root canal surgery, can be successful between 50-75% of the time in these difficult retreatment cases. With this, the dentist will make an opening in the bone and cut off the root tip of the infected tooth. This can be sealed with a small tooth filling.

Be aware that there are occasions where the teeth are too close to a nerve that goes to the lower jaw or lip. That might make it surgically inaccessible because of the risk. That is when I’d consider that the tooth has to be extracted.

This blog is brought to you by a compassionate endodontist in San Antonio, Dr. Scott Janse.