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Modern root canal therapy is a routine, pain-relieving procedure designed to save your natural tooth by removing infected pulp, not cause pain. The discomfort typically associated with root canals stems from the underlying infection, which the procedure resolves.

• The process involves numbing the area, cleaning the infected pulp from the root canals, filling and sealing the canals, and restoring the tooth, usually with a crown.
• Most root canals are completed comfortably in one or two appointments, typically lasting 60-90 minutes each.
• The procedure eliminates severe tooth pain caused by infection and prevents tooth loss, preserving your natural smile.

You went through a root canal procedure to save a tooth and relieve pain. For a while, everything was fine. But now, you’re experiencing familiar discomfort, swelling, or sensitivity. It’s a frustrating and concerning situation, leading to one big question: “Did my root canal fail?”

While it is not a common outcome, a root canal can sometimes fail to heal as expected. Understanding why this happens and what your options are is the first step toward finding a solution. First, it is important to know that root canal therapy has a very high success rate. Success is often over 95%. A ‘successful’ treatment means the tooth is saved, feels comfortable, and remains fully functional.

This guide explains the common reasons for failure, the symptoms to watch for, and how a procedure called endodontic retreatment can give your tooth a second chance.

What Defines a ‘Successful’ Root Canal?

A successful root canal alleviates pain and completely clears the infection from within the tooth. The goal of a root canal is to remove the infected or inflamed pulp (the soft tissue inside your tooth), carefully clean and shape the inner canal system, and then fill and seal that space. A final restoration, like a crown, is then placed to protect the tooth from future damage. When this is achieved, the tooth can last a lifetime.

Common Reasons for Root Canal Failure

A tooth’s canal system can be incredibly complex, with many tiny branches. Despite an endodontist’s best efforts, some issues can compromise the long-term success of the treatment.

• Complex or Missed Canal Anatomy: Some teeth have narrow, curved, or hidden canals that are difficult to detect and clean fully during the initial procedure. If an infected canal is missed, the remaining bacteria can multiply and lead to a new infection.
• New Decay or Trauma: If a new cavity develops on the tooth, it can expose the inner root canal filling material to bacteria, causing a new infection. Similarly, a crack or fracture in the tooth can create a pathway for bacteria to get inside.
• Issues with the Restoration: A delay in placing the final crown, or a crown that becomes loose, cracked, or damaged, can allow bacteria to leak back into the tooth and contaminate the treated root canal.

Signs and Symptoms of a Failed Root Canal

The signs of a failed root canal can vary, but often include one or more of the following:

• Persistent or recurring tooth pain, which can range from a dull ache to a sharp pain when biting.
• Swelling or tenderness in the gums near the affected tooth.
• A pimple-like bump (fistula) on the gum that may release pus.
• Discolouration of the tooth.

If you experience any of these symptoms in a previously treated tooth, it is crucial to have it evaluated by a dental professional.

Root Canal Retreatment as A Second Chance for Your Tooth

The good news is that a failed root canal does not automatically mean you will lose the tooth. Endodontic retreatment is a specialised procedure designed to fix the problem and give your tooth a second chance. This procedure is often performed by an endodontist, a dental specialist in root canal therapy.

An endodontist will conduct a thorough evaluation to determine the best approach. While retreatment is often the ideal solution, in some rare cases, such as a severe vertical tooth fracture, an extraction may be the only viable option to protect your overall oral health. While success rates depend on the specific circumstances of the tooth, retreatment procedures can achieve success rates between 75-90%, offering a reliable way to resolve the issue.

The retreatment process involves:

1. Access: The endodontist reopens the tooth to access the root canal filling material.
2. Cleaning: The existing filling material is removed, and the canals are meticulously cleaned, shaped, and examined for any previously untreated anatomy.
3. Sealing: Once clean, the canals are refilled and sealed.
4. Restoration: A new crown or other restoration is placed on the tooth to protect it.

Don’t Wait to Seek Help

Don’t ignore persistent tooth pain or other symptoms in a tooth that has had a root canal. An evaluation can determine the cause of the problem and help you find the right solution to save your tooth and restore your comfort.
Contact us today to schedule a consultation.