Can a Root Canal Treatment Be Done Twice?

I had a root canal treatment done several years ago on one of my teeth. That tooth is starting to hurt me again. Is it possible to have a root canal treatment done a second time or does this mean I will have to lose the tooth?

Casey

Dear Casey,

Illustration of a tooth needing a root canal treatment

To answer the question directly, yes, a root canal treatment can be re-done a second time. In fact, it can be re-done several times. However, the chances of a successful outcome go down each time, so you need to have realistic expectations.

If a dentist has done everything right, there is still a 5-15% failure rate, even on the first go. Here is why. The living tissue inside your tooth is called pulp. There are pulp chambers and pulp canals. The canals supply the blood supply and nerve channels to the chambers. When a tooth becomes infected, a dentist needs to clean out the pulp from inside the chamber and canals, then seal it against bacteria. Those canals have branches, with crazy twists and turns. Not only that, every tooth is different in how those branches go and some of them can be difficult and even impossible to reach. This accounts for the failure rate when everything was done correctly.

Here are a couple of examples of things that can go wrong. A molar is supposed to have three canals. However, some of them have a fourth, hidden canal that can be difficult to find. Other times there will be a branch that is at a right angle. We don’t currently have a tool that can handle that type of angle in a root canal treatment.

All of that being said, it is always better to have a natural tooth saved. For a root canal re-treatment, I would recommend going to an endodontist (a root canal specialist) to give yourself the best chance of a successful outcome. If it doesn’t work or if you don’t like the odds, then you can certainly get the tooth extracted and replaced. If you decide to go that route, than I recommend a dental implant for the tooth replacement. It is the closest thing to having a healthy, natural tooth.

This blog is brought to you by Baton Rouge Dentist Dr. Steven Collins.