Six years ago, my dentist did a root canal on a top right molar. The tooth is hurting again, and I am worried that I will need a dental implant. Is it possible to save a tooth that already had a root canal? Can a tooth remain stable after a second root canal? Thanks. Rachel
A dentist can repeat root canal treatment on a tooth two or more times. But successive root canal treatments don’t always make sense.
Can Root Canal Treatment Be Repeated?
Although a dentist can do a second or third root canal treatment—or more—on a tooth, the results are unpredictable. Even the most skilled dentists can perform root canal treatment that fails.
Studies show that root canal treatment has an 86 – 98% success rate. But cleaning out the canals of a tooth can be tricky. If a dentist doesn’t thoroughly remove infected tooth pulp, the infection will be sealed in the tooth only to flare up later.
A molar tooth has three canals, but sometimes a tooth has a “hidden” fourth canal. Sometimes a canal will branch out at a right angle. And although a dentist uses tiny, flexible instruments, it can be difficult—if not impossible—to get the device into angled canals to remove the infection.
Although highly angled canals are rare, when they exist, the probability of needing a repeat root canal increases. Retreatment has a 50 – 75% success rate. And if a highly skilled dentist performed the first root canal treatment, a second one might not work.
What About Root Canal Surgery?
Root canal surgery is also known as an apicoectomy. During the procedure, a dentist makes an opening in the bone, cuts off the infected root tip, and fills the end of the tooth. But if tooth roots are not readily accessible, the surgery is risky and can damage the lower jaw and lip nerve.
An extraction and dental implant are the last options. If you’re uncomfortable with your dentist’s skill level, you can seek a second opinion with a dentist who is skilled in root canal treatment. Or you can ask your dentist to refer you to an endodontist, a root canal specialist. If you’re anxious about future procedures, ask your dentist or endodontist about sedation options.
Dr. Steven Brooksher of Baton Rouge sponsors this post. Dr. Brooksher has advanced training in restorative dentistry.