Root canal retreatment gives a previously treated tooth a second chance, and when it is done properly, it can save a tooth that might otherwise need to come out.
- Removes old filling material from inside the tooth to get to the source of the problem
- Cleans and reshapes the root canals to clear out any remaining infection
- Reseals the tooth to give it the best chance of long-term success
- Can save a tooth that has not healed properly after a first root canal
With the right care after retreatment, your tooth can go on to last for many more years.
What Is Root Canal Retreatment?
Root canal retreatment is a procedure carried out on a tooth that has already had root canal treatment but has not healed as well as expected. Sometimes a tooth that was treated months or even years ago can become painful or infected again. When this happens, retreatment gives the tooth another chance.
During retreatment, the dentist or specialist opens the tooth back up, removes the old filling material, and cleans the canals again more thoroughly. Any new infection or missed canals are dealt with before the tooth is resealed and restored.
It is a more complex procedure than a first root canal, which is why it is often carried out by a specialist called an endodontist. Most retreatments take one or two visits to complete.
When you come in for root canal retreatment, here is what you can expect:
- A full assessment of the tooth using X-rays to understand why the first treatment has not worked
- Local anaesthetic to numb the area completely so you do not feel pain during the procedure
- Removal of the crown, post, or filling that is currently in place to access the inside of the tooth
- Removal of the old root canal filling material from inside the canals
- Thorough cleaning and reshaping of the canals to clear out any bacteria or missed infection
- Treatment of any extra canals or unusual anatomy that may have been missed the first time
- Resealing of the canals with fresh filling material to close off the tooth
- A new filling or crown placed on top to protect and restore the tooth
- Aftercare advice to help the tooth heal and stay healthy going forward
Every case is different, so your specialist will talk you through exactly what is needed before treatment begins.
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Why Is Root Canal Retreatment Worth It?
A lot of people assume that if a root canal has failed, the only option is to have the tooth taken out. But retreatment works well in many cases and is almost always worth trying before removing the tooth.
Retreatment tackles the source of the problem by clearing out infection that was missed or has come back since the first treatment. It saves your natural tooth, which is almost always stronger and better than any artificial replacement. Keeping your natural teeth helps protect the surrounding teeth and stops them from shifting out of place over time. The procedure has a strong success rate when carried out by a trained specialist, and a tooth that heals well after retreatment can last for many years.
Removing a tooth and replacing it with an implant or bridge costs significantly more and takes much longer. Retreatment is one of the most sensible steps you can take before giving up on a tooth.
If you are worried about the cost, ask your dentist or specialist about payment plans. Many practices offer flexible options to help spread the price.
Root Canal Retreatment FAQs
Why might a root canal fail and need retreatment?
A root canal can fail for several reasons, including canals that were not fully cleaned the first time, missed extra canals, new decay, or a cracked filling that has allowed bacteria back into the tooth. In some cases, the tooth simply takes longer to heal than expected.
What are the signs that I need root canal retreatment?
Common signs include returning pain or tenderness in a previously treated tooth, swelling in the gum around the tooth, and a new infection visible on an X-ray. If you experience any of these symptoms, you should see your dentist as soon as possible.
Is root canal retreatment painful?
Retreatment is carried out under local anaesthetic, so you should not feel pain during the procedure. Some tenderness afterwards is normal and usually settles within a few days. Your specialist will recommend appropriate pain relief to use at home.
How long does root canal retreatment take?
Retreatment typically takes longer than a first root canal due to the extra steps involved, such as removing existing filling material. Most appointments last between 90 minutes and two hours, and depending on the complexity of your case, more than one visit may be needed.
Should I see a specialist for root canal retreatment?
In most cases, yes. Retreatment is more complex than a first root canal and is best handled by an endodontist — a specialist who focuses solely on the inside of teeth. They have the advanced training and equipment needed to manage more difficult cases effectively.
What are the chances of root canal retreatment being successful?
Success rates for retreatment are good, particularly when carried out by a specialist. Many teeth go on to function well for years following retreatment. Your specialist will give you an honest assessment of the likely outcome based on the condition of your tooth.
What happens if root canal retreatment does not work?
If retreatment is unsuccessful, further options are available. Endodontic surgery (sometimes called an apicoectomy) can address infection at the tip of the root. If the tooth cannot be saved, your dentist will discuss extraction and suitable tooth replacement options with you.
Will I need a new crown after root canal retreatment?
In most cases, yes. The existing crown or filling must be removed to access the inside of the tooth, so a new restoration will be required once retreatment is complete. Your dentist will advise you on the most appropriate option for your tooth.