How successful are root canals?

A tooth restored during a root canal could last a lifetime, as long as you continue to care for your teeth and gums. As long as the root(s) of a treated tooth are nourished by the tissues around it, your tooth will remain healthy.


Research has shown that root canals are about 90% successful when properly done by a dentist.
Romesh Nalliah
The success rate of root canal treatment is over 95%. However, it is not 100% successful. Sometimes there are complications (like curved roots and calcified root canals) that make it very difficult to successfully complete root canal treatment. Root canal techniques have improved significantly in recent years and root canal treatment is a highly predictable way to treat an infected tooth nerve.
I have read in the literature 85% 10 year success rate if General dentist performs it and 93% if a specialist (endodontist) performs the root canal therapy. This is going off memory from ONE study performed, although I have heard many other results ranging from 85% to 95%. The ADA is a great resource to answer those questions.
They are very successful (studies range anywhere from 85%, which I find low, to about 95%, which, in my experience, is spot on, like most things, you can probably find a study or a statistic to support what you already believed.) Once in a great while, we do run into a root canal that fails -- oddly shaped roots, etc. If that's the case, extraction/replacement is the only answer. But again, the odds are overwhelmingly in favor of the root canal succeeding.
If properly performed by a dental professional, a root canal treatment will successfully remove the diseased pulp and restore the tooth.

During a root canal, the dentist or endodontist opens the crown of the tooth and removes the pulp tissue. The root canal is cleaned to remove bacteria and then enlarged, shaped, and filled with medications that prevent infection. A temporary filling is put inside the opening of the crown to protect the tooth. This procedure can take from one to three visits to complete. After the root canal is finished, a crown is fitted over the tooth to seal it, which prevents food, debris and bacteria from entering the tooth.

If your dentist can find all the canals on your root canal tooth and properly fills them, a success rate of 95% is reasonable. The main reason why failure happens in not from an inadequately filled root canal, but is from the tooth breaking from not having a recommended crown placed on it following treatment. Ask your dentist if a crown will be needed following your root canal treatment.

The previous doctors all offered great insights into the high success rates of root canal therapy. However, numbers are not successful, and not always because of the dentist.

The major cause I see clinically, for failure of root canal treatment is "coronal leakage". This generally means the patient failed in their responsibility, for follow up care, to properly restore the tooth, at completion of root canal therapy. Unless the tooth is properly sealed, usually with a crown restoration, bacteria from the mouth enter the area in which root canal care was delivered. The tooth becomes reinfected.

I'll take this a step farther. Often after root canal treatment and the patient is out of pain, they feel reduced motivation for needed follow up dental care. If the tooth no longer hurts, they may not realize a problem. In fact, tooth decay may continue to eat away at tooth structure, and eventually render the tooth non-restorable.

So, both doctors and patients have responsibilities in successful root canal therapy.

Root canals are an alternative to having a tooth extracted. They are generally about 90% successful. Sometimes the tooth does not heal after a root canal and surgery at the end of the root may be necessary or an extraction. You should contact your dentist with any questions that you have about a root canal and treatment alternatives.

Root Canals can be highly successful. There are many factors that can determine the success of Root Canal treatment.
  • Diagnosis -- The state of the pulp prior to doing Root Canal treatment.
  • Anatomy of the Canal system. The more complex the system the more difficult the Root Canal Treatment.
  • Proper timely Restoration -- any leakage into the canal after Root Canal treatment can reduce the success of the treatment.
  • Oral hygiene and maintenance after treatment
  • Condition of other teeth -- parafunction, malocclusion, misalignment, etc.
Taking all these factors into consideration will give a better prognosis of the treatment.
Overall, root canal treatment is very successful. But that is little comfort if the root canal treatment on YOUR tooth is one of the occasional failures.

The statistics are somewhat fungible, depending on one's definition of success. Is a tooth that's had endodontic (root canal) therapy that is free of pain but shows signs of infection a failure? Some would say no, but most dentists would say yes. Sometimes I would say "it depends" -- especially if that judgment will determine what is done next.

Success will of course depend on the skill of the dentist, the difficulty of treating the tooth (curved canals, multiple/forked/blocked canals, and immune response of the patient), as well as the criterial for success.

Furthermore, a beautifully-performed root canal on a tooth with other problems (extensive decay that renders a tooth non-restorable, significant periodontal or gum disease) can very well be considered a failure of judgment, if not of execution.

The bottom line is -- if you are trying to save a tooth, what are the chances that doing the root canal will result in saving the tooth in a condition good enough to warrant the investment of time, money, discomfort and inconvenience. If your dentist cannot answer these questions, maybe the root canal treatment should not be done.
Root canal success has been a topic of recent debate. Until recently a dentist has been forced to use one dimentional xrays to evaluate whether a root canal is radiographically successful. We now can look at the jaw in three dimentions using a cone beam xray. With the advent of this new technology it has become apparrent that MANY root canals are infected. Some dentists are finding that long term sucess on multirooted teeth can be as low as 25%. A 75% failure rate is something to consider before making the choice to undergo this procedure.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.