A root canal that has failed does not automatically mean losing the tooth. There are usually three options, and extraction is only one of them.
Why root canals fail
Most often a canal was missed or not fully cleaned, allowing bacteria to persist. Sometimes the seal has leaked over years. Occasionally the root has fractured, which is the one scenario that ends the discussion.
Failure can appear decades later. A tooth treated in 1995 developing a problem now is entirely ordinary and does not mean the original work was poor.
Option one: retreatment
Reopening the tooth, removing the old filling material, finding and cleaning what was missed, and resealing. Success rates are good when the cause was an untreated canal.
Modern magnification and imaging find anatomy that was routinely missed in earlier decades, which is why retreatment often succeeds where the original did not.
Option two: apical surgery
Treating the root tip from outside, sealing it directly. Indicated when retreatment is impractical, for example under a well-fitting post and crown that would be destroyed by dismantling.
Outcomes with contemporary microsurgical technique are considerably better than the older literature suggests.
Option three: extraction and implant
Appropriate where the root is fractured, where too little tooth remains to restore, or where retreatment has already failed.
The point worth making is that this should be the third consideration rather than the first. A tooth retained for another fifteen years is fifteen years of bone preserved.
Ask specifically whether retreatment or apical surgery has been considered before accepting extraction. A failed root canal is frequently a treatable problem rather than a terminal one.
If you want to know how this would apply to your smile, book a remote consultation with us.
