Myths about root canal treatment: Teeth that have had endodontic therapy are eventually lost anyway.

Those teeth that have had root canal treatment can last a lifetime although, admittedly, there are a number of factors that come into play in providing for this success. This page discusses many of these issues.

We would like to state at this point before you read on, despite all of the caveats and problematic scenarios that we offer here, root canal treatment typically offers a predictable, prudent and cost effective choice for those people who are seeking a long-term positive outcome for a damaged tooth. If your dentist recommends performing root canal treatment for your tooth, you should give it serious consideration.

A) Factors associated with the root canal treatment itself.

» Who will perform the root canal therapy?

The long-term survival of a tooth that has received root canal treatment will in part depend upon the expertise with which the work has been performed. In the field of dentistry, root canal treatment can be performed by either a general dentist or an endodontist (a dentist who specializes in providing root canal treatment). In most cases a patient's general dentist will examine their tooth first. As a part of this evaluation, they will make a determination regarding the tooth's need for a specialist's services.

» There may be advantages to having an endodontist perform your root canal treatment.

Specialty training can influence treatment outcome. As an example, Alley (2004) found a success rate of 98% for routine (non-surgical) root canal treatment when it was performed by endodontists. This number fell to 90% for cases treated by general practitioners. Root canal cases that have failed can be retreated. Admittedly, however, retreatment cases typically have a lower success rate. A review of dental literature by Ng (2008) determined an endodontic retreatment success rate on the order of 77%.

B) Factors associated with the way the treated tooth was restored.

Receiving expert root canal therapy is only a part of the needed recipe for an endodontically treated tooth's long-term survival. The dentist must also insure that following its root canal treatment the tooth is restored with an appropriate dental restoration.

The dental restoration that is placed on (or in) a tooth that has had root canal treatment provides two main functions. The restoration must be able to provide a lasting seal that prevents contaminates from the oral environment from seeping back into the tooth's root canal space (a process termed coronal leakage). The restoration must also be one that can help to protect the root canalled tooth from future damage (such as fracture or breakage). A failure on either one of these fronts can lead to the need for endodontic retreatment or, at worst, tooth loss.

The type of restoration that is needed will depend on each tooth's specific situation. In some instances, a dental filling may suffice. For other teeth, especially molars, a dental crown may be needed.

C) Factors associated with the patient's behavior and habits.

Teeth that have had root canal treatment are not immune to the development of tooth decay or periodontal disease (gum disease). And advanced problems with either of these can certainly lead to the loss of a "root canalled" tooth. A patient needs to realize that those teeth that have received root canal treatment require proper care (brushing, flossing, dental cleanings and check ups), just like all other teeth do.