It is one of the first questions patients ask, and a fair one: if you are going to save the tooth, how long will it last? The honest answer is that no treatment comes with a guarantee, but the research on root canal-treated teeth is very encouraging.
What the largest study found
Researchers followed the outcomes of initial root canal treatment in more than 1.4 million teeth, belonging to over a million patients in all 50 states, for eight years. At the end of that time, 97 percent of the teeth were still in place. Only 3 percent needed another procedure, such as retreatment, surgery or extraction, and most of those events happened within the first three years.
A systematic review of 14 clinical studies found similar results over longer periods: between 86 and 93 percent of teeth were still in place two to ten years after treatment.
What makes the biggest difference
The same review identified four factors that made a tooth more likely to last. In order of influence:
- A crown placed after the root canal.
- Teeth on both sides. A tooth with neighbors in front and behind it did better.
- Not anchoring a bridge or partial denture. Teeth carrying that extra load were more likely to be lost.
- Tooth type. Front teeth and premolars fared a little better than molars, which take the heaviest chewing forces.
The crown stands out. In the eight-year study, 85 percent of the treated teeth that were later extracted had never received a full crown. A separate study that controlled for other factors found that treated teeth without crowns were lost at six times the rate of teeth that had them. We cover this in more detail in do you need a crown after a root canal.
What you can do
- Get the final restoration on time. If your tooth needs a crown, schedule it with your dentist within a few weeks.
- Keep your regular dental visits. New decay or a broken filling can let bacteria back into a treated tooth.
- Protect it if you grind. If you clench or grind your teeth, ask your dentist whether a night guard makes sense.
How the details help
The first root canal is the tooth’s best chance, so the details matter. Dr. Hirose works under a surgical microscope, which helps him find small extra canals that are easy to miss, and he sends your dentist a report so the final crown or filling can go on promptly. Learn more about root canal treatment and why the microscope matters.
If a treated tooth does give you trouble years later, it can often be saved again. See endodontic retreatment, or learn more about root canal treatment.