How often does root canal treatment "fail"?

[EdJ]

My gum is very sore and as I'd already had root canal treatment some time ago, I assumed it wouldn't be that. My dentist took an xray and I've just received a letter saying that the gum has become infected and that the root canal treatment has failed.

Now, I like my dentist, but I haven't really got anything to compare him too. So I wondered, how often do root canal treatments "fail" and is this just a fairly random event, or should I be looking for him to fix it free of charge?

He has offered to make some improvements himself (which would include putting a crown on) or as an alternative he suggested I see their specialist endodontist who will charge me £800 for the root canal treatment.

Any thoughts?

[MacGee]

nearly all dental treatment fails eventually. a study in USA on root canals (RCTs)...showed a 99% survival rate. All that this showed was that the teeth were still present!!!infected/perfect/abscessed etc...all that mattered was that the tooth was still in the skull. Now our Dept of Health like to quote this as a success rate for RCTs which is nonsense. So average RCT by average dentist is prob 75%. but what if tooth was a bit dodgy and was on verge of extraction...etc. So many parameters involved. So v diff to say as stats are not of any relevance.

[EdJ]

Thanks for the reply. So based on the information above, should I let my existing dentist make the improvements and crown the tooth, or go to the specialist root canal chap?

I should add that the gum pain is not exactly causing me discomfort and if doing nothing was an option, I'd be tempted to take it.

[MacGee]

that is not my call. But on info given he is honest and if tooth/gum not too bad...can leave and watch. Xrays taken annually to watch for serious pathology (very slightly possible). Many patients quite happy with this and prefer to reRCT/surgery/cost of private RCT.

[EdJ]

MacGee said:

that is not my call. But on info given he is honest and if tooth/gum not too bad...can leave and watch. Xrays taken annually to watch for serious pathology (very slightly possible). Many patients quite happy with this and prefer to reRCT/surgery/cost of private RCT.

Great thanks - appreciate the second opinion.

[motco]

My dentist told me a week or so ago that 50% of (c.£40)NHS root canal treatments survive five years but that his private RCT (at £400+) will statistically last five years 90% of the time. [Picks up pinch of salt...]

[prg1]

I have certainly read somewhere that the average success rate of rct in general practice( non endodontist) over all teeth is approximately 2/3rds.
However it reallly is a tooth by tooth thing to estimate success rates in any case. We'd all agree an upper first molar is going to have a far lower success rate than an upper ceneral incisor.
Also it depends on your criteria for success. Some studies use the tooth being there at a certain point after inital treatment. Some use far more stringent criteria, such as condensation of gutta percha, proximity of the end of the root filling to the apex, pathology remaining apically on radiographs.
Damn Lies and statistics

[el_ringo]

For the most part root canal is successful and it depends on the exact diagnosis as to how well it is likely to work.

If the nerve is just damaged and not infected you can expect in the order of 90% over five years but in the case of infection that can drop to around 80%. For cases with huge amounts of infection the success rate is lower still.

In more and more cases these days, extraction and placement of an implant can work out cheaper in the long run than specialist re-root canal treatment.

R


(all of my advice is general guidance and I recommend seeking face to face advice for all medical/dental procedures)