How long do root canal treated teeth survive in studies?
Studies usually answer this question by asking whether the tooth is still in the mouth after a certain time, the survival rate.
- Systematic review: the review by Ng and colleagues in the International Endodontic Journal (2010) pooled 14 studies; two to ten years after root canal treatment, 86 to 93 percent of teeth were still in place.
- Prospective study: in the study by the same group at the UCL Eastman Dental Hospital in London (2011), about 95 percent of teeth were still in place after four years, for first treatments and repeat treatments alike.
- Large database study: the American Association of Endodontists (AAE) reports in its newsletter for dentists an analysis of more than 1.4 million root canal treated teeth, of which 97 percent were still in place after eight years. The comparison with an implant is in our guide root canal treatment or extraction.
In its patient information, the AAE gives a success rate of more than 90 percent and notes that the outcome depends on factors such as how quickly the tooth is restored. These figures are averages, not a promise for an individual tooth.
How long does a root canal treated tooth last without a crown?
The studies give no figure in years, but a clear direction:
- Aquilino and Caplan (2002) analysed 203 root canal treated teeth from the University of Iowa database. After adjusting for tooth type and decay, the risk of losing the tooth was about six times as high for teeth without a crown as for crowned teeth.
- In the study by Ng and colleagues (2011), the risk of loss was clearly higher when the tooth was left with only a temporary filling after treatment, and lower when it received a laboratory-made restoration such as a crown.
- The AAE writes in its 2004 newsletter that temporary fillings do not reliably keep bacteria out for long, so the tooth should be restored as soon as possible after root canal treatment.
“Without a crown” does not always mean “unprotected”, however. According to the AAE, a front tooth with little tooth loss can be permanently restored with a bonded filling; a back tooth usually needs a restoration that covers the cusps. What matters is a well-sealed permanent restoration in good time, not the crown as such. Which restoration suits which tooth is explained in our guide do you need a crown after root canal treatment?.
Which factors affect how long the tooth lasts?
Ng and colleagues found 13 factors in their study that were associated with tooth loss. Some concern general health, others the state of the tooth before treatment, and others what happens to the tooth afterwards:
| Factor | Finding in the study |
|---|---|
| Diabetes or systemic steroid treatment | Higher risk of loss |
| Pain or a draining fistula before treatment | Higher risk of loss |
| A narrow, deep gum pocket at the tooth | Higher risk of loss |
| Tooth left with only a temporary filling after treatment | Clearly higher risk of loss |
| Laboratory-made restoration (such as a crown) | Lower risk of loss |
| Contact with neighbouring teeth on both sides | Lower risk of loss |
| Tooth at the end of the row | Higher risk of loss |
Factors such as the position of the tooth cannot be changed; a timely restoration and healthy gums, on the other hand, are largely in the hands of you and your dentist.
Why can a root canal treated tooth cause problems years later?
According to the AAE, a root canal treated tooth sometimes does not heal completely and can become painful or diseased again months or years later. Inflammation at the root tip can also be present without symptoms and show up only on an X-ray. The AAE groups the causes in two:
Causes connected with the first treatment:
- Narrow or curved canals that could not be cleaned the first time
- A delayed crown or permanent restoration
Problems arising later:
- New decay that reaches the root filling and infects the tooth again
- A loose, cracked or broken crown or filling
- A fracture of the tooth
How do you recognise that something is wrong?
In the following cases you should not wait for your next routine check-up but see a dentist:
- Throbbing pain in the tooth
- Swelling of the gum or a pimple-like blister with discharge (fistula)
- Pain on biting or chewing
- A loose, cracked or lost crown or filling
Some problems cause no symptoms, so keep your follow-up appointments and regular check-ups. With swelling of the face, eye or neck, fever, or difficulty swallowing or breathing, go to an emergency department straight away. Which symptoms are normal right after treatment is described in our guide does root canal treatment hurt?.
Can a tooth with problems be treated again?
Often, yes. The AAE describes retreatment (repeat root canal treatment) as a second chance to keep the tooth: the tooth is reopened, the old root filling and, if necessary, the crown and post are removed, the canals are cleaned and refilled, and the tooth is sealed temporarily until a new permanent restoration is fitted. Where retreatment is not enough, the AAE also names surgery at the root tip as a further option.
If retreatment is not an option, extraction remains; the gap is then usually closed with an implant, bridge or partial denture. In the study by Ng and colleagues, the four-year survival rate after retreatment was similar to that after a first treatment.
What can you do yourself to make the tooth last?
- Do not postpone the permanent restoration. If a temporary filling falls out or breaks, get in touch.
- Keep up daily care. Cleveland Clinic recommends brushing after meals and flossing daily.
- Do not chew on hard things. The AAE advises against biting ice, unpopped popcorn kernels or pens.
- Mention grinding. The AAE recommends discussing a protective night guard with your dentist; what suits you is assessed at the examination.
- Do not smoke. According to Cleveland Clinic, smoking can slow healing.
- Keep your check-ups. According to NICE, the interval is between three and 24 months depending on your risk.
What does this mean for root canal treatment in Türkiye?
For patients travelling from abroad, the most important point in this guide is the time between root canal treatment and the permanent restoration. Some teeth are finished in one visit, others need several; the AAE says most root canals take one to two appointments, and the NHS says it usually takes two or more. How many visits your tooth needs is decided at the examination. Before booking, find out whether the filling or crown can still be fitted on the same trip and, if not, who will do it at home. Book your return flight only once the plan is confirmed: an article in the British Dental Journal (2023) gives 72 hours as the minimum interval between root canal treatment and a flight, provided there are no symptoms, and stresses that research on this is limited.
When you leave, you receive copies of your treatment summary and X-rays so that your dentist at home can take over the check-ups. After you return, you can still reach us on WhatsApp (see aftercare and follow-up); with acute symptoms, a dentist near you is the first port of call. The treatment itself is described on our root canal treatment page.
How do we look after root canal treated teeth at Rönesans?
Endodontics (root canal treatment) is one of the specialties at our clinic. If a root canal treated tooth hurts again, the tooth and its restoration are assessed at the examination; to clarify inflammation at the root tip or a root fracture, a cone-beam CT (CBCT) scan at our clinic can provide a three-dimensional image.
Before treatment begins you receive a written treatment and cost plan, and you know from the start who is treating you. For a preliminary assessment, you can send photos and X-rays on WhatsApp to +90 532 363 49 54 or call +90 264 606 09 43.