Americans are coming around to root canals, and it’s a good thing, too, because this unfairly maligned procedure is a great way to take a highly damaged and painful infected tooth and turn it back into a productive member of your smile. A root canal is a very successful procedure–the success rate is 95% or more, depending on how experienced your dentist is–but sometimes it doesn’t work and you have a tooth that is still infected.

If this is the case, you will have to choose between a second root canal vs an implant. Which is best?

cute red head sitting on couch

Symptoms of Root Canal Failure

Before we start talking about whether a second root canal or dental implants become necessary to optimize your oral health, you will first have to show symptoms of a failed root canal. A failed root canal can start showing symptoms at any time.

The first symptom of root canal failure is pain. Most root canal treatments will leave you feeling sore for a few days following the procedure. However, if the pain lingers for several weeks following your procedure, this might indicate that your root canal failed.

Another sign of root canal failure is swelling. Mild swelling on your face or around the tooth that had the procedure is normal for the first few days. However, if the swelling persists, it might mean your root canal failed.

The last symptom of root canal failure is a pus-filled bloody discharge from the area surrounding the gums of the treated tooth. You might also see a red bump. This is an abscess.

If you notice any of the symptoms listed above, you’re likely experiencing a failed root canal and need to seek treatment as soon as possible. Otherwise, your pain will only get worse. 

Causes of Failed Root Canals

Whether a second root canal is better than a dental implant depends on why your root canal failed in the first place. If, for example, it failed because the tooth root was broken in the procedure, then your tooth can’t be restored with a root canal and you have no option but to get an extraction and dental implant.

On the other hand, some common reasons for root canal failure can be corrected relatively easily. If your dentist just didn’t completely clean out the tooth, especially if there was a root that was missed, a second root canal can be expected to be successful.

Some of the most common causes of failed root canals include:

Undetected Canal Branches

Some teeth have as many as four canals and can hide behind others without your dentists knowing. If these undetected canal branches don’t receive treatment, it can cause your root canal to fail.


If there’s an obstruction in your teeth such as a filling or another tooth that prevents your dentist from performing the procedure completely, it can result in a failed root canal. If they can’t successfully reach and thoroughly clean the canal of your tooth, your root canal will fail.

Cracks in the Root

The last cause of root canal failure is from a cracked root. The roots may fracture or fissure deep within the gum which makes it difficult to fully seal the root canal during your procedure. This opens up the possibility of infection, increased sensitivity, and pain.

In each of these cases, you may require a second root canal or dental implant.

Damage Since the First Root Canal

Another factor to consider is if your tooth is still in the good shape it was at the time of your first root canal. If your tooth experienced damage during the procedure or by secondary infection, it might not be able to be restored with a second root canal. It’s also concerning if the gum disease progresses enough to threaten the tooth. In that case, a root canal may not be a good idea. Of course, you would still need to treat the gum disease before you receive a dental implant.

Are Implants Safer Than Root Canals?

Now you’re probably debating which is better, root canal or implant? Most dentists come down to the same consensus – keeping your natural tooth is the best option. However, if you’ve experienced a failed root canal and there’s no way to remedy the situation, extraction and a dental implant might be the best option. There’s no way to tell until you visit a qualified dentist like Dr. Strober.

Trust Our Rancho Mirage Dentist

After you experience a failed root canal, you have to ask yourself whether you want to let your dentist try the follow-up root canal or whether you want another dentist to look at the tooth and perform the procedure. Even if you still trust your dentist (and they’re not referring you to a specialist, which might also be appropriate), it’s a good idea to get a second opinion about the state of your tooth and whether a dental implant or a root canal is the better follow-up.

That’s where Dr. Strober at Country Club Dentistry can help. Dr. Strober has over 26 years of experience delivering high-quality patient-centered care. He is happy to take a look at your failed root canal to provide you with a second opinion and recommended treatment options.

If you’re experiencing a failed root canal and would like to consider a second opinion or a dental implant from our Rancho Mirage implant dentist, please call (760) 832-7915 for an appointment at Country Club Dentistry.