How long does a tooth last after a root canal?

The answer in detail

The nerve, or pulp, is the living part inside your tooth: nerves and blood vessels that feed it from within. When decay, a crack or an infection reaches it, the tooth usually hurts, and sometimes the pulp dies and an abscess forms. A root canal means cleaning that inflamed or dead tissue out of the inside of the tooth, disinfecting the canals it ran through, filling them, and then sealing the tooth from the top to keep bacteria out.

Afterwards the tooth stays where it is, on its own root, still held in the bone, and you can chew on it. What changes is that it no longer has a supply from inside, and it is hollower than before because of the decay and the opening made to treat it. So it becomes more brittle, weaker and easier to crack. It is not a “dead” tooth that will fall out on its own; it is a tooth that needs protecting.

And “how long does it last?” has no honest number, because the tooth does not last on its own. How long it lasts depends on how much of it is left, whether it was crowned in time, whether the cleaning inside was complete, and on your bite, your habits and your follow-up. The same tooth, treated by the same hands, stays for years in one mouth and cracks early in another. So any general number you hear is an average across many teeth, not a number for yours.

Front tooth or molar: why it matters

A front tooth usually has one canal and takes less chewing force, so sometimes a well-sealed filling is enough after the root canal; the examination decides. A molar has three canals or more, takes the full force of chewing, and usually had a large filling or wide decay before the root canal, so its walls are thinner. That is why a molar after a root canal usually needs a crown that covers it completely and spreads the load, or it becomes prone to cracking over time, sometimes in a way that cannot be repaired.

And the cost? It is discussed after the examination, and what decides it is explained on What decides the cost of your treatment. Everything about the procedure itself is on The tooth that hurts at night, and the crown on Crowns and bridges.

The downsides of a root canal

We list these first, before what keeps it with you. Most of them have a fix if they are caught in time.

• The tooth becomes weaker. With no supply from inside and thinner walls, the tooth cracks more easily, a molar especially. This is the main reason a crown after a root canal is not a luxury.
• It may darken. Over time, some teeth that have had a root canal turn darker than their neighbours, and it shows most on front teeth. There are ways to deal with it, decided at the examination if and when it happens.
• It no longer feels hot and cold. That reads like an advantage, but it has another side: if new decay starts at the edge of the filling or the crown, you will not feel it early the way you would in a normal tooth. So follow-up and a routine x-ray take the place of feeling.
• The infection can come back. If bacteria remain in a small canal that could not be seen, or get back in through a broken filling or a crown that was put off, the infection returns. Then the tooth needs re-treatment, and in some cases it can no longer be saved and extraction becomes the choice.
• It takes more than one step. Sometimes more than one visit, then the final filling, then the crown as a separate step. It is not one sitting and done, and you know that from the start. If you are only in Amman for a stretch, say so before you book, so the steps are planned around your stay as far as the tooth allows.

Even so, the alternative to a root canal for an inflamed tooth is extraction. And an extraction opens a gap that needs replacing later, and the teeth beside it can drift if it stays empty. And what the replacement options are: Implant or bridge: what actually differs. Our principle: we protect your tooth before we think about extraction. How the choice between the two is made: Extraction or root canal: how it is decided.

What keeps it with you, and what shortens its life

What makes it last longer

• A crown in time. Once the treatment is finished and the tooth has settled, a molar usually needs a crown, and not after you have forgotten about it. Many of the molars that crack after a root canal crack while they are waiting for the crown.
• A well-sealed final filling. The temporary filling between visits is not for good. The seal on top is what keeps bacteria from getting back in, so it has to be final and tight.
• Daily cleaning at the edge. A tooth without its nerve decays like any other. Brush and floss, with attention to the line where the crown or the filling meets the tooth.
• No biting on hard things. Nut and seed shells, ice, and opening packets with your teeth. A tooth after a root canal handles food, not tools.
• Protection from grinding. If you grind or clench in your sleep, say so at the first visit, and how your teeth are protected is decided at the examination. Grinding breaks a weakened tooth faster than the others.
• Follow-up and a routine x-ray. Because the tooth cannot feel, the x-ray is what shows whether the infection has really cleared at the root tip, and whether new decay has started at the edge.
• Healthy gum around it. An inflamed gum recedes and exposes the edge of the crown, and that is where decay can begin.

What cuts its life short

• Putting off the crown. A molar chewed on for a long stretch with only a large filling, or a temporary one. One bite on something hard is enough.
• Grinding and biting on hard things. The same enemies as for any tooth, but a tooth without its nerve has less to spare.
• Decay at the edge of the crown. It starts silently because you cannot feel it, and it reaches under the crown.
• A temporary filling that fell out and was not replaced. Bacteria get back into the open tooth, and it needs cleaning and disinfecting again, sometimes an extra visit.
• Pain that came back and was ignored. Pain that returns after it had settled is not normal, and the longer you wait, the smaller the chance the tooth can be saved by re-treatment.
• Missing the follow-up. The small problem an x-ray would have caught can grow silently until the tooth cracks or the gum swells.

How many visits does a root canal take?

Usually one or two visits, rarely more: when there is an infection or an abscess that has to settle between visits, when the canals are narrow or curved and take time, or when a tooth was treated before and is being re-treated. The visit itself usually takes between half an hour and an hour and a half, depending on the number of canals and whether there is an infection. You hear the likely number after the examination and the x-ray, as an expectation, not a promise, because a tooth sometimes turns out different inside from what the x-ray showed.

Between visits the tooth has a temporary filling. Do not chew anything hard on it, and if it falls out, call the same day so it can be replaced, because bacteria get back into an open tooth.

And once the visits are done, there are two steps you know about from the start: the final filling, and the crown if it is needed. They are not a surprise at the end of the road; they are part of the treatment itself. If you are travelling to Amman, this is what shapes a realistic stay: a root canal and its crown are rarely one visit, and it is better to know that before you book flights. Why it differs from tooth to tooth (one canal or three, front tooth or molar, infection or not) is set out in the factor cards on What decides the cost of your treatment.

What to do from here

Depending on where you are:

1. 1

   Still hurting and not started yet?Do not wait on it. Pain that gets worse at night, or that stays after the cold or heat is gone, is often an inflamed nerve, and the earlier you come, the better the chance the tooth is saved rather than extracted. Why it gets worse at night: The tooth that hurts at night. And what to do now, until your appointment: Toothache: what to do right now.

2. 2

   The first days after a visitTenderness when you bite, for a few days, is normal, because the tissue around the root tip is still settling. Do not eat on the numb side until the anaesthetic wears off, so you do not bite your cheek or lip. And do not chew on the tooth until the treatment is finished and sealed for good, or crowned if it needs to be. Any painkiller is the doctor’s decision, not something to pick up on your own. If it hurts badly now and the clinic is closed: what to do until morning. And if the pain gets worse instead of easing, you call.

3. 3

   Mention grinding at the first visitDo you wake with a tired jaw? Has anyone told you that you grind in your sleep? Are the edges of your teeth flattened? This is the most useful thing you can bring with you, because a tooth without its nerve has less to spare against grinding, and protecting it becomes part of the plan from day one.

4. 4

   Had a root canal before, here or abroad, and it was never crowned?Wherever it was done, book an examination. A molar left after a root canal with only a filling, or with a temporary filling from long ago, is prone to cracking, and the longer it waits the higher the chance, and an examination with an x-ray shows whether it can still be kept and what it needs.

5. 5

   Do not miss the follow-upThe tooth cannot feel, so the routine x-ray is what watches over it. Any edge that has started to show, a filling that has broken, or a colour that has started to darken: do not wait on them.

6. 6

   Book an examinationAt the examination the tooth, its roots, the gum around it and your bite are looked at, and you hear whether it can be kept, exactly what it needs, and what the doctor expects for your tooth and why. Mention any condition you have or medicine you take, because it plays into the decision between keeping the tooth and extracting it. And the decision is yours.

When to call

A tooth usually settles within days of a root canal. But some signs should not wait for the next check-up:

• Call this week: tenderness when you bite that has not eased after a few days, or is getting worse instead of better.
• Call this week: the temporary filling has fallen out or a piece has broken off, the crown has started to move, or there is an edge you can feel with your tongue.
• Call this week: the gum around it is red or bleeds when you brush.
• Call today: strong pain that is getting worse or wakes you at night, in a tooth that has had a root canal, whether days ago or years ago.
• Call today: a swelling in the gum or the cheek by the tooth, a small bump on the gum that leaks pus, a salty taste in your mouth that does not go away, or a fever.
• Call today: the tooth has broken, or the crown has come off. Keep any piece and bring it with you, and do not try to glue it back yourself with any adhesive.
• And not urgent: the tooth has started to darken. Not an emergency and not a call, but mention it at your next visit.

Call and we will find you the earliest slot, and tell you what to do until you arrive. Before any painkiller, ask the doctor first, so it suits your case. If the swelling has reached your eye, or it has become hard to swallow or breathe, that is a hospital emergency, not an appointment. And if the clinic is closed and the swelling is growing or you have a high fever, go to the nearest hospital emergency department, and let us know as soon as we open. And if the pain is in another tooth: Toothache: what to do right now.

Questions people ask