Retreatment means opening a tooth that already had a root canal, removing the old filling material and cleaning the canals again. It is harder than a first treatment, and the price usually reflects that. Old material has to come out, a crown or post may have to be taken off or drilled through, and canals can be narrow, blocked or hard to find. Many retreatments are done by an endodontist, a specialist with advanced training in root canal problems, and often under a surgical microscope. Fees vary by tooth and by how complicated the case is, and the crown or build-up that follows is a separate cost. Insurance usually files it like a root canal, though some plans limit repeat work on the same tooth. Ask whether the same office would do the crown afterward and what that costs, because the retreatment fee rarely includes it.
Published fees for the coded services
| Service | Delta Dental of Washington plan, 2023 | Maryland Medicaid, 2025 |
|---|---|---|
| Retreatment, anterior (D3346) | $387 | $634 |
| Retreatment, premolar (D3347) | $449 | $721 |
| Retreatment, molar (D3348) | $552 | $829 |
Private offices can charge more, and fees differ by region and case. Sources: the Delta Dental of Washington fee schedule (as of June 8, 2023) and the Maryland Healthy Smiles 2025 fee schedule. For a fee lookup by ZIP code, see FAIR Health Consumer.
What moves the number
What drives the cost of retreatment
| Factor | Detail |
|---|---|
| Which tooth | Molars have more canals and are harder to reach than front teeth, which affects time and fee. |
| Removing the old restoration | A crown, post or build-up may need to come off. Some can be treated through, and some cannot. |
| Complexity of the canals | Blocked, calcified or curved canals, or a broken instrument left from earlier treatment, add time. |
| Specialist involvement | An endodontist may charge more than a general dentist, and may be more likely to accept complicated cases. |
| Microscope and imaging | Magnification and three-dimensional scans help in difficult cases. Find out whether they are included. |
| Number of visits | Some cases finish in one visit and others need two. |
Complete cost
What belongs in a retreatment estimate
Examination, X-rays and any three-dimensional scan
Removal of the crown, post or old filling, if needed
The retreatment itself, by tooth and by canal
Anesthetic and any sedation
A temporary filling between visits
A build-up and a new crown, which are separate
A follow-up X-ray to check healing
Request a written estimate that separates the retreatment from the restoration.
Where surprises come from
Things people do not expect
Learning that the old crown must be replaced because it was damaged in access
Finding a crack or a root fracture that makes the tooth unsavable, so the plan changes to extraction
A second specialist visit for surgery if retreatment alone does not resolve the problem
A plan that limits repeat treatment on the same tooth
A build-up not mentioned in the quote
Compare like for like
Questions that make two quotes comparable
- Why did the first root canal fail, and what has changed in the plan this time?
- Who will perform it, and do they use magnification?
- Does the fee include removal of the crown or post, and what if they cannot be saved?
- What is the chance of a crack being found, and what would the plan be?
- Is the crown or build-up included?
- How do the costs compare with an apicoectomy, or with extraction and replacement?
Insurance
How dental plans usually treat retreatment
Plans usually file retreatment under the same category as a first root canal, and carriers differ on that category. MetLife lists some root canals as basic care, Cigna lists them as basic restorative care, and Guardian and UnitedHealthcare list root canals as major. Retreatment carries its own procedure code, and some plans limit repeat treatment on the same tooth within a set period. The crown that follows is major care. Ask the plan how it classifies retreatment for your tooth, whether any frequency limit applies and what the deductible and annual maximum leave for you.
Do not let a benefit year delay treatment of a painful or infected tooth. Check with the office how urgent it is.
Lowering the bill
Ways to reduce cost without lowering the standard
Call a dental school or advanced endodontic program to find out whether it accepts retreatment cases and how fees are set
Ask whether the specialist is in your plan's network
Get a second opinion on whether retreatment, an apicoectomy or extraction is best for the tooth
Ask for the crown and the retreatment priced separately
Ask what the tooth's outlook is, so you can weigh the cost of saving it against replacement
Questions people ask
Common questions
01Why does retreatment cost more than a first root canal?
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Because it is harder. Old filling material must be removed, a crown or post may come off, and canals can be blocked, narrow or missed the first time. Many cases go to an endodontist and use magnification. Check what the difficulty is in your tooth, and what the estimate assumes.
02Is retreatment always better than extraction?
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No. Saving a tooth is often preferable when it has a reasonable outlook, but a crack, a poor restoration or too little remaining tooth can make extraction and replacement the better choice. Ask what the endodontist sees, what the chance of success is for your tooth and what each path would cost. See the root canal versus extraction comparison.
03Does insurance cover root canal retreatment?
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Usually, under the same category as a root canal, which varies by carrier. MetLife lists some root canals as basic, Cigna lists them as basic restorative, and Guardian and UnitedHealthcare list them as major. Some plans limit repeat treatment on the same tooth. Request a written estimate that lists each code.
04What is the difference between retreatment and an apicoectomy?
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Retreatment reopens the tooth through the crown and cleans the canals again. An apicoectomy is surgery that removes the tip of the root through the gum. Each suits different situations. Confirm which is proposed for your tooth and why, and what the alternative would involve.
05Will I need a new crown after retreatment?
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Often. If the crown or build-up had to be removed or drilled through, or if the old one leaks, a new one is usually recommended. That is a separate cost. Ask whether the existing crown can be kept, what the risks are and what would change if it cannot.
06Can a general dentist do retreatment?
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Some do, and many refer difficult cases to an endodontist. An endodontist has advanced training in root canal problems, and may use a microscope routinely. Find out about the provider's experience with your kind of case, and whether they are in your network. See the endodontist guide.
07How long does retreatment take?
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It varies. Some cases finish in one visit and others take two. The time depends on the tooth, what has to be removed and how the canals look. Check what your provider expects and what the temporary arrangements are between visits.
08Where can I get retreatment at lower cost?
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Some dental schools and advanced endodontic programs treat patients at reduced fees under close supervision, according to the National Institute of Dental and Craniofacial Research. Scope and waits vary. Ask what the program offers and who supervises, and do not delay care for a painful or infected tooth.
09How do I know if a root canal has failed?
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Signs include pain, swelling, a bad taste or a persistent problem on an X-ray. Only an exam and images can confirm it. Ask what your dentist sees, what caused the problem and whether retreatment, surgery or extraction is best.
10Does retreatment hurt more than the first root canal?
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It is done with local anesthetic, and comfort during and after depends on the case. Ask your provider what to expect, how the visit is managed and what medication is advised. Report severe or worsening pain, swelling or fever promptly.
11What is the outlook after retreatment?
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It depends on the tooth, the cause of the problem and what remains of the tooth. Ask the endodontist what the chances are for your case, what could go wrong and what the plan is if it does not resolve the problem.
12Can a crack make retreatment impossible?
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Yes. A crack or fracture that extends below the gum can make a tooth unsavable, and it may only show once the tooth is opened. Ask what checks are done before treatment and how the fee is handled if extraction becomes the better option.
Related glossary terms
Sources
- Oral Health TopicsAmerican Dental AssociationAccessed 2026-08-17
- Medicare Dental CoverageCenters for Medicare & Medicaid ServicesAccessed 2026-08-17
- What Is a Dental PPO Plan?MetLife Oral Fitness LibraryAccessed 2026-09-24
- Dental InsuranceGuardianAccessed 2026-09-24
- Dental HMO vs. PPO PlansCigna HealthcareAccessed 2026-09-24
- Dental insuranceUnitedHealthcareAccessed 2026-09-24
- Finding Dental CareNational Institute of Dental and Craniofacial ResearchAccessed 2026-09-23