Information on Infected Roots (Dental Abscess)

How Did I Get An Infection In The Root of My Tooth?

The main trigger for an infected root is trauma. This could be trauma from bacteria, a broken tooth, physical trauma to the tooth or trauma from treating a tooth. Just like trauma in any other part of the body, the body responds by swelling and increasing blood flow to the area. However, because the tooth is a hard structure and does not expand, it does not swell well. This means that the extra blood flow and cells in the area create an increase in pressure in the tooth. If this pressure gets too much for the tooth, the blood flow to the tooth stops and the nerve begins to degenerate. With a non-vital nerve and a lack of blood flow, it is a perfect area for bacteria to grow unhindered. This is when the root is infected.

The most common trigger is untreated cavities. Therefore, it is important to treat any cavities early. Physical trauma is reduced by ensuring a mouth guard is worn during sports and by making sure that teeth are used for chewing, and not as tools for opening bottles or cracking hard nuts. The third reason is trauma from treating a tooth. There is always a little trauma to a tooth when there is work completed on it. Most of the time, the tooth heals because the trauma is minimal. However, with larger fillings or crowns, the tooth will face more trauma. Again, most of the time the tooth will heal without issue, but some of the time the trauma will be too much for the tooth to handle and it will start the irreversible pressure cascade.

I Have An Infected Root, What Are My Options?

The only way to effectively remove the bacteria from the root of a tooth is to either complete a root canal or to remove the tooth.  As always, patients have the option to not do any treatment, but this will allow the infection to spread.  Sometimes antibiotics will be given to reduce the spread of the infection, however, this is not a permanent solution as the antibiotics will reduce the bacteria in the area, but they are not able to eliminate them completely.

What is Root Canal Therapy:

Root canals are valuable dental procedures used to treat and preserve teeth with badly infected roots. The pulp is the live portion of the tooth that extends into the root and contains nerve endings and tissues. When it becomes infected, patients can experience pain, swelling and even total tooth loss unless treated. Root canals remove the damaged parts of the tooth and infected nerve and blood supply root.

What are the benefits of Root Canal Therapy:

Root Canal Therapy will result in removal of the infection and pain from the affected area.  It is a treatment that allows the patient to retain their tooth.

What are the down sides of Root Canal Therapy:

Root Canal Therapy tends to require longer appointments.  We schedule 90 minutes for teeth with 1 or 2 canals and 120 minutes for teeth with 3 or more canals.  Root canal therapy involves a biological system, so success is not guaranteed.  Studies show that success rates are approximately 90%.  Teeth treated with root canal therapy may also require further treatment in the future.

What can I expect from the treated area:

Discomfort is normal after Root Canal Therapy for a few days.  There should not be any swelling in the area.  If the discomfort is increasing or not going away or if any swelling is present, call our office to arrange an appointment.  After a couple of weeks, you should be able to function on the tooth normally.  The tooth will feel different than other teeth as there is no longer a nerve or blood supply serving that tooth.  You will still need to brush and floss the tooth as normal to prevent decay and reinfection of the tooth.  It takes approximately one year for a root canal treated tooth to heal completely.

What other procedures will be needed:

After Root Canal Therapy a full coverage restoration will be needed.  That is a restoration that covers the entirety of the biting surface.  The restorations can be made from resin (filling material), gold or porcelain, with each having a different longevity.  Regular dental hygiene visits will also be required as well as regular dental visits to have that tooth examined to ensure the tooth does not become reinfected.

What other procedures might be needed:

Sometimes teeth treated with Root Canal Therapy can become reinfected.  This is a rare occurrence, and may require a referral to a specialist.  Teeth that are heavily decayed or broken may require additional treatments such as a carbon fiber reinforcing post to be placed in the root of the tooth or an additional filling to provide support to the full coverage restoration.  Gingival treatments may also be needed to trim back or treat the gums if the tooth is decayed or broken below the gumline.

What is an extraction:

An extraction involves removing a tooth.  It is accomplished by pushing the tooth back and forth with specialized equipment.  This increases the space in the bone and allows the tooth to be removed.  In some instances, the gums need to be opened and / or bone around the tooth needs to be removed in order to gain access to the roots of the tooth.

What are the benefits of an extraction:

An extraction will result in the removal of pain and the removal of the source of infection. 

What are the down sides:

A dental extraction results in a tooth missing from your bite.  This results in a loss of function, as it will be harder to chew and grind food in the affected area.  It can also lead to a shift in the bite due to teeth tipping or drifting into the unoccupied space.  The removal of a tooth also leads to bone loss in the surrounding areas.

What can I expect from the treated area:

Some discomfort and swelling are expected for the first few days after an extraction.  If the pain is getting worse after the 3rd day, please contact our office for an appointment.  After about a week the area should be covered over by the gums, but the bone underneath will continue to heal over the next year.

What other procedures will be needed

If a tooth is being remove and replaced, a bone graft is highly recommended.  Replacing a tooth with either an implant, bridge or denture requires solid tissues to build upon and a bone graft allows that tissue to form in an extracted tooth socket. 

What other procedures might be needed

When a tooth is removed, it leaves a hole in the patient’s jaw as well as their bite.  Procedures such as bone grafts to build up the bone or alveoplasty to reshape the bone may be required.  In the event of an infection, dry socket treatment and / or antibiotics may be necessary.  Sometimes small fragments of bone and / or teeth remain in the gums and are pushed to the surface over time.  An appointment may be required to remove these fragments.  In order to restore function to the affected area, an implant, bridge or denture may be required to replace the missing tooth. 

No Treatment

What does no treatment mean.  It means just that, to leave the area alone and hope that the pain goes away.  This may be done in combination with antibiotics or home remedies. 

What are the benefits of no treatment:

There is little to no cost to not treating the area, in the short term.  However, this option may turn out to be more costly in the long term. 

What are the down sides:
The pain and the infection remain in the roots of the tooth.  The infection can also spread through the bone to adjacent teeth and into the surrounding tissues.

What can I expect from the treated area:

The pain and swelling will remain.  It may come and go with time, but the destruction of the bone, teeth and gums will continue.  It will also influence your overall health as your body spends its energy fighting this persistent infection.

What other procedures will be needed

Root Canal Therapy or an extraction will be eventually needed.  The infection will remain until it has been dealt with in one of these two ways.

What other procedures might be needed

If the infection spreads, root canal therapy or extractions may be required on adjacent teeth.  Gum treatments may also be required to repair damaged gum tissues.  A spreading infection may need to be referred to various specialists to get under control and to repair the damage that was done.  If the infection spreads to vital tissues that may influence your sight, airway or digestion, a visit to a local emergency room may be required.