Root Infection: Symptoms, Treatment, Causes

Root infection is a severe condition affecting the tooth's most sensitive area. Root infection occurs when bacteria invade the tooth's pulp, leading to infection and inflammation. It causes pain and discomfort, leading to serious dental issues if left untreated. Understanding the symptoms, treatment options, causes, and similar situations helps manage and prevent root infections effectively.

Root infection symptoms are crucial for early diagnosis and treatment. Root infection signs include intense tooth pain when chewing, pain that radiates to the jaw, foul breath, and a persistent bitter taste. Increased dental sensitivity to hot or cold temperatures and localised swelling of the gum tissue around the infected tooth are typical symptoms. Patients experience fever and swollen lymph nodes, indicating that the infection has started to spread.

Treating a root infection involves several steps to eliminate the infection and preserve the tooth. The most common treatment is a root canal, where the infected pulp is removed, and the inside of the tooth is cleaned, disinfected, and sealed. A tooth extraction is necessary to prevent the spread of infection. Draining any abscesses that have formed part of the treatment process. Antibiotics are prescribed to control and eliminate the disease, mainly if it has spread beyond the tooth.

Root infections are caused by bacteria entering the tooth's pulp through various means. A common cause is tooth decay, where cavities penetrate deep into the tooth. Cracks or chips in the tooth provide an entry point for bacteria. Damage to the tooth pulp, whether due to trauma or repeated dental procedures, increases the risk of infection. A fractured tooth root exposes the pulp and leads to infection.

Hair and scalp conditions are compared to root infections due to their similar impact on health and the necessity for timely treatment. Folliculitis is an inflammation of hair follicles caused by bacterial or fungal infections, resembling how bacteria infect the tooth pulp. Scalp abscesses and conditions like seborrheic dermatitis and tinea capitis (scalp ringworm) share similarities in infection and inflammation with dental abscesses.

Research into root infections has provided significant insights into their causes and treatment. Studies like "Patterns of microbial colonisation in primary root canal infections" by José F. Siqueira Jr., Isabela N. Rôças, and Hélio P. Lopes have used scanning electron microscopy to investigate microbial patterns in root canals. Another notable study is "Microbiological examination of infected dental root canals" by B. P. F. A. Gomes and colleagues explored the root canal microbiota of primary and secondary infections. These studies emphasise the complexity of microbial interactions in root infections and the importance of thorough treatment to prevent complications.

What Complications can Root Infection Lead to when Left Untreated?

Root infection that is left untreated leads to life-threatening complications. Initially localised, the disease spread to various body parts, causing significant health issues.

The root infection complications that are left untreated are listed below.

Sinus Infection and Blood Vessel Infection: An untreated tooth root infection spreads to the blood vessels in the sinuses, resulting in a rare and fatal illness called cavernous sinus thrombosis, a blood clot at the base of the brain.
Cellulitis: Cellulitis is an inner skin layer and fat infection caused by germs from the root infection spreading via the veins. It causes redness around the eyes, nose, and cheeks, leading to sepsis if left untreated.
Parapharyngeal Abscess: An untreated tooth root infection spreads to the deep part of the neck near the hyoid bone, causing a parapharyngeal abscess. It blocks the airway and leads to difficulty breathing.
Sepsis: The most severe and life-threatening complication of an untreated tooth root infection is sepsis. A bacterial infection that spreads throughout the entire bloodstream causes the condition, resulting in systemic inflammation that harms organs and obstructs arteries.
Bone Infection: An untreated root infection spreads to the bones surrounding the infected tooth, including the jawbone. It results in a bacterial infection of the root canal that results in swelling of the bones and bone marrow, called osteomyelitis.

What are the Symptoms of Root Infection?

The symptoms of Root infection are listed below.

Foul Breath and Bitter Taste: A persistent foul breath and a bitter taste in the mouth indicate the presence of an infection in the tooth root.
Increased Dental Sensitivity: Heightened sensitivity to hot or cold temperatures indicates a root infection if the sensitivity continues even when the temperature stimulus is removed.
Pain That Radiates to the Jaw: The infection causes pain that extends from the affected tooth to the jaw and even to the ear or neck on the same side.
Localised Gum Tissue Swelling: Swelling or tenderness in the gums around the affected tooth is a standard indicator of underlying root infection.
Fever and Swollen Lymph Nodes: Root infections worsen over time and cause fevers and swollen lymph nodes, which show the disease has spread.
Tooth Pain When Chewing: Sharp or aching pain when chewing or applying pressure to the tooth is a common sign of a root infection.

What are the Causes of Root Infection?

The causes of Root Infection are listed below.

Crack or Chip in the Tooth: A crack or chip in a tooth provides a pathway for bacteria to enter and spread within the inner components of the tooth, resulting in an infection.
Fractured Tooth Root: A fractured tooth root occurs when a tooth's root is broken, exposing the pulp and allowing germs to enter the root canal system, leading to a root infection.
Damage to the Tooth Pulp: Injury to the tooth pulp, whether caused by trauma or decay, results in infection when bacteria enter the pulp tissue.
Repeated Dental Procedures: Repeated dental operations performed on the same tooth weaken the tooth structure and elevate the likelihood of bacteria entering the root canal, which leads to infection.
Tooth Decay: Advanced dental caries infiltrate the tooth, reaching the pulp and resulting in a root infection if left untreated.

What are the Treatments for Root Infection?

The treatments for Root Infection are listed below.

Draining: Draining an abscess caused by the infection helps reduce pain and swelling. The procedure involves making a small incision to allow the pus to drain out.
Antibiotics: Prescribing antibiotics helps control and eliminate bacterial infection if the disease has spread beyond the tooth to other body parts.
Pain Management: Pain management techniques, including over-the-counter pain relievers or prescribed medications, help alleviate the discomfort associated with a root infection.
Tooth Extraction: Extraction is required if the tooth is severely damaged and has no chance of being saved. Removing the infected tooth with tooth extraction prevents the spread of infection to surrounding teeth and tissues.
Dental Restoration: Dental restorations, such as crowns, bridges, or implants, make the tooth or teeth that were hurt look and work like new after a root canal or tooth extraction.
Root Canal: A root canal treatment involves removing the infected pulp from the tooth, cleaning and disinfecting the root canals, and then filling and sealing the space to avoid further infection.

Can Root Infection Be Treated At Home?

No, root infections cannot be treated at home. A tooth infection requires professional dental treatment. A few home remedies help briefly but must not be used before seeing a doctor.

Home remedies like rinsing with salt water, baking soda, or applying cold compresses provide temporary relief but do not treat the underlying cause. The most potent natural antibiotics for tooth infections include baking soda, salt water rinse, hydrogen peroxide, clove or thyme essential oil, garlic, and fenugreek oil. The treatments are limited to symptom management and do not eradicate the infection.

Specific natural treatments help manage toothaches and prevent the worsening of tooth infections, but antibiotics prescribed by a dentist eliminate the disease. Applying garlic and onion paste helps treat tooth abscesses by increasing the pH balance in the mouth and lowering the growth of harmful bacteria, but it is only temporary.

A tooth abscess is a dental emergency that requires immediate medical attention. The infection spreads and is fatal if it is not treated. Professional dental treatment, including antibiotics and potential abscess drainage, is necessary to resolve all infections. Attempting to treat a root infection at home without proper medical care is not recommended.

What are the Researches about Root Infection?

The researches about root infection underscore the complexity of root canal infections and the importance of thorough and effective treatment to prevent failure and complications.

Patterns of microbial colonisation in primary root canal infections, authored by José F. Siqueira Jr, Isabela N. Rôças, and Hélio P. Lopes, investigated the patterns of microbial infection in root canals associated with chronic periradicular lesions using scanning electron microscopy. The study found that all examined root canals were heavily infected, with bacteria present in nearly all areas of the root canal system. The colonisation patterns were not uniform, with bacterial cells penetrating the dentinal tubules up to approximately 300 μm. The research highlighted the complexity of microbial communities in root canals, suggesting that special considerations are necessary to eliminate and prevent clinical problems.

The study titled "Microbiological examination of infected dental root canals" by B. P. F. A. Gomes and colleagues aimed to investigate the root canal microbiota of primary and secondary root-infected canals and their association with endodontic signs and symptoms. The research involved microbial samples from 60 root canals and identified 224 cultivable isolates belonging to 56 different bacterial species. The study found significant differences between the microbiota of primary infections and patients with failed endodontic treatments, emphasising the complexity of interactions between species that result in specific clinical symptoms. The research indicated that primary infections contain a mix of gram-negative and gram-positive anaerobes, while facultative anaerobes and gram-positive bacteria dominate failed treatments.

The research titled "Aetiology of Root Canal Treatment Failure: Why Well-Treated Teeth Can Fail" was supported by grants from CNPq, a Brazilian governmental institution. The study discussed the reasons behind the failure of root canal treatments, even when following the highest technical standards. The research explored microbial and nonmicrobial factors contributing to treatment failure, highlighting the importance of understanding the aetiology of root canal treatment failure. The study involved contributions from various notable researchers, including Seltzer, Engström, Sjögren, Sundqvist, Lopes, Siqueira, Nair, Lin, Möller, Kakehashi, Torabinejad, and Atlas.

The study, "Consequences of and strategies to deal with residual post-treatment endodontic disease," aimed to investigate the consequences of residual post-treatment endodontic disease and the factors contributing to these conditions following root canal treatment. The research sought to identify strategies for addressing residual infections to improve the success rates of endodontic treatments. It emphasised the importance of quality procedures that effectively remove intra-canal infections to prevent post-treatment disease, involving professionals in the field of endodontics and patients who have undergone endodontic treatments.

The review "Microorganisms in root canal infections," authored by Vytaute Peciuliene, Rasmute Maneliene, Estera Balcikonyte, Saulius Drukteinis, and Vygandas Rutkunas, aimed to understand the specificity of root canal microflora and its impact on the success rate of endodontic treatments. The research focused on the role of microorganisms in developing apical periodontitis, particularly the differences between primary endodontic treatment and retreatment cases. The goal was to enhance the understanding of microbial influences on endodontic treatment outcomes and improve treatment protocols.

What are the Differences between Root Infection and Enamel Erosion?

The differences between root infection and enamel erosion lie in their causes, symptoms, and implications for dental health. A root infection, or abscessed tooth, occurs when bacteria invade the tooth's inner core due to untreated dental cavities, gum disease, or injury. Root infection leads to significant pain, discomfort, and even tooth loss if left untreated. Enamel erosion is the wearing away of the complex, protective outer layer of the tooth by acids, exposing the underlying dentin and making the teeth more susceptible to sensitivity and decay. Enamel erosion is caused by acidic foods and beverages, acid reflux, dry mouth, and bruxism (teeth grinding).

The causes and treatments for root infection and enamel erosion are distinct. Root infections are caused by bacteria reaching the tooth pulp through untreated cavities, injuries, or prior dental work. Treatment for root infections involves a root canal procedure to remove the infected pulp, clean the canals, seal the tooth, and use antibiotics. Tooth extraction is necessary in severe cases. Enamel erosion is caused by frequent exposure to acidic substances and physical wear from teeth grinding. Treatment for enamel erosion includes using tooth bonding, sealants, veneers, or crowns to protect the damaged enamel, along with dietary changes and improved oral hygiene habits to prevent further erosion.

Root infections and enamel erosion are distinct conditions that affect oral health. Root infections and enamel erosion necessitate preventative measures. Root infection and enamel erosion lead to significant dental problems if left untreated, such as tooth discolouration, increased sensitivity, and eventual tooth loss. Maintaining good oral hygiene practices, such as brushing with fluoride toothpaste, flossing, and routine dental check-ups, is crucial for preventing root infections and enamel erosion. The best way to deal with dental problems is to be careful with eating and get dental treatment for noticeable problems. Root infection and enamel erosion emphasise the need for active tooth care to ensure long-term oral well-being

Dentist Dr. Dt. Erdem CETIN

He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).