A root canal is a common dental procedure designed to save a tooth with infected or damaged pulp. While root canal treatments boast a high success rate, a small percentage of treated teeth can become reinfected or fail to heal, causing discomfort and complications. Recognizing these signs is important for timely intervention, preserving the tooth and overall oral health.
Recognizing Signs of Infection
Persistent or worsening pain is a primary indicator of infection after a root canal. While mild discomfort is normal immediately following the procedure, pain that lingers, becomes severe, or intensifies when chewing or applying pressure may signal a problem. This pain can range from a dull ache to a sharp, throbbing sensation and might radiate to your jaw or ear.
Swelling in the gum tissue around the treated tooth or in the face and neck is another significant sign. This swelling indicates an accumulation of bacteria and inflammation. A “pimple” or boil on the gums near the affected tooth, known as a fistula, is a clear sign of infection attempting to drain pus.
The tooth may also exhibit increased sensitivity to hot or cold temperatures, or become tender to touch. Discoloration of the treated tooth, often appearing darker or grayish, can suggest internal damage or ongoing infection. A persistent unpleasant taste or odor in the mouth, not resolved by regular hygiene, can be caused by bacterial activity. In severe cases, a systemic infection might manifest as a fever or general feeling of being unwell, indicating the infection has spread beyond the tooth.
Reasons for Post-Root Canal Infection
Several factors can lead to a root canal becoming reinfected. The tooth’s complex internal anatomy, with narrow or curved canals, can make it difficult to thoroughly clean all areas during the first treatment, leaving residual bacteria. These bacteria can then multiply and cause a new infection.
Recontamination can also occur if the permanent restoration, such as a crown or filling, is delayed or compromised. A loose, cracked, or leaky filling or crown creates an entry point for bacteria. A new cavity or crack in the tooth can also allow bacteria to penetrate and cause reinfection. Saliva contamination during the procedure can also introduce bacteria.
Immediate Steps When Infection is Suspected
If you notice signs suggesting a root canal infection, contact your dentist promptly. Early diagnosis and treatment can prevent the infection from spreading and help save the tooth. Describe your symptoms clearly, including the nature and severity of any pain or swelling.
While waiting for your dental appointment, avoid self-medicating with antibiotics, as this can lead to antibiotic resistance and may not address the infection’s root cause. For temporary pain management, over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate discomfort. Applying a cold compress to the outside of your cheek near the affected area can also help reduce swelling and pain. Gently brush and floss around the suspected area to avoid further irritation.
Professional Diagnosis and Treatment
Upon suspicion of a root canal infection, a dentist will conduct a thorough clinical examination, inspecting the tooth and surrounding gums, and palpating for tenderness or swelling. X-rays are a diagnostic tool, revealing signs of infection such as periapical radiolucency, which indicates bone loss around the root tip. The dentist may also perform percussion tests (gently tapping the tooth) and palpation tests (pressing on the gums) to pinpoint the source of pain and inflammation.
Treatment options depend on the extent and cause of the infection. Non-surgical re-treatment is often the first approach: the tooth is reopened, previous filling material removed, and canals thoroughly cleaned, reshaped, and refilled. If re-treatment is not feasible or fails, an apicoectomy might be recommended. This surgical procedure involves accessing the root tip through the gum, removing infected tissue and a portion of the root end, and sealing it. If the tooth is severely damaged or other treatments are unsuccessful, extraction may become a last resort to prevent the infection from spreading. If the infection has spread beyond the tooth, antibiotics may be prescribed to control it.