A root canal procedure (RCT) is a treatment designed to save a severely infected or inflamed tooth. It involves removing the infected or necrotic dental pulp from inside the tooth’s root canals and pulp chamber. The space is then cleaned, disinfected, and sealed to prevent further microbial invasion. Choosing not to have this procedure means the active bacterial infection remains deep within the tooth structure, allowing microorganisms to multiply and cause progressive disease.
Localized Symptoms and Acute Pain
The most noticeable consequence of avoiding treatment is persistent and escalating localized discomfort. When bacteria cause inflammation, the resulting swelling creates intense pressure against the nerve endings within the rigid dentin walls. This pressure buildup directly causes severe, throbbing pain. This dental pain is often spontaneous and may intensify when a person lies down, as positional changes increase pressure inside the confined pulp chamber. This can make nighttime pain significantly worse and interfere with sleep. Furthermore, the tooth develops heightened sensitivity to thermal changes, with pain lingering after exposure to hot or cold stimuli, signaling irreversible pulp damage.
Spread of Infection and Abscess Formation
If the infection remains untreated, multiplying bacteria eventually travel out of the root tip through the apical foramen. Once outside the tooth, the bacteria contaminate surrounding tissues and the jawbone, leading to the formation of a periapical abscess. This abscess is a localized pocket of pus—a collection of dead white blood cells, tissue debris, and bacteria—that forms at the apex of the root. The pressure from this growing abscess can cause visible swelling in the adjacent gum tissue or even on the face. In some cases, the body attempts to drain this pus by creating a small channel through the gum or cheek, known as a fistula or a “gum boil.” While drainage may temporarily relieve pressure and pain, the infection source remains and continues to spread, destroying the supportive bone structure around the tooth root.
Systemic Health Risks
The untreated dental abscess functions as a constant source of bacterial contamination, which can have implications far beyond the mouth. The bacteria from the abscess can enter the bloodstream through the rich network of blood vessels near the jaw, a process known as bacteremia. While the body’s immune system usually clears these bacteria, a chronic reservoir can increase the risk of more serious systemic complications. In rare but serious instances, the infection can travel to distant organs. The bacteria have been linked to an increased risk of infective endocarditis, which is an infection of the inner lining of the heart’s chambers and valves. Uncontrolled spread of the infection can also lead to life-threatening conditions like sepsis, a severe, body-wide response to infection, or cavernous sinus thrombosis, a clot in a vein at the base of the brain.
Extraction as the Final Outcome
For a tooth that remains untreated, the progression of infection and subsequent destruction of supportive structures often renders it unsalvageable. The continuous breakdown of the surrounding alveolar bone due to the chronic abscess means the tooth loses its stable foundation. At this point, the initial goal of the root canal procedure—saving the natural tooth—is no longer possible, and the only remaining treatment option is extraction. The removal of the natural tooth introduces new long-term complications and costs. The gap left by the extraction can cause adjacent teeth to shift out of alignment and opposing teeth to over-erupt, leading to bite problems. Replacing the lost tooth requires subsequent procedures, such as a dental bridge or a dental implant, which are significantly more involved and expensive than the original root canal therapy and crown would have been.