A root canal procedure is a restorative dental treatment designed to save a tooth when the soft inner tissue, or pulp, becomes infected or inflamed, usually due to deep decay or trauma. Ignoring this recommendation allows a bacterial infection to persist and progress freely inside the tooth’s canal system. Since the pulp is trapped within hard dentin and enamel, the tooth cannot heal itself. This inaction transforms a localized dental problem into a worsening condition that can compromise the health of the jawbone, surrounding teeth, and even distant parts of the body.
Progression of Localized Infection
The trapped bacterial infection inside the pulp chamber progresses down the root canal to the periapical tissues surrounding the root tip. As the body attempts to fight this invasion, a localized collection of pus, known as a dental abscess, forms at the end of the root. This abscess creates immense pressure within the jawbone, causing the severe, throbbing pain associated with an infected tooth.
The body may try to relieve this pressure by creating a drainage channel, which manifests as a small bump on the gum line called a dental fistula. Even if this fistula drains pus and temporarily relieves pain, the underlying infection remains active and continues to destroy surrounding bone and soft tissue. Without treatment, the infection can spread to the soft tissues of the face and neck, leading to significant swelling.
The Inevitability of Tooth Extraction
If the infection is not cleared through a root canal, tooth extraction eventually becomes the only remaining treatment option. The prolonged presence of the abscess causes the body to resorb the alveolar bone that supports the tooth structure. This destructive process weakens the tooth’s foundation, often resulting in tooth mobility and making it impossible to save the tooth.
A dentist may be forced to extract the tooth once the infection has destroyed too much supporting bone or the tooth structure is too compromised for restoration. Avoiding the root canal is essentially choosing to lose the natural tooth, as the infection will continue its destructive path until the tooth is no longer viable. While extraction resolves the immediate source of the infection, it introduces new long-term dental challenges related to the resulting gap.
Spread of Bacteria to the Body
A localized dental infection is not confined to the mouth; the bacteria can enter the bloodstream and spread to other areas of the body, creating systemic health risks. One serious risk is cellulitis, a rapidly spreading bacterial infection of the soft tissues that can affect the face or neck. If the swelling from cellulitis spreads into the neck, it can potentially compromise the airway, which constitutes a life-threatening medical emergency.
In severe cases, the bacteria can travel through the bloodstream to distant organs, a condition known as bacteremia. This systemic spread can lead to serious complications, including endocarditis (an infection of the inner lining of the heart) or the formation of a brain abscess. Chronic, untreated oral infection has also been linked to the exacerbation of existing conditions, such as making blood sugar levels more difficult to control in patients with diabetes.
Increased Cost and Complexity of Restoration
While a tooth extraction may seem like a cheaper solution than a root canal and crown, the long-term financial reality is often the reverse. A root canal, which costs between $800 and $1,500, saves the natural tooth and is the most cost-effective solution over time. By contrast, an extraction followed by replacement with a dental implant and crown can cost between $3,000 and $6,000, not including preliminary procedures.
The bone degradation caused by the prolonged infection complicates future tooth replacement. If significant bone loss occurs, a dental implant cannot be placed until an expensive, time-consuming bone grafting procedure is performed to rebuild the supporting structure. Avoiding a root canal often results in a significantly higher total cost due to the need for complex surgical procedures to replace the lost tooth and restore the jawbone.