An infected tooth requires endodontic treatment, commonly known as a root canal, which involves removing inflamed or infected pulp tissue from the tooth’s interior. This procedure saves the natural tooth structure and prevents the infection from spreading beyond its roots. Delaying this intervention allows the bacterial infection to progress, potentially leading to serious health consequences. The infection will continue to destroy the tooth and jawbone, escalating the problem into a medical emergency.
Worsening Localized Symptoms and Abscess Formation
When dental pulp becomes infected, bacteria multiply within the sealed root canal system, triggering inflammation. The initial intense pain felt by the patient is often due to this inflammation and the pressure building up inside the rigid tooth structure. As the infection progresses, the pulp tissue may die, a process called pulpal necrosis, which can cause the pain to temporarily subside.
This temporary relief can be misleading, as the infection has spread beyond the tooth’s root tip into the surrounding jawbone. Here, the body’s immune response attempts to contain the bacteria, leading to the formation of a periapical abscess, a pocket of pus at the root of the tooth. The pressure from this pus accumulation causes the return of severe, throbbing pain, often accompanied by swelling in the face or jaw.
The infection continues to erode the bone around the root tip, which can lead to visible swelling or the formation of a fistula. A fistula, sometimes called a gum boil, drains pus into the mouth. While drainage may offer brief relief, the underlying infection remains active, continuously destroying the supportive bone structure and compromising the tooth’s stability. This chronic bacterial presence can also spread to adjacent soft tissues, causing facial cellulitis and tenderness.
Risks of Systemic Infection
An untreated dental infection is not confined to the mouth; the bacteria can enter the bloodstream and spread to distant parts of the body, creating systemic health risks. The infection can track through the soft tissues of the head and neck, potentially leading to deep space infections. One severe consequence is Ludwig’s angina, a rapidly progressing cellulitis of the floor of the mouth that involves the submandibular, sublingual, and submental spaces.
Ludwig’s angina is a life-threatening medical emergency because the swelling can quickly obstruct the airway, making breathing difficult or impossible. The bacteria responsible for the abscess can also enter the general circulation, a condition known as bacteremia. For individuals with compromised immune systems or other underlying health issues, this can lead to sepsis.
Sepsis is a severe inflammatory response to infection that can lead to organ failure, septic shock, and death if not treated urgently. Chronic dental infections have also been linked to an increased risk of infective endocarditis, particularly in patients with pre-existing heart valve conditions. Oral bacteria traveling through the bloodstream can attach to the inner lining of the heart or its valves, causing a severe infection that requires intensive medical care.
Tooth Loss and Replacement Procedures
If the infection is ignored, the progressive destruction of the tooth and supporting structures makes saving the tooth impossible. When the infection is too advanced or too much surrounding jawbone is destroyed, extraction becomes the only viable treatment option. This results in losing the natural tooth structure that the root canal procedure was designed to preserve.
The loss of a natural tooth initiates a cascade of long-term structural complications for the mouth. The adjacent teeth may begin to shift or tilt into the empty space, disrupting the bite alignment and potentially causing structural damage to the jaw. Without the tooth root stimulating the jawbone, the bone in that area begins to atrophy or resorb over time, which can eventually affect the facial structure.
Replacing the missing tooth is necessary to restore function and prevent further issues, requiring more invasive and costly procedures than the initial root canal. Common replacement options include a fixed bridge, which modifies healthy adjacent teeth, or a dental implant, which involves surgically placing a titanium post into the jawbone. These restorative treatments are significantly more expensive and complex than the original endodontic therapy.