Do I Need to Extract a Tooth with Infected Roots After a Root Canal?

If the tooth has been treated with root canal therapy but there are still bacteria present in the root, is it necessary to extract the tooth?

I had a root canal a few years ago, but a recent X-ray revealed that the previous treatment was not done properly, and there is bacteria in one of the roots.
Do I need to have it extracted? If not, could those bacteria affect my other teeth? Thank you.

En, 30~39 year old female. Ask Date: 2016/01/08

Dr. Zeng Guanghui reply Dentistry

The tooth root has been previously filled, but it has been found that there is new decay.
The extent of the decay needs to be assessed; if it is not extensive, the decayed area can be cleaned out and refilled.
However, if the bacteria within the decayed area are not addressed, they can affect the periodontal tissues and even neighboring teeth.
Therefore, it is advisable to see a dentist promptly for treatment.

Reply Date: 2016/01/08

More Info

When it comes to dealing with an infected tooth root after a root canal treatment, the decision to extract the tooth or not depends on several factors, including the extent of the infection, the condition of the surrounding tissues, and the overall health of the tooth.
In your case, since you mentioned that a recent X-ray revealed bacteria in one of the roots that were previously treated, it is crucial to assess the situation carefully. If the infection is localized and the tooth structure is still intact, there may be options other than extraction. For instance, a retreatment of the root canal might be possible, where the dentist cleans out the infected area, disinfects it, and then seals it again. This procedure can sometimes save the tooth and eliminate the infection.

However, if the infection is severe, has spread to the surrounding bone, or if the tooth is structurally compromised (for example, if there is significant decay or fracture), extraction may be the best option. Leaving an infected tooth root in place can lead to further complications, including the risk of the infection spreading to adjacent teeth or even into the bloodstream, which can have serious health implications.

Regarding your concern about whether the bacteria from the infected root can affect other teeth, the answer is yes. Bacterial infections can spread through the periodontal ligament and into the surrounding bone, potentially leading to infections in adjacent teeth. This is why it is essential to address any signs of infection promptly.

In summary, if you have an infected tooth root after a root canal, it is advisable to consult with an experienced dentist or an endodontist (a specialist in root canal treatments). They can evaluate the extent of the infection and recommend the most appropriate treatment option. If extraction is necessary, they can also discuss the timing for potential tooth replacement options, such as dental implants, which can be placed immediately after extraction if conditions are favorable, or after a healing period of a few months if there are concerns about infection or bone quality.

In the meantime, maintaining good oral hygiene is crucial. Regular brushing, flossing, and dental check-ups can help prevent further complications. If you experience any pain, swelling, or other symptoms, seek dental care as soon as possible.

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