Root Infection (Apical Periodontitis)

Pain can occur when biting or chewing, and the tooth may feel tender to tapping. Swelling beside the tooth, a draining sinus, or a bad taste can accompany the infection. Some chronic infections produce few or no symptoms until they flare.

Bacteria can reach the pulp through deep decay, a crack, or previous damage. When the pulp dies, infection can pass through the root canal opening and inflame the tissues around the root tip.

The process can move from pulpal inflammation to pulp necrosis, then to inflammation around the root. An acute flare may bring pain and swelling, whereas a chronic lesion may remain quiet while inflammation persists.

Fever, facial swelling, difficulty swallowing, marked difficulty opening the mouth, drooling, or a swollen floor of the mouth can indicate that a dental infection is spreading beyond the tooth. Breathing difficulty is an emergency sign.

Assessment combines the history of pain with examination of the tooth, tapping or biting tests, inspection for swelling, and dental radiographs. X-rays can reveal changes around the root that cannot be seen directly.

Root canal treatment removes infected or dead pulp, cleans the canals, and seals the tooth so the source is removed. When the tooth cannot be restored, extraction removes it. Drainage may be needed when pus has collected.

The cost is shaped by whether the tooth is restored with root canal treatment or removed by extraction, and whether an abscess needs drainage. Antibiotics are reserved for systemic spread such as fever or cellulitis rather than replacing source control.

An untreated root infection can form an abscess and spread through facial or deep neck spaces. Advanced spread can compromise the airway or cause sepsis, while bacteria entering the bloodstream can be a concern for people with prosthetic heart valves or valvular disease.

Daily plaque control and prompt treatment of decay reduce the chance that bacteria will reach the pulp. Protecting a damaged tooth and completing planned dental treatment also reduces routes into the root canal.