Dentist explains: what problems can a stealthy tooth root infection cause?
A root infection is a stealthy condition, capable of quietly destroying tooth roots — and, in some cases, affecting the whole body — for years, without the person ever knowing.
A root infection is a stealthy condition, capable of quietly destroying tooth roots — and, in some cases, affecting the whole body — for years, without the person ever knowing.
Heikki, 50, is an ordinary Estonian countryman who always has too much on his plate and tends to put his own health last on the list. Heikki only sees a doctor in a real emergency, or when his wife makes him. That’s how he managed to avoid the dentist for a good number of years — even though there was often something wrong with his teeth. “Something in my mouth was always aching, throbbing. The moment there was a bit of wind or cold, half my face would swell up,” Heikki recalls. “I knew there were a lot of problems with my teeth, and that they were in bad shape, but I also knew fixing it would cost a fortune. So I just took painkillers and antibiotics and hoped it would pass on its own.”
But his mysterious health troubles only got worse. “I was five years younger back then, but suddenly my joints started aching. Just like an old man — the moment the weather turned damp, certain joints of mine got stiff and painful. Looking back, I suspect the joint pain was actually connected to the infection raging in my teeth. My family doctor told me to take painkillers. But you can’t just keep taking those indefinitely either,” Heikki recalls. During one episode of toothache — when Heikki nearly missed an important competition, since, as luck would have it, his face swelled up around a tooth right before the start time — his wife booked him a dentist appointment and personally delivered him to the clinic door. “After that, everything went very simply. They took an X-ray, and it turned out several of my tooth roots were infected. I lost one tooth, and the dentist fixed the rest. She was a lovely dentist — didn’t scold me or anything. Said she’d seen much worse. I went to the dentist for a total of 5-6 visits, and it really wasn’t as bad as I’d feared,” Heikki admits. “The joint pain went away, and my other health troubles eased up right away too. I haven’t had toothache since, and I don’t have to think about my teeth anymore. If I catch a chill now, I get a runny nose like a normal person — not a toothache.”
Toothache comes at night
Dr Natalia Leis, dentist at the Unimed Kaarli dental clinic (formerly known as Kaarli Hambaravi), explains that inside every tooth is a cavity — known in dental terms as the pulp chamber — containing the nerve and blood vessels, together called the pulp. If a tooth is being destroyed by deep decay, has suffered trauma, or has a crack, pulp inflammation can develop. “When inflammation develops rapidly, the classic pain symptoms appear: the tooth may start hurting spontaneously, react strongly to hot and cold, and the pain typically worsens in the evening, at night, and when lying down. The characteristic nerve pain can also radiate in a way that makes it hard for the person to tell exactly where the pain is coming from,” says Dr Leis.
With a chronically developing pulp inflammation — commonly known as a root infection — clear symptoms may be absent, or they may be the kind that don’t seem serious enough to worry about. “For example, someone might notice that an infected tooth feels different from the others, be highly sensitive to temperature changes, feel pressure pain when biting down, or feel like the tooth sits higher than the rest. A typical pulp-inflammation patient will have noticed, over a longer period, that a particular tooth is more sensitive, and that painkillers don’t resolve the issue,” says Dr Leis. “With longer-standing inflammation, the tooth can also darken in colour, since a dark blood clot forms inside the tooth as the pulp breaks down, and certain microbes also produce dark pigment within the pulp chamber. Swelling can occasionally appear on the gum next to the infected tooth, and in some cases, a pus-filled bump appears on the gum. Naturally, a large, long-untreated cavity can also point to infection.”
The whole body can be affected
Pulp inflammation in a tooth isn’t just an uncomfortable problem — it actually affects the whole body. According to the dentist, it spreads into the jawbone beneath the tooth root, causing the bone around the root tips to gradually thin. By this stage, though, the process is no longer painful, since the tooth’s pulp has effectively already died. “We detect infections like this on a dental X-ray, where dark areas beneath the root tips point to bone thinning. The longer this process continues, the greater the bone loss. Yet some patients walk around with infections like this for years, simply because the process is so well hidden,” says Dr Leis.
Beyond the destruction it causes within the jawbone, this kind of infection affects the whole body — it can, for example, contribute to rheumatism or heart valve inflammation. If the infection has taken hold beneath the roots of the upper back teeth, sinus infection can become an annoyingly frequent visitor too.
Root canal treatment helps
According to Dr Leis, infections like this unfortunately don’t resolve on their own, and painkillers or antibiotics don’t help either. The reason lies in how medication works: it’s carried through the bloodstream, but a tooth’s blood supply is very limited to begin with, and with chronic inflammation, it’s absent from the tooth entirely. This means medication simply can’t reach where it’s needed. So the only real option is root canal treatment.
The dentist cleans the root canals of infected pulp and microbes, after which the canals need to be hermetically sealed with a special root filling material, and the tooth rebuilt with either a filling or a crown. Root canal treatment usually takes 1-2 visits. “This can vary, of course, depending on the complexity of the treatment and whether it’s the tooth’s first treatment or a re-treatment. Root canal treatment on front teeth tends to go faster, since they only have 1-2 canals, while back teeth can have 3-5 canals or more, and there’s less room for the dentist to work in, which takes longer,” Dr Leis explains. The cost of treatment depends on its complexity and the number of root canals, and in more difficult cases can reach €700-800.
Let your dentist keep an eye on what’s happening in your mouth
The dentist gave Heikki a stern talking-to — his hygiene should stay just as exemplary as before, but he still needs to see the dentist every year regardless. Even if it’s just to show up and get confirmation that everything’s fine. That system has worked well for him for several years now. Dr Leis says two things matter most for preventing root infections: proper oral hygiene and timely dental treatment, where cavities are fixed before they reach close to the tooth’s nerve.
A tooth left untreated for a long time can suffer damage so extensive that rebuilding it becomes difficult, or even impossible. Dentists always try to save a tooth where possible, but if too little of the tooth remains and there’s nowhere to anchor a crown, the damaged tooth may need to be extracted instead. What’s certain, though, is that the dentist always discusses every option with the patient before starting root canal treatment, and together they agree on what kind of rebuild the tooth will need once treatment is complete. “Treatment never begins until the patient fully understands the course of treatment, the prognosis, and the final cost,” Dr Leis adds.
This article was published on 01.04.2021 on Delfi
