Unfortunately, extraction of an infected tooth is sometimes required but not necessarily always the simplest solution.  An extraction will solve the problem of getting rid of the infection but creates a new problem of now missing a tooth.  The best course of dental treatment should always include the basic principle of saving as much tooth structure or as many teeth as possible.  We were all born with a certain number of teeth for a reason.  A full compliment of teeth when maintained at a healthy level will provide a lifetime of use needed to maintain optimum overall health.  Loss of individual teeth creates less chewing surface to function on thereby creating increased forces on the remaining teeth.  Asking other teeth to now work harder ultimately shortens their lifespan..

Teeth can get infected generally from two sources.  One scenario is a carious lesion (cavity) that is allowed to go on long enough to invade the center of the tooth (the pulp).  The pulp space of every healthy tooth contains a blood supply, tooth cells that can build tooth structure internally and the nerve of the tooth.  As with any infection, when bacteria invades, the process of inflammation begins.  Inflammation (swelling) of the pulpal tissue ultimately impedes the proper blood supply of the tooth and this tissue dies leaving an empty, hollow tooth.  This space then becomes a perfect environment for bacteria to live and grow.  When this infection gets big enough the bacteria can find their way out the tip of the root into the jaw creating an abscess.  Options to treat this type of infection include root canal treatment or extraction.


The second scenario of an infected tooth is one in which the bacteria invades the space and tissues around the tooth.  This is the process known as periodontal disease discussed in another section of this website.  Again, treatment of the infection is primarily a mechanical process.  Instead of cleaning out the center of the tooth, we now need to clean all the tissue around the tooth.  This includes a series of deep cleanings (scaling and root planning) and sometimes surgical access to these areas.  If the area can be fully cleaned and the bacteria removed, the periodontal tissues can heal and the tooth maintained.  Periodontal disease, if left untreated, will cause irreversible bone loss around the tooth sometimes leaving no option but extraction.  Therefore, the earlier the problem is detected and treated, the more tissue is conserved and the better the long term survival of that tooth.

Root canal treatment is a process of gaining access to these internal spaces of the tooth and cleaning out the bacteria.  The pulpal space is cleaned and disinfected through a process of instrumentation and irrigation.  This space is also shaped in a way so that a proper root canal filling can be placed to fully seal off any area in which bacteria try to hide.  Any infection that gains access out the tip of the root is generally then easily resolved through your bodies own defensive mechanisms.  In time, with proper healing, the infection will be fully resolved and the tooth can be saved..