What are the risks of not getting a root canal?

Lucia Yau, DDS

If no treatment is done, the infection in the tooth and root can spread to surrounding area of the mouth and tissue spaces leading to swelling, pain and infection. Bacteria can also spread via bloodstream to other parts of the body, closes airway and be life threatening.

If you don't get Root Canal Treatment then it can lead to much more severe consequences that can be life threatening. The infection in the root of the tooth can spread to the jaw bone and then into the surrounding tissue. This can lead to a swelling of the face and surrounding tissue and space. For example, if the swelling reaches the airway then it can close your airway making it difficult to breathe. This is known as Ludwig’s Angina. Furthermore, a tooth that once could have been saved with Root Canal Treatment may not be able to be saved anymore. If you wait too long there could be further damage to the tooth or bone and then the tooth will have to be extracted (removed). Once a tooth is removed it is really important to replace the missing tooth (excluding wisdom teeth).       
An infected tooth remains infected until the tooth has a root canal or is removed. If it is not treated the infection can spread. Sometimes delaying treatment will mean that you also have to treat (or lose) the teeth on either side of the original infected tooth.

Infection can also spread into your tissues. This is usually when you see facial swelling. For upper teeth this infection can spread to the eye area or be near the brain. For lower teeth, the throat and airway is of concern. If the swelling is severe enough it can make it hard for you to breathe. Hospitalization is sometimes necessary at this level of infection. People have died as a result of complications from an untreated tooth infection.
John H. Paul, MD
Adult Reconstructive Orthopedic Surgery
As I tell my patients, an infection in the same appendage where you keep your brain is a bad thing. If you need a root canal, because the nerves and blood vessels inside your tooth are infected, it will not get better by waiting. If you wait the simplest thing that may happen is you end up losing your tooth. It is much more common that you will have an infection that causes your gums or your face to swell and be painful. The infection may not only destroy the infected tooth but the bone holding the tooth and even adjacent teeth. If the infection in your face becomes big enough, it can close off your airway and without emergency treatment you can die.
The reason any tooth needs a root canal is because bacteria has infiltrated the nerve tissue of the tooth. At this stage of infection, the only way to save the tooth and prevent further spread of infection into surrounding areas (i.e. the bone, other teeth, blood supply, etc.) is to do a root canal. If it's not performed not only are you sure to lose the tooth, the current infection can likely spread to surrounding areas which if ultimately left untreated can lead to detrimental consequences, including death. 
Neglecting a root canal can lead to decay to the root where tooth is no longer savable and will have to be extracted.  The result can be more uncomfortable and costly with a bridge or implant to replace the missing tooth. In addition, you may be exposed to an infection spreading to your jaw or sinus. In any case, you will likely be experiencing extreme unresolved pain if a recommended root canal is disregarded. 
Once the pulp inside a tooth becomes infected, serious complications can occur if not treated with a root canal. Because the pulp runs from the crown to the root of the tooth, infected tissue can affect the tooth itself as well as the gum and jawbone. Serious infections developing from decaying pulp can cause you to lose your tooth or even part of your jaw.

There are several risks of not getting a root canal in a tooth in which it is needed. First, is the loss of that tooth. Second, is the spread of the infection and abscess to another tooth. Third, is a possible infection in the face and neck. Left untreated the infection could spread to the brain resulting in death. If you are unable to have a root canal, you should consider having the tooth extracted.

If you need a root canal, you should get one, or at the least, have the tooth removed.

The consequences of not doing such can be severe. You need a root canal because the tooth is infected. This will NOT go away on its own, it will only get worse. The infection will spread -- it can spread to other teeth, the jawbone, you sinuses, your brain... your head is not a good place for an infection.

I realize many people don't want to get a root canal due to cost, etc. But if one is recommended, it's because the problem is serious. Again, the options are typically root canal or extraction.

Root canal therapy is an essential dental treatment which can prevent serious dental infection, dental abscess, and even life threatening sepsis, cellulitis, bacterial endocarditis, heart attack, stroke, and even death. There are many historical stories of individuals who have died from complications from untreated dental infections including Jim Hensen, founder of the Muppets and even Queen Elizabeth I of England in 1603. An alternative to root canal treatment is extraction of the infected tooth.

Your teeth may have to be removed if you do not have a root canal to remove the infected pulp. Root canal treatment is necessary when the pulp (soft tissue inside your teeth containing blood vessels, nerves and connective tissue) becomes inflamed or diseased. The pulp chamber and root canal(s) of the tooth are then cleaned and sealed.

With the procedure, you can save your tooth and your smile.
Unfortunately, if a root canal is indicated, the only alternative is extraction. If treatment is delayed, the potential for serious infection can result. A filling will not resolve the problem, and antibiotics will not permanently resolve the infection. If the patient decides to have the tooth extracted, consideration must be given to replacement to avoid shifting and drifting of other teeth and to maintain good bite relationships. If the bite is not maintained, facial appearance may be affected. Tooth replacement may also be indicated for cosmetic and esthetic reasons.

Replacement of a tooth or teeth can be accomplished with a variety of non-removable or removable alternatives, including some that involve implants.

Continue Learning about Root Canal Therapy

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.