Causes of root canal inflammation

Introduction

Root canal inflammation or apical periodontitis represents a deep inflammation of the tooth and is the reaction to a bacterial infection. Infected is the tissue contained in the tooth pulp, i.e. blood and nerve vessels. But what are the causes of dental root inflammation?

Are there special risk groups that suffer more from this phenomenon than others? Can mental and psychological factors influence the development of an inflammation of the tooth root in such a way that it becomes worse or even develops? Or can the development of an inflammation of the tooth root be hereditary? What is certain is that if this disease is not treated or not sufficiently treated, serious consequences will occur if the inflammation spreads to the jawbone.

Causes of root canal inflammation

Tooth root inflammation can have various causes. Probably the most common one is advanced caries, which has reached the pulp (the tooth marrow) and inflames the nerve and blood vessels it contains. The inflammation can progress to the tip of the root, where it can also infect the surrounding tissue, including the bone.

This apical periodontitis often leads to the death of the nerve tissue running through the tooth and thus to the devitalized or, in the vernacular, “dead” tooth. The inflammation can progress so far that it infiltrates the surrounding bone compartment of the tooth and breaks down the bone. The tooth becomes loose.

In the worst case this leads to tooth loss. Another cause of inflammation of the tooth root can be anatomical. Every tooth is different.

Although the basic building block of the enamel layer, hydroxyapatite, is always the same, enamel can often have micro-grooves that allow bacteria to run free. Genetic variations are possible especially in these microgrooves. The bacteria travel through the enamel layer via the dentine to the pulp and infect the vessels contained there.

Wisdom teeth are also a possible cause of dental root inflammation. If these do not have enough space to integrate into the dental arch or are designed in such a way that they cannot break through in the first place, they are often located very close to the roots of the respective neighboring tooth due to their inclined position. The root of the neighboring tooth is often irritated by this and the surrounding bone compartment is degraded by this mechanical irritation.

Bacteria settle in this cavity, infect the root of the tooth and cause an inflammation of the root of the tooth. Another cause of this disease is trauma (mechanical injury). If a tooth has felt a blow or similar at some point in the past, it can develop an inflammation of the tooth root even decades later.

Trauma can be, for example, a fall or mechanical irritation. Nocturnal teeth grinding can also lead to trauma. In the worst case, the nerve dies due to the trauma and the tooth turns dark.

Often this is the only visible sign for those affected, as long as there are no painful effects. Even when grinding the teeth, as a pre-treatment to be able to integrate dental prostheses such as bridges and crowns, insufficient water cooling can cause an inflammation of the pulp and the root of the tooth. The protective layer of the tooth, the enamel, is only thin due to the grinding process and does not close without gaps, for example with the crown.

Bacteria can now penetrate the pulp directly through the dentine and cause inflammation of the tooth root. Inflammation of the periodontium, or periodontitis, can also be the cause of inflammation of the tooth root. If periodontitis is treated too late or not at all, it can affect and infect the roots of the teeth. The teeth whose roots have been infected often loosen and the risk of tooth loss increases.