In the mouth, as with our body, there are infections that start and perpetuate silently.

These silent infections can happen in teeth that have already been submitted to a root canal treatment, due to a reinfection of the tooth, or in teeth in necrosis (death of the nerve of the tooth).

In cases of teeth with endodontic treatment performed (devitalized teeth) the underlying causes for recontamination are varied. They may be related to a bad sealing of the tooth restoration or a fracture of the tooth and/or the restoration of the tooth leading to the entry of bacteria into the tooth. Or with insufficient endodontic treatment in which there has not been a correct disinfection of all the channels of the devitalized tooth.

These infections show no symptoms, however, they function as an infected wound that never comes to heal leading continuously to the destruction of tissues that involve and support the tooth (gum and bone), and may also spread to other structures of the body and also to an overload of the immune system that tries to fight the infection.

When timely inspected, the teeth can be saved and infections resolved with endodontic treatment, in the case of teeth with necrosis and with endodontic retreatment in the case of teeth already devitalized.

In more severe cases, you may have to have surgery to help resolve the devitalized tooth infection. In cases not in contact in a timely manner, tooth extraction may be required.

As a silent infection, it can be found or x-called in routine consultations or by the appearance of a gum rash near the tooth, which is easily visible.

Therefore, it is essential to perform routine consultations every 6 months and to perform the evaluation of the oral cavity at least once a week after the moment of brushing, removing the cheeks and lips well in order to visualize the entire gums.

If there is a small rash on the gums above a tooth you should seek an appointment so that it can be observed, diagnosed and treated as timely as possible.

How to prevent a reinfection of a devitalized tooth?

As already mentioned, a devitalized tooth with endodontic treatment can return to an active infection, either by the permanence of bacteria from the infection that the tooth had previously or by a reinfection by the entry of bacteria into the devitalized tooth.

The causes leading to this bacterial recontamination may be related to a recurrence of caries injury, a bad sealing of the coronary restoration, or a fracture of this same coronary restoration.

In all situations, the devitalized tooth is no longer hermetically sealed which leads to an inlet of bacteria inside it, and can progress through the inside of the channels reaching the tissues that are around the tips of the roots and starting or restarting to trigger such a wound that consists of a process of inflammation leading to damage of the supporting tissues of the tooth.

Thus, the planning of the restoration to be carried out after the endodontic treatment performed is extremely important for the longevity of the devitalized tooth. Since the tooth is without the tissues (tooth nerve) that allowed the sensation of cold, hot, more or less force to chew, it must be restored in order to be compensated by the loss of vitality and structure.

These restorations, depending on the amount of structure lost in the tooth, due to the cause that led to an endodontic treatment, can be total or partial crowns in ceramic with adhesive techniques, leading to a correct sealing of the coronary part of the tooth and a greater resistance to devitalized tooth fracture.

Just as important than the restorative technique is the performance of regular consultations at the dentist and also the performance of correct oral hygiene, because, like any natural tooth, a devitalized tooth can return to develop a dental caries injury.