Short answer

A tooth infection at the root tip, called apical periodontitis, is common and often silent. Research shows an association between this infection and certain health conditions, but association is not proof of cause. Dentists use imaging and a review of health history to find it early, before any outward signs appear.

What the research says

  • A 2021 analysis of over 100 studies found this infection in about 52% of adults worldwide, often without any symptoms (Tibúrcio-Machado et al.).
  • The same analysis found it in roughly 39% of teeth that had root canal treatment, compared with just 3% of untreated teeth (Tibúrcio-Machado et al.).
  • People with an existing systemic condition had this infection more often (63%) than healthy people (48%) in this analysis. This shows a link, not clear proof of cause (Tibúrcio-Machado et al.).
  • A 2008 study found that standard flat x-rays detected the infection in about 55% of cases, and panoramic x-rays in about 28%, when compared with 3D CBCT scans (Estrela et al.).
  • A 2006 review found that infection may linger inside the intricate inner canal network of a tooth even after thorough root canal treatment, often without symptoms (Nair).
  • A 2025 review of multiple studies found a 32% higher relative risk of cardiovascular disease among people with this infection, though study differences limit any firm conclusion (Talekar et al.).
  • The American Association of Endodontists reports finding no valid evidence in current science linking root canal treatment to other health problems (AAE).

Where experts disagree

Some researchers point to findings like the 2025 review linking apical periodontitis with higher cardiovascular disease risk as reason for concern (Talekar et al.). Others, including the American Association of Endodontists, report finding no valid evidence in current science that ties root canal treatment to broader health issues (AAE). The research itself notes that study differences limit what conclusions can be drawn about cause (Talekar et al.). The FDA notes that dental CBCT scans usually give more radiation than standard dental x-rays and should only be used when needed (FDA).

How we handle it at Natural Smiles

At Natural Smiles, Dr. Carlo Litano, DMD, starts every new patient exam with a CBCT 3D scan and a review of your health history. This gives us a clear picture of any hidden infection at the root of a tooth. If a root canal tooth is failing, we walk you through retreatment and extraction options and price both side by side, so you can compare them honestly. When we suspect a cavitation, we may recommend surgical debridement, medical grade ozone, or LPRF made from your own blood. Antibiotics are reserved for cases that truly need them. Before any treatment begins, you receive a written plan with itemized costs. Out of town patients are welcome to stay in our private apartment one floor above our downtown St. Petersburg office.

Sources

  1. Tibúrcio-Machado et al., global prevalence of apical periodontitis (2021)
  2. Estrela et al., J Endod (2008)
  3. Nair, Int Endod J (2006)
  4. Talekar et al., umbrella review (2025)
  5. AAE, Root Canal Safety
  6. FDA, Dental Cone-beam Computed Tomography

Last updated October 1, 2026.