Root canal treatment and general health: a review of the literature

The focal infection theory was prominent in the medical literature during t he early 1900s and curtailed the progress of endodontics. This theory propo sed that microorganisms, or their toxins, arising from, a focus of circumsc ribed infection within a tissue could disseminate systemically, resulting i n the initiation or exacerbation of systemic illness or the damage of a dis tant tissue site. For example, during the focal. infection era rheumatoid a rthritis (RA) was identified as having a close relationship with dental hea l th. The theory was eventually discredited because then: was only anecdota l evidence to support its claims and few scientifically controlled studies. There has been a renewed interest in the influence that foci of infection w ithin the oral tissues may have on general health. Some current research su ggests a possible relationship between dental health and cardiovascular dis ease and published case reports have cited dental sources as causes for sev eral systemic illnesses. Improved laboratory procedures employing sophistic ated molecular biological techniques and enhanced culturing techniques have allowed researchers to confirm that bacteria recovered from the peripheral blood during root canal treatment originated in the root canal. It has bee n suggested that the bacteraemia, or the associated bacterial endotoxins, s ubsequent to root canal treatment, may cause potential systemic complicatio ns. Further research is required. however using current sampling and labora tory methods from scientifically controlled population groups to determine if a significant relationship between general health and periradicular infe ction exists.