Persistent Infections: Prophylaxis

When endodontic therapy is started, the root canal should be cleaned and instrumented completely at the first appointment. Otherwise microbes resistant to medicaments (e.g. enterococcus and yeasts) have a better chance to become established and multiply. Leaving the canal open must also be avoided as this has been shown to increase the probability of invasion by resistant microbes. Good knowledge of root canal anatomy with its many possible variations is always required for success in endodontics.
Certain infections may be therapy-resistant already before endodontic treatment has started (e.g. periapical actinomycosis). The best way to inhibit the development of such infections is regular dental controls to prevent and treat endodontic infections as early as possible.