Are Fillers Safe for Someone Who Has Had Multiple Root Canals?

I would like to have restylane injected to my lower eyelid/cheek area, but I am increasingly concerned about the possibility of biofilm injection. I have read about several cases of it here on RealSelf, and though I know that it's a rare complication, I have come across some medical literature regarding a possible connection between endodontically treated teeth and biofilm injection after Restylane. I am concerned about this because I have had four root canals. Please advise. Thank you!

Doctor Answers 8

Are Fillers Safe for Someone Who Has Had Multiple Root Canals?

Having all your dental work first would be wise before injecting Restylane, seek an experienced injector to ensure a result you wish to achieve

Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Are Fillers Safe for Someone Who Has Had Multiple Root Canals?

The root canal and the soft tissue of the upper cheek and tear trough are anatomically separate and the lymphatic drainage of the gums goes down and laterally, so it would be unlikely that any bacteria could spread directly. Bacteria can travel through the blood stream, however, which is why it is always recommended that patients not have extensive dental work and then have breast implants placed. Patients who have prosthetic heart valves have to take antibiotics when they have deep dental work, like a root canal done, to protect against dissemination of bacteria through the blood stream.

It would be wise to have all your dental work done, fully healed, and without any ongoing inflammation of the gums before any surgical or filler procedure that introduces a foreign body or substance, although as the other doctors have noted, no one has ever seen a problem related to dental work and fillers in many years of experience and thousands of patients treated.


Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 50 reviews

Fillers and root canals

I have never had any concern with doing fillers on patients that have had multiple root canals. However, I would not do fillers on someone who was going for a big dental procedure right after my fillers done. I do not want anyone pulling on their faces and lips and increasing the chance of swelling. Rather have the dental work finished and fillers later. 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 19 reviews

Biofilm and fillers

As long your provider injects the filler through your skin and not from inside your mouth (which some providers do), your risk for biofilm is the same as someone who has not had extensive dental work (very rare). If you are very worried, you can ask your provider to prep your skin in a sterile manner prior to injection. Restylane is very safe and always dissolvable.

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Restylane and root canals

I wouldn't hesitate to have Restylane injections because you've had a root canal, or more than one. The incidence of biofilm forming is very rare as you've likely read. If it's not worth it to you to have the injections because of this very slight risk, then you should consider other options. A well-trained and reputable provider will help you make the best decision for your best outcome.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Are Fillers Safe for Someone Who Has Had Multiple Root Canals?

Fillers should be safe in people who have had root canals as well as dental implants. Fillers are typically placed either directly under the skin or deep just above the bone. However, the place where people typically lose volume necessitates placement of filler in areas that do not lie close to the dental roots or regions of placement for dental implants. In this area of medicine, anything is possible. However, the risk is very, very low if you seek a highly experienced, reputable injector. Avoid the hair salon filler "injector" to minimize your risk of complications. I hope this information is helpful.

Stephen Weber MD, FACS

Lone Tree Facial Plastic Surgeon

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Biofilm after root canal is extremely rare if it happens at all

I am not aware of any literature that solidly proves this connection, and I have treated literally thousands of patients with fillers, and I have never seen nor heard of any such complication.  I'm not saying it hasn't happened, just that if it does it is very rare, and like any complication from any procedure, its risk must be weighed statistically against the benefits of the procedure.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

Fillers and root canals

I do fillers in my office every single day. And I often work very closely with a cosmetic dentist who sends many of his patients to me to further improve their smiles after serious dental work. It has never been a concern or a problem to treat patients who've had multiple root canals with fillers. Especially into the upper cheek and tear trough area.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.