Can root canal cause capsular contracture?

I have breast augmentation in 3-4 months. A year ago I had root canal fixed. Another dentist undermined his fellow dentist work and suggested I have it redone.Don't know whether it was true concern or a desire to make a profit.Anyway, can root canals cause capsular contracture?

Doctor Answers 12

Can root canal cause capsular contracture?

Yes, invasive dental procedures all cause bacteremia (defined as releasing bacteria into bloodstream).  It is widely hypothesized that much of capsular contractures are related to an infectious process.  Regardless of cause, repair of capsular contracture must always involve complete scar removal, removal of the old implant, replacement with a new implant, and possible use of ADM.  

San Diego Plastic Surgeon
5.0 out of 5 stars 25 reviews

Root canal and capsular contracture

There is no evidence that a root canal can cause capsular contracture, but then the event is so unusual that there are no studies about it either. I would say you should first find out if you need your root canal fixed. Since there is no agreement between your two dentists, I would suggest seeing a third one, and if you really need the root canal, then not having it fixed is not an option, no matter what may happen in terms of capsular contracture.

Ciro Adamo, PhD, MD
Italy Plastic Surgeon
5.0 out of 5 stars 18 reviews

Root canal cause capsular contracture

Any seeding of bacteria can cause capsular contracture; if you had a root canal, in theory it is possible to have bacteria in your mouth be dislodged and then find your implant pocket. No literature to support above opinion, but theoretically possible.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Root Canal and Capsular Contracture

Thank you very much for your question.

If you ask 5 plastic surgeons that same question, you will get 6 opinions.  There isn't good data on dental work and capsular contracture.  The theory is that dental work can cause bacteria to enter the blood stream and possibly get to the implant and cause a "subclinical" infection and the body will respond by creating a thick capsule as it fights the infection.  As a result, some doctors ask that you take antibiotics around the time of dental work.

But you may ask, "Doesn't a thorough toothbrushing or flossing also cause that same bacteremia?  And I do that every single day without antibiotics, so why antibiotics only when I visit the dentist?"  And you would have a very valid point.

Having said all that, I do feel that the risk of giving a temporary course of antibiotics if having teeth cleaned early after the operation, or having something more substantial such as a root canal, is low.  Therefore, I advise my patients to take antibiotics in those cases.

If you can have your root canal before your breast augmentation, that may be best.

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 23 reviews

Dental work and capsular contracture

The concern with dental work and capsular contracture is that if bacteria from the root canal got into your blood stream, it could settle in the breast area and cause CC. However, this concern is for dental work done after you have your implants. You haven't gotten yours yet, correct? Regardless, let your surgeon know about the root canal and he or she may want you to take antibiotics before your surgery. Best, Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Dental work and capsular contracture

Thank you for your question.  This is a true concern with dental work around the time of breast implant surgery.  With dental work, bacteria can get into your bloodstream and with a recent breast implant surgery (within 6 weeks or so), bacteria could possibly get to the implant and cause either an infection or potentially capsular contracture (low grade infection).  I always tell my breast augmentation patients not to have any dental work done for 6 weeks after surgery.  

Best wishes.

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 34 reviews

Root canal and breast augmentation

Any pathology in which bacteria enter the bloodstream could potentially cause capsular contracture. So, if a dental work is performed and "if" bacteria enters the bloodstream, this could theoretically cause capsular contracture. Most plastic surgeons suggest antibiotics for these procedures to prevent any possible risk.

Kiran Polavarapu, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 38 reviews

Root canal

Thank you for the question and dental work can potentially shower bacteria into the blood stream which then could settle in the breast area possibly causing capsular contracure.  That is why it is generally recommended to take antibiotics while getting dental care after a breast augmentation.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Can root canal cause capsular contraction?

There are no studies to determine this.  However, dental work, such as root canal can cause seeding of the blood stream with bacteria.  A low grade, subclinical, bacterial collection in the "biofilm" around the implant is thought to cause capsular contraction.  Thus, you should take antibiotics before, during and after your root canal if it occurs within a few weeks on either side of you BA just to try to be safe.

Todd C. Case, MD
Tucson Plastic Surgeon
4.9 out of 5 stars 55 reviews

Root canal and capsular contracture

The science related to this topic is not very strong and in some cases theoretical.  What we do know is that even brushing one's teeth can "seed" a very low level of bacteria into the bloodstream.  However, not brushing one's teeth is not an option.  There are some who believe that one of the causes of capsular contracture can be a seeding of bacteria that is in the bloodstream that does not cause an infection of the implant per se, but can cause an increased inflammatory process.  Those of us who believe this ask our patients to not have major dental work done within the first 6 months AFTER breast augmentation because the inflammatory process is already taking place from breast augmentation and healing is still taking effect, and having major dental work can potentially seed bacteria and attract them to the area of inflammation, the breast implant.  Other factors that may decrease risks of capsular contracture are being nicotine free (nicotine causes decreased blood flow), a submuscular or dual plane pocket, using a "no-touch" technique for implant insertion, using a triple antibiotic irrigation during the surgery, nipple shields during surgery and using an inframammary approach when possible.  In my own practice I follow the preventative measures as outlined above as I do not like to take any chances with capsular contracture.  If you have not had your breast augmentation, get your dental work done first and then go get breast augmentation a few weeks later.  If you have had breast augmentation, then I would try to wait at least 6 months after for things that can wait, but in cases where this is not an option, I have my patients take antibiotics starting the day before their dental work and continue for 3 days after their surgery.  I hope this helps to shed light on this complex topic.  Feel free to contact me if I can be of further help to you.

Sean Kelishadi, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 25 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.