In the presence of an acute root canal infection, it is incumbent on the dentist to treat the offending tooth only. Root canal infections are specific to the individual tooth, and the bacterial population in each necrotic tooth differs in type and virulence of microorganisms. Each time an endodontist instruments, debrides, and disinfects a root canal system, he or she pushes some bacteria through the end of the root into the bone, temporarily increasing the postoperative pain and inflammation. By treating more than one tooth at the same time, the pain and inflammation will be compounded and, if there is a postoperative flare-up, it is hard to distinguish which tooth is the culprit. By treating multiple teeth simultaneously bacteria are co-mingled causing cross-contamination which can worsen the prognosis because it is more difficult to treat complex polymicrobial infections.
Root canal infection medical expert witness specialties include endodontics and infectious disease.