Question:
I am having a problem with my upper left tooth on the side I think it
is a #13 not sure though. The thing is when I smile it can baerly be
seen. so I am trying to save this tooth. I am in the process of a root
canal the only problem is this infection won't go away. I am on my 3rd
bottle of antibotics and it doesnt want to go away. I don't know what
to do. Should I try and save it and risk pain later not to mention
loosing all my money. Anyway my dentist has cleaned it two times and
it felt so good after that but only for two days then the infection
started coming back. All he has to do is finish the last bit of the root
canal. He thinks if he cleans it again and finish the root canal no
bacteria will seep in and it will be fine but, he is not sure. It was a
big cavity. Just tapping it gives lots of pain. Should I yank it or go
with what my dentist say, root canal,buildup,crown even though the
infection won't go away?
Answer:
A very good dentist / friend who does excellent root canal therapy
once told me that he tells patients that he will fill the root canal
and they probably will experience some degree of pain afterwards.
However, after 3-4 days, it will heal and be just great!
I've looked at the x-rays and they are superb. He usually does the
entire job in one visit!
Depending on which tooth is beeing treated there are different
numbers of rootcanals. Maybe your dentist hasnīt found and cleared them all
out yet?Even if your tooth has been properly cleaned out you shouldenīt
have your root canal treatment completed until all your symptoms are gone.
You shouldnīt be taking antibiotics since the effect will camouflage if
there are any bacteria left or not.
You should defenitely NOT have a crown made on a tooth thatīs not free from
symptoms.
Different kinds of "bugs" respond to different kinds of medications.
Maybe the medication you taking is ineffective and therefore not
responding to the kinds of "bugs" that are present. I would strongly
recommend changing the antibiotics if there is true infection (ie.
drainage) and the possibility of culturing the bacteria to see what
antibioitc is most effective. Sometimes patients confuse infection
with inflammation, meaning the sensation caused by pressure on the
tooth. When root canal instrumentation is performed, bacteria,
irrigation solutions and files placed beyond the apex, may irritate
the tooth and cause inflammation in the supporting structures around
the tooth. There is no harm in placing antimicrobial agents in the
tooth like Cal-Sept or calcium hydroxide paste in the canal sealed
with IRM and allow the tooth to calm down. I would also check for any
cyst or lesions that may be present at the apex of the tooth and for
any evidence of root fracture. I would not recommend placing a
post/core and crown on any tooth until the tooth is completely
comfortable and chewing on the tooth has been restored.
We do quite a bit of one visit root canals with not too many post-op
problems/complaints. Though not all are done in one visit. One of the
dentists in the office Rx's Decadron after a root canal packing and this
seems to do wonders. Anyone else use it? As someone else said, there
may be an ancillary canal in there that is hiding in the x-rays. If we
get a stuborn one we generally take several different angles of x-rays
to see if there is a root hiding out in the back. Also, if the
infection has sat in the bone too long and there is a large area around
the apex there is always the surgical route of apicoectomy.
What does the Dentist say? If you "yank" the tooth now you will loose
all that you have already put into it. A tooth is a part of your
anatomy. Give it a chance. If you have recurrent kidney infections you
would not think to just yank out your kidney (over the top analogy?
maybe. but backed by very strong feelings against amputation of a
tooth).
At least get through the root canal, give it a little time to "calm
down", and decide where to go from there.
