Question:
I have a cracked lower left molar that became abscessed--swollen gum,
slightly swollen cheek, bits of oozing pus.
After a week of tetracycline and Azithromycin that brought the swelling
down somewhat, my dentist did a root canal yesterday (4 canals).
But here it is just one day later, and my gum has swollen up all over
again and is turning reddish too.
Can this possibly be "normal"? I can't believe the infection just
spread so quickly again after just 24 hours.
Will this swelling resolve itself with warm salt water rinses?
Or could there be some infection in one of the canals (or maybe there's
a 5th canal) that wasn't fixed?
Answer:
The infection was not resolved by your last endodontic
appointment. Contact your DDS and request another protocal of antibiotics.
I would use Clindamycin (Dalacin-C) 300mg unless contra-indicated, in my
practice. The root canals need to be further cleaned and sterilized.
I recommend you read these studies performed at the Jan Drew Center for
Dental Metallurgy.....
http://www.rmdentalcentre.com/article.cfm?artId=16&catid=3
http://www.zip.com.au/~rgammal/RCTframeset.htm
http://www.ericdavisdental.com/root_canals.htm
http://www.whale.to/d/root2.html
http://www.drshankland.com/rootcanal.html
http://www.nationalenquirer/dental/techniques/voodoo/rootcanals.htm
http://webpages.charter.net/kyarbrough/rootcanals.htm
http://www.dentistry-toothtruth.com/faq.htm
http://www.cfsn.com/maz/
http://www.tldp.com/issue/1578-/157rootc.htm
http://cnorman.best.vwh.net/blazing/dental.html
http://rheumatic.org/teeth.htm
http://www.crazybitch.org/jdrew/journal/amalgamremov/PN/dirtyvag.htm
http://www.zip.com.au/~rgammal/root_therapies.htm
http://zap.intergate.ca/root.html
http://www.toothwisdom.net/
Sometimes a root canal tooth feels great
afterwards, other times it give the patient a
hissy-fit [a technical tem I learned in dental
school - sorry patients for my professional
jargon!]. Several possibilities come to mind
......... [a.] overinstrumentation, [b.] timing or
[c.] a normal physiologic response.
We both used the word "resolve" in our independent
assessments. That is key. After all there are
bacteria .... and there is an immune system. A
battle of sorts. We always recommend debridement
and a wait-and-see approach to avoid sequelae.
But it does happen.
These are my advice to dentists ....... (patient
has no control over this):
(a) suggests a gentle touch to avoid pushing
bacteria beyond the apex ......
(b) suggests NOT filling a still-moist
(putrescent) root canal space .....
(c) suggests this sometimes occurs no matter what
one does .....
That type of break (if described accurately) should not effect the success
or failure of a Root Canal Procedure.
Your description of re-current pain and infection makes me suspicious of a
fracture line extending down into the root surfaces. Once these types of
cracks open enough to allow bacteria to "wick" down below the crest of the
bone, the tooth becomes rather hopeless. Remember, that I have not seen
your tooth and am not trying to diagnosis it. I am only trying to help you
understand what sort of things we dentists see.
