Hi Peter,
Thanks for the kind words! I am doing my best to help here
Thanks for posting the xray. You have what is referred to as a perio/endo situation with a large blatant infection regarding tooth #14. This is a picture of your upper left first molar tooth #14. Teeth #26 and 27 are your lower right lateral and canine.
The infection may have invaded the sinus as well. I cannot tell for certain but it does appear that you have pathology in the sinus. I also cannot be sure if the root of this tooth is actually in the sinus or not as the xray is only 2 dimensional. It also looks like you a cavity on the tooth behind it in tooth #15 in the distal portion... possibly the mesial of this tooth as well.
Irrelevant of what your dentist may tell you.... this is not a failed root canal. The truth of the matter is... once a tooth has become infected and/or had a root canal procedure or an apicoectomy, the tooth remains infected. There is no access to the miles of microscopic canals (called dentin tubules or accessory canals). These canals harbor necrotic nerve tissue and there is no changing that. Generally root canaled teeth will not display symptoms until the infection is severe.
Regarding an apicoectomy.... first of all apicos never solve the problem as they are nothing more than a surgical root canal procedure that destroys the bone at the apex of a tooth. It does nothing to "cure" the infection inside of the tooth. In your case an apico would be extremely invasive as the sinus is going to be involved. This could set you up for a chronic sinus infection or worse.
The only way to rid yourself of the infection is to remove the tooth and have the socket and sinus surgically debrided of necrotic bone and tissue. You also have the tooth in front, #13, root canaled. Whether or not you would consider removing both of them at the same time is up to you.
You said your gland on that side was tender... indicative that your immune system is burdened by this infection. You may be able to wait until monday but you may not. The pressure from the infection is building up in the bone and sinus that's why the pain meds are not able to lessen the pain. The first thing to do is decide whether or not you are going to remove this tooth as that will determine who you contact for help. If you are, then contact an oral surgeon tomorrow.
Bryanna
Quote:
Originally Posted by raintaker
Hi Bryanna and all,
first of all, very good message board with lots of interesting info, good job! I planned to post here about my unexplained jaw pain problems, but I have a fresh problem.
I've been having sporadic pain in gum between teeth 26 and 27 (upper left molars) for half a year now, every 3 weeks or so for 2-3 days. But this week, this just won't go away and seems to come not from what my dentist says it's a periodontal pocket but from the gum above tooth 26. My dentist performed the root canal on that tooth about 10 months ago, did an x-ray later to check the filling and said it's ok. This week he gave me antibiotics and did a panoramic x-ray, blamed the periodontal pocket for the pain and referred me to a paradontist. But the pain is getting worse as of yesterday and no over the counter analgetic helps one bit. The gland in my jaw on that side is a bit painful today. I had the x-ray done - see it attached.
Question: Am I correct in assuming this is a failed root canal with infection present again and that I'm in need of apicoectomy??? It's now late friday, can I wait till Monday or is it better to run to emergency dental care (I will do so promptly if my body temperature rises above normal...)?
Thanks
Peter
|