I have neuropathic facial numbness and pain bilateryally and some other symptoms such as burning through my nostrils and occasionally earache. Symptoms are constant and vary in intensity. Neurologists say not Trigeminal Neuralgia. Had MRI's - normal. For awhile i have had a sensitive tooth (sensitive when i touch or tap it). X-rays do not show anything significant. I have a filling (silver) of 10 years in that tooth. Recently it has flared up and become very sensitive to hot and cold. Again a further x-ray showed little of significance. Am trying antibiotics but so far no difference. Dentist has said that if the filling has to come out because the antibiotics don't work the tooth may need a root canal treatment. I am quite concerned about this as have read a bit on dental procedures exacerbating facial pain. Is the root canal procedure safe. Any advice would be greatly welcome.

...the more i read about this the more tempted i am to just have the tooth out, won't look too good though.

Hi rweidn,

The tooth could be fractured which would cause it to hurt when tapped on and sensitive to temp as well. Root canal therapy does nothing for a fractured tooth and warrants the tooth chronically infected.

When you say the xray doesn't show anything significant.... what does it show? Which tooth is this?

Bryanna

It's an upper tooth, one of the bigger ones towards the back (you'll have to forgive my lack of knowledge about teeth). The xray showed a shadow in the gum but i can't for the life of me remember what the dentist said about that, i am seeing her again on Monday. The problem has calmed down about 50% from when it was at it's worst but the tooth still has some sensitivity to being touched and still some to hot and cold. If it was infection wouldn't you expect the antiobiotics to completely kill it. Am on 4th day of 5 day course of Amoxycilin 250mg.

Hi rweidn,

The shadow on the xray is not in your gum, it is in the bone and it's called an apical radiolucency.... it means a pathological area of infection (usually a cyst) in the bone above the root of the tooth. This occurs when the infected bacteria from the tooth has proliferated (spread) into the bone. No, antibiotics will not cure this infection because the source of the infection is the tooth and unfortunately it is not possible to rid the tooth of the infection. The meds may temporarily subside the symptoms, but nothing else. A root canal may or may not temporarily subside the symptoms, but it cannot cure the infection lingering in the microscopic canals.

I assume your dentist will offer you the option of root canal or extraction of this tooth. You may have read other posts on this board about the unfortunate outcomes of root canaled teeth. The roots of an upper molar are often very near the sinus membrane so an infection in these teeth can spread to the sinuses. Even after a root canal procedure, the chances of the infection spreading are highly likely.

If you are uncertain about what to do.... speak with your dentists about your treatment options. To extract the tooth means to get rid of the infection, to root canal it means to live with an infected tooth. Replacement of this tooth if you decided to have it extracted may include doing nothing, an implant, a bridge or a partial denture.

I know this is a bit scary..... but it would be helpful for you to have your concerns and questions written down before you see your dentist. This way you will have more control over your decision.

Please keep us posted!
Bryanna

so i saw my dentist today. Asked her about that x-ray which shows a shadow above the root of the tooth (between the two prongs). She said that it shows the effect of what could be infection. There was also another very thin black shadow near there which the dentist said she could not know what it was. It was like a line in a u shape. Decided today to try the least invasive procedure first so took the old filling out and it's been replaced by a temporary filling in case the old filling is the culprit. She said the tooth looked relatively ok under the filling, some yellowish colouring on the tooth but no clear sign of infection and said she is not convinced i need root canal treatment. There is no evidence of the tooth being fractured. It's now about 7 hours later and the tooth feels slightly uncomfortable when tapped. Haven't tried the hot and cold test yet. She feels the next step should this fail would be my choice of either a root canal treatment or extraction but said the root canal treatment for this particular tooth was not the easiest to do and therefore if i went for that she could refer me to a specialist clinic. It's a case of wait and see. She didn't feel that i should have any particular concern about having root treatment with the history of these facial nerve problems though. If the bone is infected (she mentioned possible low grade infection) would a root canal treatment cure that or is an extraction a better option?

rweidn,

No, a root canal treatment will not cure the infection. It will however, cause a chronic inflammation along with the existing infection. Is there any way you could post the xray of this tooth?

Bryanna