Hello, Ginnie. Thanks for responding. Well, I am supposed to go back today at 1 o'clock to see what the plan is for that tooth if there is one. Hot or cold drink doesn't seem to bother it, but biting directly down on it does, and it is very sensitive at the bottom around the root. I can still feel the "bubble" with my pinkie finger. The antibiotic did help some but it did not remove all the soreness and pain. Should I ask for a stronger antibiotic and wait another week or so to see if this improves? Bryanna seems to think that more antibiotics won't help.

I plan to ask for an x-ray or to at least look at the x-ray. Not that I know enough to tell what exactly the image indicates, but I'd like to at least have some input into what happens inside my own mouth. I am a little concerned about this being so close to my jaw bone. I do know that a bone infection is a very serious thing which is difficult to treat.

The previous plan was/ is to remove the perm. crown on an adjacent tooth (same side) which had a piece broken off the very bottom when it was put on a few weeks ago. Apparently the lab made it a bit too thin along the outer side bottom of that particular tooth.

Supposedly the rework/redo/salvage plan included "sawing" the crown so it could be pryed and or ground off with a dental drill. I'd think this might be a somewhat touchy procedure since the crowned tooth has a small metal plate underneath the porcelain crown top. As I recall it was is coated with some type of greenish material and then cemented to the tooth. I'll wear my heart monitor this afternoon in case my BP surges during this sawing prying drilling de-crowning procedure. Hopefully I won't have a stroke from all this. I'll take another Lortab just in case things get nasty. If things go really bad consider this my group thank you to you and the others who have patiently listened to my incessant whining.

Bryanna is correct, more antibiotics won't help at this point. If it is a RC tooth, remove it. If you do not trust this dentist, have another opinion as soon as possible. If decay goes deep down inside, retaining the tooth isn't the best Idea, and of course it is a fortune to do what he is telling you needs to be done. If the tooth is that fragile underneath, I would opt. for simple extraction, end of problem end of the money pit. Let me know what happens. No stroke, just relax, and remember you have a right to say NO to treatement untill you are very sure what needs to be done. xginnie

Hi Murtain,

Please let us know what occurred at the dentist today
Hope you are doing ok!

Bryanna

Nothing happened...except I am being referred to an outside endodontist across town for a root canal in approx. three weeks, or sooner if someone cancels an appointment at that office, and if they can somehow manage to work me in between other patients. The tooth is not nearly as painful as it has been, but it is still sore to the touch and sensitive to pressure as in chewing or biting downwards on that side. I have been drinking lots of pomagranate juice and cutting out caffiene as I was told that something in pomagranate is good for inflamation. Of course if it suddenly gets worse there will have to be a plan B.

I'd rather not have the tooth extracted if at all possible. This tooth has a double root system and the x-ray shows a darkened area at the very bottom of the root. I'm bouncing back from a brief summer sinus problem, and hopefully when my immune system recupes sufficiently I'll be able to handle this situation. I don't usually put myself at the mercy of others like this.

Hi everyone,

I had a root canal on tooth #30 about 6 months ago (only had a filling on it and hadn't gotten it capped yet). I healed up and everything seemed fine. Once in a while, after eating food with that tooth, it would feel sensitive to pressure and would feel somewhat swollen. I'd rate the pain as 5/10, not that bad. Those symptoms would disappear the next day and all was well. It happened again a couple times. In May, I went to the dentist and she didn't find anything wrong but said it might've cracked and to wait a while to see what happens and if all is well we can then put a cap on it.

On Tuesday I was eating dinner and chewed something with that tooth. The familiar pain came back but this time it was more severe, I'd say a good 9/10. Took some advil hoping that it'd get better and went to sleep. Next morning, still in pain. I went to the dentist and had an x-ray taken which ended up showing dark spots around the roots of the RC'ed tooth. She told me that it was most likely infected. Prescribed me with Amoxicillin and toradol (which didn't work that well for me). She said I could get it extracted or do another RC. I decided on an extraction and set up an appointment for next Tuesday (soonest possible, as per her schedule).

It was really hard to sleep last night due to the throbbing pain in my tooth. It seems to be radiating to my ear and jaw. Today it still feels swollen and sensitive to pressure. However, the constant discomfort has subsided a tiny bit. Also, not only is the tooth sensitive to pressure but also the part of my lower jaw that is aligned with the tooth (side of jaw, i.e. from the bottom of tooth to the bottom of the jaw - it doesn't hurt if I push my jaw from underneath).

After reading these posts in this thread I felt like asking some questions.

1) Is there a significant risk in waiting 'til Tuesday to get the tooth extracted?
2) From my description, would an extraction be an adequate solution?
3) What kind of anesthetic should I ask for during the extraction?
4) Is it OK to weight lift with an infected root? (fearing that it would promote proliferation of the infection or similar effects.)

I'm very happy that I found this thread, Bryanna has shown tremendous consideration and expertise - thank you for that. I hope you can help me too!

Jason

Hi Murtain,

I understand how vulnerable you feel and how you are not comfortable being in that position.... I totally get that.

A couple of things that your dentist evidently did not inform you about. One is that a root canal treatment cannot cure the infection because the bacteria resides inside of the microscopic canals which are not accessible. The darken area at the apex of the tooth indicates a spread of infection into the jawbone. This does not mean that the the infection has left the tooth and moved elsewhere... it means that the tooth is overwhelmed with bacteria and it has proliferated beyond the tooth. So irrelevant of how well the rc procedure is performed, the tooth will remain in infected. Your immune system will continue to deal with this infection as long as the tooth is present. As you know, a chronic infection is risky (especially) for someone who has cardiac stents. It would certainly be wise to (re)consider the risks associated with keeping this sick tooth.

Regarding pomegranate juice.... whole pomegranate or unsweetened pomegranate juice does have great anti inflammatory properties especially associated with the coronary arteries. However, it is not going to cure the inflammation that is caused by the chronic tooth infection as the source of the infection is the tooth.

Have you discussed removing this tooth with your dentist and what replacement options are available to you?

Bryanna

[Not to sway you in anyway, but truthfully a RC tooth is not a good tooth. That proceedure costs a lot, and it is a money making adventure to retain a tooth that really has infection in it. There isn't any possible way of removing all the infection no matter how many times that proceedure is done. Read the posts from bryanna if you can. I had my tooth out, end of money pit, end of pain, end of re-treatment. I have a nesbit, which really is a wonderful device. ginnie

Hi Jason,

I will post your questions and answer in bold

1) Is there a significant risk in waiting 'til Tuesday to get the tooth extracted?

WELL, THERE COULD BE. BUT HOPEFULLY THE ANTIBIOTIC WILL SUBSIDE THE INFLAMMATION AND BACTERIA PREVENTING IT FROM BECOMING WORSE WITHIN THE NEXT FEW DAYS. IT IS ALSO BEST TO BE ON THE ANTIBIOTIC FOR THE EXTRACTION APPOINTMENT.

2) From my description, would an extraction be an adequate solution?

ABSOLUTELY! RE TREATING WITH ANOTHER ROOT CANAL OR AN APICOECTOMY WILL NOT ALTER THIS PROBLEM AT ALL. IF YOU WANT A SOLUTION TO THE INFECTION THEN REMOVE THE SOURCE WHICH IS THE TOOTH!

3) What kind of anesthetic should I ask for during the extraction?

THAT'S A REALLY GOOD QUESTION! THE ANTIBIOTIC WILL HOPEFULLY LESSEN THE INFLAMMATION ENOUGH FOR THE LOCAL ANESTHETIC TO TAKE AFFECT. INFECTION IS ACIDIC, ANESTHETIC IS ALKALINE... SO IT CAN BE DIFFICULT TO GET THE TWO TO MIX WELL ENOUGH TO BE PROFOUNDLY NUMB. BUT SEVERAL DAYS ON THE ANTIBIOTIC WILL HELP. YOU MIGHT OPT FOR SOME NITROUS OXIDE IN ADDITION TO THE ANESTHETIC...? ALSO REFRAIN FROM ANY ORAL VITAMIN C FOR 24 HRS PRIOR TO THE EXTRACTION AS THIS COULD INHIBIT THE EFFECTIVENESS OF THE ANESTHETIC. TAKE A B COMPLEX AN HOUR OR TWO PRIOR TO THE EXTRACTION AND THAT WILL HELP ENHANCE THE ANESTHETIC. VITAMIN C IS ADVANTAGEOUS POST OP THE EXTRACTION. DO YOU SUPPLEMENT WITH ANY VITAMINS ON A DAILY BASIS?

4) Is it OK to weight lift with an infected root? (fearing that it would promote proliferation of the infection or similar effects.)

ACTUALLY, ANOTHER GOOD QUESTION!! IT REALLY IS NOT IDEAL TO WEIGHT LIFT OR DO ANY OTHER STRENUOUS EXERCISE WHEN YOU HAVE A BAD INFECTION AS THE EXERCISE STIMULATES THE IMMUNE SYSTEM TO RECOVER. IT IS ALSO BEST TO PUT OFF LIFTING FOR THE FIRST WEEK OR SO AFTER THE EXTRACTION.

I want to add one thing here..... I don't know your dentist or how much experience or training she has in oral surgery.... most general dentists have limited of both.... so if it were me, I would go to an oral surgeon to remove #30 especially due to the infection. An OS extracts molars all day long and they have specific techniques to use even with getting a patient numb. They also use specific instruments that the general dentist typically does not have. The OS is also more likely to debride the socket and bone clean of the periodontal ligament, necrotic tissue and bone... the typical general dentist rarely does either of those things.

I hope this information is helpful to you! Thanks for asking specific questions .. sounds like you've been doing a bit of dental homework

Oh.. and thanks for the kinds words Three decades of dentistry gives me the knowledge to help others and that's why I'm here.

Keep us posted!
Bryanna

Thanks again B. I took all of the Amoxicillin that the dentist prescribed. It helped some, but still have some soreness. I think I will call my cardiac doctor tomorrow and see if his nurse will ask him about how this might impact stents. The last thing I need is some type of infection that moves from the tooth to an artery with a stent (I have 4 of these).

To be safe, I am considering asking for a stronger antibiotic until I can get to the endodontist. This thing of having me wait almost three weeks to see the endodontist is not sitting so well with me at present. Would it be wise to see an oral surgeon and get his/her opinion on this? If I understood the dentist correctly, he is referring me to the endodontist with the understanding that I will not be a charged for this RC procedure. I have always been under the impression that it was not a good idea to do any type of work on a tooth if it was infected at the gumline/root area. I'd think this would have to be drained and cleaned thoroughly before any type of work on the actual tooth could begin.

Bryanna....Another thing....I think this all can be traced back to the fact that the crown on that tooth (number 29) was sticking up a bit too high and therefore the tooth directly above it put excessive pressure downward onto #29 and that in turn caused or may have caused the inflamation to form at the bottom. Initially the tooth only hurt on the top surface and front/back of the tooth, but after going for three or four days in that condition, it moved downwards, or at least the pain and swelling did.

Keep in mind that I went for over a month with a temp. crown on #29 tooth and the three teeth adjacent to it and had no significant pain [just some mild discomfort while eating, etc.] The temp. crown had to be replaced once because some pieces broke off while I was eating and or brushing. The temp. was a one piece item made from an impression mold [by the dental assistant not the dentist] and covered all four back teeth on that side. I just find it hard to believe that a tooth can become infected that quick. I've had the same metal filling in that tooth since 1966 and not had one minute's trouble or pain until this recent dental work which btw began in mid February. Almost 6 months to get 8 crowns seems a tad long don't you think?

At the time I could not get to the dentist's office sooner for an adjustment of the perm. crown because he was out of town. Ok, so could this be caused from the downward pressure [which was his original theory if I remember correctly].