My wife had a root canal ~18 months ago and we recently found it is was severely infected.

She didn't have any pain in that area but exhibited other issues that we believe were caused by the infection (migraines, temporary facial palsy and more).

She had a retreatment last Friday, 6/29/11, and has been in severe pain since. My wife has a high pain tolerance but the endodontist did not prescribe any pain pills or antibiotics initially and it was unbearable. After calling they prescribed vicodin but it really doesn't help, Advil does more for her.

Should she be in this much pain after 5 days? Any tips? Anything that may help?

Thank you for your time.

Hi mikinho,

The reason the tooth hurts so much is because it is overwhelmed with infection. The pressure from the inflammation inside of the tooth is similar to inflating a balloon. Frequently the pressure pushes the bacteria into the bone and in trying to find a release, the bacteria burrows a hole through the bone and attempts to push it's way out through the gum above/below the tooth resulting in what is called a fistula, looks similar to a pimple. However, the fistula is not the end of the infection. It is simply a pressure release for the bacteria to continually drain. Fistula's are serious oral infections and they can close off at any time causing the pressure to expand internally. Fistula's can only be cured once the tooth is removed because the sick tooth is what is causing the fistula to form and it will occur again and again. Root canal therapy cannot cure an infected tooth for several reasons but the one reason that is most easy to understand is because the microscopic canals cannot be cleaned out.... thus the chronic infection. An apicoectomy surgery also cannot cure an infected tooth... for the same reason(s) as a root canal.

If a fistula has not formed yet, then that means that the pressure from infection is building up internally. Again, this is considered a serious oral infection. If it is an upper tooth the infection can travel to the sinuses and beyond. If it is a lower tooth, the infection can travel into the soft tissue of the throat and cause the airway to close. The pathological process of these types of infection are complicated, but I'm giving you the basics of what can occur if the tooth is not removed.

Antibiotics cannot cure an infected tooth....again the simple answer... the microscopic canals are not accessible and they are loaded with necrotic nerve material. Antibiotics would only be a temporary bandade...if anything.

I'm sorry she is having so much trouble with her tooth. The only way to cure the infection is to remove it's source.... which is the tooth.

Please view this link which explains very well what a root canal really is...
http://articles.mercola.com/sites/ar...0218_DNL_art_1

Keep us posted on how she is doing.

Bryanna

Bryanna,

Thank you very much for the reply and sharing your knowledge and experience. We were able to schedule an appointment with the endodontist tomorrow and will update how it goes.

It sounds like pulling the tooth will be needed, if not now, sometime in the near future--a scary thought for my wife.

-Michael (aka Mikinho)

Hi Michael,

The endodontist may try to convince your wife to retreat the tooth or do a surgical root canal called an apicoectomy. Keep in mind that endodontists perform root canals for a very impressive salary.... they do not divert from that procedure. If he says he can "cure" the infection.... ask him what happens to the dead nerve material inside the microscopic canals, called dentin tubules/accessory canals, that cannot be cleaned out. Ask him if the term "cure" really means to "retain" as in keep an infected tooth. Also ask him if this long term infection can compromise the jawbone and make replacement of this tooth complicated in the future.

I know it is scary to think of having a tooth removed. However, it truly is inevitable when a tooth is infected. The big problem with waiting is that the longer the infection is present, the more deterioration in the jawbone which makes replacing this tooth complicated. Also, any long term infection puts a lot of stress on the immune system and other organs of the body.

So the real concern that your wife needs to realize is.... remove an infected tooth and be healthy.... retain an infected tooth and live with the risks of systemic disease. I know this sounds cold... but it is the truth that your dentist may not make you aware of.

Let us know how she's doing.... hopefully she will be able to sort through her choices and make a clear decision not based on fear but what she believes is in her best interest.

Bryanna