I developed a fistula in early December. I went to the dentist and it was my #7 tooth, the filling had fallen out and the root was infected. I was put on a zpack and then a week later, another zpack. She opened up my tooth and lanced the fistula in order to drain. I went back to have the root canal finished and the fistula was filling again. She put me on clyndimyacin for ten days and when I went back, the fistula had drained and she was able to finish the root canal. I finished my antibiotics this past Thursday and I woke this am to find that the fistula had filled back up. I touched it and it burst again. It has been filling up and busting all day. Should I be worried? She is a very good dentist yet this is the first time something like this has ever happened to me. I just don't understand why the fistula keeps filling back up. Reading some posts, I'm getting a little worried about something else causing this. I think it's also important to note that when I first went in with the fistula, she did xray the tooth next to #7 as well, that had a crown the month prior, just to be sure it was not that tooth.

Thank you!

Sorry, that is my number 6 tooth, that had the infection and the root canal performed.

Hi bubble,

A fistula is the result of a long standing infection. In your case, the tooth is infected and most likely a cyst has formed at the end of the root. The area is overwhelmed with bacteria so in an attempt to release the pressure, the bacteria burrows a hole through the bone and gum resulting in a visible fistula. This is not a shallow infection. The infection is not the fistula itself. The infection is deep in the bone.

Once a tooth is infected there is no procedure to "cure" the infection. The tooth has thousands of tiny canals that are not accessible. These canals are not cleaned out during a root canal or apicoectomy which means they will continue to harbor infected nerve material.... leaving the tooth chronically infected. Sooner or later, the infection spreads from the tooth into the bone... resulting in a fistula and/or large swelling. Antibiotics cannot cure the infection either. The most the meds will do is temporarily subside some of the symptoms. But eventually the bacteria becomes resistant to the antibiotics which can make it difficult to eradicate the infection once the tooth is removed..

The infection in the bone causes the bone to deteriorate and there is no rebuilding of bone that is lost to this type of infection. So the sooner the tooth is removed, the more favorable the outcome. The cyst would be removed when the tooth is removed.

I wish I could give you better news but the only way to rid yourself of the infection is to remove the tooth and clean out the infection. It is BEST to have an oral surgeon remove this tooth and not a general dentist because the surgery needs to be thorough and unfortunately many GD's are not thorough enough with their oral surgery.

Please talk with your dentist about this and replacement options asap and get in to see the oral surgeon. I know this is scary, but you will be okay
Let us know how you are doing...

Bryanna

Thank you. That's what I have feared, as I have done some research on fistula's and it is scary. I just hope that if the tooth is removed, they will be able to treat the infection. I know I shouldn't dwell on it, but if the antibiotics don't treat the infection after the tooth is removed...then what happens?

Thank you and I will be talking to the dentist on Tuesday and looking for an oral surgeon as well.

Hi bubble,

The source of the infection is the tooth. During the extraction of the tooth, the oral surgeon will also remove the cyst and all necrotic tissue and bone associated with the infection. Most likely you will then be put on an antibiotic to help kill off any residual bacteria. The key here is to get it done asap.

Please try not to be scared.... you will be okay.
Please think twice if your dentist tries to sell you on waiting, re treatment, or an apicoectomy. None of those options are wise or worth the effort.

Check back with us.. ok

Bryanna

Will do! Thank you so much!!!

Well, the dentist said she would be concerned if I didn't have the fistula, that the bacteria would have nowhere to go and would be sitting up there, possibly causing a systemic response. She prescribed me Flagyl as she said it should settle down with that. She looked at the xrays again and they looked fine.

However; the bump hasn't refilled back up since Monday night(fingers crossed) and I don't plan on taking the Flagyl. I have been having massive stomach pain and black stool that I just came back from the Dr's for and she said it could have been due to the clindamycin, that I took my last does of last Thursday. She said to let my dentist know that I cannot take anymore antibiotics at this time.

Should the bump (fistula) come back, I will have to get another opinion with an oral surgeon. I do not like the idea of taking all of these antibiotics....

I had a root canal,post and new crown on the tooth between the eye tooth and the front tooth on May 15th.
Two days ago it began to get sore and I remembered the dentist telling me that it will take awhile to "settle in". I just completed the WORST night of my life as the pain was unbelievable so of course NO SLEEP.
Yesterday I made an appointment for 10:30 this morning and the first time in my life I CAN'T WAIT TO GO TO THE DENTIST!
No apparent swelling,no reaction to hot/cold.........just by touch.
I was online a good part of the evening looking at home remedies.
Warm salt water with a swab gently around the area. NOPE
2 aspirin every 2 hours instead of 4 hours NOPE
One Advil every two hours,then went to two every two hours NOPE
Finally....ONE Advil with a little bourbon ,keeping the bourbon against the roof of my mouth>>>>>>instant relief. Go figure.
I have already had 5 Advil in 12 hours, so that's it.
Does this sound as if it could be a fistula?

Hi Mylilelar,

An oral fistula from a tooth infection is visible on the gum above the tooth. It looks like a pimple. Do you have that? This is one of the tell tale signs that the infection has spread from the tooth into the jawbone. But it does not always occur even when the infection has spread.

It is not surprising that this tooth is hurting you. Most people are under the impression that once a tooth is root canaled it is healthy again. However, this could not be farther from the truth. Root canaled teeth will always harbor infected nerve material because it is not possible to remove all of it from the microscopic canals. Root canal therapy is done so a person can keep their tooth for an undetermined amount of time. But the procedure does not cure the infection and the tooth eventually needs to be removed. Placing a post inside of a tooth is done to give the tooth retention as in make it more of a solid piece. However, teeth are not meant to be so rigid so the post actually causes various fractures to occur leading to further inflammation and infection within the tooth. All of this bacteria and inflammation spreads from the tooth, into the periodontal ligament that holds the tooth in the bone and then eventually into the bone itself. Unfortunately, this is the eventual path of root canaled teeth.

The only way to cure the problem and the infection is to remove the tooth. A re treatment with another root canal or a surgical root canal called an apicoectomy will not alter the infection status inside of the tooth. The path of deterioration remains the same.

I'm sorry to inform you of this now that you have already gone through the procedures. If your dentists didn't inform you prior, then perhaps they should have as you have the right to be properly informed.

Please check back with us ok...
Bryanna

I experienced the same pain several years ago however mine was caused by a very deep filling. The dentist said the same "wait for a few days and it would go away". I remember eating 2-3 pieces of advil everyday for 2 week straight and pain disappeared. I thought the problem was gone but after 4-5 months but a fistula grew on my gum. It would come and go every 5 months. It's been 2-3 years so far.

All I know is that if a root canal procedure is successful, you should not experience any pain afterwards (from my experience as a patient).

I finally made up my decision and my oral maxillofacial suregon will extract/clean bone for me next month.

You should talk to your dentist, endodontist, or oral maxillofacial suregon.