I've read some of the informative posts on here about problems associated with root canals and thought I would share my story to see if anyone has advice for me.

I started with ear and jaw pain three months ago. Eventually, the dentist put me on antibiotics and the pain went away and I scheduled a root canal. I had the root canal (number 2 tooth) and the endo said it was full of infection. I finished the antibiotics after the root canal and the pain came back.

So the dentist recommended a root canal on number 3 tooth that was showing some bite pain. The endo said that tooth was inflamed but didn't see any infection. Once again, I finished the antibiotics and the pain came back. The endo retreated #2 tooth and same story: as soon as I finished antibiotics, the pain came back.

The endo wanted me to have surgery to clean out the roots, but I opted to have the tooth pulled. (Of course, I got a dry socket as all that could go wrong went wrong.) It's now been two weeks since the extraction. The dry socket has gone away. I finished antibiotics two days ago and this morning woke up to jaw pain once again. #3 tooth feels a little sensitive.

I'm kind of at the end of my dental rope. I called the dentist this morning and he said that I either need to see a neurologist or go for a CT scan to determine what is causing the pain. I think, hello? It's some infection, or it wouldn't go away on antibiotics again.

Any advice will be greatly appreciated!!

Hi ereiam,

I am in the dental field and can offer you some information here.

A few things you should be aware of which will make more sense of what is going on.....

First, your dental situation is seen practically every single day in most dental offices. Dentists always seem "puzzled" with these cases as if they didn't know a thing about the transmission of bacteria from one tooth to another.

Second, when a dentist (including an endodontist) recommends a root canal he/she should inform the patient that the procedure is not going to cure the infection as there is no access to the tiny canals that will continue to harbor infected bacteria. This bacteria will eventually spread through the tooth, through the periodontal ligament and into the jaw bone. The antibiotic also does not kill the infection inside of these canals nor does it prevent the spread of the bacteria. The medication temporarily subsides the inflammation which can temporarily subside the symptoms. Therefore the patient should be informed that the root canal is done in an attempt to "retain" the tooth for an undetermined amount of time... not "cure" or make it healthy again.

Third, many dental infections have vague symptoms at the onset or symptoms elsewhere in the face, head, neck, ears, sinus.... etc. Most of the time the infection inside of a tooth has been brewing for weeks, months or even years before it is diagnosed.

Fourth, depending on the duration of time between the onset of the infection and the diagnosis, the bacteria may already be spreading to the adjacent teeth or beyond.

Fifth, the surgery prescribed by your endodontist to "clean out the roots" is called an apicoectomy. I have no doubt his description was as you have stated. However, this procedure is a painful and expensive surgical root canal and those tiny canals that I mentioned earlier.... unaccessible. The end result of an apico is more inflammation, more trauma to the tooth and jaw bone, spread of bacteria and the surgical access hole made in the bone is usually plugged up with a mercury filling material. There are many dentists who feel this procedure is barbaric, permanently detrimental to the health of the jaw bone and do not recommend them.

Six, it is not unusual for someone to have pain in their ear or face and have one tooth .... then another tooth... then another tooth root canaled. Many times the initial infection began with one tooth but the diagnosis came after the bacteria had already spread to the adjacent teeth and beyond.

Seven, very often (either during) or shortly thereafter a badly infected tooth is root canaled a chain of events occurs (referred to as inflammation) causing the adjacent teeth or the ear, the face to become inflamed and symptomatic with pain. When this happens the dentist tends to recommend more root canals. If the patient is reluctant to do that then the dentist feels he has done his job in tooth carpentry and sends the patient onto their physician and/or neurologist.

Eight, whenever a tooth is extracted, especially one that has been root canaled and/or has severe infection, it is imperative that the oral surgeon remove the entire tooth, the periodontal ligament and all of the diseased bone that they can scrape away. Any residual disease left in the bone has the potential to become another severe infection.

Nine, a dry socket occurs when either the blood clot didn't form properly OR there was residual bacteria still left in the jaw bone. Sometimes the bacteria is minimal and the body will take care of it. Other times there will be symptoms of a phantom tooth ache or pain in the bone or in an adjacent tooth as if there was another tooth problem. A "dental" CT scan done in slices may show if there is an ongoing infection in the bone and also if tooth #3 is infected.

A side note regarding #3...... the inflammation your endo spoke about can be an early sign of an infection brewing from the bacteria associated with tooth #2. If there is no radio-graphic pathology, no swelling, pus or throbbing pain associated with tooth #3...if the sensitivity is to cold temperature and/or chewing, then it is wise for your dentist to make sure that the tooth has no decay, that there is no periodontal problem, that the existing filling or crown on that tooth fits well with no open margins and the tooth should be checked for signs of a fracture. If all of that is negative, then it is best to avoid cold temperatures and eating on that tooth until the symptoms subside. But if there are any visible or radio-graphic signs that this tooth is infected, you are going to run into the same issues that you had with tooth #2 and quite possibly tooth #4. So think twice about retaining tooth #3 if it is infected.

It is never healthy to retain an infected tooth. Every dentist in the world has been taught that fact but very few will inform their patient of that. Some dentists are reluctant to be informative because the procedure is very profitable ... others do not want to be ostracized by their peers for thinking against them ... and others find it difficult to tell a patient that their best option is to remove their diseased tooth. I believe people have the right to be informed of these facts so that they can decide what they feel is in their own best interest.

I'm sorry to deliver this "late" information to you. I hope it helps you to sort through your situation so you can proceed with a direction that is most comfortable for you. Perhaps the dental scan is the way to go... that is up to you.

Bryanna

Thanks, Bryanna. I have another question now.

The throbbing jaw pain that I am having could be a jaw infection rather than infection in tooth #3? Is the CT scan the only way to figure this out?

I found a biological dentist not too far from where I live and I think I am going to make an appointment.

Hi ereiam,

You are welcome!

Yes, the jaw pain could be due to infection separate from tooth #3. Any scan that you have done needs to specifically be a "dental" scan. Make sure
who ever writes the script is explicit with what they want done so the tech performs the proper test.

Yes, consulting with a biological dentist is a good idea. It is wise to have ALL of your x-rays emailed to him just prior to your appointment. Hopefully the xrays are digital as they are the most diagnostic when transferring. If he feels that you need additional xrays, please consider letting him do that as it may be his way of saying the ones that were sent are not of diagnostic quality. I'm telling you this because unfortunately some dental offices are not that fussy about the quality of their xrays and sometimes another office will try to work with them to avoid giving a negative impression of that first office. Stupid, I know. But just to be clear it is never a good idea to make a diagnosis off of xrays that are not of diagnostic quality.

I would suggest that when you talk with this dentist you inform him that you have done your research and you are aware of the residual bacteria harboring in root canaled teeth inside of the dentin tubules... other names for those tubules are accessory canals or microscopic canals. This will hopefully open up a straight forward conversation between the both of you as he will feel he can speak to you freely about this issue.

Let me know how it goes.

Bryanna

Hi Bryanna,

I had a root canal done on my right lower molar #30 about a year ago by this endodontist and ever since the root canal, I was having sensitivity to hot and cold and this loose and wiggly feeling of my permanent crown. So this year about a week ago, I went to see another endodontist who performed X rays and CT scans and told me that there was a missing root that the first endodontist has missed and therefore, now I had an abscess and I needed a retreatment. I agreed to a retreatment since he was a good reputation and I trusted him. But it's been a week since the retreatment and even though the sensitivity is gone, the loose and wiggly feeling of my permanent crown still persists and I can't chew anything on that right side because it hurts to bite between that tooth #30 and the one in front of it. I've almost finished my 7 days of Amoxicillin and Ibuprofen and the pain is not any better. When I went to see my general dentist on Monday for a restorative work, she told me that I might need an extraction because there may have been a fracture of that tooth because the second endodontist had to drill through my tooth to get to that "missing" canal. Before I go on with this next procedure, I wanted to hear your opinion. I've spent a lot of money on this one tooth and I'm very sick and tired of this.

Thanks for your help. I'm attaching the X rays of pre and post retreatment of the tooth.

-Kris

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I'm still having a lot of pain with the tooth and just wanted to know what I should do at this point. Thank you!!