[ripply]

Hello, I'm new here and could really do with some advice as I'm so worried. I got a root canal done in my upper first molar as a child (21 years ago). Six months ago, it had to be retreated due to infection. The endodontist was very happy with the work and it seemed to settle down. However, recently I got another infection and the pain was worse than ever. It's still bad. I think it might have spread to my ear on that side as the doctor said it's very swollen and I have a constant thumping sound in it. My eye keeps watering also. I'm on antibiotics and they're helping but not getting rid of it fully.

The endodontist offered to do an apiecectomy for free. But I refused as I'm really fed up with this tooth. He did say that if I choose to extract it, it shouldn't cause me any problems with function or eating. So, I'm getting it extracted tomorrow morning.

Have I made the right decision? I feel like such a failure for choosing to extract this tooth but it's like my body is telling me to 'get it out, now'. Also, I'm terrified about getting an apiecectomy. I've never had to get a tooth extracted before and part of me feels like I've let myself down.

Also, I'm going on holiday in two weeks time. Will it still be bleeding and swollen from the extraction?

[Bryanna]

Hi ripply,

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

All root canaled teeth are chronically infected as there is no way to access the tiny canals that harbor dead infected nerve tissue. RC and apicos are an attempt to reduce the inflammation in an infected tooth but neither of them cure the problem. The only way to cure the infection is to remove the source of the infection and that is the tooth.

Do not feel like you are letting yourself down by extracting this sick tooth. You will be doing yourself a huge favor as your immune system has been dealing with this chronic infection since the initial root canal procedure.

It would be wise to have it extracted asap so that in 2 weeks time you are already on the road to healing. If you wait, you could end up with an emergency while on holiday. Antibiotics will temporarily subside the symptoms but they will stop doing that at some point.

Follow your instinct... do your body good... get rid of the infection once and for all!!

Let us know things go.
Bryanna

Originally Posted by ripply

Hello, I'm new here and could really do with some advice as I'm so worried. I got a root canal done in my upper first molar as a child (21 years ago). Six months ago, it had to be retreated due to infection. The endodontist was very happy with the work and it seemed to settle down. However, recently I got another infection and the pain was worse than ever. It's still bad. I think it might have spread to my ear on that side as the doctor said it's very swollen and I have a constant thumping sound in it. My eye keeps watering also. I'm on antibiotics and they're helping but not getting rid of it fully.

The endodontist offered to do an apiecectomy for free. But I refused as I'm really fed up with this tooth. He did say that if I choose to extract it, it shouldn't cause me any problems with function or eating. So, I'm getting it extracted tomorrow morning.

Have I made the right decision? I feel like such a failure for choosing to extract this tooth but it's like my body is telling me to 'get it out, now'. Also, I'm terrified about getting an apiecectomy. I've never had to get a tooth extracted before and part of me feels like I've let myself down.

Also, I'm going on holiday in two weeks time. Will it still be bleeding and swollen from the extraction?

[Kitt]

Welcome ripply.

[ripply]

Hello Kitt!

And thank you Bryanna for your advice. I had no idea that these root canals do not get rid of the infection permanently. I've already scheduled an appointment to have it extracted tomorrow morning. I'm just worrying I'll get a lecture about not going ahead with the apiecectomy. But I don't want to have a source of infection inside me and it does feel like the right decision.

The endodontist did mention that there can be tiny canals that he cannot access but said the apiecectomy would sort it out because they're nearly always in the upper part of the root. But I've had enough stress with this tooth and am beginning to think it could be why my nose always runs, especially on that side. It's scary as I've never had a tooth extracted but it's more scary to think of leaving it in, and making my immune system deal with it.

[Bryanna]

Hi ripply,

The endodontist was correct in that there are <hundreds> of tiny canals however they are located throughout the circumference of the entire tooth, not just at the top.

Every dentist knows that apicoectomies are a failed procedure and they in no way alter the bacteria that resides inside of the tooth. They are done to scrap away the cysts that form in the bone at the root tip. However, the cysts keep growing back because the tooth is infected. Makes sense now??

You will do fine tomorrow. The extraction is easier than the apico. Just be sure to tell the surgeon you want him to debride the bone of all necrotic, diseased tissue. He is suppose to do this automatically but when the patient indicates that they are well informed of this, the surgeon is more likely to be more thorough.

Please give us a shout tomorrow after the appointment. You will be okay.....

Bryanna

Originally Posted by ripply

Hello Kitt!

And thank you Bryanna for your advice. I had no idea that these root canals do not get rid of the infection permanently. I've already scheduled an appointment to have it extracted tomorrow morning. I'm just worrying I'll get a lecture about not going ahead with the apiecectomy. But I don't want to have a source of infection inside me and it does feel like the right decision.

The endodontist did mention that there can be tiny canals that he cannot access but said the apiecectomy would sort it out because they're nearly always in the upper part of the root. But I've had enough stress with this tooth and am beginning to think it could be why my nose always runs, especially on that side. It's scary as I've never had a tooth extracted but it's more scary to think of leaving it in, and making my immune system deal with it.

[ripply]

I'm just back after the extraction, still a bit numb and I've to keep the gauze in for another half hour. Bryanna, you were exactly right about the tiny canals causing more infection. When the dentist took the tooth out, he told me that one of the roots had infection in it and talked to me about how these tiny canals can never be cleaned out fully, which is why I still had infection spreading.

It might sound strange but I actually felt better hearing that he could clearly see infection in it. I don't know if I'm correct or not, but it seems to tell me that the apiecectomy would not have stopped this pain returning, as these tiny canals could be anywhere, since no one can see them. What I don't understand is how the endodontist couldn't see much sign of infection on the X-rays yesterday. He said it only looked mildly inflamed! He couldn't understand why my pain was so bad or why the antibiotics had not cleared it up fully.

As for the extraction today, I found it really awful. It took an hour, there was loads of drilling and he had to crack the tooth into pieces to remove it. I guess these root canals are really like concrete because it didn't want to move. There was no pain though and I'm glad I've finally done it.

[Bryanna]

Hi ripply,

THANK YOU for giving us the update and THANK YOU for confirming the information that I offer here about the infection that resides inside the tiny canals. Most dentists hesitate to inform a patient of that and it makes me hopeful when I hear of one that does!

I understand that it's hard to believe that something could be bad if the bad is not visible to the eye or radio graphically. The example that I give to patients is ..... heart disease, diabetes, high cholesterol are all invisible until there is an obvious symptom or a blood marker shows up abnormal. But until either of those things occur, the "symptoms" are silent or unseen.

For a tooth infection to show up on an x-ray, it has to be either acute from trauma or it has to be brewing for quite awhile.

The apicoectomy procedure does not alter the bacteria inside of the tiny canals. No dental procedure or medicine can alter that bacteria.

The extraction of a root canaled tooth, especially one that has had multiple root canals done and/or an apicoectomy, can be a tedious procedure. The tooth is non vital which makes it very brittle. Due to the spread of bacteria and lack of blood supply, the surrounding bone become ischemic and it too is brittle and unhealthy. So the tooth and the bone tends to break apart during the extraction. Sometimes the tooth becomes ankylosed, fused together, with the bone which means it has to be separated from the bone with the drill.

I am glad that you had no pain during the procedure and hopefully the only thing you will feel post operatively is mild discomfort.

Follow the post op instructions to the "T". Even if you feel fine, follow them anyway. Okay

Check back with soon.....
Bryanna

Originally Posted by ripply

I'm just back after the extraction, still a bit numb and I've to keep the gauze in for another half hour. Bryanna, you were exactly right about the tiny canals causing more infection. When the dentist took the tooth out, he told me that one of the roots had infection in it and talked to me about how these tiny canals can never be cleaned out fully, which is why I still had infection spreading.

It might sound strange but I actually felt better hearing that he could clearly see infection in it. I don't know if I'm correct or not, but it seems to tell me that the apiecectomy would not have stopped this pain returning, as these tiny canals could be anywhere, since no one can see them. What I don't understand is how the endodontist couldn't see much sign of infection on the X-rays yesterday. He said it only looked mildly inflamed! He couldn't understand why my pain was so bad or why the antibiotics had not cleared it up fully.

As for the extraction today, I found it really awful. It took an hour, there was loads of drilling and he had to crack the tooth into pieces to remove it. I guess these root canals are really like concrete because it didn't want to move. There was no pain though and I'm glad I've finally done it.