I was hoping someone on here would be able to help me.

I had a root canal 3+ years ago.
I have some sensitivities in my root canal lately (past 6 months) where it hurts drinking hot or cold. The pain is bearable though it fades shortly after.

The doctor has said he can see at the bottom of my tooth that an xray shows a slight infection. I have little to no symptoms of the infection - its barely painful and no other symptoms besides that. Am I right in thinking that every root canal tooth basically has an infection and that it is just a matter of time or waiting to see if it spreads further.

Problem is I am going away for a 3 week holiday abroad (in 2.5 weeks) and for it to suddenly become infected would be disasterous. Would my options be pull the tooth? Or if i am on holiday for 3 weeks and this isnt possible at the time to just continue taking amoxicillan for 3 weeks and wait till I get back from Holiday to discuss pulling the tooth options?

I am slightly freaking out that it will become infected before/on holiday which means constant taking of antibiotics for 6 weeks. Is that even possible~? Will antibiotics alone mean the infection will go away or will just be treated until a further solution is available?

HELP, VERY CONFUSED AND WORRIED.

Hi erinbard,

You are correct in that every root canaled tooth has some degree of a infection percolating inside of the tooth. There are several reasons why this occurs but the easiest to understand has to do with the inability to remove all of the nerve tissue from inside of the tooth. The only canals in the tooth that can be debrided of infected nerve tissue are those that are visible and large enough to get into. This leaves the microscopic canals untouched. These canals are called dentin tubules and there are many many hundreds of them in every single tooth. They are too tiny and too irregular for instruments, lasers or medications to get inside of them. So the nerve tissue inside of these canals remains there after the rc procedure is done. Nerves require blood to thrive and be healthy. The rc procedure severs the blood vessel that use to supply the tooth with blood. This leaves these nerves trapped inside these spaces without nourishment. The nerves die quickly and inflammation and bacteria take hold of the contents. It is only a matter of time before the contents become infectious, overwhelms the tiny canals and spills out beyond the tooth. That is the infection that is being picked up on the radio-graph. So to be clear, the infection is not just at the end of the tooth in the bone, it is also inside of the tooth in those tiny canals. I will post a diagram of the anatomy of a tooth for you to see what they look like.

Depending on the individual case, some people will have pain with an infected tooth while others do not. It depends on the on the infection and the persons immune system. So pain is not a good indicator of the severity of the problem.

Dentists know about the trapped nerve tissue inside of the dentin tubules but there is nothing they can do to remove it. Some dentists most of whom practice conventional dentistry proclaim without biological evidence that the nerve tissue just dies and the body miraculously takes care of it. Much research and evidence has proven that to be false and even just in common practice it is typical to see time and time again the proliferation of bacteria from inside the tooth spread beyond the tooth into the jaw bone. The consequences of a long term jaw bone infection can be permanent bone loss and sometimes that can lead to a stubborn bone infection called a osteonecrosis and osteomyelitis. Other concerns have to do with systemic (whole body) health as any virulent chronic infection in the mouth can travel to other areas of the body through the vascular system.

The only means of trying to eradicate the infection is to remove the source of the infection and that is the tooth. Irrelevant of what procedure is done to the tooth and/or the bone to lesson the infection the tooth will remain infected. These are the things a dentist should be informing you about so that you can make a decision based on what you believe to be in your best interest. However many dentists, in particular those who still practice conventional dentistry, prefer not to get delve too much into this information because root canals are a big part of their livelihood and they also don't acknowledge the systemic correlation of retaining a moderately infected tooth and how it will affect the rest of the body. It is also never easy to tell someone that the only choices they have is to do a root canal which is essentially keeping an infected tooth for an uncertain amount of time... or extract the tooth which means to remove the problem but then the tooth may need to be replaced.

If you decide to have the tooth remove, it is best to see an oral surgeon for the removal as they are more experienced in removing infected teeth. It is also wise to let the surgeon know that you want a very thorough extraction to be sure that all diseased tissue and bone is removed to help prevent post op complications. I know that sounds silly to have to say that to a dentist but it is better to have your concerns made clear than to make an assumption that someone will just automatically do their best.

I have given you a lot of information that you may or may not have been aware of previously. Don't let is scare you into any decision. You can do your own research on google.... type in Dr Mercola and root canals as a start.

Here is the diagram. The dentin tubules are marked and show as brown lines throughout the dentin of the tooth.

Bryanna

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Thank you for your kind reply. I am slowly accepting pulling the tooth is the best option. But I'd rather wait until im back from my holiday. Is 6 weeks waiting too long? Although having said that ive already been putting it off since April. What is the longest you can be on antibiotics ?

erinbard,

Anytime you take an antibiotic your immune system becomes comprised as the medication kills the healthy bacteria in your intestines. This predisposes the user to various degrees of intestinal upset that can lead to an intestinal infection. Unnecessary use of antibiotics can also cause someone to become resistant to that species of medication. Which means when then happens, if you were to need that particular antibiotic at some other time it may not be effective. So it is not wise to go on an antibiotic unless it is absolutely necessary and it is not wise to stay on the medication any longer than necessary.

Just so the time frame is clear .... The problem with your tooth did not begin when your symptoms began. The problem started the day you had the root canal done as the tooth has been infected since then. It was just asymptomatic until the infection spread beyond the tooth.

I know this is a hard decision to make and the timing is not good as you are going on holiday. If your intention is to have the tooth removed then it may be best to do that asap so that it has some time to heal before you go away. Of course the choice is yours and hopefully all will be fine with whatever you decide to do.

Bryanna

So I think I am finally getting my head around this.

Once you get pain in your tooth and it requires a root canal that is the 1st point of infection. The root canal helps the infection but does not actually get rid of the infection completely. So all teeth that are root canaled are 'infected'. The problem is when the pain re-starts - that means thats the infected tooth has become 'abscessed'?

So a tooth can be infected for years and years and nobody notices? Its just in an x-ray that you notice. It is then basically a wait and see game to see if it develops into an abscess? So effectively If i have no pain but know that it is 'infected' I could be waiting months before it actually 'abscesses?'

erinbard,

I know this information is a lot to take in especially since it is not coming directly from your treating dentist. But if you read through some of the threads on this forum you will notice that the problems people are having with root canaled teeth are very common and fairly similar. Which means dentists see these problems on a daily basis.

I am going to re post your thread and clarify it a bit better for you. I will reply in bold type.

<<Once you get pain in your tooth and it requires a root canal that is the 1st point of infection.>>

NOT EXACTLY. THE TOOTH IS PROBLEMATIC AND LIKELY INFECTED PRIOR TO ANY SYMPTOMS. THE SYMPTOMS OF INFECTION ARE OFTEN DELAYED UNTIL THE INFLAMMATION CAUSES UNDUE PRESSURE INSIDE OF THE TOOTH. DOING THE ROOT CANAL DOES NOT CURE THE INFECTION. IT IS DONE TO ATTEMPT TO TEMPORARILY RETAIN AN UNHEALTHY TOOTH.

<< The root canal helps the infection but does not actually get rid of the infection completely. So all teeth that are root canaled are 'infected'.>>

THE RC AIMS AT REMOVING THE VISIBLE NERVE TISSUE INSIDE THE LARGE VISIBLE CANALS. THE STATUS OF THE INFECTION AND INFLAMMATION MAY BE TEMPORARILY REDUCED. BUT THE INFECTION BREWING INSIDE THE DENTIN TUBULES IS VERY ACTIVE AND EVENTUALLY SPREADS BEYOND THOSE AREAS. THIS RENDERS ALL ROOT CANALED TEETH CHRONICALLY INFECTED.

<<The problem is when the pain re-starts - that means thats the infected tooth has become 'abscessed'? >>

NO. THE PROBLEM IS ONGOING IRRELEVANT OF THE SYMPTOMS. PAIN AFTER A ROOT CANAL PROCEDURE IS A GENERAL INDICATOR THAT THE INFLAMMATION HAS INCREASED AN THERE IS NOW MORE PRESSURE BUILDING UP INSIDE OF THE TOOTH. NOT ALL TEETH WILL ABSCESS.

<<So a tooth can be infected for years and years and nobody notices?>>

CORRECT. OFTEN THERE CAN BE INTERMITTENT OR VAGUE SYMPTOMS WITH EITHER THE INFECTED TOOTH, THE ADJACENT TEETH, THE SINUS, THE JAW, THE EARS, ETC.

<< Its just in an x-ray that you notice.>>

SOMETIMES THE SYMPTOMS ARE NON EXISTENT OR VAGUE BUT THE INFECTION IS PICKED UP ON AN XRAY. THE BACTERIA INSIDE OF THE TOOTH HAS TO BECOME VIRULENT TO BE PICKED UP ON A 2 DIMENSIONAL XRAY. HOWEVER, THE INFECTION IS OFTEN BREWING LONG BEFORE IT APPEARS ON THE XRAY.

<< It is then basically a wait and see game to see if it develops into an abscess?>>

DEPENDS HOW YOU LOOK AT IT. IF YOU UNDERSTAND THAT ALL ROOT CANALED TEETH HAVE SOME DEGREE OF A CHRONIC INFECTION INSIDE OF THEM PRIOR TO OR AT THE ONSET OF THE RC PROCEDURE AND YOU ARE COMFORTABLE WAITING FOR THE INFECTION TO BECOME SEVERE, THEN THAT WOULD BE CONSIDERED A WAIT AND SEE APPROACH. WHICH IS THE APPROACH THAT MANY CONVENTIONAL DENTISTS WILL TAKE. IF YOU ARE NOT AWARE THAT RC TEETH ARE CHRONICALLY INFECTED AND HAVE BEEN TOLD THAT THE RC CURES YOUR TOOTH, THEN YOU WOULD NOT EVEN THINK THE TOOTH WOULD EVER GIVE YOU A PROBLEM AND WOULD BE SURPRISED TO HAVE PAIN IN THAT DEAD TOOTH AT ANY POINT IN TIME. MOST PEOPLE WOULD THEN GAUGE THE SEVERITY OF THE INFECTION BY THE AMOUNT OF PAIN THEY HAVE. WHICH FROM A PATHOLOGICAL VIEW, IS NOT A GOOD INDICATOR OF THE SEVERITY.

<<So effectively If i have no pain but know that it is 'infected' I could be waiting months before it actually 'abscesses?>>

CORRECT. DURING THAT TIME, THE INFECTION BECOMES MORE VIRULENT AND THE CHANCES OF IT SPREADING TO THE JAW BONE, ADJACENT TEETH, THE SINUS (IF AN UPPER TOOTH) AND BEYOND INCREASES. AS DOES THE POSSIBILITY OF PERMANENT BONE LOSS IN THE SURROUNDING AREA OF THE TOOTH.

I know this is not what you want to hear and I am really sorry.
What are your thoughts after you look at the diagram of the anatomy of the tooth showing all the dentin tubules?

Bryanna

Hi Bryanna,

It's me again, Nukuspot.

I cancelled the root canal for #7. I got two ozone injections, one a week, for the last two weeks. I have not seen any improvement of the tooth pain, and my dentist told me this week that he doesn't see the need to have anymore as it doesn't seem to be helping. Most likely (he thinks) the pain is not from anything ozone can fix.

The pain was manageable with positive thinking for awhile, but now it has spread mainly to the back of my tooth, the side of the tongue/palate. It feels like it is burned or on fire. I know it cannot be from an actual burn because I have been putting ice in all my drinks/soup and letting hot food cool to room temperature due to the pain in #7. From the very base where my tooth hits my palate, all the way into my whole right side of my palate is so painful I am finding it hard to now talk or eat. I (gently) touched with the tip of a toothpick, and it seems to be around the back of #7 and the cainine tooth next to it. It feels almost like a splinter is stuck under the gum but nothing is there.

I have had multiple family members look at the area with flashlights and they all say it doesn't look any different than the other side. It's not red or swollen. It feels like it should be bright red and blistered from the pain but it looks normal.

I called my dentist again and asked what I should do. I cannot live like this. He thinks maybe it is from clenching my teeth!? I am not able to wear my upper splint (it is so uncomfortable and it pushes right on #7) so I called the TMJ doctor and left a message to ask if I could try a lower splint. However that process is going to take weeks---with getting the impressions, ordering the splint, adjusting it, etc. And I don't even know if it will work!

When I speak I feel like #7 is hitting the lower teeth. It doesn't make it more painful, it's just weird. Like as if it suddenly grew a little? I am trying not to talk as a result.

My dentist says when I get back from my 2 week trip to see my family he can see if he can adjust my bite on that side. He still thinks that a root canal should be the last resort to stopping the pain and I agree. But I seriously cannot keep going on like this. I am so worried about these next two weeks on my trip.

I am taking the herbal antinflammatories and have doubled my dose of fish oil (which my ND said was the best thing to try to relieve inflammation.)

I thought it was working but it's gotten worse since the last ozone injection. I wonder if the ozone could have caused damage? The dentist said there were no side effects, that the worst thing that could happen was that it just didn't work, and it was good for the body anyway.

If you have any advice for either what might be causing this pain into my palate or any pain relief options, I would greatly appreciate it. I can barely eat or focus on anything that is not the pain.

I am even using sensitive teeth toothpaste (Toms of Maine) which I normally don't use because it has SLS but I am just desperate to try anything even remotely natural at this point.

Hi Nukuspot,

You are not going to see anything visually with tooth #7 unless it develops swelling or a fistula. The problem is inside the tooth.

The symptoms you describe sound like inflamed nerve pain. You have a small area of open canal with nerve tissue in it near the apex of this tooth. The area above the apex with that bump may be where bacteria is draining from the canal inside of the tooth. As I mentioned earlier you can track the (dark) periodontal ligament from the bump on the top of the root down it's right side near the canine. Both xrays of this tooth show a prominence of the periodontal ligament which generally indicates inflammation. The symptom of feeling like the tooth has grown may be another indication of an inflamed ligament because as the ligament swells, it pushes this tooth downward. Also the bone above #7 is darker than normal which could indicate inflammation/bacteria and/or some irregular change in the bone. That splinter sensation you feel is inflammation.

It would not be unusual to feel pain in the palate and near the canine if that is where the bacteria is moving to.

I feel so badly that you are suffering so much with this. I agree that ozone is not going to subside or cure this problem, unfortunately. I think the problem is not new, it's just become symptomatic. You could be clenching or grinding your teeth which will exacerbate the inflammation. But wearing the guard at this stage is going to aggravate it.

I think you know you are getting down to the wire to make a choice between rct and extraction. I know neither is what you want to do but you cannot go on like this much longer. Anything I would suggest to help with the pain would only be minimal help at this point and with no much duration. I would also NOT use any toothpaste with SLS in it because you are prone to mouth ulcers and SLS is a known trigger for those in some people. Just brush with coconut oil and a pinch of baking soda.

Bryanna

I am so sorry to hijack the OPs thread! I thought I had posted this in my own new thread. See what pain can do to the brain? Is there a way my post can be moved so I do not take over this thread?

So I spoke to both my dentist and the holistic dentist who also does oral surgery.

The dentist who would pull it and do the oral surgery says that I should hold on to both this tooth and #11 as long as I can. They both do not have the best bone for an implant. #11 especially because of the prior surgeries, but #7 too because the roots are so blunted it did not stimulate great bone growth. He says that an implant in that space might work---But it might fail either sooner or later and in that case, I am stuck. He says I cannot get a bridge because of the blunted roots next to both of these teeth, and both he and I agree that a removable tooth would be a very poor outcome for a 35 year old, especially with it having to put pressure on the blunted root teeth adjacent.

It is not a great situation. He advised me to not extract unless pathology was shown on the xray. I mentioned the bump on the xray and he said that that did not make him think of infection. He said that he feels it is a thickened periodontal ligament from years of biting on a tooth that is so blunted and cannot take the pressure. He looked at both the recent and the 2011 xray and said that he sees no change so he is not thinking it is a bacterial cause. This is most likely why the ozone did not work, because ozone would have been effective against bacteria but not nerve pain. He said the same as you, inflamed nerve.

Both dentists have advised me to try whatever I can to see if I can get it to calm down (the nerve). If I cannot, the one dentist advised doing the root canal with ozone. He said that he does not usually advise them but it might be the best choice in my situation if I could not live with the tooth anymore. He also said interestingly that since the tooth is so calcified, the issue of dentinal tubules harboring bacteria might not be an issue, because my body has effectively sealed the tubules off.

My general dentist who probably hates root canals as much as you do, has said that he feels that I should try 100% everything I can to settle the nerve. Being that there is no pathology on the xray, I could wait indefinitely and work on it to heal. I leave on my trip with my bottles of antinflammatory supplements in 2 days. I will be gone for 2 weeks. When I get back I have an appointment with him for an occlusal adjustment, he will see if I have any points of heavy contact on that tooth and gently file it down. He seems to think that will help along with getting a lower guard, and not using my upper night guard.

I am happy to have a plan but I am concerned I will not be able to live with the pain this long. I will just have to take one day at a time and see how it goes. The interesting thing was that it was doing a little better the day before my last ozone injection and now it's so bad again especially the burning and gum pain. He says that ozone could not have exacerbated the pain. So I guess it was a coincidence. I can only hope it can get back to that point it was at before the ozone again during my trip. Right now it is about a 5 on a 1-10 pain scale. I think if if gets higher I will have to call it quits with trying to save this tooth. But if I can get it back to even a 4 or a 3, I can live with it for awhile longer.

I am stopping the Toms sensitivity toothpaste and have gone back to my normal toothpaste (Coral White). I will try just coconut oil too.