[Salsaad]

I got a filling done on sept 16 and it's been a nightmare ever since. I experienced a little bump under the tooth (Bottom molar) 5 days I had the most painful night! Wake up and my entire left side of my face was a balloon! My GP gave me antibiotics which reduced the swelling after a few days. I was no longer in pain when I went to another dentist who told me I needed a root canal. I was fine for about 2 weeks after my antibiotic course when I started to experience a fever and weakness all over my body. I threw up a few times that day too. Next day woke up with swelling again on the left side (same tooth!!!) went back to the gp for more antibiotics. Went to the new dentist again who told my infection as spread and is getting worse and my only option is a root canal or extraction. My issue is this. I have a little pimple like under the tooth and shard like bump further up against the wall of the gum and cheek. I'm in no pain (thank God for that!) but I'm getting married in 2mths and really don't want the bump (it's visible when I talk or yawn etc). What should I do? Should I wait out the 2mths after the wedding and get the root canal, or risk getting it down now and hope it gets rid of the bump and this serve infection that has been there for years apparently?

[Bryanna]

Salsaad,

The bump coming from the gum beneath the root of the tooth is called a Fistula. This is caused by a badly infected tooth. The Fistula is similar to a pimple in that bacteria is trying to find a way to release itself. The fistula is only the head of a passage of infection that has traveled from the tooth, through the bone and out the gum tissue. The fistula is not the actual source of the infection, it is the result of a long standing infection in the tooth.

Antibiotics cannot cure this infection because they cannot reach the infection inside of the tooth. Therefore, it is the infected tooth that is keeping the infection alive. Repeated usage of antibiotics in cases where the source of infection is not eliminated become a more complex problem as the bacteria will become resistant to the antibiotics and they will no longer have a positive affect. Also antibiotics always deplete the intestines of healthy bacteria and with repeated usage the user becomes susceptible to a serious intestinal infection called Clostridium Difficile. If you want to learn about this intestinal infection, please google it.

The choices you have as stated by your dentist are a root canal or an extraction. Here's the difference between those two options:

1) The root canal procedure is not able to remove all of the infected nerve tissue from inside of the tooth. I will attach a diagram of the anatomy of a tooth to show you the many hundreds of microscopic canals that contain nerve tissue but are not accessible during the rc procedure. So basically the rc is done in an attempt to temporarily retain an unhealthy tooth. The Fistula may or may not temporarily subside after a root canal procedure. If it does remain, it will continue to swell and may exude pus. If it subsides, that generally means that the tract of bacteria has just found an alternative passage to drain into. Infected teeth can infect the jaw bone as well as the adjacent teeth.

2) An extraction of the tooth removes the source of the infection. An important issue to discuss with your general dentist is whether or not the tooth needs to be replaced with a dental implant, a permanent bridge or a removable appliance.

I understand that the timing of this is not ideal with the wedding coming up, etc. However, to leave the tooth alone and keep taking antibiotics is truly like playing Russian Roulette. The infection will not go away and your dentist may or may not have told you but an infected lower molar could become an emergency situation due to the confinement of the mandible.

If you choose to have the tooth extracted it is best to not wait and give yourself as many weeks as possible to heal before the wedding. Also it is ideal to have it done by an oral surgeon, rather than a general dentist, as the surgeon is performing these surgeries all day long and has a more thorough knowledge/experience of the procedure. I always recommend that when consulting with the surgeon prior to the extraction that people make it clear that their goal is to be infection and pain free. I know that sounds like a no brainer, but it doesn't hurt to leave them with the impression of what you expect to achieve.

I know this information is a bit scary and difficult to read but I do hope it is helpful to you. Please keep us posted on what you decide and how you are doing.

I will attach the diagram of a tooth showing the microscopic canals called DENTIN TUBULES.