So this morning I awoke in in excruciating pain realizing I had been clenching my jaw all night I rushed to the bathroom to make sure I hadn't cracked any teeth, and low and behold a month after my root canal treatment there is a large lump on the side of my gum, I had a root canal done on my bottom lower left molar, 2nd to the back. It healed relatively welland I thought I might pull through, but a couple weeks after I was having re occuring pain, I went back to the dentist and he told me my bite must be off so he shaved the tooth down a bit and it helped for about a week, then it sweeled up around the tooth again, I decided I'd try dealing with it since im an OX, and it went away for a couple weeks, then it came back today it's super swollen and a pale yellow in color, im going back tomorrow to get it checked out, im sure he will want to do additional treatment, im just unsure as to what I should do, extract it? Or try to save it? Has anyone had luck with root canals? Thanks I am in need of help, I am 19 and this is really hindering me, I can't do normal things I used to

Sorry you didn't have any response to your problem. What was the outcome of your dental visit?


Gerry

Hi, Elliebeans, and welcome to Neurotalk! Please let us know what happened.

They gave me antibiotics that lasted for about 4 weeks, this have swelling and pain often accompanied by a fitsula. Im almost done my medication then I will be going back, I can't afford an implant or anything, they tell me my only option is to get it re root canaled which I don't want to go through again, it was a really traumatic experience for me that was painful the whole time - im not sure what to do, they say since im only 19 that I should keep my tooth, but they also say if I get it pulled it will set my whole jaw and teeth alignment off balance, stressed and nervous.

Hi Elliebeans,

What is the dental history on this lower left molar? Was it badly decayed? Did it have a filling in it prior to the pain? What was the reason for the pain that led to an infection and the root canal being done?

How is the health of the rest of your teeth? Do have other root canaled or decayed teeth? Do you have any other missing teeth? Do you have your wisdom teeth?

Root canals are not a cure for an infected tooth. The procedure is done to attempt to temporarily retain an unhealthy tooth. Each tooth has many hundreds of microscopic canals that are not accessible which means after the root canal procedure, they will always harbor infected dead nerve tissue. It does not matter how many times the root canal is done to the tooth, these canals are not accessible.

Antibiotics are not given to cure an infected tooth. The medication is given to reduce the infection and inflammation surrounding the infected tooth. However, as long as that infected tooth is present, the infection will be present. In that case, the infection will spread beyond the tooth which could infect the adjacent teeth, the lymphatic system and beyond.

The only current option to attempt to cure the spread of the infection is to remove the source of the infection, which means to extract the tooth. An oral surgeon is the specialist who should do the extraction as this tooth is going to need his expertise. When the tooth is removed, the surgeon is trained to also remove the periodontal ligament and all diseased tissue and bone that is visible to his eye and picked up on the xray. The reason these things need to be done is to reduce the risk of residual infection and post operative complications and promote proper healing. I know this sounds weird but... this debridement step is unfortunately not routinely done. It is important that the patient inform the surgeon that they want a thorough surgical debridement after the tooth is extracted. Keep in mind that a well informed patient is usually one who receives the most thorough treatment.

Regarding the explanation you were given to keep this tooth because removing it will mess up the rest of your teeth. From what you have described regarding the location of this tooth.... there is a possibility that the tooth behind this one will move a bit forward into the empty space where this tooth use to be. It is also possible that the upper tooth above this molar may shift downward but that is unlikely as you have other lower teeth for the upper one to bite against.

When considering the options...... it's important to do a risk vs benefit calculation:

** Do nothing or Re root canal the tooth or have a surgical Root Canal called an Apicoectomy = No positive change as those infected accessory canals keep the tooth infected = Progressive infection to possibly the adjacent teeth and beyond. Eventual extraction of a the long standing infected tooth which could leave little to no viable bone in that area.

** Extraction of the tooth now with thorough surgical debridement = Removal of the source of the infection along with diseased tissue and bone = Offers a higher success rate of complete eradication of the infection compared to retaining the tooth and extracting it at a later date.

The fistula you keep developing is actually an opening into the bone leading directly to the tooth. The infection is so virulent that it has burrowed a hole from the tooth, through the bone and out through the gum tissue. When this tunnel of infection becomes overwhelmed with bacteria, it breaks open on the gum side in an attempt to drain the infection. This infection is draining into your mouth and down into your digestive system. The only cure to the fistula is to remove the source of the infection which is the tooth and for the surgeon to perform a thorough surgical debridement.

I know I have given you a lot of scary information. However, your dentists should have been informing you of all of this prior to the root canal procedure and certainly afterwards when the swelling and fistula developed again.

You need to give serious thought to extracting this tooth after you weight the benefits vs the risks of temporarily retaining it.

I am attaching a diagram of the anatomy of a tooth to show you the size and number of those microscopic accessory canals that will always harbor infected nerve tissue. These canals are noted as Dentin Tubules and are tan colored. Each tan line represents one microscopic canal.

I hope you can get in to see the oral surgeon very soon. The sooner you get this taken care of, the better the outcome will be.

Attached Images

dentin tubules.jpg (84.3 KB, 51 views)

Hello! Thank you and no worries about the scary information, I was prepared for it. Just some questions as to how I go about getting the after care for it, as I can't afford an implant or a bridge really, is it possible for someone like me to get this kind of thing done? Im only 19, living with a couple roommates, I have no steady income. I don't really know what to do anymore about this. The tooth has a large cavity for a long time, then I cracked it so I went to the dentist and got a root canal and filling done, I knew that something was off as I could still FEEL in that tooth after the procedure.. so I was unsure about it all, it almost feels as if things have gotten worse since the initial root canal treatment, im going to have to go back for root canal treatment again soon, as I don't have any other dentist really I can go to. It's my family dentist.