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 Thumbnails

 

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.

Ellibeans,

Please re read my previous lengthy reply to you as it will explain why the root canal or another root canal will not solve your problem.

That tooth is going to need to be extracted irrelevant of how many times you have the root canal procedure done. Please go back to my reply and open up the attached diagram to see the many hundreds of microscopic canals that will remain infected as long as the tooth is in your mouth.

Your family dentist can and should offer you a referral to an oral surgeon to have a consultation and extraction of that tooth. He should also reimburse you the money that you paid him for the root canal procedure because the root canal had no positive benefit and the tooth is going to need to be extracted.

#1- It is healthier for you to have this infected tooth extracted, than it is to retain it because the infection is going to erode your jaw bone which is called osteonecrosis, which then leads to a bone infection called osteomyelitits. That type of infection is very painful and very difficult to eradicate. The infection can also easily spread to the adjacent teeth... to your lymphatic system.. and to other vital organs. It is not something to dismiss or just live with.

#2- You do not have to replace that tooth. Your age is a positive factor with extracting this tooth as your bone will fill in a lot thicker and healthier than for someone who is older. It is important to take care of the rest of your teeth, get your cleanings 2 times a year and make sure your oral hygiene is very thorough with brushing and flossing. You will do fine without this tooth.

If your family dentist is insistent on doing another root canal procedure and tries to scare you again into retaining this sick tooth and won't refer you to an oral surgeon.... then you should seriously consider finding an oral surgeon on your own. Another root canal is not in your best interest and he knows that. He should also reimburse your money so that you can use it to pay the oral surgeon to cover the cost or part of the cost to extract the tooth.

Please do not wait to take care of this. A lower molar infection can cause a condition called Ludwig's Angina which is a potentially life threatening cellulitis in which the swelling can close off your airway. Again, not to scare you but to inform you of the seriousness of your infection. Your family dentist should be informing you of this also. This is not something to procrastinate on.

Please, seek a consult with an oral surgeon.
Bryanna

Hi Ellibeans,

First, i didn't have time to read through this whole thread, but since i had a root canal done and my teeth extraction, i thought i give you my two cent.

You should absolutely be seeing an endodontist; you don't want to see a general dentist. Endodontist can really work miracles and fortunately that is what happened to my infected tooth. It's still doing well and it's been three years since i had the surgery.

I had another tooth that a dentist advised to me to pull when i was 15 years old, and another one that never grew in. I had a titanium implant placed and had to pay lots of money to remove it after learning i am allergic to titanium. I than had it replace with a ceramic implant, but the process is horrifying and i still blame my health issue on the implant. Implants are the worse, so I highly recommend you keep working on your infected tooth. It's not as easy as they make it look in animation video. It's all lies. And you will learn quickly that these dentist work together to protect their industry and practices.

I also recommend finding a biological dentist to consult.