HI I am hoping for suggestions.

I went to a new dentist for the first time seeing the dentist in a few years. He found 3 cavities and filled them. One of them developed distinctive root-canal-needing pain in the next week. After shaving the filling one day, he went ahead and did part of the root canal the next day to "stop the pain". It worked until about 24 hours later when I started to get a horrid new pain. HE prescribed an antibiotic, had me come in opened up the tooth and refilled it using something for infections and that ended the big pain and the pain went away over then next week. 2 weeks later he finished the root canal (2 weeks ago) again 3 days later i started to get increased pain.I got another Antibiotic and I feel mostly better.

So now I have constant headaches and a stiff feeling in my jaw. I also have a lump like a cyst in my jaw (in front of the spot where the tooth was worked on I think #31). you cant see the lump but I can feel it. I don't think it has grown and may have been there before, but I don't think so. NO pain specific to the tooth. Any thoughts. Is this standard fair? Should I be concerned? I would really appreciate any thoughts!

Add to that a fever 100ish and feeling exhausted. Thanks

I'm sorry to hear what you are going thru. I can't help you but for me personally, I would never have a root canal. And I never have had one. Having said that, I know people who have and apparently did not have any problems. Someone will be along to help.

Hi Oliviasmom,

Root canal therapy is standard of care for a tooth infection. However, the procedure and or the antibiotic cannot "cure" the infection in the tooth it can only remove some of the infected nerve material from the large canals inside the roots of the tooth. What has basically happened is the tiny canals within the tooth called the dentin tubules or accessory canals have not been cleaned out so they still harbor infected nerve material. These tiny canals cannot be accessed with the dental instruments because they are microscopic. They cannot be cleaned out with a laser either because they are very curvy and a laser beam only shoots in a straight direction. The antibiotics cannot cure the infected nerve material because the bacteria is of various strains that are non resistant to most antibiotics. The bacteria would have to be cultured to determine the proper antibiotics and since there is no way to retrieve the bacteria, the antibiotics you are taking are not going to cure that infection. The infection from the tooth (those tiny canals) proliferates (expands) from the tooth into the jawbone. That will cause pain, swelling (or a bump) and fever.

It is never normal to have "horrid" pain from any non surgical dental procedure unless there is a definite problem. Any recurrent pain from a tooth also indicates an ongoing problem usually infection.

Typically, a root canaled tooth will show signs of infection at some time or another. Sometimes, actually quite often, the person does not even know the tooth is infected because the symptoms can occur slowly inside the bone without an obvious swelling. But ALL root canaled teeth harbor infected nerve material and will need to be readdressed at some time.

It would be wise to see your dentist again and have xrays done to see what is happening in the jawbone around #31. If the lump turns out to be related to an infection, then it may be wise to have the tooth removed because it is a constant source of the infection. Any lump in the jawbone, especially near an infected tooth (or a root canaled tooth) should be evaluated by a dentist.

I hope this information is helpful to you. Please let us know how you are doing.

Bryanna

thanks it was helpful.

I went to the dentist and he could not find any dental reason for the pain. HE also indicated he did not feel a lump. (he seemed frustrated by my issues as if I was becoming a difficult patient, I am considering relieving him of the problem i.e. finding someone new) i checked in with my MD because he was concerned it was periotitis (Sp) but did not think so when I saw him. He said to call on monday if the headache was not gone for a CT. the fever is gone and the headache is less. I get small twinges of pain from the jaw so all and all I am feeling okay with the progress.

I have one more question if you have time. I did not like getting a root canal but it was not presented as if I had other options. IF this happens again to another tooth,Is extraction an option in this case? are there other suggestions? Should I request antibiotics in advance? I am not ignoring your comment about culturing. I am a microbiologist, so I recognize the problem misuse, but they seemed to help.(placebo?)

Hi Oliviasmom,

I think it would be a good idea to consult with another dentist. There is no reason why anyone should be annoyed with your concerns. Your MD may have been looking for periodontitis which is a progressive form of gingivitis that leads to loss of teeth and jawbone. This would be very obvious to your dentist upon examination.

Anytime you have a deep cavity into the pulp of the tooth, or an infected or fractured tooth you have the option of extracting it. Depending on the situation and the location of the tooth, you will have replacement options as well. Sometimes the tooth does not need to be replaced at all.

Good that you are a microbiologist....... so you can appreciate how the bacteria can be of numerous species and how it can proliferate to other areas via the tooth to the jawbone. Also you would understand how necrotic bacteria remaining in microscopic places would contribute to a secondary infection. That is exactly what happens in the accessory canals of the root canaled teeth which the immune system continuously tries to deal with. The reason the antibiotics do not cure this type of infection is because the culprit of the infection is the necrotic material located in these canals that cannot be removed. The antibiotics may temporarily subside the inflammation but the necrotic nerve material remains inside those canals. The other issue with root canal therapy is when the instruments are used to remove nerve material from the large canals, some of the nerve get pressed against the inside wall of the canals and that is where it remains. So it too becomes necrotic and infected very quickly.

So even if you took antibiotics at the early stage of an infection in a tooth, it would not make any difference once the nerve material has become involved.

I would rethink that second opinion if the tooth does not calm down completely. I hope I've been of some help to you...... please keep in touch.

Bryanna