Swelling on gum and burning on cheek, post root canal!
 

Hello,

I had my upper left tooth #26 was root canaled on June 5. I started feeling okay. However, I felt my cheek swollen the next night after RCT, but still I was okay. The next day, I had swelling but it was not so much noticeable and I thought that it could be post-rct so ignored it. I was not able to sleep whole night so I called up my dentist next day and visited him. He told that the swelling is not due to material or filling etc, it is in fact maxillary abcesses, as he found swelling on very top of the gum (probably the place where gum and cheek meet inside). I do not remember if I had burning sensation by then outside of my cheek or not. However, five days later I started feeling burning sensation outside of my cheek, pressure inside or sense of fullness and was using painkillers for this burning. My dentist had prescribed me amoxycilin and flagyl 500 mg each for thrice a day, and while I complained him about burning in cheek, he said that it could be a side affect of flygyl so I stopped taking it. Met him on June 12, and he said that my swelling has considerably reduced and the swelling could be due to toxins production, so my nerve is sending such response to my brain. And he told me that I have "maxillary abcesses".

Now after completing one full and one half round of antibiotics, I still have burning sensation on my cheek, sometimes on nose and sometimes on eye lid top or bottom, on same side of RCT tooth. I am really worried. Been an international student and residing in Canada, I am totally lost. I even do not want to think about trigeminal neurolgia, Please help me out, what I should do now?? At this time i still have swelling on very top of my gum. And it is very hard, not soft kind of thing. While I pressed it, I felt pain inside and outside of my cheek. Does it happen in maxillary abcesses?? I am so worried to think about nerve issues....... I have even read that chances of nerve injury are while working with lower jaw tooth...... I am feeling so much anxiety as well and skin outside of my cheek is burning just like after a wound... Pl help what should I do!

You need to find a oral surgeon today and have the tooth extracted immediately!

Hello cleo,

Yes i have contacted the oral surgeon and asked for appointment, since its saturday so he will get back to me sooner. actually he is most reputed oral surgeon in my area so i want to go to him, rather than other options.

Cleo.... does it indicate that something is wrong with my nerve??? I didnt experience any numbness though. And i am worried about this burning sensations.

Burning is not normal. If i were you i'd call the dentist right now an ask what was used during your root canal to clean out the canals and if you should go to ER or wait for OS you called to direct you. Was an xray taken to prove it wasn't some kind of filling or whatever outside the tooth?

You are right, cleo.

Yes, x-rays were done soon after root canal to check about the filling of root canals, which my dentist says that seemed OK. I recall they use sodium hypochlorite to wash canals, but I am not sure though.

Hi Aslam,

Your symptoms are not unusual pertaining to an abscessed tooth because the infection is not localized to the tooth. Abscesses do not occur overnight, they take time to develop. So as the infection grows, the bacteria proliferates into the surrounding bone and tissue which stimulates the branches of nerves that correlate with the teeth in that quadrant.

The root canal procedure is not a cure for an infected tooth as there is no access to the many hundreds of microscopic canals inside the tooth. These canals will continue to harbor infected nerve tissue irrelevant of what is done to the tooth. A root canal procedure is an attempt to temporarily retain an infected tooth. Sometimes after the rc the initial symptoms of the infection will calm down and sometimes they will get worse. But the tooth remains infected irrelevant of the symptoms.

Antibiotics are not given to cure the tooth infection. They are given to reduce the bacteria and inflammation in the areas surrounding the tooth. Because the tooth is still infected, the antibiotic will not cure the surrounding infection.

The only current procedure to attempt to cure the infection is to remove the source of the infection which is extraction of the entire tooth along with the periodontal ligament and all visibly diseased bone and tissue.

An oral surgeon is the dentist to see for this type of extraction. However, it is important for the patient to inform the oral surgeon that you want him to remove the entire tooth, the periodontal ligament and all diseased tissue and bone. Although all of those things are suppose to be done very thoroughly with every tooth extraction to help prevent proliferation of infection and post operative complications, they unfortunately are often not done. But a well informed patient who makes that request often receives a thorough surgery.

In the meantime before you see the surgeon, salt water rinsing 3 times a day will help reduce some swelling. Avoid mouthwash as it is too irritating to the oral tissue and can exacerbate the symptoms. Drink several glasses of water during the day to stay well hydrated and help remove some toxins from the infection.

I am going to attach a diagram of the anatomy of a tooth to give you a visual of the size and number of accessory canals in every tooth that are inaccessible and harbor infected nerve tissue. They are called Dentin Tubules and each tan colored line represents each tiny canal.

The soonest you can get in to the oral surgeon the better. He should also take his own radio-graph. Please let us know how you're doing.