Q. I have had a root canal done on main chewing tooth on my bottom row of teeth. It has been a few weeks since my dentist filled up the tooth. My gums have now gotten puffy and sore under the tooth that was worked on for many visits. Do you think that means the root canal didn’t take? Has it become an abscess?
Your dentist should consider referring you to an endodontist or root canal specialist, for a second opinion. When root canals do not respond and continue to weep fluid or swell, there is a possibility of an existing cyst or a fracture in the treated tooth. You cannot continue to nurse an infection but should allow review as soon as possible. Marianne W. Schaefer, D.D.S
Q. I had a root canal some time ago and a few months ago an x-ray showed what looked like a small abscess or something there. My new dentist said it could be developing or healing. In an x-ray yesterday the x-ray was the same. My dentist then said that the bone might just never have healed after the abscess that necessitated the root canal, and she said she’d probably in time need to go in there through the underside of the jaw and irritate the area to try to cause some re-growth. Obviously, I’d prefer to avoid that contingency! My dentist suggested that bone re-growth might be helped by comfrey but I’ve heard it’s not safe. Is it safe? And if not, are there any other measures I could take to try to encourage the bone re-growth healing so as to avoid the procedure?
At this point, I would like to suggest that you ask your dentist to send you and all the available x-rays to an endodontist for a second opinion. An endodontist is a root canal specialist and they can help you and your doctor to accurately determine whether or not there has been any measure of re-growth. If a cyst is halting the healing process, the endodontist can easily manipulate the removal of this tissue to hasten the healing process through a procedure called an “apicoectomy”:/services-provided/patient-education/#endodontics. Marianne W. Schaefer, D.D.S
Q. I have been told by an endodontist that he may not be able to do a root canal on a first molar because of calcification that formed during the time the tooth was crowned (12 years ago). I don’t have any pain or an abscess and the x-ray does not show decay. If he can’t do the root canal he will put the temporary crown back on and I will have to have the tooth extracted by another dentist. Are there new procedures, or special instruments that would allow an endodontist to open even calcified or narrowed canals? In my professional life I can’t afford to be without a tooth near the front of my mouth, but I also can’t afford the replacement options. Any alternatives that you can suggest?
Correct me if I’m wrong, but did you not just tell me that your tooth, though badly calcified and endodontically untreatable is currently asymptomatic (without pain)? If this were true, what would be the harm in inquiring whether the tooth can remain untreated but with a permanent crown? The only risk you might be accepting would be the loss of the money involved in crowning the tooth should you eventually lose it. If the endodontist was unable to open your canals I am sure you would not be able to find another dentist or a product that would reverse the situation. Please ask your dentist if one additional alternative to your treatment plan might be to retain this tooth as long as you can. Marianne W. Schaefer, D.D.S
Q. I have been to a general dentist 12 times for one bicuspid root canal. After the root canal, I was given a 4 day supply of penicillin to combat possible infection. Shortly after the procedure, I developed above the tooth a swelling that was tender to the touch. I have since been put back on penicillin for a 24 day period. The swelling did subside somewhat; however, there was still a bit of swelling (it is kind of hard) and tenderness. I was then put on “chodamycin” (sp?) for two 4 day periods and still the lump and tenderness persists. (Never mind the terrible diarrhea it gave me.) Am I battling an infection? Could I have other damage? Am I in danger of losing the tooth? Could I possibly be endangering the rest of the teeth? I am supposed to go back this Friday for another visit. Please help! Thanks.
Sorry for the delay in correspondence. You may have already attended to this problem. I was going to suggest that you allow your dentist to refer you to an endodontist (root canal specialist). It is likely that the tooth has an irreparable fracture or a non-healing cyst at its apex. An extraction might be in your future, please do get a second opinion. Marianne W. Schaefer, D.D.S
Q. I came from the dentist today and she did an “emergency pulpotomy” What did she do to my tooth?
I assumed that your dentist performed a pulpectomy. A pulpectomy is basically a procedure in which the nerve or "pulp’ of a tooth is mummified. The agent or agents that are placed into the canal space are also anti-bacterial agents and help to offset the chance of abscess. Ultimately, the patients must proceed by either choosing to root canal the tooth or extract it. Most dentists will inform their patient that while they are unlikely to experience pain for a period of time, not to forget to make more concrete decisions about the treatment best suited for this tooth.
Q. I had a root canal done about 3 years ago. Two days ago I started suffering from immense pain throughout my lower jaw all the way to my ear. I called my dentist and he wasn’t there but left the name of another dentist for emergencies. I went to him and he said that the root canal has to be re-done and prescribed “Tylenol” w/codeine #3 and penicillin. I went to the dentist who had done the root canal and he is in the process of re-doing it. My question is this: is it normal that a root canal has to be re-done after only three years? And what would cause this?
Dentists do not plan to redo their dental work only years later. If the original root canal had to be re-worked, a variety of reasons could have necessitated this. There could have been unseen canals that remained unfilled. There could have been excess material extruding from the original fill. A cyst could have formed. A fracture could have occurred. These are just a few of the many possibilities. If you like your practitioner please ask them to discuss the reason that they think this particular root canal did not succeed.
Marianne W. Schaefer, D.D.S
Q. I am about to have a root canal. This is my first one and I am sure that the endodontist is extremely capable, and that is just an every day procedure for him, however, I am very nervous. My biggest concern is that any time I have had any procedure that included numbing the area, I always end up feeling it because I tend to metabolize the anesthetic very quickly and more is injected which never seems to help, it only leaves my jaw very sore afterwards. I explain this to every dentist and specialist I have seen, but they all seem to think their methods are different and that I will not experience any discomfort. Any suggestions would be helpful at this point. Thank you for your time.
You are correct to be concerned. A tooth with a restoration that is high can become irritated to the point that the resultant damage to the nerve tissue is irreversible, sometimes requiring a root canal to bring peace to the patient. I hate to use a pun but I think that you should “bite the bullet” and return to your dentist who sounds genuine in his concern. Please pursue this with the original treater if you choose, with a new dentist who might have a fresh outlook on the case. Marianne W. Schaefer, D.D.S.
Q. I am confused. My former dentist would have me get a root canal if I had decay under a crown. My new dentist wants me to have a new crown instead of a root canal.
It sounds as if your new dentist is taking a more conservative approach to prescribing your care. Either way, the dentist should warn you that the necessity for a root canal couldn’t be determined 100% prior to the beginning of the dental work. Sometimes, things that would appear to be simple have a way of cannonballing into much more. Marianne W. Schaefer, D.D.S.
Q. What is this? I wake up, early in the morning with a low-voltage, high-current kind of increasing pain in the front tooth. I know that if I just lift my head onto the pillow, the pain disappears leaving just an afterglow of temperature sensitivity in the tooth. The pain normally only comes when my body is horizontal, and my head is lifted to the right. Lifting the head onto the pillow also changes the curvature of the neck. X-ray is normal, tooth should be fine. What is wrong?
My experience with this question, which others have actually asked, the sensation you are experiencing is due to an increase in the blood pressure to your head and neck. Somehow by standing upright patients will experience a cessation or decrease in the symptoms they have been experiencing upon reclining. You may want to confer with an endodontist (root canal specialist) and see if indeed the nerve of the tooth is hyperemic. Good luck, Marianne W. Schaefer, D.D.S.