So many things wrong – where do I start? Find another dentist!

Dr. Hall,
I had a toothache.. Went to the dentist… He said that my filling in my 2nd to last molar is cracked… he also said the last molar needed to be fixed. So they did a deep cleaning… Drilled out the old fillings and capped both teeth with a single temporary cap… The next night I was in sooo much pain and my face swelled up… My throat and under my tongue was swollen… They put me on pain killers and antibiotics… After a week the told me that the tooth 2nd to last tooth died and it needed to be pulled… So they pulled it… this was all done on 9/18/10… But some friends told me that the dentist should have lanced my gums to let the infection drain… I’m still on pain killers and antibiotics.. There are still some swelling under and on my jaw on my throat and under my tongue… So what should I do???? I don’t want to be hospitalized for this or die after everything I have been reading… Can you please inform me of what to to????
– Joyce from California

Joyce,
Either I’m not getting the full story or there is something wrong with your dental care. I’ve got a lot of questions about what was done for you.

But first, pulling the infected tooth without lancing the gums is usually okay. The idea is to get the infection to drain, and with the tooth removed, the infection will usually drain just fine through the empty socket. But since you have swelling in your throat, hopefully you are still taking the antibiotics. If you’re not on antibiotics, I would find an excellent dentist and get another prescription.

But the way you’re telling about what happened in your dental care makes it sound like other parts of your treatment weren’t done right.

First, if you had a toothache and then putting the temporary cap or crown on made the tooth start to hurt as much as you’re saying, that means that this tooth was already infected before anything was done. I’m not sure why your dentist couldn’t tell that. It appears that the tooth was already abscessed, and that should have been visible on the x-ray that they hopefully took.

Second, I question doing the deep cleaning and fixing the teeth at the same time, as a treatment for your toothache. What was going on here? Couldn’t the dentist figure out what was the cause of the pain – is that why you got this scatter-gun-style treatment of trying everything? Was he or she hoping that one of the treatments would work? Usually when there is a toothache, you do a careful diagnosis and figure out the cause of the pain, and then get you out of pain. Deep cleaning is a great treatment for gum disease, but it carries a risk of causing an infection to flare up temporarily.

And I don’t understand why you were on antibiotics for a week before the dentist could tell that the tooth had died. That doesn’t make sense to me.

And you didn’t say anything about any suggestion the dentist made about saving this tooth. The tooth is dead so you have to extract it? Am I just being given a shortened version of this story? There are options that should have been mentioned to you.

If all of this was done and I’m just missing those parts of the story, then I would go back to this dentist and make sure that you are being given an antibiotic that is actually effective against this particular infection. If I am hearing this story right, then I wouldn’t have confidence that this dentist would give you the right prescription. I would recommend you find another dentist to get you the right prescription for the right antibiotic and get you healed.

Dr. Hall