Dr. Hall,
I had a root canal on Friday. I was told that there was a definite infection and that the tissue in the molar that was infected. The doctor closed the root canal and left a temporary filling. He also gave me penicillin and told me to take 800 mg of Motrin. On Sat. eve there was a lot of swelling and tremendous pain. I called the service on Sunday morning and the antibiotic was switched to clindamycin by the on call endodontist. I saw one of the other endodontists on Monday because of the pain and swelling and he said just to wait as the antibiotic hasn’t had enough time to kick in and to swish warm salt water every half hour to an hour and gave me an Rx for Vicodin. It is now 4:00 am and have taken Vicoden, still taking Motrin but can’t take more for another 2 hrs and am in tremendous pain. What can be done? I think he should have left the molar “open” to let it drain. My left side of my face looks like a chipmunk. I think it needs to be drained, is this still possible? Can the tooth be saved? Should I see an oral surgeon? Thanks.
– Jim from New York
Tuesday
James,
It does sound like this tooth needs to drain. Maybe he finished the root canal and that is why it wouldn’t do any good to open the tooth, because the roots are now sealed.
Post-operative flare-ups with root canal treatments not typical but not rare either. It’s no reason to give up on a tooth. You just have to get through the root canal. I’m guessing the tissue in your tooth was dead and that the infection had already begun to spread to the bone. In the process of cleaning the infection out of your tooth, some of it is unavoidably pushed up through the end of the root, and sometimes that will cause a flare-up like you have had. In retrospect, it would have been good to have left everything open and sealed the tooth later.
Some endodontists are really tough cookies – not very sympathetic about pain. Did your family dentist send you to this endodontist? If so, I’d call your family dentist for advice, and if you can get an endodontist who is a little more sympathetic. Or you can call the endondontist’s office and tell them that you got an e-mail from a dentist on the Internet that said it sounded like this tooth needs to drain. Swelling usually means something needs to drain.
If the roots are sealed, they can often get you quite a bit of relief by reducing the occlusion on the tooth so you don’t hit it when you close.
Dr. Hall
Dr. Hall,
Thank you for responding so quickly. I went back to my endodontist and told him my concerns. He said it definitely needed drainage. They made the arrangements and I immediately was seen by a team of very good oral surgeons. The put me “out” with versed and something else (because I can’t open my mouth much) and made an incision on both sides of my gums. Added metronidazole to the clindamycin. I slept through the night. Don’t need (as of now) the vicodin and am taking the Motrin 800 4x/day. My cheek is even more swollen but I’m not in as much pain and am constantly rinsing with warm salt water and warm compresses, still hard to open my mouth.
Thanks again for your advice!
– Jim from New York
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.