I had a root canal performed more than a year a half ago. At that time, the endodontist performing the procedure said there were C-shaped roots and she ‘hoped’ it worked. I was given the standard antibiotic regimen, which I followed. I was told to follow up with my regular dentist. About six weeks later I had a routine cleaning and mentioned to the hygienist I still had the same pain (referred to the tooth in front of the root canal treated tooth). The dentist was not in the office that day, she said she would have him call me after he looked at the x-ray. I never heard back from the dentist, so I assumed all was well. In December 2015, I saw my dentist for a routine cleaning. I reported I still felt the root canal was less than successful. The problem tooth was x-rayed again and showed signs of infection. I was told there was a problem and I should call the endodontist for re-evaluation. Due to holiday scheduling difficulties, the endodontist’s office prescribed Penicillin tablets and scheduled an appointment for later in in the month. I ended up having the tooth pulled on January 8, 2016 by an oral-maxillofacial surgeon. Since then I have had improvement of a myriad of symptoms: sinus symptoms and pain, facial pain, headache, ear pain. At this writing, I continue to have pain in my jaw directly under where the tooth was extracted. While the tooth socket has healed well and many symptoms have improved, I am concerned there may be simmering infection in the jaw bone. Is this possible? How best do I proceed? My faith in my regular dentist has, understandably, been shaken. The dentist who pulled the tooth did not schedule a follow-up appointment. Your opinion would be most appreciated. Thank you.
– Kellie from Missouri
It’s quite rare to have a lingering infection in the bone after the extraction of a tooth. The open socket left after the extraction leaves a clear path for drainage and your body, in that case, has no trouble getting rid of the infection. Where you can occasionally get a post operative infection is in the case of a surgical extraction, particularly if the tooth is fully impacted, and the tissue is sutured closed over the extraction site. And from your description of your symptoms, it sounds like your jaw healed normally.
If There Is a Post-Operative Infection
Nevertheless, there are some cases where a stubborn infection can linger and it can require a strong dose of post-operative antibiotics to be completely rid of the infection. I would go back to the oral surgeon for an evaluation.
If that is the case, I would not go back to the penicillin, since you apparently took that over an extended period already. In the rare possibility that you have a lingering infection, that infection is probably penicillin-resistant. I would go to a strong antibiotic like clindamycin in a situation like that.
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Hi Dr. Hall,
So I had my root canal done a few years ago (3 or so) and just started hurting hard a week and a half ago. I saw a dentist on Tuesday last week, who saw infection on an x-ray and did root canal re-treatment and sent me home with Penicillin 500mg and Vicodin. Pain wasn’t going away after these meds so I was using 400mg ibuprofen too to get a minor relief until Saturday when I did get an hour or two no pain but everything still highly sensitive. And pain keeps coming back hard! Sleepless nights all this time!
Sunday to Tuesday it kept hurting. I feel pressure in my jaw and my tooth is kinda hurting, numb pain, constant feeling that I am trying to ignore most of the day. Not to mention headaches during the whole week and also earache Saturday thru Monday!
I saw the same dentist again to consult, and he said that some people have a longer recovery and since pain is less – it is going to be better. And if still hurts after two weeks, we can do another dose of antibiotics. I am still up at night (it’s the 9th night since he did re-treatment!!!) and taking 400mg ibuprofen and waiting for pain to stop!
I want to know is it really that my course of recovery is so long or is something else? Thanks much!!!
– Kate from New York
I think you should see a root canal specialist. This infection should be resolving by now if the penicillin were working. I have a couple of points for you.
When you have a root canal that fails, generally a root canal re-treatment will be successful somewhere between half the time and three quarters of the time. So there is a reasonable chance that this root canal re-treatment won’t be successful.
Also, penicillin would not generally be the first choice of antibiotic for a root canal infection, especially for a situation of root canal failure, so I question your dentist’s judgment on that. And I question his judgment further if he hasn’t offered to change the antibiotic when this has been going on for a week. Penicillin resistance of infections is very common. He should have switched you to clindamycin or another strong antibiotic when you had gone a few days and weren’t seeing any significant improvement.
Also, if I am understanding what you are saying, the pain did get better but then got worse again. That’s a particularly bad sign. Clearly this isn’t working.
Ask him for a referral to a root canal specialist (endodontist), and if you get any delays, find one on your own.
– Dr. Hall
Response from Kate:
Thanks so much! I didn’t have anyone to tell me that this is not normal or that meds he gave don’t work. I really knew that something is wrong and all he said was to wait for 14 days! horrible.
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