Retreatment of root canal for absess tooth hurting two months later in jaw

[Girlinpain]

I had a retreatment root canal done after the original one was done ten years ago- it became absess. After it was done the infection spread to my whole side of face and couldn’t be drained as it was spread through my face not a single spot. It was severe. Antibiotics cleared it. Clindamycin. The pain persisted though I have discomfort in the jaw spot same area but the tooth does not hurt for pressure nor it isn’t sensitive to hot or cold anymore but my jaw is throbbing - dentist put me on two weeks more antibiotics- swelling is better but pain is still there. Endodontist I called and they said give it another month. They said if not better they will do a procedure to cut root on side of gums but how do they know this will work without a 3D scan to know the problem even and will it work forever or temporarily- should I just extract the tooth and get implant. All three dentist don’t know why it hurts regular X-ray shows fine. Do I live with pain or fear it’s hurting bone. Swelling is down but my pain persists. Please help.

 

[Busybee]

Sorry that you are in so much pain.

Apicoectomy is the last option before they pull the tooth. Getting an implant if you have had a long term infection may not be feasible as there may be bone loss. You may need a bone graft. They do apicoectomy to try to save the tooth as it can work but from what I recall the percentage chance of success is lower than the original root treatment. The procedure also weakens the root.

Which tooth is it? Perhaps you could post your x rays here so that dentists can give you a qualified opinion. In some cases there is no way that any professional will be able to ever understand why you feel pain when there is no obvious sign of residual infection.

It can be very frustrating but diagnostic processes are simply not refined enough. X rays must have seemed like a miracle turning point in dentistry. They are still the main diagnostic tool which is surprising given the myriad of tech developments we have seen since.

 

[Girlinpain]

Sorry that you are in so much pain.

Apicoectomy is the last option before they pull the tooth. Getting an implant if you have had a long term infection may not be feasible as there may be bone loss. You may need a bone graft. They do apicoectomy to try to save the tooth as it can work but from what I recall the percentage chance of success is lower than the original root treatment. The procedure also weakens the root.

Which tooth is it? Perhaps you could post your x rays here so that dentists can give you a qualified opinion. In some cases there is no way that any professional will be able to ever understand why you feel pain when there is no obvious sign of residual infection.

It can be very frustrating but diagnostic processes are simply not refined enough. X rays must have seemed like a miracle turning point in dentistry. They are still the main diagnostic tool which is surprising given the myriad of tech developments we have seen since.

 

[Girlinpain]

Thank you so much for your feedback as I need to make a decision - at this point my mouth two month later after retreatment is throbbing all day and I don’t want to let this go and have infection do damage to my root system. I don’t feel from what I’m hearing to cut the roots has a good chance of success - and I don’t want to cut bone away as I want to be able to have a good success for an implant. I will post my xrays and would appreciate any professional advice I can get please.

 

[Girlinpain]

Thank you so much for your feedback as I need to make a decision - at this point my mouth two month later after retreatment is throbbing all day and I don’t want to let this go and have infection do damage to my root system. I don’t feel from what I’m hearing to cut the roots has a good chance of success - and I don’t want to cut bone away as I want to be able to have a good success for an implant. I will post my xrays and would appreciate any professional advice I can get please.

Thank you so much for your feedback as I need to make a decision - at this point my mouth two month later after retreatment is throbbing all day and I don’t want to let this go and have infection do damage to my root system. I don’t feel from what I’m hearing to cut the roots has a good chance of success - and I don’t want to cut bone away as I want to be able to have a good success for an implant. I will post my xrays above and would appreciate any professional advice I can get please.

 

[Busybee]

It's infection that destroys bone. I don't think they remove bone in an Apicoectomy, It may save the tooth.

By the way, I can't open your attachment but perhaps others can see it.

 

[MattKW]

Can't open attachment. Maybe post it via Imgur.

 

[Girlinpain]

Thank you so much for your feedback as I need to make a decision - at this point my mouth two month later after retreatment is throbbing all day and I don’t want to let this go and have infection do damage to my root syst

Can't open attachment. Maybe post it via Imgur.

It's infection that destroys bone. I don't think they remove bone in an Apicoectomy, It may save the tooth.

By the way, I can't open your attachment but perhaps others can see it.

I’m reading that they do cut the bone to get to the root in an Apicoectomy and also reading the success rate is not great when a retreatment fails. This tooth the inside was squishy he said not solid filled so it seems more compromised to start.

 

[Girlinpain]

Thank you so much for your feedback as I need to make a decision - at this point my mouth two month later after retreatment is throbbing all day and I don’t want to let this go and have infection do damage to my root syst


I’m reading that they do cut the bone to get to the root in an Apicoectomy and also reading the success rate is not great when a retreatment fails. This tooth the inside was squishy he said not solid filled so it seems more compromised to start.

Also it’s tooth 30 bottom molar second from back for me as I had wisdom removed and one other molar removed with braces.

 

[MattKW]

Yes, bone is removed in order to do an apicocectomy, but that is not the real issue that determines success or failure. The surgeon must be able to get to the tips of all roots and either simply clean out, or trim off the tips, or trim off tips and seal. Lower 1st molars are very difficult to do successfully as they can have up to 4 roots. Personally, I wouldn't advise you to attempt it. Success rates are poor, and it's rather an aggressive technique if you don't know the exact nature of the problem. I certainly wouldn't even think of letting an oral surgeon do it; I'd want a good endodontist.

 

[Girlinpain]

Yes, bone is removed in order to do an apicocectomy, but that is not the real issue that determines success or failure. The surgeon must be able to get to the tips of all roots and either simply clean out, or trim off the tips, or trim off tips and seal. Lower 1st molars are very difficult to do successfully as they can have up to 4 roots. Personally, I wouldn't advise you to attempt it. Success rates are poor, and it's rather an aggressive technique if you don't know the exact nature of the problem. I certainly wouldn't even think of letting an oral surgeon do it; I'd want a good endodontist.

Thank you for taking the time to give your expert advice- I feel more confident now following up with my other periodontist to now extract the tooth and get an implant. My regular dentist siding with you. The Endodontist was terrible as he wasn’t evaluating the situation or treating the infection or following up with any scans just wants to do the Apicoectomy as a next solution and I’m relieved to get your honest feedback - as much as I hate to extract the tooth this seems the wise route to take and go for implant -thank you

 

[Girlinpain]

Yes, bone is removed in order to do an apicocectomy, but that is not the real issue that determines success or failure. The surgeon must be able to get to the tips of all roots and either simply clean out, or trim off the tips, or trim off tips and seal. Lower 1st molars are very difficult to do successfully as they can have up to 4 roots. Personally, I wouldn't advise you to attempt it. Success rates are poor, and it's rather an aggressive technique if you don't know the exact nature of the problem. I certainly wouldn't even think of letting an oral surgeon do it; I'd want a good endodontist.

yesterday I went to a periodontist who removed the tooth, it turned out to be the correct thing to do as there was a lot of infection and bone loss even though xrays didn't show. I had a bone graft and have to wait three months to heal and make sure infection is gone and then I will proceed with implant. Thank you for advice.

 

[Girlinpain]

yesterday I went to a periodontist who removed the tooth, it turned out to be the correct thing to do as there was a lot of infection and bone loss even though xrays didn't show. I had a bone graft and have to wait three months to heal and make sure infection is gone and then I will proceed with implant. Thank you for advice.

 

[Girlinpain]

I have a follow up question please. It’s been six days since the extraction and the pain remains in my jaw where the infected tooth was- and the teeth on both sides of the extracted tooth both hurt. Is this something normal as not from what I’m reading. I’m on clindamycin . The tooth behind it was also retreated root canal too at the same time. Please advise?

 

[MattKW]

I think it's risky when sometimes a few difficult and potentially painful procedures are done simultaneously. So extracting plus redoing an RCT would not be my choice; now that you are having post-op pain, it can be difficult to tell which treatment is the cause. Having said that, it's a bit early to say you're past the normal post-op pain period. Give it another week, and if it's improving, then all is well.

 

[Girlinpain]

I think it's risky when sometimes a few difficult and potentially painful procedures are done simultaneously. So extracting plus redoing an RCT would not be my choice; now that you are having post-op pain, it can be difficult to tell which treatment is the cause. Having said that, it's a bit early to say you're past the normal post-op pain period. Give it another week, and if it's improving, then all is well.

Thank you for your attention - and advice as I’m really upset and in pain . The retreatnent rootcanals were done two months ago and were infected my whole side of my face was double in size and infection couldn’t be drained because it was spread thru my face not to one point. Antibiotic helped. Then it returned again after getting permanent filings in crown etc in those teeth. Referred to a periodontist last Thursday when he extracted it he said infection present. He did a bone graft after extraction. Now on the side of the gum it’s all red and swollen and the top of the gum is white. I’m getting in more extreme pain by the minute tonight -and then there’s the tooth behind it that was also retreated root and that hurts too now and a perfectly healthy tooth in front of 30 hurts now. It’s been two months and I just want to cry in such pain

 

[Girlinpain]

Please I need some advice to move forward I had a tooth number 30 extracted 10 days ago or so and a bone graft on there so that I may do an implant when all the healing is done however the tooth behind it in the back which was also a re-treatment of a root canal at the same time it seems not to hurt so much But it is more sensitive than the other teeth in my mouth when you touch it but not bad though. The problem is the infection that originally swelled up my face and I took anabiotic’s for a good month Clindamycin The pain in my jaw at that Centerpoint that always hurt originally two months ago and was infected is still hurting really bad the x-rays do not show infection on the roots however When the dentist pulled out tooth number 30 there was infection present and he’s concerned that the other tooth behind may be the same situation. But xrays show nothing. I don’t want to keep just pulling teeth out because if the tooth isn’t bad I just had all that re-treatment done and they post put in and crown on top So what would you do if you still have the pain and the specialist cannot see anything on an x-ray would you go ahead and pull that tooth too now without knowing - this is really depressing. I don’t know what else could be causing the pain other than maybe the infection is inside my jaw bone and how would I find that out.

 

[Busybee]

Sorry you are in so much pain. I hope someone here can reassure you. It may be worth uploading your latest x rays.