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Dentistry/tooth infected

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Expert: - 11/9/2008


Question
My six year old daughter is taking antibiotics for an infection that swelled her face up in a day, and the dentist has scheduled the tooth, a molar, to come out next week.  There is no evidence of a cavity, but the tooth moves in the gum. The dentist saw no problem there when she filled a cavity in the tooth next to it 6 weeks ago.  Is this an absessed tooth, and can you be sure of that without x/rays? When the tooth is pulled, she will need a spacer, correct?

Answer
Of course, without x-rays I cannot determine what the problem is.  It's possible, however, that the original cavity caused an undiagnosed and therefore untreated infection of the pulp of the tooth which ultimately resulted in an abcess, causing pain, swelling and mobility of the affected tooth or an adjacent tooth.  This should be confirmed by x-ray examination to determine which tooth is causing the problem.  If the affected tooth cannot be saved with a root canal treatment (pulpectomy) and must be extracted, then a space maintainer must be placed to prevent drifting of the remaining teeth which can further compromise bite development.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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