Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 12/10/2009

Question
I had a root canal 5 weeks ago. The dentist suspected an infection because of my symptoms and the fact that my tooth did not bleed during the root canal. He put me on Amox. I came in a week later and he put me on augmentin. Two weeks later I am in the doctor's office with an ear infection and she puts me on two wounds of Zithromax. I have been experiencing severe pain in my jaw and ear area all this time, so I went to the ENT and he said my ear infection had all cleared up, but suggested I was still suffering from the root canal. I had a jaw x-ray taken to rule out osteomylitis and several bloods test. I have passed all my doctor's tests, so she is convinced it is my root canal causing this horrible pain. My dentist does not know how to help me. I am having to take a tleast one Vicodin a day to manage the pain in my jaw and ear area along with ibuprofen. What do you think is causing my pain? Can the root canal cause this sort of pain and last this long?

Answer
Sandy -  When a root canal treatment produces severe pain, although there is no strict evidence of infection, it usually means that there is inflammation involving the ligament that holds the tooth to the bone and the bone itself.  A redo of the root canal treatment may arrest the problem, but usually a redo of the root canal does little to get to the source of the pain.  My suggestion is for you to make an appointment with a board certified oral and maxillofacial surgeon.  Advise the surgeon of the problem and ask if an apicoectomy is the correct approach.  An apicoectomy is a simple surgical procedure used to make a tiny hole in the bone at the tooth's root and then cleaning of the ligament and bone surrounding the tooth.  This is a simple procedure with minimal complications, if done by a knowlegeable and skilled surgeon.  So you can either ask your dentist to refer you to only a board certified oral and maxillofacial surgeon or you can find one listed in the yellow pages.

This is a simple and highly successful approach for the symptoms you describe.  If you have any additional questions, feel free to contact me again.