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Dentistry/Infection & extraction for failed root canal

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Question
Hello,

Thank you for taking the time to review my questions, I very much appreciate it.

Background: Couple weeks ago had upper left, 2nd molar, extracted, as RCT failed.  It had RCT twice (last time was 5 yrs ago) & been infected for long time.  Been on and off antibiotics for over a yr for recurring sinus infections above that tooth, had x-rays, recent CT & saw ENT about infections.  ENT recommended go back to dentist to see about having the tooth removed before going for sinus surgery to see if infections resolved that way.  Dentist agreed, so tooth is gone. Dental Surgeon said was very badly infected, tooth fractured, took over 2 hrs to remove, & freezing not fully work, so was pretty sore. Took penvee & just now on clindamycin for a week, as still have infection.  Did have other tooth pulled few years back that also had failed root canal, which was redone more than once too.

Questions:  I am concerned about next step if this round of antibiotics does not clear up infection.  (I can feel it in my sinus, nose, up around eye-little swelling, just sore & feel awful).  Would it entail more antibiotics?

Having had 2 teeth fail RCT (both were done by endodontists and redone more then once), should I not consider them in future, if needed?  

Again, thank you for taking the time to review my ?.  I didn't think to ask dentist these ?'s at the time.

Answer
Dear Jae Lynn,

Root canal is not always successful, as you have experienced.  Even when done by the best of endodontists, about 4% of root canals fail within 5 years.  And more than 10% of root canal retreatments fail within 5 years.  Despite these statistics, root canal remains the best choice for treatment of infected, inflamed or painful tooth nerves.  The alternative is extraction and replacement by a bridge or implant.  Both these choices are more expensive and more extensive than root canal treatment.

Sometimes combining steroid medication with antibiotics will solve your sinus infection problem.  Also, be sure that there is not another tooth that is contributing to your problem.  You may want to suggest these ideas to your dentist or endodontist.

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Howard Finnk, D.D.S., P.A., CEO

Expertise

I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.

Experience

Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center (floridaimplantcenter.com). On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (nobhilldentalcenter.com), I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

Organizations
American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

Publications
"How To Save Money At The Dentist" Going to press soon.

Education/Credentials
Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

Awards and Honors
Membership in The Vedder Honors Society

Past/Present Clients
HIPAA rules do not allow me to post this information.

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