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Dear Dr. Backlund,
Three days ago I had a retreatment on a root canal that was done 4 years ago. The swelling remains the size of a golf ball on my jawline and the pain is especially not manageable in the middle of the night. I am taking steroids (the 5 day dose) and 2 antibiotics, and pain meds only when it flares up. I am gargling with hot salt water and applying ice packs several times a day.

My main concern is the swelling and pain on my face, along with the fact that I am a flight attendant that needs to work, but at this point I am afraid to get on a plane to China, after hearing horror stories of the pain/pressure effect of flying...

Please help me understand if this is normal and when shouldI expect the swelling to go down?

Many many thanks,

Deborah

Answer
Hi Deborah,

I'm sorry to hear all this is going on. When root canals flare up like this, it's not much fun for anyone, especially the patient! I can also understand your reluctance to go to China, however they do have some very well trained dentists. The problem is finding one if you are in need.

To be honest, I concerned about your medication and other self treatment. Steroids are designed to reduce your bodies ability to fight infection. They work great in instances when there is inflammation but no infection like if you had a severely traumatized tooth from maybe an accident. We will sometimes add an antibiotic when giving steroids, but that is to protect your body from some other infective process. WE do that mainly when a patient is otherwise health impaired. I would NEVER use them to treat an infection.

AS for the hot & cold you are using. While cold can reduce swelling, like if you sprain an ankle, but it is not a good choice for an infection. The cold reduces the blood flow into the infection around the tooth, but that keeps the blood from bring antibiotic and white cells into the area to heal the problem. The cold does make it feel better, but you should really stop  using them and concentrate on the hot salt water rinses which increase blood flow to the area. You might even use hot packs on the outside of your face. It may make you swell more, but will help you heal. Sometimes the heat will bring the swelling to a head and it can be drained by your dentist...almost instant relief.

While this is not "normal", it certainly does occur. Usually, it take 7-10 days for things to feel normal and less than that for the pain to ease. You may want to give your dentist a call and ask for help. Since I can't examine you or know what exactly was done, it's hard for me to diagnosis what is causing all this to go.

Hope this helps some any way.

Gary Backlund DMD, MSD

Dentistry

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Gary Backlund, DMD, MSD

Expertise

I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.

Experience

25 years practicing as a specialist

Organizations
American Association of Endodonists, Past President Washington State Association of Endodontists.

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