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Dentistry/4th round of antibiotics for root canal



On 12/24/13 I emailed you about a root canal #19 pain. You have given me excellent suggestions which I have done.   Your last suggestion was to see a specialist. I did go to an endodondist a few weeks ago and he said the x-ray looks good, tooth looks good and he wanted to put me on my 4th dose of antibiotics.  Something a little stronger (clindamycin 300- 4/x day).  Again it took a few days to kick in, but when it did I had zero pain.  I am now off the antibiotics for 4 days and the bad root canal pain is back.  What are my options now?  Would it be wise to get another root canal or do I have to get it pulled?  He said an apico was not something I should do.

I am trying desperately not to get it pulled as there is a pontic connected to the tooth.

Please help!

Thank you very much.

ANSWER: Sharon-if the antibiotic stops the pain and it returns after the medication is stopped, it means that there is definitely an active problem within the tooth or the bone surrounding the tooth.  I don't understand the endodontist saying everything looks good and yet he prescribed and antibiotic.  That means he did see something or knew something was wrong and yet he did not want to get involved.  

I would suggest that you have yourself examined by a professor in endodontics.  A Dr. Laurie Fleisher is such a doctor and she has a practice associated with NYU dental school faculty practice. I suggest you call, (212) 443-1300, the faculty practice office.  Call and make an appointment with Dr. Fleisher.  She is experienced and has taught endodontics and has seen many different situations.

I hope this doctor can help you.

---------- FOLLOW-UP ----------

QUESTION: Dear Dr. Teig,

So another question to you would be:  if there is definitely an active problem within the tooth or the bone surrounding the tooth should I have a re-treat by the endodontist?  Would that resolve the problem?  Is that my only option besides possibly needing to have it pulled (as a last resort)

I only went to the endodontist for a second opinion.  He wanted me to try one more time a heavier dose of antibiotics and if that didn't work he would do a re-treat if the pain was still there.  He said the root canal that was done looked great on the x-ray and everything on the outside looked great.  I have no pain upon touch or trying to move the tooth.  He didn't want to jump in and re-treat on the consult day.  He was highly recommended.

Thanks again in advance and for taking your time and volunteering on this site.


Sharon - if the cause is not that evident and yet it recurs after the antibiotic is stopped, then it means that there is an active problem.  If that endodontist cannot arrive at a cause that is not good.  The doctor should have formulated a list of possible causes and check each one.  

I understand he didn't want to jump in, but with the recurrence after the antibiotics is stopped, it means that there is a problem.  There are not a lot of causes that cannot be deciphered, but the endodontist should test and nothing should be done without really knowing what is occurring.  If he is unable to arrive at a cause, a different doctor is probably needed.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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