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Dentistry/Re-treat Root Canal


Hello Dr. Teig,

I was supposed to have the final root canal treatment last Thursday, April 10, but I was in so much pain he cleaned out the canals again and left it opened.  

I asked why I'm still in so much pain and he said it was the bacterial infection and that he will have to clean it out again. He is away on vacation now.  So I will go back again on April 28.  He said he will clean it out one more time and then close it on April 29th.

I am now on Augmentin 875 3x/day and flagyl 4x/day and I still don't have relief.  He said it will get better....but how and when is the time to say "it should be pulled?"  Is it possible that the bacterial infection is so deep he can't get to it?  I'm totally lost.

Thank you.

Sharon -  Root canal treatment can only work at eliminating an infection within the tooth.  Unfortunately, many patients have an extension of the problem within the tooth to the bone surrounding the tooth.  If this is what occurred, any attempt at closing the tooth or finishing the root canal treatment will not eliminate the problem.  Antibiotics can help to some extent, but if there is an infection in the surrounding bone, the blood flow to the area is re-routed and antibiotics do not gain full access to the infected area.  So if the pain continues, the infection in the bone may need to be cleaned out.  That would be via a simple surgical procedure called an apicoectomy.  That should only be done by a board certified oral and maxillofacial surgeon.

So see if the pain gets better.  If not, the doctor should not attempt at closing the tooth.  I am sorry to give you this news, but you should be aware.  I hope the infection goes away, but if not, that minor surgery is probably necessary.  

I wish you well and hope the pain resolves.  If you have further questions now or later after seeing the dentist, feel free to contact me again.


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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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