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Dentistry/Root Canal on upper tooth #4


Hello Dr.

I'll try to make this as straight forward as I can.

Sept 2013- Dentist sent me to an Endodontist to have RCT on
         tooth #4. Endo said I had a very bad infection advised
         him my Dentist gave me no Antibiotics. He said I three
         canals and it would be difficuly but he would try to
         save the tooth. I had three visits, he was able to
         treat two canals but could not get the third.
         I was given no antibiotics during the 3 visits despite
         me complaing of pain and red/swollen cheek.

2014 - present - No sinus problem confirmed by ENT
         Learned by 2nd endo 3rd root is calcified
         so he would not do or need a Apicoectomy

         Dentist just put a crown on tooth #4
         She did find a large cavity on the tooth behind
         it under the crown. She fixed that an I am
         getting a new crown. it has been 4 days and
         the tooth # 4 feels like it did last year!!!
         It is so strange that i have intermitted pain now
         and it is tender to touch tooth 4, but if I chew
         on it and bite down hard I have now pain at all !

I guess I am curious if the first endo said I had a very bad infection that somehow it never went away ?? Not sure if I should insist on getting a round of antibiotics or see another specialist
If so what king, A Peridontist ?

Many thanks in advance.


I am sorry to hear about this.

It seems to me that there are two main possibilities at play here;
1. The infection has re-occurred. This can be due to accessory canals in the tooth or remaining bacteria that proliferates over time and eventually causes a new infection. In this scenario, you would need to see an endodontist to have the root canal either redone or an apicoectomy performed.


2. There is a fracture inside the tooth. Often times, teeth can have micro-fractures which are almost impossible to pickup either visually or on a radiograph. However, bacteria will infect those areas and cause a new infection. These then leads to pain and difficulty chewing on that tooth. Unfortunately, most teeth that have deep fractures (even small ones) will require an extraction.

In either case, you would want to see an endodontist. They are the only specialist that is trained to deal with root canals.

In regards to the antibiotics, you can go on a dose of antibiotics as it will help with some of the local infection around the tooth. However, the antibiotic will not rectify the problem and will only help for a short period of time. Since the antibiotic does not address the cause of the issue, it's not a permanent fix. You will either need to have the root canal/apicoectomy performed, or the tooth removed for the area to properly heal.

I wish you the best!


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Benjamin Schwartz, DDS FAGD


I can answer a range of questions in dentistry, ranging from cosmetic dentistry, fillings, root canals, and comprehensive treatment. Specifically, my fields of interest are in CEREC technology, Invisalign (Invisable braces), and Endodontics (root canals).


Full time practicing dentist in New York City, treating all phases of adult dental needs. Specific focus on Invisalign cases, Endodontic (root canal) treatment, and CEREC single visit restorations.

Schwartz Benjamin, Boczko Fae, McKeon S. Oral Care For The Elderly. Perspectives in Gerontology December 2006

New York University College of Dentistry - D.D.S.
Woodhull Medical Center, 1 year post-graduate residency program - GPR

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