About Mark Bornfeld DDS Expertise I can respond to all questions dealing with the practice of dentistry, from both the dentist`s and patient`s perspective. I am knowledgeable about all dental disciplines, from cosmetic dentistry to surgery, from restorative dentistry to root canal treatment. I have strong opinions about controversial issues in dental practice, including those topics which directly impact on the reputation of the profession in the eyes of both the lay public and our health profession colleagues.
Experience
Past/Present Clients Editor, Queens County Academy of General Dentistry newsletter; contributor to Dentistry.com 29 years practicing general dentistry partnered with brother Steve as one-half of the DentalTwins®
Question I had a root canal done (lower left tooth)several years ago where they did not remove enough of the root and allowed saliva to seep in after closing. I have had shooting pains in my face from this tooth recently. A month ago I was referred to a specialist who retreated the root canal and put me on antibiotics. It has been 3 weeks and I STILL am in pain. I do not want to continue taking the strong pain killers.
The Dentist suggested that I give it a year to heal or do surgery on the tooth where they have to peel back the gums. I do not want to do that drastic surgery.
Any suggestions on what I can take to heal myself? They took another x-ray and said that most of the infection was removed, but that there is still a little bit that they can't do anything about.
Any advice?
Patrice
Answer Dear Patrice,
Pain following a root canal treatment is not unusual-- to a point. However, pain of sufficient magnitude to require "strong pain killers," as you put it, 3 weeks postoperatively is unusual, and suggests the need for additional professional intervention. This is not something that is amenable to self-treatment, and there is nothing that you can take to compensate for a problem that has not been sufficiently managed by your doctor.
At 3 weeks, you should have experienced at least a diminishing trend in the symptoms, if not complete resolution. If this is not the case, you should return to your dentist for further evaluation.
It is customary to wait six months to a year to re-examine a troublesome tooth by x-ray to see if bone fills in around the root; this process is slow-- hence the waiting period. Bony fill implies that the infection has resolved; however, it is a delayed indicator, and reflects a resolution of the infection along with the symptoms, which should optimally have occurred soon after completion of the root canal treatment. If signs of infection persist (such as pain), one does not need to wait a year to know that further treatment is in order.
Just what that treatment may be depends on the cause of the pain. For example, a persistent root-end infection may require a repetition of part of the root canal treatment, or may alternately be managed by the surgical procedure to which you refer, an apicoectomy (by the way, it's not a particularly "drastic" surgery). Or, it may be something else altogether-- for example, a fractured root, or perhaps even a completely different tooth is to blame for your current symptoms.
All this must be evaluated by your dentist, who must implement a proper diagnostic protocol. However, you most certainly should not wait a year to visit your dentist when you well know there is something wrong with your tooth now.
Good luck!
Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY
