Expert: Gary Backlund, DMD, MSD - 6/8/2005

Question
Hi Gary,

I'm near the end of having root canal therapy of a tooth that has a gold crown in the lower left bottom jaw. It became suddenly painful one night and the abscess was there for a while. I go back for the 5th and final visit to have the filling (bonding). The X-rays showed the dentist did a very thorough job of widening and cleaning the canals. I was told the tooth would not be completely healed for up to 2 years. The tooth is still sensitive near the base. He prescribed an antibiotic and painkiller again, if needed, although he believes all the infection and inflammation is gone. He wants to see me agian in 6 months to monitor it. My question: Is it the usual protocol to expect a 2 year period for it to totally heal? And is it also usual to prescribe an antibiotic again after the therapy? I thought the antibiotic is useless after the therapy is done and the canals are sealed. I've heard some negative things about RC therapy(like latent bacteria causing other health problems?) and am looking for some subjective feedback-thanks.

Answer
Hi Dan,

You raise several good issues here. Let's deal with them one at a time. First about the healing. It may take 1-2 years for the bone around the end of the tooth to completely repair itself, but that does NOT mean you should have sensitivity or pain during that time. It just takes time for bone to repair. This is why your dentist wants to see you in 6 months. In our office, we recall all patients 6 months after the treatment and if we see that the bone is filling in, we assume it will continue and don't recall any further if the patient has been comfortable.

As for antibiotics, sometimes immediately after the root canal is completed, everything can get stirred up again and it may even be necessary to use antibiotics. Usually this is within 2-5 days after treatment is completed. If it has been longer than that, you may want a second opinion. You say the xray shows everything has been cleaned out....who made that diagnosis? If you are having problems and it has been awhile since it was completed, I would ask your dentist for a referral to a specialist just to make sure all is well. If the problems occurred right after the final treatment, I would just give it more time. The appointment for bonding doesn't really count, because all they are doing is filling the hole in the crown.

As for health problems from latent bacteria, that is pretty much an "old wives tale". Current and recent past clinical studies simply don't substantiate those claims. The human body is pretty incredible and deals easily with the little bit of infected material from root canals. I would not worry about that aspect at all.

Hope this helps. Good luck!

Gary Backlund DMD, MSD