Expert: Mark Bornfeld DDS - 6/4/2007

Question
QUESTION:
I had a rootcanal performed 2 weeks ago. On the same day I got the procedure done, my jawline started to swell up and I was in a lot of pain.
I went back to the dentist twice, but they (two different dentists at the dental office) said they do not see any problems on X-rays. They said I had an extra pulp, and they had to go in deeper to clean, therefore my gum is irritated.

They gave me penicillin and some 600 mg ibuprofen. The swelling went down a little and pain is not as severe, but it is still present.
I am going back to the dentist this week for crown, but should I be worried about this pain and little jaw swelling?


ANSWER: Dear Elizabeth,

You should be encouraged by the improvement in the symptoms. However, I think it would be prudent to postpone starting the crown until the swelling and pain are totally gone. This way, it will be easier to re-enter the tooth for additional endodontic treatment should the need present itself. It will also make it less likely that the stresses of crown preparation will cause a resumption of symptoms.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY

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

QUESTION: Thank you for your response, Dr. Bornfeld.
The jawline/gum also feels senstive to warm. In your opnion, would you say I'd need another endodontic treatment or is this normal that I am experiencing this?
Thank you again.

Answer
Dear Elizabeth,

Symptoms alone are insufficient to determine if your root canal therapy was successful. Granted, some postoperative pain and swelling is the rule rather than the exception in cases like these, but that does not mean that these symptoms can be dismissed as normal. Your dentist will need to monitor the tooth for continued pain, swelling, drainage, or evidence of persistent infection on x-ray. Assuming that all the diagnostic information points toward a successful resolution of your dental infection, it will then be safe to resume your treatment.

Mark Bornfeld DDS