Expert: Mark Bornfeld DDS - 8/3/2006

Question
I had a root canal 10days ago. I have noticed that my gum where my temporary crown is placed is slightly swollen,red,and vry tender. I also noticed a white spot next to the tooth behind my root canal tooth that is painful. My lymph nodes are swollen and Iam having to take 800mg motrin twice a day to deal with the pain and inflammation. Iam an RN,so, I have been trying to treat myself. What could possibly be causing this? It is truly painful!!

Answer
Dear Ms. Wallace,

It is difficult to offer a reliable answer without seeing you personally, However, the issue is a bit ambiguous, since you seem to have had two separate procedures-- the root canal, and the placement of the temporary crown. Either of these treatments, or the procedures that are associated with them, could account for your symptoms.

For example, the physical grinding down of a tooth in preparation for a crown unavoidably inflicts a wound to the gum, since most dentists extend their crown margins under the gum. This would be expected to manifest all the symptoms of inflammation-- redness, swelling, pain, and exudation. Also, keep in mind that root canal therapy is prescribed for pulpal infections, so we might infer a reason there for the regionl lymphadenopathy.

The sequellae of dental treatment might well include all the symptoms you have reported despite a favorable outcome, so it is premature to assume that anything has gone wrong at this point. However, you should be seeing an improvement in the severity of the pain by now, even if it hasn't yet disappeared. In any event, there is no reason why you should need to try treating yourself-- it is the dentist's responsibility for rendering postoperative care, and pain control is part of it. You should involve your dentist at this point, if only to assure that everything is proceeding as expected. I suggest you contact your dentist so that he may assess the status of your ongoing dental treatment.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY