Expert: Steven C. Scherr, D.D.S. - 7/25/2006

Question
I have one small cavity in the front and one tooth on the left one up from the wisdom that needs a root canal. This tooth has had a temporary filling in it for 10 years and has never caused any pain.

I recently visted the dentist with some mild pain around my tooth and asked to have the small cavity filled. The Dr inisted I see a specialist so out the door I went with my Xray in hand.

Four days later the pain was severe and I luckly found another dentist who said my Xray clearly showed I had an infection possibly below 2 different teeth on the lower left side. He filled my small cavity and gave me a prescription for Penicilln VK 500mg and asked I take one every 6 hours.

Its been another 4 days and the pain is still severe. I have swelling on that side on the outside of my mouth below the jaw line. I can barely open my mouth at all and the pain is effecting my work and sleep. I am currently rotating between 2 Extra strength 500mg tylenol and 3 200mg motrin but neither is doing enough for my situation.

I have 4 more days of penicilln left but I am worried the dossage may not be enough. My questions are;

How long does it typically take to rid myself of this infection ?

Am I just in asking for something prescribed for the pain ? I didnt do this up till now because I would prefer not to take prescribed pain killers.

Providing we can get the infection under control I just need to make it 25 days until I have the tooth that needs a root canal removed along with all 4 wisdoms which have never bothered me.  

Answer
Richard,

I am sorry to hear that you have had so much difficulty.  Sight unseen, I cannot provide you with specific solutions.  The best I can hope to do is offer some direction.

When a tooth needs a root canal, it is most often because the nerve inside the tooth has become infected.  An infected nerve is not always painful.  In fact, it can remain chronically infected for years in some cases and feel completely normal.  The tooth becomes painful only when pressure builds up inside the tooth or in the jaw bone that holds the tooth.  Antibiotics have limited usefullness, because the blood supply to the infected area has already been disrupted.  At best, antibiotics may be able to help contain the infection until definitive treatment (root canal therapy, extraction, surgery, etc. can be accomplished).  If the pain has not improved after 4 days on the penicillin, you may either need a different antibiotic, or definitive treatment may not be able to be deferred any longer.  I suggest you return to your dentist.  You and your dentist can decide together about the need for pain killers.

Richard,  I hope you are feeling better soon.

Steve