Expert: Mark Bornfeld DDS - 7/7/2007

Question
I had a crown put on the 18th of June this year, the left lower molar,2nd from the back. It was a little sensitive since that procedure but 4days ago I started experiencing severe tooth pain. I called my dentist he put me on Clindamyacin and 800mg Ibuprofen.(He was going out of town.) Two days ago I woke up with a small area underneath left lower lip that was numb. I went to the Dr. on call, he took a X-ray and he said there was fine dense line around one of the roots, it was questionable for an infection. I now have more numbness and some swelling at the jaw area, should I see an endo right away? I have an appt with my dentist in four days. Thank-you!

Answer
Dear patti,

The answer depends on the severity of the swelling and pain and whether you think you can wait until your scheduled appointment with your dentist.

Your narrative definitely suggests that you have a pulpal infection, and root canal therapy is clearly one of your options. The argument for seeking immediate care with an endodontist is that it may avert more severe symptoms, and you can be more confident that he will be better able to manage any procedural difficulties encountered during the root canal treatment. However, your general dentist may be sufficiently skilled to achieve a comparable outcome, and his fee is likely to be lower than a specialist's.

There is no unequivocally right answer, and this may be your call to make. However, if you do decide to wait it out until you can see your general dentist, be careful to use common sense. If the infection continues to worsen, it may be resistant to the antibiotic, and this would call for a more prompt intervention.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY