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Oral Surgery/Root canal issues

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To give you adequate background information, I will have to date back approx two weeks or so. I went in for a regular cleaning and check up. I had a sore spot above my right incisor #6 I believe. X-rays discovered a small cavity above the gum line. So, my dentist made two incisions and filed it. He then said it was internal resorption, and that there would be no guarantee on the filling and that I may need a root canal sometime.
So, one week later I begin having horrible pain on the right side if my face. I go in (and my dentist is of course in vacation now), and they try to preform a root canal. There was so much pressure that the anesthetic came shoot out a number of times. Three surrenges full were places and I was still in too much pain to even to begin to do anything. I was prescribed amoxicillin and Vicodin. In the days following, my face swelled greatly. After five days of antiobiotics, I went back in for a second attempt. We had a hard time getting numb again, but eventually did. When he drilled into it, the worst smell possible came. I he states he could not believe the amount of pressure that was built up in there. I drained fluid for about fifteen minutes and went through a large number of dental absorbent sticks before he got one to come out dry. He then proceeded with the root canal. When we concluded he howed me the X-ray and it had a perforation in the top, but he wasn't worried about that. About a half an hour after leaving, I ended up with the worst headache. It made me physically I'll and vomit three times. Tylenol and Motrin would not even begin to touch it. I called the next day, and he seemed to think that it was unrelated to the root canal but gave me a day and half worth of pain meds. It is now day three and the right side of my face is swelling continually. I have a nasty fistula above the tooth (my sister was a dental asst and checked it out today.) I have been on antiobiotics for now eight days. It is the weekend, I'm in pain, can't sleep. What will help? Do I call the emergency number? Do I need to find someone else?

Answer
Tracey - What was done to you was absolutely the worst possible treatment that could be imagined.  If during the opening of the tooth, there was drainage of fluid and gas, that means that an infection existed.  Just because some drainage occurs, it does not mean the infection is gone.  Appropriately, the dentist should have left the tooth open to drain, have you begin a regimen of warm salt water rinses 4-5 times a day for about 2 minutes for a couple of days plus antibiotics.  At that point, the dentist should have attempted placement of a temporary filling to determine if pressure rebuilt and more drainage and treatment was needed.  Performing the root canal at the time he did trapped bacteria, infecting the bone surrounding the tooth and building up pus and pressure.  

What should be done now is removal of the root canal filling.  Have you begin warm salt water rinses and antibiotics and test the tooth until no evidence of a continuation of the infection.  Now, since you have developed a fistula(a drainage site) immediately begin warm salt water rinses for 3-4 minutes, 4-5 times a day.  It sounds like the dentist is not knowledgeable and it is probably best that you make an appointment with a root canal specialist(endodontist).So do the warm salt water rinses a find the specialist to help save that tooth.

If you have additional questions, feel free to contact me again.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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