Baton Rouge Dentist

Why Is My Tooth Still Infected After an Apicoectomy?

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African American woman wearing glassed and frowningMy tooth is still infected after an apicoectomy. I had a raging toothache and infection that required a same-day visit in early October. The dentist did an apicoectomy on a tooth that had a root canal 2 years ago. I had a checkup and x-ray two days ago. The bone is rebuilding, but a small pus sac on my gums shows an infection is lingering. My dentist gave me antibiotics to take for ten days. Is there anything else I can do to get rid of this infection? I

t’s going to be three months and counting with this. I’m waiting for it to clear before I get a new crown. I opted for a one-visit crown because I want to wrap this up and move on. Since I’ve had problems with this tooth, my dentist wants to wait before making the crown. I feel like making an emergency appointment with another dentist before I return to mine – if I return. I don’t know what to do. Thanks. Marianna from TN

Marianna

After your struggle with a tooth infection for almost two months, your concerns are understandable. We will share some information that may help you decide whether to wait for your dentist or to get a second opinion.

What Is an Apicoectomy?

  • Unlike root canal treatment that approaches the pulp chamber by drilling a small hole in the tooth, with an apicoectomy, a dentist or endodontist surgically accesses the tooth through the gums.
  • The surgery allows the dentist to access the root tip and remove infection or inflammation.
  • The dentist places a small filling to seal the root tip.
  • Stitches close the small incision.

How Will Antibiotics Help?

Root canal treatment, apicoectomy, and any other apical surgery will help the tooth heal, and the infection will eventually disappear. The dentist or endodontist needs to remove all the dead tissue inside the tooth and seal the end of the root well.

Antibiotics

Although antibiotics can speed up the healing process, removing the source of the infection determines if the treatment will succeed.

If the bone around your tooth is healing, your dentist likely removed the infection. Any residual infection will eventually disappear, and the antibiotics will speed up the healing process. It takes patience, but your tooth will heal, and you can get a dental crown.

Although you can get a second opinion from a dentist with root canal treatment experience, an emergency dental visit won’t give you the necessary information.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

How Long Can I Delay Treatment for a Tooth Infection?

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Man holding face in pain and needng an affordable dentist for root canal treatmentI need some advice. I am out-of-town on business. My tooth has been hurting on and off for three weeks. This week, the pain became constant, and my cheek is a bit swollen. I will be on this assignment for two more weeks. And yes, I know that I should have taken care of this before I left home. Is this something that can wait, or do I need to find a dentist here who will take me on an emergency? Thanks for your answer. – Jason from Chicago

Jason,

Based on your description, it’s likely that you have an infection in your tooth that has spread and created an abscess.

It’s best to find an emergency dentist to treat the infection. You have two more weeks on your out-of-town assignment, during which an untreated infection will continue to spread and cause more problems.

Treating a Tooth Abscess

The dentist will give you an antibiotic to treat the abscess. Root canal treatment will clear the infection from the pulp of the tooth. That may be all that is necessary if the tooth is otherwise in good condition. If the tooth is cracked or damaged, a dentist may need to remove it.

Although many people get anxious about root canal treatment, the procedure is painless.

  • A dentist will numb your gums before injecting a local anesthetic.
  • After making an opening in the crown of your tooth, the dentist will clean out the infection deep into the roots.
  • After treatment, the dentist will cover your tooth with a temporary crown.

If You Need an Extraction

If an extraction is necessary, find an experienced cosmetic dentist to replace the tooth with a dental bridge or a dental implant when you return home. The restoration will look completely natural. In either case, you can ask each dentist about their payment options, including payment plans or financing.

 

Ryan Perry, DDS, a Baton Rouge dentist, sponsors this post.

Horrible toothache and headache, but my dentist sees no problem

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In January, my dentist did a root canal on an upper right molar tooth. The tooth felt better afterward but has not been symptom free. Two weeks ago, I felt a flare-up of pain that felt like it affected the tooth next to the root canal tooth, and I have a headache, too. I returned to my dentist on Monday, and she took x-rays. She says that both teeth look fine. She suggested that I see a neurologist. I do not think my dentist is investigating enough. Why a neurologist?  Thank you. Bryson from Arkansas

Bryson,

Although Dr. Perry would need to examine your tooth and x-ray to give you an accurate diagnosis, we can offer insight that might help you decide what to do next.

Pain from a tooth that looks healthy

Man in his 40s with a headache and toothache holding the side of his face
Headache and toothache pain are not always easy to diagnose

It is not uncommon to feel pain in a tooth that looks healthy in a visual examination and on an x-ray. Some causes of tooth pain include:

  • Referred pain – Infection from a tooth can refer to an opposite upper or lower tooth. Or it can feel like the pain is coming from an adjacent tooth. But pain does not refer from one side of the mouth to the other.
  • Neuralgia – Chronic nerve pain can transfer in your face, jaw, teeth, or gums. Although the condition is usually not the cause of a toothache and headache, a nerve problem can feel like a toothache. That is why your dentist recommended that you see a neurologist.
  • Infection – A sinus infection can cause headaches and pain that feels like a toothache. The maxillary sinus is near the roots of upper teeth and can press on the roots, causing a toothache sensation. Sinus pain can also transfer to a lower tooth.
  • Other health issues – Some conditions that can feel like a toothache and cause headaches include jaw pain, clenching or grinding your teeth, or gum disease. According to the American Migraine Foundation, TMJ (temporomandibular joint) disorders can contribute to chronic headaches.

If you feel that your dentist is not a good listener or rushed for a diagnosis, we suggest getting a second opinion. You can get a second opinion from another dentist or a root canal specialist (endodontist).

Are your tooth pain and headache a dental emergency?

Sudden or lingering toothache – If you have a sudden or lingering toothache and headache but no recent dental work, see a dentist right away. Toothaches are most often a symptom of infection.

Toothache after dental work – If you had root canal treatment or other dental work that seems to be your pain source, contact the dentist who completed the treatment. If the pain persists beyond the healing period or gets worse, consider it an emergency.

Dr. Ryan Perry, a Baton Rouge family dentist, sponsors this post.

 

Why Aren’t Antibiotics Working?

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Hi,

I was prescribed antibiotics by my dentist for a possible tooth infection. My gums were red and painful, and even my face was swollen a bit. I’ve taken them a few times a day for the past two weeks. The swelling went down for awhile, but now it’s back and worse than before. My cheek is swollen and yellow-ish, and there’s a weird taste in my mouth. Do I need to go to an emergency dentist? I’m not sure what they will do besides give me more antibiotics. What else can I do?

Thank you,

Jake, from Big Arm, Montana

 

Hi Jake,

I’m sorry to hear about your situation. Antibiotics aren’t the only treatment for tooth infections – they are a part of it. Once the infection is under control, then your dentist start your treatment plan. One treatment would be to extract the tooth, but a more common treatment is a root canal, which would open and drain the source of the infection. Once your infection is cleaned out, you should feel relief. Your infection sounds serious, so it’s unclear why your dentist has not done anything about it. If your pain worsens, go see an emergency dentist.

It sounds like your dentist does not fully understand tooth infections. Infections come when the organic material inside your tooth dies. Antibiotics are one treatment, but dead tissue receives no circulation, so a root canal or extraction is necessary. The antibiotics alone cannot clear out the infection. If you just take antibiotics without any treatment plan, you risk creating antibiotic-resistant bacteria in your mouth. This can cause complications, so you want to follow-up with your dentist, or a second opinion from an emergency dentist.

This blog post is brought to you by Baton Rouge emergency dentist, Dr. Ryan P. Perry.

 

Emergency Dentist Said the Wrong Tooth Needed to be Fixed

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I have some pretty severe tooth pain in one of my teeth. I know exactly which tooth hurts. I went to an emergency dentist because I don’t have a dentist of my own. He told me that it’s a tooth next to the one I showed him which has the problem. I can tell exactly which tooth hurts. Could he be just trying to get me to fix an extra tooth to get more money?  I didn’t let him move forward because I wanted to make sure he wasn’t cheating me first, but I’m still hurting. Now I feel like the appointment was wasted.

Bobby R. – Denver

Bobby,

I don’t even know which dentist you went to, but I can tell you with almost complete certainty that the emergency dentist isn’t trying to trick you. I don’t know if you’ve ever heard the phrase “referred pain”, but that’s likely what you’re experiencing. That’s when you feel pain in one part of your body, but it’s actually coming from a different part of your body.

It sounds like the dentist wanted to work on the source of the pain and not just the tooth you thought was hurting. I know this is a new dentist for you, so you hadn’t built up trust, but in the long run he was trying to not only do the right thing for you, but his actions would save you money.

He could have appeased you and just worked on the tooth that hurt you and said you also had another tooth that needs help, charging you double. He didn’t.

However, if you’re still not sure and want a second opinion, I’m going to make a suggestion that you don’t tell the second dentist who you went to and what their diagnosis was. Just tell him you have a toothache, tell him where, and leave him to make his diagnosis. If he comes to the same conclusion as the other dentist, you’ll know you’re on the right track.

What I don’t want you to do is put off getting treatment. This is likely a tooth infection and it will spread. I’m not saying this is you, but sometimes when a patient is putting off care even while in pain, it is actually because they have dental anxiety. If that happens to be you, be aware that sedation dentistry is an option. It will give you a pain-free dental experience.

This blog is brought to you by Dr. Ryan Perry.

I can’t afford to get my wisdom teeth out?

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I have a rotting wisdom tooth. It was hurting, but the pain has moved from the tooth to my cheek and eye. I just can’t afford to have it removed. Can I remove it myself and then go to the ER for some antibiotics or will the ER just remove it? You don’t have to pay them the same day.

David D. – Pennsylvania

David,

I am being completely serious when I tell you this. You cannot afford NOT to have this wisdom teeth removed. You have a serious infection and it is spreading. It’s already at your eye, guess where it will go next?  Your teeth are too close to your brain to not get this dealt with. It could get life threatening.

Unlike with other infections, antibiotics alone do not solve a tooth infection. The infected tooth has to be removed.

If you go to a dentist and explain your situation, almost all of them will work with you to make this affordable for you. Most of them have payment plans, some with zero interest.

Please don’t put off getting this treated.

This blog is brought to you by Dr. Ryan Perry.