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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Severe Toothache. Taking Amoclan Forte, Dolgit. Took X-ray. Suggested For Root Canal. Should It Be Done Now?

I had a severe toothache about seven days ago. It was around the upper left molar teeth.

I have had sensitive teeth for a long time, but the impact would be only for a few seconds. And that too my teeth have been sensitive to only cold things, not hot. But now, the pain would become more severe even if drank something hot.

I tried home remedy initially. I applied clove oil, but that did not help. And then I took a dose of Panadol (Paracetamol 500mg x 2 tablets), but that wasn't of much help too. The ache lasted for several hours. I couldn't sleep at all that night. The next morning I went and saw a dentist.

He did cleaning and scaling. He had to local anaesthesia when working on the left side, due to the existing pain. He took an x-ray. He said the pain was caused by inflammation of gums which was due to infection in the pulp. He said two teeth were affected. He has indicated that I would need to do root canal treatment for both the affected teeth.

He prescribed an antibiotic and a painkiller: Amoclan Forte 625mg (Amoxicillin and Clavulanic Acid - 1 tablet twice daily for 5 days; Dolgit 400 (Ibuprofen 400mg) - 1 tablet twice daily for 5 days, if I the pain exists). He asked me to come bad for the next visit after completing the course for five days.

I have completed the five days of medication. My next visit to the dentist is due today.

My questions are:

(1) Do I really need root canal treatment? How can I be sure? Are there any alternative treatments?

(2) I have been told that I will need to come for two visits. Does root canal treatment take multiple visits? Can it be done in one visit? What all steps does it involve?

(3) Is it possible that commercial reasons may have prompted the dentist to recommend root canal treatment instead of an alternative treatment that may cost much less?

(4) I was told that if I delayed the root canal treatment, the infection would get worse. Is that right? I live in the UAE, and I would be on a visit to India two months later. Medical costs are much lower in India than in the UAE. Would it be okay if I postponed the root canal treatment, so that I can do it in India.

(5) How much of an emergency is root canal treatment? Does it need immediate attention? After this course of medication that I have already been through, in case the pain does not occur again, then will it be okay if I saw a dentist in India and then take action as required - whether a root canal treatment or any other treatment?

Look forward to your response. Many thanks.

Regards,

Arun Joshi


Thu, 25 Apr 2013
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Dentist 's  Response
Hello there,

Welcome to HCM forum

Toothache indicates infection of the tooth that had spread to the pulpal tissues, this can be confirmed by taking an x-ray. Such type of infected tooth can be treated with root canal treatment to save it permanently. Root canal treatment requires 3-4 sittings it can also be done in a single visit depending upon the condition of the tooth.
If you are having a continous unbearable pain I would suggest you to start the treatment immediately.
Delay in treatment will definately lead to spread of infection.
If the pain is under control with the medications, so you can maintain a good oral hygiene you can visit the Dentist on the day of appointment and discuss whether the treatment can be postponed for two more months or not.
In case if you are having sensitivity with the teeth you can use desensitizing toothpaste like Sensodyne.

Hope this helps out.
Regards.
I find this answer helpful
Dentist Dr. Bindiya Bhaskar's  Response
Hello Arun joshi,
Thanks for writing in.
Since you c/o severe pain at the affected side,pulp within the tooth will be infected.
As the tooth is painful,the removal of vital pulp as well as obturation of canals will take minimum of 2 days.
Your dentist has diagnosed your problem after looking into x-ray of the tooth.
Its better to get the treatment as soon as possible.
If you wait until another 2 months,the infection may spread into periapical region resulting in abscess formation.
You may have to continue with your antibiotics too if the infection has not removed.
Depending on the severity of decay,treatment is usually planned.
yOU CAN GO FOR A SECOND OPINION TOO.
tAKE CARE.
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Dentist Dr. Sivaji Kavuri's  Response
Hi,

After going through the case history you have given your answers lie here,

1.Yes, if thier is infection in the pulp you need to undergo root canal treatment.

2.Root canal treatment can be done in both single and multiple sittings,but it is advisable to go for multiple sittings since the pulp is infected.It includes the following steps ,
a.access opening of tooth
b.bmp ie.,cleaning and debridement.
c.obturation and access filling.
in these first step is done in first sitting and second and third steps can be done in either one or two sittings.

3.Once any infection might be due to caries from teeth surface or any abscess from the periapical area affect pulp, Root canal treatment must be done.Their are alternatives if the infection would not have affected pulp.

4.Its better to get it done as early as possible,Yes you can wait for 2 months if the infection is in the initial level.

5.If the infection aggrevates or the pain continues its better to get it done, or if it susides by using the medication you can wait for some time.

Hope so this helps you,
Thank you.
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Dentist Dr. Farah Hussain's  Response

Hello there ,

Thanks for writing your query,


Tooth ache indicates bacterial decay or infection in the tooth that involves the exposed tooth nerve tissues .

such infected tooth needs to be treated by a root canal procedure so please consider getting the treatment done by consulting a dentist.

Tooth decay is nothing but bacterial infection that spreads to the deeper structures of the tooth and involves the tooth nerve tissue leading to pulpitis.

We can save such infected and fractured tooth by root canal procedure, provided the periodontal status of the tooth is good. That is, if the tooth is not mobile.

Root canal procedure disinfects the tooth by removing the infected nerve tissue and the root canals are cleaned,shaped and filled with permanent restorative material.Once the treatment is completed , the tooth can be restored by a post and core preparation with a prosthetic crown coverage.

i hope this helps ,

take care.
I find this answer helpful
Dentist Dr. Benley George's  Response
Hello,
Requirement of root canal treatment can be decided only after examining your oral cavity. If the tooth is decayed and it has involved the pulp it should be root canal treated. Root canal treatment usually takes 3 sitting but now there is single sitting RCT which can be done if the tooth is not infected. Since the cost of RCT is higher in UAE you can get it done at a cheaper cost in India. You can use Colgate Prorelief tooth paste for sensitivity. It gives quick relief.

Regards
I find this answer helpful
Dentist Dr. Benley George's  Response
Hello,
Requirement of root canal treatment can be decided only after examining your oral cavity. If the tooth is decayed and it has involved the pulp it should be root canal treated. Root canal treatment usually takes 3 sitting but now there is single sitting RCT which can be done if the tooth is not infected. Since the cost of RCT is higher in UAE you can get it done at a cheaper cost in India. You can use Colgate Prorelief tooth paste for sensitivity. It gives quick relief.

Regards
I find this answer helpful

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Have Severe Toothache. Taking Amoclan Forte, Dolgit. Took X-ray. Suggested For Root Canal. Should It Be Done Now?

Hello there, Welcome to HCM forum Toothache indicates infection of the tooth that had spread to the pulpal tissues, this can be confirmed by taking an x-ray. Such type of infected tooth can be treated with root canal treatment to save it permanently. Root canal treatment requires 3-4 sittings it can also be done in a single visit depending upon the condition of the tooth. If you are having a continous unbearable pain I would suggest you to start the treatment immediately. Delay in treatment will definately lead to spread of infection. If the pain is under control with the medications, so you can maintain a good oral hygiene you can visit the Dentist on the day of appointment and discuss whether the treatment can be postponed for two more months or not. In case if you are having sensitivity with the teeth you can use desensitizing toothpaste like Sensodyne. Hope this helps out. Regards.