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Have fully abscessed tooth. Took antibiotics. Considering extraction. Developed severe pain. Suggest?

Dec 2012
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Answered by

General & Family Physician
Practicing since : 2012
Answered : 1704 Questions
Hi - I have a fully abscessed tooth (#31) and have been on six different antibiotics (amoxicillin, zpac, cipro, flagyl and now clindamycin) over a period of 8 weeks.Dentist did partial root canal and has waited for infection to get better, which it has not. I am considering extraction vs. root canal. I have also developed a severe pain in my right knee. Someone suggested it might be infectious arthritis. Is this possible and what are benefits of extraction vs. root canal?
Posted Mon, 21 Oct 2013 in Dental Health
Answered by Dr. Nsah Bernard 2 hours later
Brief Answer:
Partial root canal fails extraction is alternative

Detailed Answer:

Thanks for posting on XXXXXXX

First you need to know that, a partial root canal removes the nerve(s), arteries, veins, and infection from a tooth but keeps the root hence your tooth. In the other hand, tooth extraction removes your tooth completely hence all the possibilities of an infection persisting. If partial root canal failed, then tooth extraction is the next best alternative which should be considered in the immediate as complications of dental abscess are much more worst. Also, abscess draining is a considerable treatment too.
Before we accuse infectious arthritis (which is a possibility given your dental abscess) we could also look at use of medication such as ciprofloxacin as a likely cause of knee join pain (arthralgia as side effect). I believe that with all the antibiotics taken, you developing infectious arthritis is an unlikely possibility. To me ciprofloxacin might be culprit especially if the pain started shortly after you started the treatment. Some tests such as ASLO, CRP, ESR etc could help rule out or confirm the suspicion of infectious arthritis. You will have to see another doctor beside a dentist to check on that.
Also analgesic medications should be included in your treatment to help with both the pain from dental abscess and the arthralgia.
Sorry for all your trouble and I hope you recover soon enough.

Hope this helps and wish you the best.
Dr. Nsah
Above answer was peer-reviewed by
Follow-up: Have fully abscessed tooth. Took antibiotics. Considering extraction. Developed severe pain. Suggest? 1 hour later
Dr. Nsah - thank you for your well thought response. I now on the clindamycin - will that help the knee pain as well, or since it most likely isn't infectious arthritis will it have no effect on it? If, indeed it was the cipro is causing the serious knee (and subsequent shooting pain down shin), how long before this side effect may disappear? I do believe I am going ahead with extraction.
Answered by Dr. Nsah Bernard 27 minutes later
Brief Answer:
See answers below

Detailed Answer:

I am most delighted that my answer was able to throw more light on you.
Clindamycin is a very efficient antibiotics and should be able to help if you indeed have infectious arthritis, but in the other hand, if cipro is the cause of the arthralgia, then the effect should be able to wear off in a couple of days. Some analgesia may help with the pain.
Ok nice to know that you finally decided. Do how ever still ask your dentist his own opinion or if he allows the choice to you, then it is still good alternative to take extraction.

Hope this helps further and wish you the best.
Dr. Nsah
Above answer was peer-reviewed by
Follow-up: Have fully abscessed tooth. Took antibiotics. Considering extraction. Developed severe pain. Suggest? 25 minutes later
Endo was a second opinion - he gave me the choice, presenting extraction as first one and further stating tooth coukd be saved with heroic measures, which leads me to choose extraction. My final question is I am taking Motrin along with the clindamycin and norco for pain for both tooth and knee. Will all this subside when tooth is extracted? I just need to be able to sleep without waking up from this horrible pain in my knee.
Answered by Dr. Nsah Bernard 3 hours later
Brief Answer:
Then it is a good option

Detailed Answer:

Thanks for the update,

Actually you have a combination of 3 pain killers motrin (ibuprofen) and Norco (Hydrocodone Bitartrate and Acetaminophen) with clindamycin as antibiotics. These 3 pain killers should normally had to put the pains away. If after tooth extra, say in a couple of days the knee pain does not improve, I suggest you see a pain management doctor or a GP for further evaluation. I might have been wrong on the cipro side effect and you might be having non-infectious arthritis which will require another considerable treatment.

Hope this helps further.
Dr. Nsah
Above answer was peer-reviewed by
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