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Severe ache on tooth with root canal, infection, taken medicines, persisting soreness and swelling on face with fever. Spreading?

I had a very bad toothache for about 3 days and didn t understand why because the tooth that was so painful was on that had a root canal and crown place over it over a year ago. So I went to the dentist and they found a huge infection in that tooth and that it had reinfected itself. They put me on clyndamiacin and Iv been taking that four about four days I m not sure if its helping my tooth gums and face are still very sore and swollen and its followed by a fever of 101 just feel very weak and tired and wanting to no if there is a possibility the infection is getting worse or spreading?
Asked On : Wed, 3 Oct 2012
Answers:  7 Views:  159
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Dentist 's  Response
since the tooth has got re infected it needs to be re treated. since the area that is the tooth is closed . it must be opened through the canal i;e redo rct so that drainage of the pus is attained. trust me drainage is the only treatment for pus . antibiotics and painkillers only help when drainage has been established.
so first get the pus drained and then everything else will work
Answered: Mon, 22 Oct 2012
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Dentist Dr. Bindiya Bhaskar's  Response
hello and welcome,
as you have pain on the root canal treated tooth with crown on it,there are many possibilities.
the huge infection may be due to-
1.poor oral hygiene maintenance as a result of plaque and deposits of food debris in the interdetal areas which caused gingivitis.
in such cases remove the crown placed and get the scaling and root planning done by your dentist.
2.faulty RCT done like incomplete pulp removal,perforation/ledge formation/ x-ray will reveal whether re-rct is needed.
3.improper crown placement-which interfer with occlusion and chewing of food .replace the crown and check the occlusion.this can even cause temporomandibular joint dislocation/tenderness.
Answered: Wed, 3 Oct 2012
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Dentist Dr. Katta R Venkatesh's  Response
Hello Welcome to HCM Public Dental health forum,
You have mentioned you have been prescribed clyndamycin which is given to take care of infection but you need to take analgescis along clyndamycin to control the pain. You can start with Hifenac - P or Zerodol-p to getrid of your pain. These medications are just symptomatic which will not solve your problem, To get rid of the problem you need get it treated with re-rct with scaling & root planing if it is perio-endo problem. Till then you keep rinsing your mouth with normal saline.

Thanks & Regards,
Dr Katta R Venkatesh

Answered: Wed, 3 Oct 2012
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Dentist Dr. Udaykumar Bondre's  Response
Hello & welcome,

Symptoms you have mentioned here are typical of the infected tooth though it may have been treated by Root canal Therapy in the past.

If there is large infection noticed by your dentist, then intake of Antibiotics & painkillers only will not be sufficient to resolve the problem.

I hope that your dentist had taken a x-ray of the same tooth which is must in your case to know the exact cause and extent of the infection.

Tooth which is treated by Root canal Therapy might get reinfected if there was some debris of necrotic pulp tissue remaining in the canal before obturation.
Another reason is the filling in the root canal being over extended or tooth might have got fractured.

Evaluation of adjacent teeth is very important to know the exact focus of the infection.
Final solution will be to repeat the root canal treatment with proper sterilization & accurately filling the canal with inert material to achieve intact periapical seal.

You might be feeling weak due to use of antibiotics which causes disturbance in gastric flora thereby reducing willingness to eat.

Eat high protein containing diet, drink plenty of water to avoid dehydration & fatigue.

Take care.
Answered: Sat, 20 Oct 2012
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Dentist Dr. Santanu Sain's  Response
your history reveals that either your rct was not done properly or your rct treated tooth was exposed to accidental massive force (such as chewing a very hard substance accidentaly during eating)....but now if the infection is controllable re-rct is only the treatment you have for which you will be better to go to an endodontist...mean while you may take antibiotics,analgesicsand antacids ,if required to get symptomatic relief....wish you good health .thank you.
Answered: Wed, 3 Oct 2012
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Dentist Dr. Geoffrey Ward's  Response
Hello and thank you for your question.
Your infection sounds like it has been getting worse. The antibiotics should help but if it's within the bone and an abscess, antibiotics typically will not help unless an incision and drainage has been performed on it. The tooth has a failed root canal and either needs to be retreated or extracted at this point. A fever of 101.5 F and higher is a good indication that an infection is active.

I encourage you to get this treated with an I&D, RCT or EXT as soon as possible.

Best regards

Dr. Ward
Answered: Sat, 13 Oct 2012
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Dentist Dr. Neha Sumra's  Response
Welcome to HCM
I read your query & would like to tell you the chief causes of such RCT treated teeth:-
-faulty RCT- due to improper pulp debridement, improper working length, improper obturation or perforation
-faulty prosthesis-can be some high point in your capping which might be pinching you.

You need to go for proper investigation of tooth like get an IOPAR done & check there can be some peripapical infection.
Also get started with Zerodol SP thrice a day along with amoxi-clav 625 twice a day & some multivitamin capsule once daily.

Take Care
Answered: Tue, 9 Oct 2012
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