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Infection after gum surgery
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang. Topics covered include bridges, cavities, crowns, and x-rays.

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Infection after gum surgery

I had a large cracked filling replaced about a month ago.  The gum in that area had been sore ever since, so I went back to the dentist.  It was between #19 & #20.  Turns out a piece of the new filling lodged into my gum and it got infected.  The dentist said that the filling didn't take, and that I now needed a crown on #20.  He was going to fit me with a temp crown.  

When he gave me a recap after the procedure, he told me he had to perform gum surgery due to the damage from the filling.  He cut away a piece of gum all the way around the front and back of the tooth.  He put on a temp crown & sealed the inside of my mouth with dental putty.  The outside gum closest to the cheek was not covered with the putty, so I can easily see it.  He did not prescribe any antibiotics.  This was 4 days ago and I think the gum is infected.  It still bleeds, but not a lot.  It hurts & burns more every day.  The gum is red and a little swollen.  There is a large dark area between the tooth next to it, and there is a white spot next to that.  A piece of the putty fell off today and now there is a white "blister" thing there.  I called the dentist and he told me that there should be no infection because he removed it all.  He did call in antibiotics today after I asked for them.

The tooth is also very sore.  I don't know if it is because of the crown prep, or because I need a root canal.  He recommends that I get a root canal on the tooth before fitting the permanent crown.  He says the tooth doesn't need it right now, but I should do it now as a preventative measure.  

So finally, here are my questions.  Does it sound like the gum is infected or is this normal 4 days after gum surgery?  Should I get the root canal even though I don't need it right now, or should I risk ruining a crown in the near future?  Is there any way of knowing if this dentist caused the damage in the first place?  Should I get a second opinion?  

Thanks for listening to my sob story, I appreciate any help!
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It sounds more to me that you're experiencing some discomfort and soreness from the crown lengthening procedure (I think that's what he/she did).  

As for the root canal, its a hard call to make.  I've had both scenarios happen.  One in which we avoided the root canal for several years.  Others where the patient came back with an abscess and swelling due to the infection spreading rapidly.  I, and I don't think any dentist, can accurately predict your particular situation over the internet.  If the odds are greater than 50/50 of needing a root canal soon, I would get the root canal done.  

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Irvine Modern Dentistry
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