Please help. Dentist on vacation. Swelling, numbness normal after root canal?

[valleykat]

I began having a toothache on my front right tooth last Friday.  Over the weekend, it became more and more uncomfortable.  By Monday morning, I was feeling numbness and swelling in my upper lip area in addition to the pain.  I called my dentist and they got me started on penicillin Monday afternoon.  I went in yesterday morning.  They took xrays and started a root canal without ever really saying much as to what was going on.  The only thing I really gleaned from my dentist is that there was an infection and that the nerve was dead.  This tooth is on it's second crown, which I got two years ago.  He left the crown intact and went in through the back.  He packed it back up and told me I needed another visit to complete it, which they scheduled for two weeks from now.

I asked the hygienist what I should expect and she indicated that I should be pretty much back to normal by today.  She said that if the pain went away and then came back after a few days that I should be sure to let them know.  Well, it's never really gone away. The swelling and numbness is the same, maybe worse.  It's like I have a shot of novacane in my lip.  I cannot smile.  I don't have any tooth pain though, just a tenderness in the gum area all the way up to my nose, especially if I put any pressure on it.  I called their office and they are out until Monday.  The exchange said that they would relay my message, but I haven't heard from them.

Perhaps this is all normal, but I just don't know.  I am continuing the antibiotic treatment.  Should I be concerned?  

[Jerome Bogin, D.D.S.]

The clinical infection has not cleared up and it is correct for you to remain on the antibiotics. If the swelling gets worse I would suggest you see the doctor that is covering for your dentist, an endodontist or an oral surgeon.Also rinse out with very warm saline rinses as much as you can.

[valleykat]

Actually the swelling seems to have spread a little.  I have a 1/2 inch long oval area under my eye that is puffed up.  It's kind of weird.  I don't know if it's related but it would be odd for it to just suddenly appear if it's not.  I talked to another dentist's office that I have been treated at, and they expressed concern and suggested I see my primary physician for a shot of antibiotics.  They encouraged me to keep trying the dentist that did the root canal.  I called the exchange again and he called me right back this time.  Apparently, he tried yesterday and got no answer because we have call waiting and my daughter didn't switch over.  He acted like it was no big deal and would go down in time.  He said I could get the shot to speed things along.  It wouldn't hurt, but he didn't think it was necessary either.  I am trying to get into my g.p. for the shot because I am going out of town and I would feel better to do something.

[valleykat]

Thank you both for replying.  It is about the same today, no better or worse.  I will try the saline solution, basically a salt water rinse, correct?  I am leaving for the holiday weekend today, so hopefully, the situation will improve.  

[mike1105]

perhaps the back of the tooth (the access) needs to be left open for a few days so the tooth can drain. in my practice, when infection is eviden, I almost never closed the hole up until the patient was feeling much better. i would leave it open for a few days while the patient was on the antibotics. almost always, the swelling went down.