post root canal pain and decreased facial sensation

[Maggierose]

I had a root canal on 1/24/06. The dentist opted not to put me on antibiotics at the time saying that he felt that I had just worn through my dentin and there was no infection present. I was told to take ibuprofen for discomfort, which I did as directed. I knew something was not right when the pain post root canal was worse than before. As of 1/25 AM my face started to become swollen and I contacted my dentist who called in a prescription for penicillin which I began almost immediately and have been taking as directed every 6 hours. I am running a low grade fever, ranging from 99.4 to 100.5, I have decreased facial sensation in the area of tooth 20 (the affected tooth), and I still have very slight facial swelling with a swelling at the root area of tooth 20 which I can feel with my tongue. I am happy to report that it is not especially painful but I have continued to take ibuprofen every 6 hours along with the penicillin. I know that I have to contact my dentist but I am curious to know how often this happens? This is my fifth root canal and this is my first bad experience. Is it likely that what I feel with my tongue is an abscess? And if it is, does that mean the entire thing must be done again or can that abscess be drained? And is the decreased facial sensation secondary to the presumed infection? or is it nerve damage? I realize that you can not answer with absolute certainty but I kind of want to know what to expect when I call my dentist again on Monday morning! Thanks for any help you can provide.

[Jerome Bogin, D.D.S.]

It sounds to me like the tooth was non--vital when the RCT was started. That means the nerve was dead and necrotic. There is bacteria present in the root which sometimes gets turned on(for a better term)when the tooth is touched. This would be the cause of the swelling.I don't know if the RCT was completed.I would rather have the tooth asymptomatic before the treatment was completed.The numbness could be directly related to the swelling and the feeling should return as the swelling diminishes.

[mike1105]

sounds like a post operative infection,.. either their is an abcess (abscess), or, less likely, there is trauma/infection from the anesthetic injection. usually, if the root canal procedure was done well, atibiotics will take care of it and your nerve sensation should return to normal. sometimes the infection has to be drained thru an incision but if it were me I'd prefer the root canal filling be removed and the procedure redone by a specialist rather than draining the infection by making an incision. there is no harm in seeing a root canal specialist for an opinion on the quality of the root canal procedure if your symptoms persist or if you are not satisfied..  go to someone your dentist does not refer to. if the antibiotic is effective you should start to see improvement in 24-48 hrs.

[fluidfeet]

A related discussion, root canal was started.