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tooth infection facial swelling/reaction to med?
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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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tooth infection facial swelling/reaction to med?

Severe toothache of a lower leftside tooth has been diagnosed as infection by my dentist; this tooth had a long-ago root canal and subsequent crown so he recommended re-evaluation by endodontist. (my dentist first presribed antibiotic (clindamycin) and vicodin for severe pain.
Saw the endo yesterday, said to wait for infection to clear; then will re-do the root canal (either by drilling hole etc, plan A, or the apicentry (sp?) procedure. However since yesterday, my face on left side  (by teeth) has swollen, is warm, and slightly sore. It feels lumpy, and is more swollen today than last night. No fever. It's not under my togue, and my lymph nodes don't seem swollen. The inside of my mouth almost feels like its had novacaine, getting numb.
I'm at a loss as to why the face swelling after I'd started the antibiotic 24 hrs? Could be allerigc to vicodin?
any insight most appreciated. Thanks
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Avatar_dr_m_tn
It is posssible that the antibiotics didn't get to the infection in time and the swelling is still a result of the infection that is present.I am more inclined to think that the retreatment is a better choice than the surgery.
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Avatar_m_tn
antibiotics typically take 24-48 hrs to "kick in". I would at this point make contact with the endodontist to let him (or her) know of your situation. You should know that apicoectomies are not always successful--and have a worse prognosis the farther back in the mouth you go. Retreatments are also not always successful, they definitely have a lower success rate than an initial root canal procedure. Before undergoing any treatment you may:

1. want to obtain a second opinion
2. wish to have the crown removed and the tooth itself checked for fracture, which is a common cause of infection in teeth that have had root canal procedures. Apicoectomies and retreatments are both involved and expensive procedures. you should rule out tooth fracture as a cause of the problem before proceeding. If it is fractured, it most likely will need extraction.

Lastly, even at this point you should have ALL the pros, cons, risks, bebnefits and alternativs explaned to you, including extracting the tooth NOW and placing an implant. Sometimes this is the best route given a particular prognosis. This should ALL be discussed at length with your reular general dentist who is in charge of ALL your teeth, and who has the knowledge AND the time to do this.
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Avatar_n_tn
A related discussion, Infection how bad can it get? was started.
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