Can a tooth ever have too much infection for a root canal to treat it?

[Issa150]

For a bit of a backstory I am currently in the process of having quite a bit of dental work done. My top teeth are too far gone at this point to save enough to matter so I will be getting them all extracted soon and a full upper denture made. My bottom teeth, of what's left, are in fairly decent shape and my regular dentist is working up a plan on those. Well a couple weeks ago my bottom molar began to hurt. In the course of just over 24 hours it went from being slightly sore to unbearable and my face began to swell. At the same time I had an appointment with my dentist to develop the plan for my bottom teeth. He looked at the molar that was bothering me and said a root canal could save it so he referred me to an specialist and wrote me a prescription for penicillin to help with the infection. Well it's been a crazy two weeks, 2 days after I met with my dentist I had to go out of town for work, and then had to do the same this past week. Needless to say my appointment with the specialist is just over a week from now. However, I am starting to wonder if this tooth can even be saved. I am in the middle of my 2nd round of antibiotics for it and while it's better and the facial swelling is gone there is still a pretty big abscess on the gum near the tooth and it still throbs occasionally and has pain that seems to travel down to my jaw bone. I have never had a tooth so infected that a round of antibiotics didn't treat it until I could get the tooth itself fixed. Will a root canal really be able to fully treat the infection? Coulid it be that the infection in this tooth is so bad that the best course of action would be an extraction? Also the tooth itself is in pretty bad shape. I believe it at one time had a fairly large filling that I must have lost. Pretty much the entire back of the tooth is completely gone. Can a tooth with so much decay be successfully root canaled? I always thought with that much of the structure of the tooth gone it was unsavable. I am trying to figure out if I need to proceed with my root canal appointment or just make an appointment with my oral surgeon instead to have the tooth pulled.

As a side note I have had multiple bottom teeth extracted previously so while all my front bottom teeth are still intact I only have one remaining molar (the first molar) on each side, past that all of them have been extracted. My dentist has talked to me about getting a partial denture for my missing bottom teeth. Does the partial denture need the molar to hook to? If I end up having that bottom molar extracted will it effect my ability to get a good fit from a bottom denture?

Any my help or advice is greatly appreciated!

 

[gentledental]

If the tooth has pus coming out then we usually place a medicament to dry it up and then we try and fill it at a later date. We need the root canal to be dry so then we can get a good seal.
If you have a massive abscess then the swelling is caused by fluid buildup so the root canal would be impossible to seal.