Fear over Post Root Canal Pain

[Nyxia]

I used to be so terrified of the dentist that I couldn’t even attend a check-up, but have been mostly fine with minor things recently.
However, exactly a week ago, I had to go for a root canal on my left upper front tooth (first part, there’s some sort of medicine and a temporary filling right now). I fell on the tooth and chipped it over a decade ago, had no issues for a long time and then only what felt like mild gum irritation before the treatment.
The X-ray showed a fairly large shadow at the root, there was no reaction to cold and the dentist said there wasn’t much left of the nerve.

Since the treatment, I’ve been in more or less constant pain (moderate, interferes with activities, but not unbearable). The area above the tooth has a swelling and aches even on Ibuprofen. My jaw feels tight and hurts and most of the teeth on that side hurt at points. The tooth next to it feels odd to bite on. There is no visible facial swelling.
I’ve been on Amxocillin 500mg 3x day. It hasn’t gotten worse, but it also doesn’t feel like the pain is improving much.
My dentist says to wait until I’m done with the antibiotics unless it gets worse, but I’m extremely anxious and exhausted from the constant pain. Is this normal?

 

[Gordon]

Not normal but it can happen. Sometimes when there's a chronic abscess present, going in to treat it seems to really stir it up Doesn't mean that the treatment won't be successful in the end though!

 

[Nyxia]

Thank you. Would the adjacent (or, due to crowding, more like slightly behind & adjacent) tooth feeling kind of numb when I bite on it also be something that could be caused by this?

 

[Gordon]

Yes. The nerve supply to the upper teeth is a real mish-mash of nerves going everywhere, it's quite hard to be specific when it comes to sensations in the upper arch.

 

[AlexG_308]

@Nyxia How's your tooth doing now?

 

[Nyxia]

It settled down after about two weeks, and I had the treatment finished six days ago. Might not be the end of things, though, as I've just started having some pain again, and from the x-rays last week, the dentist said there might be a cyst there. So better, but not great.

 

[Nyxia]

Hello again. I've not had much fun with this tooth since my last post. The root canal was finished on 9/11 and I had a few days with just some soreness, nothing else. The doctor said the root canal looked good on an x-ray, though he seemed a bit concerned that there wasn't much healing of the radiolucency and said it might be a cyst that would have to be removed later, if it's still looking off in 3-6 months.


Over the past two weeks, there was always some level of tenderness / pressure with the tooth. Earlier this week it moved to mild - moderate pain plus pressure and the little lump high above the tooth got a little bit bigger. The dentist put me on Amoxicillin 500mg when I called, which I've been on since Wednesday morning (same antibiotic as before, in-between treatment stages). The pain got a little bit worse and the lump a little bigger in the first 24 hours of the antibiotics, and nothing seems to be improving so far.
Is all of this normal / expected, or should I have been seeing improvement on the antibiotics already / not have had pain and a swelling in the first place? I'm quite scared I might lose the tooth.

 

[Gordon]

Might need a different antibiotic, amoxycillin is very effective against one class of bugs but not the other major class (aerobic and anaerobic if you're interested) so a change to an antibiotic that kills the anaerobes might help. There's a fair number of things that can be done before anyone reaches for the forceps though, don't panic!

 

[Nyxia]

Thank you. I've got a bit of a follow-up question on that: I've finally managed to see the dentist who treated me. The pain is now more occasional twinges and tenderness rather than actual pain. The lump still seems quite a bit larger than, say, two weeks ago. The approach seems to be to wait, and then potentially do some sort of scan that's better than a x-ray in a month or two, to see if there's a cyst.
Does this sound fine or should I be getting a different antibiotic or some sort of other treatment?

 

[Gordon]

Don't really want to try to second guess a dentist who has actually examined your mouth, so I'd not be arguing with what they want to do, sorry.