gum infection in root canal tooth

[Cindyo]

Im a nervous patient...When I get novacaine with epinephrine in it, my heart pounds, I start shaking....So I take a valuim before any dental work. I now have an infection in my root canal tooth. I had the root canal done 40 years ago. My dentist took xrays and said i had an infection. He found it on a normal bite wing. I have absolutely no symptoms. My tooth never bleeds. I am 70 years old. Can I possibly just wait and see if I get some symptoms before I see an endocomist? It is very tough to spend 300 for a consultation regarding this issue when I have no pain or any symptoms. I am using a special mouthwash the dentist gave me. Would it hurt to just wait till my next 6 month cleaning to get another xray to see if this infection has gotten worse? If I do get any of the mentioned symptoms before my next cleaning I would get right to the dentist. What are your thoughts? Can I wait it out safely?

 

[Gordon]

I'm confused. If you've got an infection in the gum, then there is no reason to see an endodontist. If it's an endodontic problem then you don't need special mouthwash...

Can you clarify exactly what you've been told is happening by your dentist?

 

[Cindyo]

Hi...I went for my 6 month cleaning in dec. the Hygenist said that my teeth and gums looked great, no bleeding of my gums, no signs of gingivitis. Then the dentist came in and said he wanted a look also. He poked my gum where my 45 year old root canal is, with like a metal toothpick thing that they use. My gum started bleeding bad... He said he thinks I have an infection at the root canal and prescribed me a special mouthwash and toothbrush to clean up in my gums where the upper right root canal tooth is. I went back in jan....He then took an xray and said it was a gum infection. he sent me to a periodontist. She did a full paragram of my whole mouth and said that I did have an infection in the gum at the root canal tooth. She then gave me the name of an endodontics dr who only does root canal and root canal repair with a apicoectomy. I have made an appt with him in two weeks. I am 70 years old. I have a dental phobia somewhat where I have a sensitivity to epinephrine and have to take a valuim to counteract the shaking and heart beating that I get from the novacaine injection. I have NO symptoms, I am otherwise very healthy in great shape, look 50, no other medical issues. On this forum it seems like its 50/50 of a successful apico procedure. I brush harder, softer, etc, I do not produce any bleeding or pain....Id like to just wait and see, and if the infection gets worse and I do have bleeding or pain I will go to the dentist to have it pulled. I will get an implant. I dont want to spend 1700 for this procedure only to lose the tooth some time anyways. what are your thoughts? thank you.

 

[Gordon]

I'm sorry, but this is my best guess from what you've told me... it's sounding like you've got periodontal disease which has led to bone loss around this tooth, if the bone loss goes far enough then you can get bacteria into the root apex area, which then causes the root canal to fail.

We call this a "Perio-endo" lesion. It almost always results in the loss of the tooth. Redoing the root canal is pointless as the bacteria will still get in via the lost bone and you can't replace the bone when it's been lost.

Chances are you're not getting any symptoms because the infection is draining out through the gum area.

What you choose to do about it is down to your appetite for risk.

Leaving it as is can result in a major flare up at a time which might be inconvenient to you, think Xmas day or your birthday dinner etc, or it might never flare up at all. You will be living with a chronic infection in the area, which isn't a big problem for somebody with a healthy immune system, but could be a bit of an issue if something happens to that.

Your dentist is probably best person to go over your options with you, rather than my best guesswork.

 

[Cindyo]

Thank you very much gordon for your sound advice. These dentists nowadays tend to scare ppl imo. Telling me the infections "COULD" go to my brain etc. I am not willing to put myself in pain in order to MAYBE have the apico be a success. I am very healthy otherwise. I had a bad infection in my lower tooth 3 years ago while in AK on vacation. My tooth was starting to bleed a lot while brushing, no pain at all. I went to my dentist the next day after coming home and he said it was badly infected and pulled it the next day, so I have been on vacation when stuff has happened. I must be very pain tolerant. I will talk with my dentist but am willing to wait until I get the bleeding or pain to have it pulled. I agree with you, that I will prolly lose the root canal tooth eventually anyways even with the apico procedure. thank you for your advice....and input