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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 3188
Experience:  Dentist and Anesthesiologist for 37 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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I had a root canal last Friday. It was a redo of a ten year

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I had a root canal last Friday. It was a redo of a ten year old root canal. Apparently I had a tributary that was missed. I was on antibiotics prior and took my last dosage on the day I had the root canal. After the root canal it seemed to be progressively getting better until today. It seems to be on the verge of becoming uncomfortable again. It should be noted that I have not been eating on the tooth because I have a partial below and haven't been wearing it to allow the tooth to heal. I am 60 year old female.

Do you have an X-ray of the tooth in question that you can upload. Do you currently have any swelling? Do you have missing teeth on either side of this root canaled tooth?

Customer: replied 13 days ago.
No I don't have an X-ray. The regular x Ray could not find anything. Had the 3D kind and he found the tributary. No swelling...no missing teeth on either side

You stated that you were wearing a partial so there are missing teeth somewhere.What type of symptoms were you having that prompted redoing the root canal?

If you normally wear a partial and then stop, the teeth can shift enough to actually change the bite enough to cause too much pressure on the teeth adjacent to the missing teeth next to the partial and the opposing teeth.

Customer: replied 13 days ago.
I had a tooth pulled in July. It was part of a permanent bridge I have because I had a molar that never grew in when I was younger. I opted for a partial over implants. The partial is for the two molars on my lower jaw. The bad tooth is the molar on my top jaw directly over the pulled tooth. The bad tooth is the second to last upper molar..

What were the symptoms with the tooth that prompted redoing the root canal?

Customer: replied 13 days ago.
It kind of felt mildly uncomfortable to chew on. I would wiggle it and it seemed more irritated. It eventually started hurting the side of my face...kind of like bad sinus....called the doc and got antibiotics then he did the root canal a week later.
Customer: replied 13 days ago.
Never any swelling. Had the 3D image about a month before.....and doc said he saw the infection but it was contained within the tooth so didn't prescribed anything until I called because of the pain

If you could wiggle the tooth,it may be that your problem was a periodontal problem(gum problem) rather than a problem with any missed canal in the tooth. After 8 years,if there was an infection from a missed canal,it would have been detected on an X-ray. Most of the time the problem with these teeth are gum problems. It is impossible to see an infection inside of the tooth. An antibiotic cannot kill an infection inside of a tooth.My suspicion is that this tooth did not need a retreatment at all. I am sure that you paid a lot of money for it too. I believe just from your symptoms and history that this tooth did not need a retreatment.The xray at this point would enable me to confirm that for you.I will repeat,X-rays cannot see infection contained within a tooth. Infections never stay in a tooth.As the bacteria multiply,they leave the tooth through the apex and destroy bone. The X-ray would show bone destruction and yours showed nothing.

Customer: replied 13 days ago.
Hmmmm...I floss daily and I have not smelled any thing bad from flossing that tooth. I constantly had an odor from the tooth below that was pulled. Yes I paid lots of money. I initially just wanted the tooth pulled. But my tooth pulling dentist said it was better to try and save it. So I went to the place who has done all my root canals. How do you fix this type of gum problem?
Customer: replied 13 days ago.
Also I did see the X-ray before and after which showed the tributary was done.

I will further add that teeth that are mobile,are not good candidates for doing root canal retreatments on.My take is the reason that the tooth is uncomfortable again ,is that an improper diagnosis was made.These upper molar teeth have 3 or 4 roots. If there has been any bone loss around the tooth from tooth extrusion,they develop something called furcation involvements. They are very difficult to treat and many times end up being extracted.If the unfilled canal was your problem,you would not still be having problems.

Customer: replied 13 days ago.
The tooth did have three roots he only redid one. Not sure if this matters but this was the first root canal that actually hurt during the procedure. I told him ...but I declined further numbing because he was almost done.

After 8 years ,it would be highly unlikely that there was any live nerve tissue in the tooth. If you had pain in this tooth during the procedure,I am questioning more the anesthesia technique that was used and the person administering the anesthesia. There should have been no reason for you to feel any pain whatsoever while treating this tooth unless they perforated your sinus while doing it.That tooth is by all definitions,dead and does not even have the ability to transmit pain. The pain is coming from the tissue around the tooth and the ligament and not the tooth itself.In any case, if the local was given correctly,you should not have felt any pain at all.

My feeling is that you were misdiagnosed.The tooth either has a vertical fracture or you have a gum problem around the tooth.I would ask for my money back for the retreatment.

Customer: replied 13 days ago.
I seriously doubt I will get my money back... but I am definitely going to ask for my part back...the rest was paid by insurance. So it sounds like my next step would be to get the tooth pulled? Should I have them check regarding whether the sinus was perforated before doing that?

If it were perforated it would only be a small perforation which will heal in time. There is no way to really check it.The roots of the upper molars do protrude into the base of the sinus in many people.You can always ask the insurance company to return the money back into your account and they will withdraw the payment that they made to the dentist.Amoxicillin 500 mg every 8 hours for 7 days should cover the gum and possible sinus problem.Do you have a stable tooth behind and in front of this tooth?

Customer: replied 13 days ago.
I have stable teeth in front and behind. I just got off of amoxicillin last week before the root canal.

You can easily have a bridge made if the tooth needs to be extracted. If you can get a copy of the X-ray,I could give you a better idea of what is going on and how to proceed.If you have swelling now,it indicates that the problem was not solved.

Customer: replied 13 days ago.
Ok I don't have swelling that I can see. I will try to get the X-ray. Thanks

You are welcome. If you start to have swelling in your face,you need to get to a dentist that has more experience so that a proper diagnosis can be made.

Dr. Katz and other Dental Specialists are ready to help you
Customer: replied 13 days ago.
Thanks....always happens on the verge of a long weekend lol��

Sometimes if there is really no swelling,you may just need a minor bite adjustment. If your bite is off,it could make you feel like you have a toothache. It only takes a few seconds and just involves flattening slightly the cusp of the tooth that is in contact with the opposing tooth.

Customer: replied 1 day ago.
Hello again to recap I had a redo on a ten year old root canal about two weeks ago. The tooth had been sensitive and I had started to get some pain on the side of my face...the pain was tolerable. I have had root canals before and know that it can be sore after the procedure for some time. However, I am more than sore. I am getting random shooting pains on the side of my face. I went back to the dentist yesterday. He said the gum on the inside around the tooth looks a little inflamed. He was going to put me on antibiotics but I had just finished a course of them two weeks ago. So he wanted to put me on steroids and I said no. He advises taking 400mg Motrin every four hours for five days. I just think the tooth should be pulled. What do you think. There is no swelling that I can see.

Please see my response in your new posting.