Do I Still Have an Infection Months After Tooth Extraction?

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After seeing my dentist for a broken crown, she took an x-ray of the tooth and said it was infected. My dentist referred me to an endodontist for the root canal. Months after the root canal, I felt referred pain in the tooth in front of the root canal tooth. I reported the issue to my dentist during my next cleaning appointment. An x-ray showed the tooth was still infected.

I called the endodontist, and she prescribed penicillin. I’ve had a series of family health issues and could not return to the endodontist as life would have it. Two months ago, an oral surgeon extracted the tooth. Still, I have jaw pain below the area of the tooth extraction. I was planning to get a dental implant to replace the extracted tooth, but I am concerned that something is not healing correctly.

I do not trust my dentist’s opinion. Could I still have an infection? And why is it lingering? – Thank you. Juliana from NM

Juliana,

Dental implant model with the fixture in the bone

A dental implant helps preserve bone and prevent your teeth from shifting

Unfortunately, you could not return to the endodontist to save your tooth. Still, you are wise to pursue getting a dental implant. An implant will preserve your jawbone in the space and prevent other teeth from shifting, disturbing your bite, and creating orthodontic issues.

Although it is rare to have a lingering bone infection after tooth extraction, it can occur. If you have an infection, a potent antibiotic can get rid of it. We recommend that you return to the oral surgeon for an examination.

Also, a post-operative infection can result from an antibiotic-resistant infection. So, you would not want to retake penicillin to get rid of the infection. Ask the oral surgeon to try different antibiotics to help you progressively heal.

Dr. Steven Brookser, a Fellow of implant dentistry in Baton Rouge, sponsors this post.

Unsure If You Need Root Canal Treatment? – 4 Clues from the X-ray

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In April 2019, I received a filling in a tooth, and now my new dentist is recommending root canal treatment. I relocated, and in January of this year, I went to a new dentist for my yearly cleaning and exam. I also received x-rays, and the dentist said that the x-ray seems to show some decay beneath the April 2019 filling. She recommended root canal treatment, which I declined at the time. Now that I have time to think about the tooth, which isn’t bothering me, I want to get an online second opinion. If there is decay, I don’t want it to get worse and end up needing an extraction and dental implant. – Thanks, Segura from San Antonio

Segura,

X-ray of an invisor tooth with a filling and a dark spot beneath it

Although there is a dark area near the fillng, the tooth doesn’t need root canal treatment, an extraction, or a dental implant

Thanks for sending us a copy of your x-ray. Maybe dental schools need to give more training in x-ray diagnostics. Although Dr. Brooksher would need to examine your tooth, your x-ray doesn’t show inflammation or any reason that a dentist would disturb it with root canal treatment. But what about the dark area beneath the filling?

Facts About a Dark Area Beneath a Filling

  1. Dark areas – Not all dark areas on a tooth x-ray are a result of tooth decay. Decay, a gap in the filling, or a radiolucent material beneath the filling will appear dark on the x-ray.
  2. Location of darkness – The dark area on your x-ray is on the surface of your tooth. In this case, your dentist can use an explorer and poke the area. If it’s soft, there is decay.
  3. Effect on tooth pulp – Tooth pulp includes the living tissue and nerves inside the tooth. Root canal treatment removes infected pulp. When the dark area on your x-ray isn’t near the pulp, you don’t need root canal treatment. On an x-ray, it might seem that the dark area is between the filling and tooth pulp. You can resolve the illusion while looking at the x-ray: Cover the white filling with your finger and look at the remaining tooth structure. You can see the dark area and the distance from the pulp.
  4. Comparison with adjacent tooth – The lamina dura is a thin white line around the tooth root. An infection will break the line around the root tip or pull it away from the tooth. Look at the x-ray on this page. The tooth with the filling, and the canine tooth next to it, has a lamina dura that intact. Both teeth are healthy. You won’t need root canal treatment. And you surely don’t need an extraction and dental implant.

If you still have reservations about the health of your tooth, consider scheduling an appointment for a second opinion. You can take your x-ray with you for a dentist to examine it in person.

 

Steven Brooksher, DDS practices in Baton Rouge, LA. Dr. Brooksher is one of ten dentists in Louisiana accredited by the American Academy of Cosmetic Dentistry.