Root Canal Failure and then retreatment worry for aortic valve problems

[westkane]

Two weeks ago I found out that I had a root canal that failed, you could see the shade shaped round spot on the xray. Been on Clindo 300 3X a day, finished them up 3 days after the procedure. All seemed fine, Saturday nite was horrid, then it calmed down again, then on Monday it begain to ache, not yet throb. Normally pain from canals is just a few days, but now I wonder if the infection had gotten down in the bone and is coming back to life, or should the clindo have killed it off? Kinda nervous about where the discomfort is coming from, the procedure, or something else going on. I go tomorrow for the permanent filling (yesterday I would have said no way as it was too tender) today not so bad (The retreatment was last Wednesday). Should I tell him to hold off on the permanent filling (then I have to get a cap)? Or is ther anyway to tell that I have an infection present? Blood Tests? I had the same tooth act up for a couple of days the it calmed down about a month ago, so I am willing to bet the infection has been brewing for a while. The actual root canal was last year and failed because of leakage (who knows when, but I say it was symptomatic a month ago, then took off over the past couple of weeks. I just have this doubt in my head that there may be infection still lurking around after the retreatment and am half inclind to over react and pull the damn thin out now that it's got $2000 in it. Yes I'm paranoid and want to know if the infection is gone - how can I tell, what tests? As a side note my father died from sepsis then bacterial ebdocarditis when he was 56, he had a unknown heart murmur and had dental procedures (no pre med since it was not known) and slowly starting downhill after that. They found his heart had branch like growths on it during the autopsy. I would appreciate any input/comment you fine folks have. I forgot to mentioned that my root canals were performed by an endodontist, one that I was referred to by my dentist. All told I was on Clndo for 15 days, so would have thought that wouldv'e killed the buggers off. I do have a area on the base of my jaw below tooth is tender (due to the procedure?) (the tooth itself doesn't hurt) that I keep watching. I don't know, but it seems odd too have discomfort 6 days after the retreatment. As a side note, I have made an appt with my Cardiologist, 1st available - Oct 15th. See my general dentist tomorrow to discuss this issue. Thanks for the replies

 

[tom in MO]

Not sure what to say. I've had four root canals and never had your experience. However, I had a root canal from hell given to me by a dentist who gave up 1/2 way through. His boss sent me across town to an endodontist to finish the job. Two full doses of novacain in 3 hours, boy was I flying. Ever since then, I've stuck to endodontists for root canals. They are specialists in root canals. Make sure you are going to a good endodontist. If you are going to a dentist, consider getting the work finished by one.

 

[westkane]

Oh, I forgot to mention that the above wher performed by an endodontists

 

[dick0236]

I would get to my cardio asap. With an artificial valve, you don't want endocarditis(sp?).

 

[Protimenow]

Dick -- you spelled it right.

If you were in the L.A. area, I'd refer you to a really good dentist who helped me over the Thanksgiving weekend, and who, as far as I'm concerned, is every bit as capable - and more compassionate - then the endodontists that I've seen.

In terms of your infection, a blood test should reveal if your white blood cell (WBC) count is up -- this would indicate infection. A good X-Ray of your mouth should show pockets of infection in tooth, jaw, and other tissues.

It sounds like the root canal may have been done improperly -- wouldn't the nerve have been completely removed (so no pain in the tooth)?

In any case, you should consider taking Dick's advice and contact your cardiologist - if only to start some prophylactic antibiotic. You should find a good dentist or endodontist who is familiar with patients on warfarin and know how to manage them.

An extraction may be out of the question if you're taking antibiotics because the antibiotics can cause an increase in your INR.

(FWIW - last week, I lost a filling in a wisdom tooth and was able to get to my dentist the next morning. My choices were root canal and crown or extraction. I was unable to get a good enough drop of blood for testing my INR before I went to the dentist, so the only real choice was the root canal.)

Good medical and dental care should help you through this painful issue. I hope you get both.

Good luck -- I'm sure that a lot of us are eagerly awaiting updates of your status.

 

[pellicle]

Hi

Two weeks ago I found out that I had a root canal that failed

eugghh ... sorry to hear that.

but now I wonder if the infection had gotten down in the bone and is coming back to life, or should the clindo have killed it off?

hard to know with Bacteria ...

Or is ther anyway to tell that I have an infection present? Blood Tests?

to my mind at the moment the most obvious test would be a CRP test, but that's a "blunt instrument" and may not be effective in this instance.

I'd ask my doctor to give me an antibiotic cover for a few days ... can't hurt and as long as you're monitoring your INR shouldn't cause any issues.

better to be safe than sorry.

what valve did you say you had?

 

[Eva]

I would not go for the permanent filling unless all the infection is gone!!

Also, as Tom said, I would see an endodontist instead.

Sedimentation rate of blood is good marker for infection. But, If you have pain, that is enough marker. Check the tender part in the mirror for anything unusual.

Tell your dentist or physician/cardio and ask them to prescribe antibiotics for you.

Do not wait on this. Or go to one of the 24 hrs clinic if there is any near your in case none of your doctors can see you right away.


15 years ago, the temporary filling my dentist started on my eyetooth root canal kept getting infected after a day or so of seeing him. This went on for three weeks. I stayed on amoxicillin all the time until I went to an endodontist to finish the job!! It was very frustrating!

Unfortunately, and like you, that same root canal failed...not sure when. But, I noticed an abscess on September 2nd at the end of the canal while I was on vacation! With my dr's approval, I started taking amoxicillin. Upon my return, my doctor checked me for any murmurs and ordered complete blood work. Luckily, no damages! Once the abscess was gone, I saw my dentist. The X-Ray showed the grey area you mentioned above. My dentist referred me to an endodontist, who in my case will perform surgery instead of rescaling, etc. I am postponing this as I'm scared for now!

Good luck and take action soonest.

 

[tom in MO]

"It sounds like the root canal may have been done improperly -- wouldn't the nerve have been completely removed (so no pain in the tooth)?"

From my experience, after evey root canal you go back for a free checkup with XRay several months later. This is to make sure the root was fully removed and the area is OK. I believe they cannot tell if the job is done and complete w/o follow-up.

 

[Jkm7]

No way I would go forward with making permanent this root canal work until I was absolutely sure any chance of infection had been treated.

Good luck. Hope all is well.
Please let us know.

 

[Terry45]

West, I've just gone through this myself. I had a root canal that had failed and had infection in it. I was actually getting a reoccurring abscess bump on the gum that I would have to pop. I had it extracted about two months ago. Once a root canal fails there is not much you can do for them other than extraction. It took me months to get it looked at, scheduled and extracted. I was really starting to worry about the affects of the infection by the time I actually had it extracted and wish I would have had it extracted sooner. I have not had any issues since but probably should have blood checked for precaution. I would not mess around with fillings. Take the amoxicillin and get that sucker out! Oh yeah my Cardio did not have me stop taken my warfarin and my INR was 2.9 the day before the extraction. I made sure the oral surgeon was aware of the heart valve and INR and had no problems. Bleeding was not an issue. I may have oozed just a little longer than normal but that's it.

 

[Sunshine susan]

Hi! I've also been there....just ended up getting tooth removed ASAP by an oral surgeon that my dentist paid for since it was his root canal that failed. Did not stop Coumadin. No bleeding issues. It was a back lower molar and once healed , can't say I miss it. It was a very painful experience but I took all the necessary pre-meds and other meds. Hope you are feeling better now! No fun!

 

[Eva]

Any update on your condition, Westkane?!

Please let us know, as this may shed a light on what I'm going through now. After the final filling was inserted, X-ray revealed a shaded area in the center of canal!! I asked the assistant why is that there? Her answer wasn't convincing to me. The Endodentist wasts to see me on Thursday. Any advice pleas. I'm on CLINDAMYCIN 150 mg every six hours since ready. There is still some swelling and some pain!! This is the second dose as I had to take one after the temporary filling which was two weeks ago.
Thanks in advance.

 

[Paleowoman]

Well I'm going through this. Root canal treatment two weeks ago. Awful pain since, worse when I lie down so sleeping (trying to sleep) sitting on the sofa like post AVR. The pain is NOT in the tooth itself but in jaw, ear area, hearing muffled and sinus pain. The tooth is my low left wisdom tooth. I was on a week's course of amoxicillin and now on metronidazole - given to me by doctor in A&E (ER) as I was sent there due to palpitations. Doc said they were due to pain and infection. But who knows where the infection is. Going back to the dentist on Wednesday. Wasn't given antibiotic prophylaxsis - hey this is the UK where I live where they don't give it. I've now got 2g amoxicillin to take for any further invasive work given to me by my GP. Bit late after the horse has bolted. I'm not happy about having extraction either as it's a wisdom tooth and I dread complications on extraction or afterwards.

 

[skeptic49]

Just had an extraction of an old root canal...tooth fractured...gum pocket had some infection...had to come out pre-surgery even though the tooth was stable for over a decade and gave me no issues.

 

[Eva]

Skeptic,

How do you feel after the extraction?! Anymore issues?! I finished my antibiotics on Friday, my gum got swollen yesterday afternoon and it is painful. . I'm in pain. My endodontist recommends extracting the tooth and made me an appointment with oral surgeon tomorrow. Feeling tense about this.