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Tooth Infection posts

Why Is Cold Water the Only Thing That Relieves My Toothache?

Posted on by AllSmiles.

I had two fillings about ten years ago. One fell out, but that tooth doesn’t hurt. The other filling is still in place, but the tooth causes severe pain most of the time. Biting down doesn’t hurt, and only cold water helps, but the relief lasts just a few seconds. What could be causing this? – Thanks. Justino

 

Justino,

Your symptoms suggest that the pulp inside your painful tooth may be severely inflamed or dying. You may need root canal treatment to save the tooth. We would also recommend having a dentist examine the tooth that lost its filling before further decay develops.

Why Does Cold Water Temporarily Relieve Your Toothache?

Persistent pain that improves briefly with cold water, or pain triggered by heat, can indicate advanced pulp inflammation or damage that requires prompt treatment. Cold water may briefly relieve your pain by reducing inflammation or pressure inside the tooth. However, this type of pain can indicate a serious problem with the pulp, which contains the tooth’s nerves and blood vessels.

Decay may have developed beneath your existing filling and reached the pulp. As the pulp becomes inflamed or infected, pressure can build inside the tooth and cause severe pain, even when biting doesn’t hurt.

A diagram with seven stages of root canal treatment from accessing the tooth to protecting it with a crown

Root canal treatment

In some cases, the pulp begins to die, a condition called pulp necrosis. Older dental explanations describe gas buildup in dying pulp tissue as a cause of pain that improves with cold water. However, this symptom alone cannot confirm pulp necrosis.

Will You Need a Root Canal?

You may need root canal treatment if the pulp has become irreversibly inflamed or infected. A dentist can examine the tooth and perform tests to determine whether the pulp can recover. If root canal treatment is necessary, the dentist will remove the damaged or infected pulp, clean the root canals, and seal them to prevent further infection.

Sometimes, opening the tooth during emergency treatment can relieve pressure and pain. However, this is only part of the treatment, and the dentist must complete the root canal to protect the tooth.

We recommend scheduling a dental appointment as soon as possible.

 

The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read how Dr. Finley and his team strive to offer some of the best dental care in Monroe.

What Are the Treatment Options for Internal Resorption?

Posted on by AllSmiles.

Two different dentists recently told me I have a tooth with a large defect inside. Both were surprised I wasn’t experiencing severe pain. I sought a second opinion last week because the diagnosis concerned me, but the second dentist agreed with the first.

Last Thursday, I began feeling a mild pulsing sensation in my gums around the tooth, and I’m wondering if an infection is spreading. The dentists told me that without treatment, the tooth could eventually break apart and become more painful than ever.

Is it better to save a tooth like this with a root canal, or are extraction and an implant more efficient? I’m scheduled to receive an implant for the opposing upper tooth due to root canal failure and a tooth post that kept falling out. I want to get out of the root canal cycle if possible. Thanks. Jalynn

 

Jalynn,

Based on your description, two dentists have confirmed the diagnosis. What may appear on an X-ray as a cavity inside the tooth is often internal resorption rather than traditional tooth decay. The condition is usually associated with inflammation of the pulp tissue, although the exact cause is not always known.

What Is Internal Resorption?

Internal resorption is a rare condition in which a tooth begins to break down from the inside.

Is Root Canal the Right Treatment for Internal Resorption?

In many cases, yes, a root canal is the preferred treatment. When internal resorption is identified before extensive damage occurs, root canal therapy can remove the inflamed tissue and stop the process from progressing. The goal is generally to preserve a patient’s natural tooth if it can be done predictably and safely. Many teeth treated at this stage can be preserved and function well for years.

Your concerns are understandable if you’ve had a failed root canal before. Some patients with failed root canals choose extraction and replacement with a dental implant instead of repeat root canal treatment. However, we encourage choosing the option that offers the best long-term outlook and that you feel comfortable with.

Before and after internal resorption repair of a lower tooth.

 

When Does Internal Resorption Become More Serious?

Internal resorption becomes more serious when it breaks through the root. If a perforation develops, repairing the tooth is considerably more complex. It’s a challenge to seal the perforation and deal with the loss of internal tooth structure. As more of the tooth is destroyed, the risk of fracture increases.

If the remaining tooth is too weak to provide a reliable long-term result, consider replacing it with a dental implant rather than attempting a repair with an uncertain outcome.

The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read why patients say Dr. Finley and his team provide the best dental care in Monroe.

 

Managing Furcation Involvement in a Tooth

Posted on by AllSmiles.

I have an old root canal tooth that my dentist says has a furcation involvement. The gums around the tooth are swollen, and pus sometimes oozes out. I am worried about losing the tooth. I don’t want to disturb it unnecessarily. What should I avoid? Thanks. Seth from WA

Seth,

Pus around a tooth is a greater concern than furcation involvement. It reflects an active infection that must be controlled to prevent further bone loss. Furcation involvement is significant but does not automatically mean the tooth is failing.

Gum Inflammation vs. Infection

Puffy or bleeding gums usually indicate inflammation caused by plaque bacteria and often respond well to professional cleaning and diligent home care. Pus indicates a deeper, more serious infection in a periodontal pocket that you cannot clean on your own.

Treatment depends on remaining bone support. Some teeth benefit from surgical therapy to allow ongoing cleaning, while others may not be savable if support is too compromised.

Root Canal Outcomes Are Predictable

Root canal treatment removes infection without threatening a tooth’s longevity when healing progresses as expected. The dentist removes infected pulp and seals the space. If the treatment fails, infection usually returns at the root tip within the first few months. Once the tooth heals, relapse does not occur.

Managing Furcation Involvement

Furcation involvement in a lower molar and a small brush in the furcation

A small specialized brush can clean a furcation in a tooth

Furcation involvement means that bone loss or gum recession has exposed the area between a molar’s roots. This complicates home care but often leaves enough bone—sometimes 80–90%—to keep the tooth stable.

Dentists typically recommend specialized brushes designed to reach into the furcation area. Success depends on daily plaque control:

  • Clean the furcation thoroughly every day
  • Ask your dentist for guidance and proper tools
  • Use a small brush specifically designed for this purpose

 

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

Can a Tooth Cavity Start from the Inside?

Posted on by AllSmiles.

I’m concerned about my dentist’s recommendation for my left lateral incisor. She says it has a cavity inside and needs a root canal. She referred me to a root canal specialist who has the same last name as my dentist, which makes me wonder if they are related.

Diagram of tooth cavity progression

Tooth decay begins on the outside and, if untreated, progresses until it infects the tooth pulp

My previous dentist took x-rays in the early spring this year, and nothing showed up on this tooth. The outside of the tooth has never had work, and there’s no visible cavity. This tooth also sticks out at an angle and doesn’t receive pressure from chewing. Is it possible to have a cavity inside a tooth when there are no outward signs of decay or wear? I wonder if my dentist referred me to the specialist just for their profit. – Thanks. Eli from Chicago

Eli,

Tooth decay begins on the outside and, if untreated, progresses until it infects the tooth pulp[/caption]

No, cavities always begin on the tooth’s surface. Decay progresses inward until it reaches the pulp. When bacteria infect the pulp, root canal treatment becomes necessary.

What Is Internal Resorption?

If your dentist mentioned an “internal cavity,” they may have been referring to internal resorption. This condition occurs when the pulp tissue begins to destroy the inside of a tooth. Although rare, it can happen when something, possibly trauma, irritates the pulp.

Because internal resorption is uncommon, you should confirm the diagnosis with an endodontist. Specialists in root canal treatment see these cases more often and can give you clarity.

How to Get a Reliable Second Opinion from a Dentist

For the most helpful evaluation, prepare before your appointment:

  • Ask your dentist for a copy of your X-ray to take with you.
  • Avoid telling the second dentist the first diagnosis or the names of dentists involved.
  • Let the new dentist review the case independently.

 

How Long Will It Take Antibiotics to Resolve My Toothache?

Posted on by AllSmiles.

I have a toothache that’s been getting worse. Two days ago, my dentist looked at my X-ray from three months ago when I had a routine exam and cleaning. She said the X-ray looks fine, and my filling in the tooth is in good condition. She prescribed antibiotics in case I have an infection. How long should I wait before returning to her if the toothache doesn’t go away? Thanks, Rebekah from CT

Rebekah,

Although you had radiographs two months ago, your symptoms have changed since then. At that time, you didn’t have a toothache, so now, you need a new X-ray.

The previous images were likely bitewings, which only show the crowns of the teeth, not the roots. When diagnosing a toothache, a dentist should take a periapical X-ray that includes the tip of the root to see signs of infection in the pulp or surrounding bone.

Why Isn’t a Filling Check Enough If You Have a Toothache?

If your dentist only looked to see whether your filling was cracked, that’s concerning. A dentist must check for other clinical signs when you report pain.

These simple in-office tests can offer valuable insight:

  • Tapping on the tooth to assess sensitivity in the ligament
  • Response to cold—whether it worsens or alleviates the pain
  • Sensitivity to heat, which may suggest nerve inflammation
  • Pulp vitality tests, such as an electric pulp test to evaluate nerve health

If none of these were done, your dentist’s evaluation was incomplete.

Why Aren’t Antibiotics a Cure for a Toothache?

Prescribing antibiotics and telling you not to return if the pain subsides is the wrong approach. If the antibiotics relieve the pain, that confirms there’s an infection that needs further treatment — root canal treatment.

Antibiotics cannot eliminate the infection inside the tooth. They only reduce the surrounding inflammation in the bone. Once you stop taking them, the infection will return, often more aggressively.

When It’s Time for a Second Opinion Dentist

If the account you’ve given is accurate, this dentist did not take your symptoms seriously enough. You need a provider who will investigate thoroughly and treat appropriately. We recommend getting a second opinion.

The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read how Dr. Finley and his team strive to offer some of the best dental care in Monroe.

Can a Tooth Infection Become Fatal?

Posted on by AllSmiles.

Dental infections can be serious, even life-threatening. While many people may be tempted to take pain relievers or antibiotics to alleviate the symptoms, doing so can lead to dire consequences.

Can a Tooth Infection Become Fatal?

Tooth infections are serious and can lead to hospitalization, even death. A study published in the Journal of Endodontics revealed that between 2000 and 2008, there were 61,439 hospitalizations and 66 deaths in the United States attributed to dental infections. This equates to roughly five to ten deaths per year.

A True Story of a Fatal Tooth Infection

A tragic example of the dangers of untreated dental infections is the experience of long-haul truck driver Vadim Kondratyuk Anatoliyevich, a husband and father of two daughters. Vadim had a toothache when he left California for New York. The toothache worsened, so he stopped to see an Oklahoma dentist.  Despite seeking attention and receiving antibiotics, Vadim’s infection progressed so much that his brother took a plane from to New York to drive him home. The infection progressed rapidly, eventually spreading to his blood and lungs. Unfortunately, despite a stop in Utah for treatment and a transfer to Salt Lake City, where he received aggressive treatment, Vadim died from the infection.

Why See a Dentist for a Tooth Infection?

Taking antibiotics is insufficient for a tooth infection because the medication cannot penetrate the dead tissue within the tooth. A dentist must treat the infection with root canal therapy to prevent tooth loss and the need for a dental implant.

It’s essential to seek professional dental care promptly if you experience signs of a dental infection, such as tooth pain, swelling, or sensitivity to hot or cold temperatures. Prompt care can significantly reduce the risk of serious complications and potential long-term health issues.

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

 

I Still Have a Pus Sac on My Gums After Apicoectomy

Posted on by AllSmiles.

I had an apicoectomy in early May on an infected old root canal tooth. Yesterday, I had a follow-up appointment and an x-ray that confirmed the bone was rebuilding. However, my dentist thinks there is some minor infection because she noticed a small pus sac on my gum. I will take antibiotics for a week. Is there anything else I can do to eliminate the infection? Thanks. Teddi

 

Teddi,

With standard root canal treatment, an apicoectomy, or root canal surgery, if a dentist removes the dead tissue and seals the root tip well, the tooth will likely heal, and the infection will resolve.

What’s the Difference Between Root Canal Treatment and Apicoectomy?

Standard root canal treatment is not a surgical procedure, but an apicoectomy is surgery. Root canal treatment accesses the tooth from its crown or the biting surface of your tooth. However, a dentist opens your gum to access the root tip during an apicoectomy.

Will Antibiotics Cure a Tooth Infection?

Although antibiotics do not eliminate tooth infections, they can speed healing after root canal therapy. Successful treatment requires removing the source of the infection.

If the bone surrounding your tooth is healing, it suggests that your dentist removed the source of the infection and sealed the root tip well. A residual infection and pus sac will improve gradually. Your dentist prescribed antibiotics to accelerate healing. Ensure you finish the antibiotics and wait for healing. You will not need to do anything further.

If the infection lingers or worsens, contact your dentist. You may need an exam from a root canal specialist (endodontist).

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

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