Painful Gum?

Question

The pain began in my front tooth, which is a crowned tooth. I wasn't able to put any pressure on it what so ever. The next day my upper gum was swollen and quite painful. Now a hard bump has developed and above my upper lip and lower nostrils are very sore. I had a root canal done on that tooth a while back. I had chipped that tooth when I was younger and since the nerve died I had a crown placed to avoid chipping and additional expenses. Is it normal to have an infection or an absess on a tooth that has had a root canal and is crowned? What possibilty do I have that I would simply need antibiotics and not another root canal or worse? Can I hold off for several more days to have a procedure done since I will be taking antibiotics? Please help.

Answer 1

DC,

It is absolutely possible to have a root canal treated tooth go bad.  Several possibilities:  1)  All of the nerve wasn't originally removed, resulting in an incomplete root canal, or 2) You have a vertical root fracture associated with this tooth.  Either way, the bump that you are noticing and the resulting tenderness is infection.  

Hopefully, the tooth is not fractured.  If it is, it must be extracted and you and your dentist will need to come up with a new restorative plan.  :-(

If the tooth is simply reinfected, then two possible modes of treatment: 1) Root Canal retreat:  put a hole through the crown, remove the root canal filling, and bacteria, then refill, or 2)  Apicoectomy:  a semilunar incision is made on your gum above the tooth and the root tip is accessed from the window made in your gum and maxilla.  Then, the bacteria cleaned, and a retrograde filling placed on the tip of your root, then everything is covered up with a stitch or two.  Your dentist or endodontist will have to decide the best course of action for you, based on a thorough examination.

Antibiotics might help keep the bacterial load in check, and give you a couple of days, but will not cure the problem.  You definately have needed dentistry in your immediate future.  Sorry.

I sincerely wish you the best, and I hope I was of some help to you.

Answer 2

A common cause of toothache could originate from number sources, but mainly from any of the following: dental cavities, gum disease, tooth root sensitivities, cracked tooth syndrome, impaction and eruption. To fully understand the cause of toothache it’s probably best to analyze each one and hopefully ascertain the cause of toothache in each individual case. Gum infection is perhaps the second most common cause of toothache. Gum disease refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. The cause of toothache connected to gum disease is created by toxins secreted by bacteria in "plaque" that accumulate over time along the gum line. This plaque is a mixture of food, saliva, and bacteria. Early symptoms of gum disease include gum bleeding without pain. The cause of toothache is a symptom of more advanced gum disease as the loss of bone around the teeth, which leads to the formation of gum pockets. Bacteria in these pockets cause gum infection, swelling and further bone destruction.

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