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Medical Forum / General / Dentistry / March 2008

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news.chi.sbcglobal.net - 28 Mar 2008 03:14 GMT
If a root canal is done on a molar, and is supposedly successful, but there
is an infection at the root, and penicillin is given and if that clears up,
the post will be placed plus cap.
But I would think the infection could reoccur unless some other procedure
cleans it for good.    What is the thinking on this.    Thank You,
Gail
Steven Bornfeld - 28 Mar 2008 03:35 GMT
> If a root canal is done on a molar, and is supposedly successful, but there
> is an infection at the root, and penicillin is given and if that clears up,
> the post will be placed plus cap.
> But I would think the infection could reoccur unless some other procedure
> cleans it for good.    What is the thinking on this.    Thank You,
> Gail

Gail--

    The short answer is that if there is an active infection at the root
tip, the treatment has not been successful.  There can be signs of
infection around a tooth that has had root canal if some infected
material is pushed through the root end during instrumentation.
Antibiotic can help resolve this.  However,  if these symptoms arise
some time after completion of the root canal there is an indication that
something is wrong--whether due to an endodontic failure or a split
root.  You are right that the infection will return when the antibiotics
are discontinued.

Steve
news.chi.sbcglobal.net - 28 Mar 2008 04:51 GMT
How long to wait to see if the complications occur or should the procedure
be abandoned totally.
Gail

>> If a root canal is done on a molar, and is supposedly successful, but
>> there is an infection at the root, and penicillin is given and if that
[quoted text clipped - 15 lines]
>
> Steve
news.chi.sbcglobal.net - 28 Mar 2008 05:29 GMT
Dr. Bornfeld.

I appreciate your attention.    Why would the dentist say the root canal is
successful, if there is an infection.    An infection always means something
is wrong.    Would he be justified to put a cap on the tooth.    Very
distressing.
Gail
Steven Fawks - 28 Mar 2008 12:32 GMT
> Dr. Bornfeld.
>
[quoted text clipped - 3 lines]
> distressing.
> Gail

As Dr. B. mentioned, it is important to know what time frame is
involved with the 'infection'.  If the root canal is just being
done and antibiotics are used to clear up any residual symptoms,
this may be OK.

If the root canal has been performed months or years ago, and is
having more infection problems, I would never rush to place a
crown unless I have retreated the root canal (or had an endodontist
deal with it).  Any retreatment would include assessing the tooth
for a cracked root.

The 'fly in the ointment' comes when a tooth is in danger of splitting
or needs a crown to otherwise restore the tooth.  I would then place
a stainless steel crown (on a posterior tooth) to hold things
together while waiting for healing instead of moving straight to
a more costly restoration.

Steve
Steven Bornfeld - 28 Mar 2008 13:38 GMT
>> Dr. Bornfeld.
>>
[quoted text clipped - 22 lines]
>
> Steve

    That's a nice strategy for time-buying.

Steve
Steven Bornfeld - 28 Mar 2008 13:35 GMT
> Dr. Bornfeld.
>
[quoted text clipped - 3 lines]
> distressing.
> Gail

    Why do you think there is an infection--pain, swelling, drainage?  This
doesn't meet my criteria for a tooth ready for restoration--I agree.

Steve
Steven Bornfeld - 28 Mar 2008 13:34 GMT
> How long to wait to see if the complications occur or should the procedure
> be abandoned totally.
> Gail

    You mean wait before restoring the tooth?  I wait until the tooth is
symptom-free, assuming I don't suspect anything is wrong.
    Things of course can happen down the road--even years later.  That's
why even in a caries-free mouth it's a good idea IMO to throw an x-ray
film in there (a PA which will show the whole tooth) every few years to
make sure things are holding up.

Steve
news.chi.sbcglobal.net - 28 Mar 2008 16:51 GMT
Thank You Steve and Thank you Steve,    The fly in the ointment is that the
dentist feels no need to explain the situation clearly for someone as
uninformed as I and most others are.   We are lucky to have SMD for the
detail that may help.I better understand what is meant now (If the infection
is a result of some sligth damage in the course of the procedure done not to
the tooth but as a side effect  and the tooth is still solid?  If the
infection is cleared, the cap can be placed.   As is the case, the root
canal was just done and the dentist is waiting for the infection to clear up
to put the crown on.    So  barring any catastrophies to the root or tooth
(and me)  the dentist will proceed.   Actually, in the absence of being a
millionaire or even a mensch with lots of money, in my opinion a stainless
steel cap is as good as gold if not  seen.    Why is not white gold used .
Thank You again Steves, for the post.
In the next life, maybe I will remain childless.     One child is enough in
one family (me).    Is there hope?
Gail
>> How long to wait to see if the complications occur or should the
>> procedure be abandoned totally.
[quoted text clipped - 8 lines]
>
> Steve
Steven Bornfeld - 29 Mar 2008 01:45 GMT
> Thank You Steve and Thank you Steve,    The fly in the ointment is that the
> dentist feels no need to explain the situation clearly for someone as
> uninformed as I and most others are.   We are lucky to have SMD for the
> detail that may help.

    Thanks, and hope my advice is correct.  Certainly a poor substitute for
a dentist who actually sees what's going on.  Sad that communication
skills too may be too much to ask for.

I better understand what is meant now (If the infection
> is a result of some sligth damage in the course of the procedure done not to
> the tooth but as a side effect  and the tooth is still solid?  If the
> infection is cleared, the cap can be placed.   As is the case, the root
> canal was just done and the dentist is waiting for the infection to clear up
> to put the crown on.

That sounds right.

    So  barring any catastrophies to the root or tooth
> (and me)  the dentist will proceed.   Actually, in the absence of being a
> millionaire or even a mensch with lots of money, in my opinion a stainless
[quoted text clipped - 3 lines]
> one family (me).    Is there hope?
> Gail

    Heh heh--we all have our moments of doubt.  My daughter would love a
sibling.  But if we buy a house, she'll likely settle gladly for a dog.

Steve

>>> How long to wait to see if the complications occur or should the
>>> procedure be abandoned totally.
[quoted text clipped - 8 lines]
>>
>> Steve
news.chi.sbcglobal.net - 29 Mar 2008 03:17 GMT
The guinea from long ago, "the love of my life" is still enjoying the
hospitality.    Wonder how his teeth are.
Gail
 
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