After having a root canal on my upper right canine, the temporary filling fell out. Soon afterward, I noticed an abscess on my gum. My dentist examined it and said I would need the root canal redone to treat the abscess.
The area isn’t painful unless I press on it. Should I be worried that the abscess will become toxic? Could antibiotics take care of the infection, or is another root canal the better option? – Thanks. Karmine from AL
Karmine,
A temporary filling that falls out after a root canal should be evaluated as soon as possible. Although it may not seem urgent if there is no pain, the temporary filling plays an important role in protecting the root canal treatment until the tooth receives its final restoration.
During root canal treatment, bacteria and infected tissue are removed from inside the tooth. The root canals are then sealed with a filling material and dental cement. That seal must remain protected. If saliva reaches the root canal filling, bacteria can seep back into the tooth, compromise the seal, and allow the infection to return.
Temporary fillings are intentionally designed to be easy to remove when it is time to place the permanent restoration. Because they are not meant to last long, they can occasionally come loose. If several days pass with the root canal exposed to saliva, the seal can begin to fail.
Can Antibiotics Fix the Problem Without Retreating the Tooth?
Antibiotics cannot eliminate an infection that remains inside the tooth. This can be frustrating because taking medication often seems like the simplest solution. Unfortunately, the inside of a tooth no longer has a blood supply after root canal treatment, so antibiotics carried through the bloodstream cannot reach bacteria trapped within the tooth.
Instead, antibiotics may only provide temporary relief if an infection has spread into the surrounding gum or bone. Once the medication is stopped, the infection can return. Frequent or unnecessary antibiotic use also increases the risk of antibiotic-resistant bacteria, making future infections more difficult to treat.
Is It Safe to Leave the Tooth Alone If It Doesn’t Hurt?
A lack of pain does not necessarily mean the tooth is healthy. A tooth with a failed root canal seal can remain comfortable while infection slowly develops inside. Left untreated, the infection may continue to spread into the surrounding jawbone. In the upper jaw, infections deserve particular attention because, although uncommon, they can spread into nearby areas such as the tissues around the eye or even the brain. Serious complications from untreated dental infections have occurred, including well-documented cases that became life-threatening.
What Can Happen If Treatment Is Delayed?
Delaying treatment increases the risk of additional problems. Once the protective seal has been compromised, several things may occur:
- Bacteria can re-enter the root canal system.
- The original infection may return.
- Decay can begin inside the tooth where it may not be visible.
- The tooth may eventually become too damaged to restore.
- More extensive treatment, or even extraction, may become necessary.
The sooner the tooth is evaluated, the better the chance of preserving the successful outcome of the original root canal treatment, which helps you avoid tooth loss and replacement.
Dr. James Gavrilos, an accredited cosmetic dentist from Barrington, Illinois, sponsors this post. Read about how he strives to provide some of the best dental care in Barrington.