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Dr. Thomas

How Long Can I Delay a Root Canal If My Tooth Doesn’t Hurt?

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I had my 6-month dental exam and cleaning last week. My dentist took an X-ray and said I had an infection in my right front tooth. I noticed the tooth was discolored, but I didn’t think it was infected because I didn’t have pain or sensitivity.

My dentist asked me to schedule a root canal for the tooth, but I told the lady at checkout that I would call to schedule it. Is root canal overtreatment for a discolored tooth? If I don’t feel any pain, how long can I delay the root canal? Thanks. Max from Tacoma, WA

Max,

You shouldn’t delay treatment. Consider these factors.

  • A tooth turning dark can be a sign of an underlying issue. You might not experience pain or discomfort, even if the tooth is infected because the tooth pulp died, which is why it’s discolored. While other reasons may cause a tooth to change color, an infection is the most likely culprit, especially if only one tooth is affected.
  • What is the best way to treat the tooth? While a crown can improve the tooth’s appearance, addressing the infection with a root canal is essential for oral health.
  • If you need to spread out the costs, consider getting the root canal done first and then the crown a few months later. Once the infection is treated, you might even feel a little better.
  • Ask your dentist for reassurance. Your dentist may let you smell the instrument used inside the tooth during the root canal procedure. The odor can be unpleasant, but it will help you understand the extent of the infection.

Leaving an infection untreated allows it to spread to other teeth, causing a dental emergency. A tooth infection can even spread into the jawbone and bloodstream.

 

Sugar Land cosmetic dentist Dr. Siny Thomas sponsors this post. Read how Dr. Thomas provides patients with some of the best dental care in Sugar Land.

Anbesol Doesn’t Work for My Toothache Anymore

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Man holding the side of his face, portraying a root canal dental emergencyI’ve been using Anbesol, ibuprofen, and cold packs on the side of my face for two months. Anbesol doesn’t help anymore. This morning, the toothache woke me up at 3:00 am. I am afraid that I will have an abscess. The last time I was at the dentist, I had to leave before treatment because I was so nervous. The dentist recommended that I agree to sedation, or he couldn’t do anything for me. I probably need sedation, but I don’t like how the dentist responded to my anxiety. I want to find another dentist, but can you tell me how much time I have before I’m forced to choose a dentist quickly? I don’t want any regrets and need to keep switching dentists. Thank you. Mike from DE

 

Mike,

Thank you for contacting Cornerstone Dentistry in Sugar Land. After an exam and an x-ray from Dr. Thomas, he could estimate when the tooth infection might worsen. As a tooth infection progresses, over-the-counter products, such as Anbesol®, become less effective, and you need professional care from a dentist. Below are some guidelines for finding a dentist to care for your tooth.

How Can You Find a New Dentist?

You can find a new dentist by asking friends or family for recommendations, visiting dentist’s websites, and checking patient reviews.

  • Asking for recommendations – Someone you know may be a dentist’s long-time patient. So, ask friends, family members, or acquaintances for a recommendation. Also, ask if they have seen the dentist only for a routine exam or if the dentist has performed any procedures for them. Ask questions about the dentist’s chairside manner and whether they are gentle.
  • Visit dentist’s websites – Look at the dental practice’s services and the dentist’s biography page. Services offered and a dentist’s training and background can help you understand their experience and treatment philosophy. Also, check the website for types of sedation the dentist provides.
  • Patient reviews – Read Google reviews for each dentist to see what patients may or may not like about the care received.

If you have a tooth infection, you can expect the dentist to recommend root canal treatment, so look for the dentist’s training and experience in that area. After root canal treatment, you will likely need a dental crown to protect the tooth. A dentist with post-graduate cosmetic dentistry training can provide you with a natural-looking crown.

We encourage you to complete your search for a dentist as soon as possible to prevent an emergency and a rushed decision for a new dentist.

Sugar Land cosmetic dentist Dr. Siny Thomas sponsors this post. Read how Dr. Thomas provides patients with some of the best dental care in Sugar Land.

Antibiotics for Tooth Infections

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I went in for a toothache and my dentist said I have an infected tooth. He prescribed me an antibiotic, which I took diligently. While the infection started to get better, it has now flared back up. Do I need to have him call in a second round of antibiotics or do I ask for a stronger antibiotic?

Madison

Dear Madison,

Woman in pain needing an emergency dentist

 

I think there was some miscommunication here. While antibiotics are sometimes prescribed for tooth infections to either get them under control before treatment or hold it at bay until treatment, it is not enough on its own. What will happen, as you have experienced, is the infection will improve a bit but then flare back up once you are no longer taking the medication.

There are two viable treatments for a tooth infection. The first is a root canal treatment. This is the preferred treatment because it will enable you to keep your tooth. You never want to lose a tooth if it can be helped. The second option is to have the tooth extracted. While it will get rid of the infection, it does mean you will need to replace the tooth. If you leave the open space there, the other teeth will drift or tip into the spot. This will throw off your bite which will lead to jaw pain, headaches, and possibly even TMJ Disorder.

I’m not sure you are being well looked after by this dentist. I would have thought there would be some follow-up on this so that they would schedule you for the necessary procedure to deal with your infection. Call their office and tell them you need to schedule an emergency dental appointment. Let them know you’ve already used the antibiotics they gave you and the infection has flared back up and is beginning to spread. If they say they want you to take more antibiotics first, that is fine, just make sure they schedule a date for your treatment at the same time.

One other note. Hopefully, it is not too late to save your tooth. If it is and you need to replace it, I would get a dental implant. It is by far the best tooth replacement option. If you don’t have the money for that right now, It would be worth it in the long run if you got a cheap-o temporary replacement, such as a dental flipper, as you saved up for the better permanent replacement.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

Decaying Tooth with No Money

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I have a wisdom tooth that is rotten and decayed. Now the tooth next to it has decay and holes as well. My jaw is also starting to swell. I don’t have dental insurance at the moment and would rather not pay out of pocket. Is it possible to just take antibiotics until I have insurance again or can I just go to the ER for this?

Brad

Dear Brad,

Man grabbing his tooth in pain.

 

I am worried that you are playing with fire here. If the jaw has started to swell, that is a particularly bad sign. Your decay has turned to an infection and that infection is spreading. Think about how close your jaw and cheek are to your eyes and brain. Or, if the infection goes lower, how close it is to your heart. I would consider this a dental emergency. If you don’t get it looked at, it will quickly become a life-threatening emergency.

Hospital Emergency Rooms will not treat dental issues, so that won’t be an option for you. As for an antibiotic. It can be briefly useful for holding the infection at bay, but that is the best it will do. I cannot heal the infection. Nothing short of a dentist physically removing the infected pulp can do that. This is done either by a root canal treatment or a tooth extraction if the tooth is too far gone to save.

I’m going to suggest you get this treated, even if it means out of pocket. There are dentists who will be willing to work with you on payments if you explain the circumstances. Waiting, at this point, is too risky for your health.

Hopefully, the teeth can be saved. If they cannot they you will need tooth replacements. If you are worried about finances, I would just get a temporary tooth replacement, such as a dental flipper and save up for a permanent one, like a dental implant.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

 

 

Is a Tooth Infection Really Dangerous?

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I need some advice.  My back molar (in front of the wisdom tooth) broke in half. I’ve been in a lot of pain ever since. Now my cheek is swelling. and my eye is starting to hurt. My wife insists this is dangerous and I need to go to a dentist, but I just got back to work after a long time furloughed. I don’t want to have to take off work and spend money unnecessarily. Is this really dangerous or is she overreacting? I am sure I can get my doctor to write me a prescription.

Dan S.

Dear Dan,

Man grabbing his tooth in pain.

 

Yes, this is serious. You do need to see a dentist. Tooth infections are not like other bacteria we deal with under normal circumstances, where you can just take an antibiotic and get better. Instead,  a dentist has to physically remove the infected pulp. This is typically done either by a root canal treatment or extracting the tooth.  All an antibiotic will do is temporarily forestall the infection while you get to a dentist.

This is one of the reasons tooth infections are considered dental emergencies. This infection will continue to spread. If you think about how close your jaw is to your heart, lungs, or brain you can understand why people still die from tooth infections. Yours has already spread almost to your eye.

You need to see a dentist as soon as possible. If money is an issue, talk to your dentist and just be honest. The lockdowns hurt everyone financially and most dentists are compassionate. I am positive you will be able to find a dentist willing to work with you on payments.

Ideally, you will want a root canal treatment, which will save your tooth. If that isn’t possible, and it does sound like your tooth is pretty far gone, you will need to have it extracted. Because of the location of your tooth it will be important to replace it. For now, you can get an inexpensive dental flipper. Ideally, you will want to save up for a dental implant, which is the closest thing to having a natural tooth.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

She Needs a Second Opinion About this Tooth

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I need some advice. I don’t know if I’m not trusting this dentist because of legitimate reasons or because of my fear of any dental work. I don’t want to put myself at risk, but I don’t want to put myself through any torture unnecessarily. I had a toothache starting last week and went to see a dentist today. I don’t have a regular dentist because of my anxiety and just tend to go when an issue comes up. He did an x-ray and said that a tooth which already had a filling would need to come out. He said only 10% of the tooth was still viable and the tooth would need to be extracted. This absolutely terrifies me. Is a second opinion worth it or should I just suck it up and get this tooth extracted? He also said I’d need a dental implant afterward to replace it.

Sandy

Dear Sandy,

Woman holding her jaw in need of an emergency dentist

I think this warrants a second opinion. Here’s why. First, a tooth that far gone would not require an x-ray. The decay would be massive and visible. Additionally, your filling would literally have fallen into the tooth. Thirdly, you said this tooth just started hurting last week. I believe this would have been hurting for longer than that. All of this is making me suspicious.

The only thing I agree with him on is a dental implant if the tooth needed to be extracted. They are the closest thing to having a healthy natural tooth again. Plus, it is always important to replace a missing tooth to avoid throwing off your bite and developing painful TMJ Disorder. However, I’m not convinced your tooth does. Something to consider when getting a second opinion is to make sure it is what is known as a blind second opinion.

Many dentists, especially in the same area, are friends with one another. They’re part of the same professional peer groups. It is always awkward for one dentist to say something negative or in disagreement with a friend. Because of that, it is easier for both of you if you just ask him to look at the tooth and give his opinion on how to deal with it without telling him who the dentist was and what his diagnosis was. He should completely understand you wanting a blind second opinion.

A Word About Dental Anxiety

It is very common for patients to have dental anxiety. One thing we want to do is get you to a place where you are not just seeing a dentist when you have a dental emergency. That both increases your anxiety and is much more expensive for you. To that end, I would highly recommend for you to see a sedation dentist for a while.

There are varying levels of sedation. For just your checkups and cleanings, you will likely only need nitrous oxide, which relaxes you. However, whenever you have a more extensive procedure, you may prefer oral conscious sedation. This is sometimes called sleep dentistry, because it is so strong you can actually just sleep through the procedure.

Many patients with anxiety find that using dental sedation as needed completely changes their lives. If you keep up with simple cleanings and checkups you are able to catch things much sooner. This not only will save you a TON of money for not needing the bigger more expensive fixes, but will also make your treatments much less invasive and scary.

I do understand how frightening dental work can be. You’ll find dentists who offer sedation are much more compassionate and understanding about those who struggle with dental anxiety.

This blog is brought to you by Sugarland Dentist Dr. Siny Thomas.

Can I Just Take Antibiotics Until I can Extract the Tooth?

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I have a tooth that I am sure is infected. I don’t have time to deal with it right now as we are about to leave for a family vacation. I do have some leftover antibiotics and am sure I can get my doctor to call in another prescription. Then, when we get back, I’ll have the tooth extracted.  Is there a preferred antibiotic for this?

Douglas W.

Dear Douglas,

Man grabbing his tooth in pain.

I want to make sure you understand that antibiotics will not “heal” an infected tooth. The infected tissue has to be physically removed. I think you’re planning on doing that with an extraction. You should know you do have an option that will save your tooth, called a root canal treatment. This is a procedure where the dentist goes into the tooth canals with a tiny instrument to take out the infected pulp. It is always better to save a tooth whenever possible. This is because of the danger of root resorption.

What an antibiotic can do is sort of hold off an infection until then. How long they hold it off varies on the infection. Bear in mind, tooth infections are considered a dental emergency for a reason. If the infection grows too rapidly, it can become life-threatening. Think about how close your jaw is to your heart, lungs, and brain, you can see that you don’t want to let the infection spread.

There is a danger that you take your antibiotic and in the middle of your family vacation the infection blows up and you end up in the office of a strange dentist you don’t know while your family flounders on without you.

The better plan is to go ahead and get a root canal treatment before you go. This is a much easier procedure than a tooth extraction.

If It Comes to an Extraction

if it does turn out that the tooth can’t be saved, there are other considerations. First and foremost is the tooth must be replaced. If you don’t, the nearby teeth will begin to shift or tip into the spot. This will throw off your bite. When this happens, you’ll begin to experience jaw pain and it can even lead to migraines and TMJ Disorder.

There are quite a few tooth replacement options. The best replacement is a dental implant. This has a prosthetic tooth root that is topped by a dental crown. Having a dental implant is the closest thing to having a healthy, natural tooth in your mouth again.

Another option is a dental bridge. This suspends a false tooth between dental crowns. The downside of this is it requires two healthy teeth to be crowned. You may not want to do that.

Finally, there is a removable partial denture or a dental flipper. Both are removable. The latter is generally used as a temporary replacement option while you’ are waiting on something better like a dental implant.

This blog is brought to you by Sugarland Dentist Dr. Siny Thomas.