I had a root canal treatment that seemed to go fine, but then several weeks after the procedure, I developed pain. I went to see my dentist who did the procedure. He took some x-rays but didn’t find a crack or anything so he referred me to an endodontist. She placed me on some antibiotics which helped dramatically. Everything was fine until a couple of months later when I woke up in horrible pain from that same tooth. I went back to the endodontist and she put me on a round of steroids. Unfortunately, that hasn’t helped at all and I feel worse than ever. What should I do?
It sounds like your endodontist is jumping on a treatment bandwagon. Steroids have become a popular prescription with root canal treatments. However, the best dentists understand the pharmacology of something and how it will work with the body. When used with the correct diagnosis it is very effective. Yours wasn’t.
Steroids are effective anti-inflammatory medications. When there is inflammation, it is usually for the purpose of fighting an infection by bringing white blood cells into the area. Using steroids, in this case, fights against the body’s defense system. However, if the inflammation isn’t infection related it is a wonder drug. Your endodontist got this wrong.
When to Use Steriods with a Root Canal Treatment
Often, immediately after a root canal treatment there is irritation. This can result from infected material inside the tooth getting pushed out including the disinfecting solutions and filling materials. Also, root canal files can poke through the end of the tooth.
This starts a cycle of post-operative irritation causing inflammation. That swelling pushes the tooth up which increases the irritation and inflammation. Using a steroid in this situation is both appropriate and effective. The best use of this is to prescribe post-operative steroids along with a course of antibiotics.
When the pain starts weeks later, as yours has, it is obviously not post-operative. This is more likely the result of a failed root canal treatment. This happens to the best of dentists. Those canals can be quite intricate and it is easy for a dentist to miss one in those cases.
I’m surprised your endodontist didn’t realize this and it actually concerns me. At this point, you have three choices. You can have another root canal treatment and try to get that pesky canal. You can have root canal surgery. Or, you can extract the tooth. Whichever you choose, don’t wait too long. That infection will spread and lead to a dental emergency.
If you do decide to extract the tooth. There are excellent tooth replacement options. Two of those are a dental implant or a dental bridge.
This blog is brought to you by Fountain Valley Dentist Dr. Tammy Tran.