Swollen Gums After Root Canal: Is It a Sign of Root Issues?

Swelling of the gums after tooth decay in a root canal tooth?

About two years ago, I had a root canal done on my upper left molar, but I didn't get a crown.
Last month, I discovered a significant cavity between the teeth.
After about two weeks, that tooth started to feel slightly sore, and the next day my gums began to swell, but there was no abscess.
I visited the dentist, who suggested monitoring the situation for two weeks to see if it was a root issue (like the development of an abscess).
I would like to ask if the fact that my gums have been swollen for about two weeks without subsiding indicates a potential problem with the root? (There is no abscess, and I'm unsure if it's advisable to wait another two weeks...
Should I consider seeing another dentist?)

Niming, 20~29 year old female. Ask Date: 2020/11/07

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Anonymous,
It is best to consult an oral and maxillofacial surgeon or an endodontist for a diagnosis.
Take care!
Sincerely,
Dr.
Huang Ting-Fang, Dental Director

Reply Date: 2020/11/07

More Info

Swollen gums after a root canal can indeed be a sign of underlying issues, particularly related to the health of the tooth's root or surrounding structures. In your case, it seems that you had a root canal performed on your upper left premolar about two years ago, but you did not have a crown placed afterward. Recently, you noticed significant decay in the tooth, followed by mild discomfort and swelling of the gums without the presence of an abscess.
The absence of an abscess (which typically presents as a pus-filled bump) does not necessarily rule out complications. Swelling can indicate inflammation, which may arise from several factors, including infection, residual bacteria in the root canal, or issues related to the tooth structure itself. The fact that you have experienced swelling for two weeks without improvement is concerning and warrants further investigation.

When a root canal is performed, the goal is to remove all infected tissue and bacteria from the root canal system. However, if the procedure was not entirely successful, or if the tooth was not adequately restored with a crown afterward, bacteria can re-enter the canal, leading to reinfection. This can cause inflammation of the surrounding gum tissue, resulting in swelling. Additionally, if there is significant decay, it can compromise the structural integrity of the tooth, making it more susceptible to further complications.

Given that your dentist has suggested a wait-and-see approach for another two weeks, it is essential to monitor your symptoms closely. If the swelling persists or worsens, or if you develop new symptoms such as increased pain, fever, or the appearance of an abscess, you should seek further evaluation. It may be beneficial to obtain a second opinion from another dental professional, especially if you feel uncertain about the current treatment plan.

In the meantime, maintaining good oral hygiene is crucial. Gently brushing and flossing around the affected area can help reduce irritation. Additionally, using warm salt water rinses may provide some relief from inflammation. However, these measures are not substitutes for professional dental care.

If it turns out that the root canal has failed or that there is an ongoing infection, treatment options may include retreatment of the root canal, apicoectomy (surgical removal of the tip of the root), or extraction of the tooth if it is deemed non-restorable.
In conclusion, while the absence of an abscess is a positive sign, the persistent swelling of your gums is a concern that should not be ignored. It is advisable to follow up with your dentist or seek a second opinion if symptoms do not improve. Early intervention can prevent more severe complications and help preserve your dental health.

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