Dental Issues: Necrotic Nerve and Gum Abscess Concerns

Nerve necrosis + dental gap acid

Hello Doctor,
1.
My tooth was replanted last June, but recently the gum tissue near my cheek has become red, swollen, and soft, with pus discharge.
I visited a major hospital and the dentist diagnosed it as a necrotic nerve requiring a microscopic root canal treatment.
I was prescribed antibiotics to take at home.
I have finished the antibiotics, but the abscess has not resolved (although it hasn't gotten larger).
Even when I squeeze out the pus, it swells back to its original state (the pus remains).
Should I drain the abscess or leave it alone? My root canal appointment is scheduled for May.
Will the condition of my tooth worsen if the abscess does not resolve?
2.
After finishing the antibiotics, I still have inflammation and pus.
Should I return to the doctor for another prescription of antibiotics? Is there a risk of developing antibiotic resistance from prolonged use?
3.
Additionally, I have been experiencing soreness in some of my tooth gaps.
I had an X-ray previously, which showed no cavities, but when I press on my jaw to my chin, I feel soreness and tightness.
What could be causing these symptoms?

moku, 20~29 year old female. Ask Date: 2021/01/25

Dr. Huang Tingfang reply Dentistry

1.
Without root canal treatment, relying solely on antibiotics may not effectively cure an abscess.
If the abscess is drained but quickly swells again, prompt root canal therapy should be sought to prevent worsening or even the development of cellulitis.
2.
Gum recession, exposed tooth roots, or tooth grinding can all contribute to tooth sensitivity.

Reply Date: 2021/01/25

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your dental issues, particularly the necrotic nerve and gum abscess. I understand that you are experiencing significant discomfort, and I will do my best to address your questions comprehensively.

1. Gum Abscess and Necrotic Nerve: It seems that you have developed a gum abscess, which is often a result of an infection stemming from a necrotic (dead) nerve within a tooth. The presence of pus and swelling indicates that your body is responding to an infection. While it may be tempting to squeeze or drain the abscess, this is generally not recommended without professional guidance. Attempting to drain it yourself can lead to further complications, including the spread of infection. It is crucial to wait for the scheduled root canal treatment, as this procedure aims to remove the infected nerve tissue and clean the area thoroughly. If the abscess persists or worsens before your appointment, it is advisable to contact your dentist for further evaluation.

2. Antibiotic Use: You mentioned that you have completed a course of antibiotics but are still experiencing symptoms. While antibiotics can help control bacterial infections, they may not eliminate the source of the infection if the necrotic tissue remains. It is essential to follow your dentist's advice regarding antibiotic use. If the infection is not improving, your dentist may prescribe a different antibiotic or adjust your treatment plan. Concerns about antibiotic resistance are valid; therefore, antibiotics should only be used when necessary and under a healthcare provider's supervision.

3. Pain in the Jaw and Teeth: The discomfort you are experiencing in your jaw and teeth could be related to several factors. If you are feeling pain when pressing on your jaw or chin, it may indicate muscle tension or inflammation in the temporomandibular joint (TMJ) area. This can occur due to clenching or grinding your teeth, often exacerbated by stress or discomfort from dental issues. Additionally, if there are any underlying dental problems, such as gum disease or issues with the alignment of your teeth, these could contribute to the pain you are feeling. It is essential to communicate these symptoms to your dentist, as they may want to perform a more thorough examination or refer you to a specialist if necessary.

In summary, it is crucial to manage your dental health proactively. Do not hesitate to reach out to your dentist if you notice any changes in your symptoms or if the pain becomes more severe. They can provide you with the best course of action tailored to your specific situation. Remember, timely intervention is key to preventing further complications.

Take care, and I hope you find relief soon.

Best regards.

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