Root Canal Treatment: Managing Gum Abscesses and Dental Pain

Root canal treatment

Hello, doctor.
Last Monday, a small abscess appeared on the gums next to my molar, and it wasn't very painful, so it didn't go away.
Later, I visited a dental clinic on Thursday, and they said it was due to inflammation of the nerve inside the molar crown, and that I needed to remove the crown and undergo root canal treatment for it to improve.
Then on Friday, I also saw an ENT specialist, who said it looked like a dental issue.
This Monday, I noticed a very small abscess forming on my upper jaw as well.
Yesterday, I went to the dental department at Zhongxiao Hospital, and the doctor said the gum abscess was due to inflammation from the crown, and it should resolve after the root canal treatment.
When I asked about the upper jaw, she said it could also be related to the teeth or possibly from eating.

Later yesterday, I underwent root canal treatment at Zhongxiao Hospital, but the doctor I saw was different from the one I had previously consulted.
It seemed like a resident preparing for their internship, and they mentioned that multiple root canal treatments might be necessary because it's a molar.
After brushing my teeth yesterday, I felt like a piece of the filling came off, and today I noticed that the original abscess has turned into two abscesses.
I'm extremely worried that something might be wrong, or if the abscesses are reappearing due to the root canal treatment.
Shouldn't the abscesses gradually disappear after the root canal treatment?
Doctor, how should I manage these abscesses? I called the clinic and was told that I need to address the abscesses first.
Zhongxiao doesn't have an emergency dental department; can I go to another hospital for emergency dental care? My teeth have been hurting continuously, and I have a history of liver transplantation, so I'm very concerned about the risk of infection.

Wenwen, 40~49 year old female. Ask Date: 2022/03/11

Dr. Zeng Guanghui reply Dentistry

If a root canal treatment is performed due to an abscess, it indicates that the infection at the root tip has reached a certain extent.
Although the initial one or two root canal treatments may have been done, the abscess may not disappear immediately.
It may require multiple sessions of canal cleaning and disinfection before the abscess completely resolves.
It is recommended to return for a follow-up visit to have the treating dentist evaluate the situation.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/03/11

More Info

It sounds like you are experiencing a challenging situation with your dental health, particularly following your recent root canal treatment. The presence of gum abscesses and ongoing dental pain can be concerning, especially given your medical history of liver transplantation, which may put you at a higher risk for infections.
First, let's clarify what a gum abscess is. A gum abscess, or periodontal abscess, is a localized infection that can occur in the gums, often resulting from untreated dental issues such as tooth decay or gum disease. In your case, the abscesses may be related to the inflammation of the nerve inside your tooth, which can occur if the root canal treatment is not fully effective or if there are additional complications.

The fact that you have developed multiple abscesses after your root canal treatment suggests that there may still be an underlying issue that needs to be addressed. It is possible that not all of the infected tissue was removed during the procedure, or there may be additional canals in the tooth that were not treated. This is particularly common in molars, which can have complex root systems.

Given your symptoms, including the increase in the number of abscesses and persistent pain, it is crucial to seek further evaluation from a dental professional. Here are some steps you can take:
1. Seek Immediate Care: Since you are experiencing pain and have developed new abscesses, it is advisable to visit an emergency dental clinic. Even if your usual dentist does not have an emergency department, many hospitals have dental services that can address urgent issues.

2. Antibiotics: If you have not already been prescribed antibiotics, it may be necessary to start a course to help control the infection. Given your history of liver transplantation, it is essential to inform your healthcare provider about your medical history so they can prescribe the most appropriate medication.

3. Follow-Up on Root Canal Treatment: It may be necessary to have a follow-up appointment with an endodontist (a specialist in root canal treatments) to assess the effectiveness of the initial treatment. They may need to perform retreatment or additional procedures to ensure all infected tissue is removed.

4. Monitor Symptoms: Keep track of any changes in your symptoms, including the size of the abscesses, the level of pain, and any systemic symptoms like fever or chills. This information will be valuable for your healthcare provider.

5. Discuss Your Concerns: Given your history of liver transplantation, it is vital to communicate your concerns about infection and any other health issues with your dental care team. They can provide tailored advice and treatment options that consider your overall health.

In summary, while root canal treatment can often resolve issues related to dental pain and abscesses, complications can arise that require further intervention. It is essential to seek prompt care and communicate openly with your dental team about your symptoms and medical history. Taking these steps will help ensure that you receive the appropriate treatment and care for your dental health.

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