Inflammation Below Teeth: Treatment Options and Advice - Dentistry

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When dealing with inflammation below the teeth, particularly after a root canal treatment, it is essential to understand the underlying causes and the best treatment options available. Based on your situation, here are some insights and recommendations.


Understanding the Condition
1. Inflammation and Infection: The inflammation you are experiencing is likely due to an infection that has developed in the bone surrounding the tooth. This can occur if bacteria have persisted in the tooth or surrounding area, even after a root canal treatment. The presence of pus indicates that there is an active infection, which needs to be addressed promptly to prevent further complications.

2. Previous Root Canal Treatment: If the tooth has already undergone a root canal, it is possible that the treatment was not entirely successful, or there may be additional canals that were not treated. This is why a microscopic examination is often recommended, as it allows for a more thorough assessment of the tooth's internal structure.


Treatment Options
1. Microscopic Root Canal Treatment: While it is not strictly necessary to have a microscope for root canal treatment, using one significantly increases the chances of success. Microscopes allow the dentist to see finer details and locate additional canals or areas of infection that may not be visible to the naked eye. If your dentist recommends this approach, it is likely because they believe it offers the best chance for a successful outcome.

2. Extraction vs. Retreatment: The decision to retreat the root canal or extract the tooth depends on several factors:
- Success Rate: If another dentist has indicated that the success rate for retreatment is less than 50%, it may be worth considering extraction, especially if the tooth is not crucial for your bite or aesthetics.

- Overall Health: If the tooth is causing significant pain or if the infection is affecting your overall health, extraction may be the more prudent option.

- Future Implications: Consider the long-term implications of both options. Retaining the tooth may be preferable if it can be successfully treated, as it maintains your natural bite and prevents shifting of adjacent teeth.


Current Medications and Management
You mentioned that you are currently taking Ponstan (an anti-inflammatory) and Amoxicillin (an antibiotic). These medications can help manage pain and reduce inflammation, but they do not address the underlying infection. It is crucial to follow up with your dentist or an endodontist (a specialist in root canal treatment) to determine the best course of action once your symptoms have stabilized.


Recommendations
1. Consult a Specialist: If you have not already, consider consulting an endodontist who specializes in root canal treatments. They can provide a more detailed assessment and discuss the potential for retreatment with a microscope.

2. Evaluate Extraction: If retreatment is not viable or if you prefer not to pursue it due to cost or low success rates, discuss the option of extraction with your dentist. They can provide information on the implications of losing the tooth and options for replacement, such as implants or bridges.

3. Monitor Symptoms: Continue to monitor your symptoms while on medication. If you experience increased pain, swelling, or other concerning symptoms, seek immediate dental care.

4. Consider Financial Aspects: If cost is a significant concern, discuss payment plans or financing options with your dental office. Many practices offer solutions to help manage the financial burden of dental procedures.

In conclusion, the decision between retreatment and extraction should be made based on a thorough understanding of your specific situation, the potential for success, and your personal preferences. Consulting with a specialist and considering all factors will help you make the best decision for your dental health.