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FAQ:  Root Canal Therapy RCT



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Question:
Apicoectomy: I have an infection in the bottom front tooth, #24. I had a root canal 5 years ago. Seemed fine. Last June had x-ray slight infection, took penicillin VK500 mg, didn't get work done, referred to oral surgeon, who said could get apicoectomy. Left it alone. Last week went to dentist. Infection back worse than before. Apicoectomy suggested again. Taking penicillin again. Does the antibiotic ever clear up the infection totally, or do you always need the apico? Symptom was no pain, but internist was looking for clues of why I've been feeling dizzy for the last 2-3 weeks, and night blurriness temporarily in the left eye, which went away. Went to opthomologist, no problem. Have a stress echo scheduled for tommorrow. Does antibiotic affect results of test? Switched to augmentin XR half of 1000mg pill for spot on tonsil and throat inflammation. Could be caused by tooth infection? ...Visitor from NY

Answer:
The infection at the base of the root (apex) will not go away with just antibiotics. What is happening is that there is still some bacteria and dead nerve tissue in the accessory canals.

Lets look at the anatomy of the root canal. If you have ever pulled a weed from the garden you will notice that there is a tap root which has root hairs extending from it. This is what the nerve looks like in the tooth. On the x-ray you will only see the tap root part and not the root hairs. The dentist removes the tap root and tries to get all of the root hairs, however our instruments can not get into the small spaces so we must rely on the sterilization solution in the canal.

As time goes on the body can often fight off an infection from the remaining root hair material. However if the body gets sick or the infection area gets to the point where the infection grows out of control then it is seen on an x-ray. There is no pain because those nerve fibers have been removed, There will be a dull pain later on if the condition does not change.

The dizziness and eye problems are unlikely to be coming from a bottom tooth however they do need to be addressed in the manner which you seem to be doing. The antibiotics should not interfere with the stress test.

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