Steroids and antibiotics aren’t helping after my root canal

By August 11, 2016 February 13th, 2019 Root Canal Treatment

I got a canal at the beginning of July and my tooth still hurts. The pain is pretty bad. My dentist prescribed steroids and antibiotics but I can’t tell that they did anything at all. Actually my tooth has been hurting since July but not it is getting worse. If I mistakenly bite down on anything with the tooth the pain is off the charts. The gum around the tooth hurts and the pain feels like it is deep in the tooth. I am not sure what should be done about this but I am not taking any more steroids for a tooth especially since it didn’t help at all. What should I ask my dentist to do about this tooth? Thanks. Vickie

Vickie,

Your concern about not taking any more steroids is valid. Although steroids can help treat root canal pain, they also prevent your body from properly fighting the infection. We’ll explain why some dentists prescribe steroids after root canal treatment.

During root canal treatment, instruments are used to clean the tooth. The tooth gets irritated, the tissue in it inflames, and there is pain after the treatment. The swollen tissue also raises the height of the tooth, which affects your occlusion, or the way your teeth fit together. The pressure on the tooth from the imbalanced bite causes more pain and inflammation. Steroids are effective in treating the inflammation.

As we mentioned, not only is inflammation blocked with steroids, so is your body’s ability to fight the infection. So antibiotics are prescribed for the infection. The symptoms you describe probably indicate here is still an infection in your tooth and another root canal treatment is needed. If a specialist didn’t perform the first root canal treatment, ask to be referred to a specialist. He or she might be able to get to the very tip of the roots and remove the infection. If the case is complex, the tooth might need to be extracted.

Instead of prescribing steroids and antibiotics, some dentists choose to give patients high-strength ibuprofen before the appointment. Time is allowed for the body to absorb the anti-inflammatory drug, which in turn limits inflammation after the root canal treatment. Additionally, the tooth that requires the root canal treatment is reduced a little to prevent it from rising and causing occlusal issues after the treatment. The tooth would eventually need to be reduced in size to accommodate a dental crown. Post-operative pain is minimal.

Contact your dentist for another evaluation of your tooth, or schedule an appointment for a second opinion with a prosthodontist.

This post is sponsored by Naperville dentist and board-certified prosthodontist Dr. Anthony LaVacca.