Dear doc, we went out of town for the 4th of July and I got a raging tooth ache, the tooth had been getting sensitive for a couple of months as I had a filling fall out, but I ignored it and hoped it would go away, it didn't. Bottom line I had to see an out of town dentist who took and x-ray and informed me I needed a root canal because I had an infection and abscess at the tip of my root, he said if I didn't I would have to pull my tooth, can't I just take antibiotics, how did I get this infection?

Dear Don, sounds like you didn't have much of a holiday. I can only speak in generalities, as I have not examined you. However you mentioned you had pain for several months preceding this episode, and that an existing filling in the tooth had fallen out. In my practice tooth decay is the most common cause of an inflamed pulp, [pulpitis]. When active decay is present in a tooth it continues to infect the tooth deeper and deeper until it hits the nerve; once the bacteria reaches the root it can travel down the root and form and area of infection called an abscess. You never know if your cavity is going to decay quickly down to the nerve or slowly, but once it reaches the nerve the damage is done and a root canal will have to be done or the tooth extracted. The tooth will be extremely painful and sensitive until something is done. The antibiotics you mentioned will help clear up the infection, but because the source of the infection is still present you infection and pain will re-occur. Don the good news is that most teeth today can be saved with root canal therapy, when preformed by an experienced dentist.

The moral of the story is one of vigilance; if you notice something out of the ordinary occurring in your mouth, don't ignore it. My professional experience has shown, that Small problems ignored, will only get worse, cause more pain and cost more!

Better smiles for all,
Dr. John Russo
Director of Russo Dental Care
San Bruno, California