Long wait for dental abscess treatment?

Snuggles

I started getting pain in a front tooth over a week ago. Finally got a dentist appointment on Weds just gone, where it was confirmed I have an abscess and need root canal treatment. I was sent away with antibiotics and an appointment to go back on the 7th of December to have the treatment. The thing is, the pain is getting worse by the day, constant throbbing, and the pain when I try to eat or drink is almost unbearable. I was told to take painkillers but they are making little difference.

I just don't know how I can face another 9 days of this. Is it normal to have to wait this long??

perplexed.com

I suggest you contact your dentist again. However I had an abscess and was given antibiotics and told I'd need to have my tooth extracted. ( previously root canal work but with a root fracture this time, plus infection ). It took a few days for the pain to subside and like you, I thought it was not getting better. My dentist told me that they would not extract the tooth until the course of antibiotics was completed, something to do with interfering with the anaesthetic and I was sceptical. The pain did, though subside after about 3/4 days on the anti b's and I felt much better, so you may find it improving soon. Good luck.

BitterAndTwisted

Try and get an appointment with the dentist on Monday. They can prescribe painkillers for you if necessary. I had an abcess many years ago and I understand completely what you're going through. I think I went through about four or five courses of antibiotics and painkillers and I hope you won't have to.

The dentist will not touch the tooth until the abcess and all its infection are gone completely because the risk of blood-poisoning etcetera is too high.

Poor you

jugglebug

Snuggles wrote: »

I started getting pain in a front tooth over a week ago. Finally got a dentist appointment on Weds just gone, where it was confirmed I have an abscess and need root canal treatment. I was sent away with antibiotics and an appointment to go back on the 7th of December to have the treatment. The thing is, the pain is getting worse by the day, constant throbbing, and the pain when I try to eat or drink is almost unbearable. I was told to take painkillers but they are making little difference.

I just don't know how I can face another 9 days of this. Is it normal to have to wait this long??

When you say drinking hurts too, is that the change in temperature?
Abscessed teeth generally are not sensitive to changes in temp, as the nerve is dead inside. The pain comes from pressure build up inside. Sometimes teeth with more than 1 root can have infection on 1 root and not on another so there are exceptions.
There is no reason not to have an abscessed tooth treated antibiotics or not. However it is true you cannot inject into a swollen infected area, but there are ways around that. Also it is harder to get a acutely inflamed area numb, but not impossible usually.
I would go back, because if the tooth isn't dead and there is still some vital tissue in there the antibiotics will have no effect whatsoever on the pain, although it may be that the nerve finishes dying during those 9 days :-) In which case the pain will go. Just not because of the antibiotics.

Snuggles

jugglebug wrote: »

When you say drinking hurts too, is that the change in temperature? Abscessed teeth generally are not sensitive to changes in temp, as the nerve is dead inside. The pain comes from pressure build up inside. Sometimes teeth with more than 1 root can have infection on 1 root and not on another so there are exceptions.
There is no reason not to have an abscessed tooth treated antibiotics or not. However it is true you cannot inject into a swollen infected area, but there are ways around that. Also it is harder to get a acutely inflamed area numb, but not impossible usually.

Hi Jugglebug, yes the change in temp was initially causing severe pain, although that seems to have died down over the last few days. The problem with eating now is I can't bite or chew properly, as if the tooth touches my bottom front tooth when I close my mouth, it is so painful. The rest of the time I just have this awful constant throbbing, which as you say is the pressure build up. I was lying awake half the night fantasising about having it drained and getting relief!!

I'm glad to hear there should be no reason for them not to treat the tooth, I don't want to be fobbed off with just more antibiotics. I am thinking about ringing my old private dentist tomorrow to see if he can fit me in. I know it will cost a fortune, but I have so much more faith in him than the NHS dentist I saw last week.

jugglebug

Snuggles wrote: »

Hi Jugglebug, yes the change in temp was initially causing severe pain, although that seems to have died down over the last few days. The problem with eating now is I can't bite or chew properly, as if the tooth touches my bottom front tooth when I close my mouth, it is so painful. The rest of the time I just have this awful constant throbbing, which as you say is the pressure build up. I was lying awake half the night fantasising about having it drained and getting relief!!

I'm glad to hear there should be no reason for them not to treat the tooth, I don't want to be fobbed off with just more antibiotics. I am thinking about ringing my old private dentist tomorrow to see if he can fit me in. I know it will cost a fortune, but I have so much more faith in him than the NHS dentist I saw last week.

OK so it sounds (and of course I cant be sure over the internet) That the tooth is non vital, and probably abscessed as your dentist said.
Getting the tooth drained is the best plan, but if the area is swollen then they cant inject right there, but they can inject a distance away and let the gum numb through that method. If there is that much swelling though they should be able to drain through the gum with a little nick. Otherwise a channel cut into the tooth into where the dead nerve is will allow the pressure to be drained. this can sometimes be done without any injection at all as the tooth is dead, but the vibration onto the inflamed areas can be uncomfortable.
The problem that you have is that the NHS provides for the bare minimum for any given scenario. Pills take 3 seconds to dole out, drainage rather longer.


Oh by the way, non vital to a dentist means dead, not that it isnt important!

Snuggles

jugglebug wrote: »

OK so it sounds (and of course I cant be sure over the internet) That the tooth is non vital, and probably abscessed as your dentist said.
Getting the tooth drained is the best plan, but if the area is swollen then they cant inject right there, but they can inject a distance away and let the gum numb through that method. If there is that much swelling though they should be able to drain through the gum with a little nick. Otherwise a channel cut into the tooth into where the dead nerve is will allow the pressure to be drained. this can sometimes be done without any injection at all as the tooth is dead, but the vibration onto the inflamed areas can be uncomfortable.
The problem that you have is that the NHS provides for the bare minimum for any given scenario. Pills take 3 seconds to dole out, drainage rather longer.


Oh by the way, non vital to a dentist means dead, not that it isnt important!

Thanks Jugglebug, I can't actually see any swelling, the gum above the tooth just looks a little inflamed. The dentist said he could see a small abscess on the xray (although it feels huge from the pain!).

I forgot to mention that the tooth has a crown on it, which I guess makes things more complicated. This is another reason I think I might go back to my private dentist for treatment, as I really don't want to lose the tooth/crown. The NHS dentist I saw was so young (23 - I asked him!), I think I would rather see someone more experienced, even if it means paying through the nose. Right now, I'd sign my house over to anyone who could take this pain away!

jugglebug

Snuggles wrote: »

Thanks Jugglebug, I can't actually see any swelling, the gum above the tooth just looks a little inflamed. The dentist said he could see a small abscess on the xray (although it feels huge from the pain!).

I forgot to mention that the tooth has a crown on it, which I guess makes things more complicated. This is another reason I think I might go back to my private dentist for treatment, as I really don't want to lose the tooth/crown. The NHS dentist I saw was so young (23 - I asked him!), I think I would rather see someone more experienced, even if it means paying through the nose. Right now, I'd sign my house over to anyone who could take this pain away!

The crown does make it more complicated, particularly if it has a post supporting it,

Always_Harassed

If you have a crown and the antibiotics don't work, the only way to treat the abcess is to operate above it. What they do is open up the root above the tooth and try to treat it that way. It is rather painful as you have stitches in the gum. I had that done twice in the same tooth and eventually lost it about a year later.

An old fashioned way of treating an abcess is rinse with boiled salted water, once it is at a temp that you can stand similar to a hot drink. Rinse it around the mouth and hold for a few seconds before you spit it out and repeat several times. Do this a few times a day. My dentist stills suggests that you do that even if you have antibiotics which can take 3 days to get into your system. Don't think private or NHS dentists treat you differently.

jugglebug

Always_Harassed wrote: »

If you have a crown and the antibiotics don't work, the only way to treat the abcess is to operate above it. What they do is open up the root above the tooth and try to treat it that way. It is rather painful as you have stitches in the gum. I had that done twice in the same tooth and eventually lost it about a year later.

An old fashioned way of treating an abcess is rinse with boiled salted water, once it is at a temp that you can stand similar to a hot drink. Rinse it around the mouth and hold for a few seconds before you spit it out and repeat several times. Do this a few times a day. My dentist stills suggests that you do that even if you have antibiotics which can take 3 days to get into your system. Don't think private or NHS dentists treat you differently.

Antibiotics never ever cure abscesses. All they can do is settle down the infection until you have the definitive treatment done. Sometimes they settle for some time but if the cause is still present the abscess will return.
You wont find many NHS dentists performing apicectomies nowadays. The new contract gives them no incentive to try it and the success rates are low

Snuggles

Always_Harassed wrote: »

If you have a crown and the antibiotics don't work, the only way to treat the abcess is to operate above it. What they do is open up the root above the tooth and try to treat it that way. It is rather painful as you have stitches in the gum. I had that done twice in the same tooth and eventually lost it about a year later.

Nothing like that was mentioned to me. The NHS dentist said they will drill through the back of the crown. I have alreadly had root canal treatment on my other crowned tooth some years ago (my two front teeth have crowns), and that's what they did then.