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Thursday, May 23, 2013
A middle aged adult had the root of 1 of his front teeth severed some 30 years ago. Last spring a severe infection occurred in the small amount of remaining root tissue; antibiotics cleared the infection. A few months later a routine dental hygiene check-up showed no signs of infection; no prophylactic antibiotics were given. Around 4 weeks later the root canal infection recurred & is being treated. Would routine prophylactic antibiotics at the last dental hygiene visit prevented this last infection?
No. A prophylactic dose of antibiotics would only last about 24 hours, not 4 weeks. The use of antibiotics for dental infections merely helps the immune system cope with bacteria that have invaded the bone. The antibiotics do not resolve the problem.
In this patient's case, root canal therapy would be the only way the infection would resolve and not return and the bone could heal. The endodontist needs to remove the infected tissue from inside the root of the tooth and disinfect the root canal and seal it. The signs and symptoms of endodontic infections do flare up and resolve themselves.
However, even though the patient does not show a sign of infection (swelling or drainage) does not mean that an infection is not present. It simply means there are no obvious signs or symptoms to the patient. The infection is in a form of remission, but it is still present.
John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University