Experiences w/ a Root Canal Go Wrong? Worried about my DD15...

[TLSnell1981]

I have too much personal experience with root canals. Your daughter is not experiencing a normal recovery. Tooth pain can be excruciating. The tooth may need to be reopened to relieve the pressure and retreated. If infection develops and persists after retreatment..an apicoextomy may be necessary.

 

[gwynne]

I would find a new dentist. "The lump is still hard and warm to the touch" and he is not seeing her to check it? The receptionist misspoke? red flags!

I have too much personal experience with root canals. Your daughter is not experiencing a normal recovery. Tooth pain can be excruciating. The tooth may need to be reopened to relieve the pressure and retreated. If infection develops and persists after retreatment..an apicoextomy may be necessary.

OP, I agree with both of these posters. I think you've gotten a lot of good advice about being pro-active, earlier and now. I don't think phone consults are nearly as helpful as a health care professional actually looking at the area of what sounds like an on going infection and or other problem. The part above that I boldened would worry me. Wishing your dd well.

 

[HM]

OP, I just don't understand your mindset here. Are you not taking your daughter to the doctor or back to the dentist because you want to save money? Isn't her well-being worth any amount you'd have to pay? I think you are risking spending a lot more money down the line by not being more proactive now. And I just hope your DD isn't going to be risking more healthwise too.

 

[Pea-n-Me]

I'm glad your daughter is feeling better. Maybe the two antibiotics finally kicked in.

The reason myself and the other nurses here were so concerned is likely because of what we know about septicemia, or infection in the blood. When you have a massive infection like that, it can spread to the blood. When it's in the blood, it travels around the body. That's what can make people appear really sick, i.e. lethargic, fatiqued, unable to eat, sleepy, etc., basically some of the descriptions you used.

But there is also something else, called bacterial endocarditis, that can happen when bacteria is in the blood, often from a dental procedure. It more often happens when a person has underlying disease of the cardiac structures, but it can happen to people with normal structures, too - I see it a fair amount in my line of work. Bacterial endocarditis is kind of a nightmare to deal with because it makes a person very sick and requires weeks of IV antibiotics and sometimes open heart surgery to repair damaged heart valves. Would being on an oral antibiotic or two prevent this? Well, that is the question. I don't know. Nobody would really know for sure. But what likely would have happened in an ER setting is that they would have given IV antibiotics anyway, as a preventative measure. To make sure, or at least give the best shot, of preventing something like endocarditis. (Note, I am not saying I think she has endocarditis, I am saying she could be at risk for it in this situation.) I didn't say this the other night cause I didn't want to freak you out or have others say it's an over-reaction, etc. I'm saying it now because it could still be an issue and so others here can learn about it.

http://patient.info/health/infective-endocarditis-leaflet

 

[minnie mum]

OK, I'm going to be the nurse who comes along and tells you not to let the horror stories freak you out. And I'll be the one to tell you that you aren't a bad parent because you haven't taken her to the ER.

Dental infections don't always respond as fast as we might like to antibiotics, but the vast majority do clear. She doesn't have a fever. She isn't lethargic. She has the energy and 'spark' to engage in her normal activities. She's eating. The pain level has decreased, and the swelling is slowly subsiding. All indications that she is getting better.

Her dentist is monitoring her condition and her pediatrician did not see a need for additional intervention at this time. They have both left recommendations for follow-up. They know your DD better than any of us. Unless you see a decline or relapse, just follow the instructions you've been given, and continue to monitor her progress.

 

[Wendy31]

I would find a new dentist. "The lump is still hard and warm to the touch" and he is not seeing her to check it? The receptionist misspoke? red flags!

I admit. Earlier I was very much second-guessing the dentist. However, he's been diligent about either calling us himself (I spoke w/ him on Monday) or having either his hygienist or receptionist call to check on her. I can also understand how the receptionist could have accidently given me incorrect information (based on her own experience/knowledge & not having enough experience/knowledge of what is going on w/ DD), & I appreciate her calling me to apologize.

I have too much personal experience with root canals. Your daughter is not experiencing a normal recovery. Tooth pain can be excruciating. The tooth may need to be reopened to relieve the pressure and retreated. If infection develops and persists after retreatment..an apicoextomy may be necessary.

She was in a great deal of pain over the weekend. Her pain has lessened dramatically since then. She has not taken any pain meds at all so far today. And, during this, she was only taking OTC meds such as Advil & Tylenol, & it was working.

I do agree, though, that if she doesn't continue to see improvement, further action will be needed, & we will seek it.

OP, I agree with both of these posters. I think you've gotten a lot of good advice about being pro-active, earlier and now. I don't think phone consults are nearly as helpful as a health care professional actually looking at the area of what sounds like an on going infection and or other problem. The part above that I boldened would worry me. Wishing your dd well.

OP, I just don't understand your mindset here. Are you not taking your daughter to the doctor or back to the dentist because you want to save money? Isn't her well-being worth any amount you'd have to pay? I think you are risking spending a lot more money down the line by not being more proactive now. And I just hope your DD isn't going to be risking more healthwise too.

Of course, her well-being is worth any amount of money! I don't even know why you would ask that! We also have good health & dental insurance, so, no, I'm not worried about the money.

I trust our pediatrician. It is a practice, & the doctors there & the practice are very highly respected in our community. Our children have been going there since birth. They know our children. They know my daughter. As I talked w/ the nurse, she had my daughter's file in front of her. At this point, the doctor does not feel she needs to be seen. Within 24-48 hours, if we don't continue to see improvement, she will need to be seen. I trust that assessment.

Additionally, I know my DD, & she is doing better. She's not lethargic. She's talking & laughing. She swam last night & was engaged w/ her friends. She's eating. She's reading (she loves to read), & she's back to writing (she also loves writing).

We are staying in contact w/ the dentist, & now, as well, her pediatrician.

I'm glad your daughter is feeling better. Maybe the two antibiotics finally kicked in.

The reason myself and the other nurses here were so concerned is likely because of what we know about septicemia, or infection in the blood. When you have a massive infection like that, it can spread to the blood. When it's in the blood, it travels around the body. That's what can make people appear really sick, i.e. lethargic, fatiqued, unable to eat, sleepy, etc., basically some of the descriptions you used.

But there is also something else, called bacterial endocarditis, that can happen when bacteria is in the blood, often from a dental procedure. It more often happens when a person has underlying disease of the cardiac structures, but it can happen to people with normal structures, too - I see it a fair amount in my line of work. Bacterial endocarditis is kind of a nightmare to deal with because it makes a person very sick and requires weeks of IV antibiotics and sometimes open heart surgery to repair damaged heart valves. Would being on an oral antibiotic or two prevent this? Well, that is the question. I don't know. Nobody would really know for sure. But what likely would have happened in an ER setting is that they would have given IV antibiotics anyway, as a preventative measure. To make sure, or at least give the best shot, of preventing something like endocarditis. (Note, I am not saying I think she has endocarditis, I am saying she could be at risk for it in this situation.) I didn't say this the other night cause I didn't want to freak you out or have others say it's an over-reaction, etc. I'm saying it now because it could still be an issue and so others here can learn about it.

http://patient.info/health/infective-endocarditis-leaflet

I understand, & thank you. I'm aware of those type of infections. My mother has MVP & takes antibiotics before she has any dental work. When this first started (after the root canal), I was very worried about this kind of thing because I've always heard (& read) about how easy it is for a mouth/dental infection to travel to the heart - which is one reason we were back at the dentist on Friday, &, had we not started to see improvement, we would have been either at our doctor's office or at the ER. But, just when I was ready to take her & thinking "this is not right," she started improving a little. I'm a worrier, so, many times, I have to talk myself out of these worst-case scenarios because that's immediately where my mind goes. And then lots of times I don't know... should I be worried about this, or am I just worrying because that's what I do?

Again, (1) I have very limited experience w/ dental procedures & (2) I think I'm just used to antibiotics working a lot more quickly & was not prepared for this.

And I do appreciate everyone's advice & thoughts!

 

[TLSnell1981]

Other complications of an ongoing infection is damage to other teeth and regression of the jawbone. This can cause long term issues, that can be very expensive.

 

[Wendy31]

OK, I'm going to be the nurse who comes along and tells you not to let the horror stories freak you out. And I'll be the one to tell you that you aren't a bad parent because you haven't taken her to the ER.

Dental infections don't always respond as fast as we might like to antibiotics, but the vast majority do clear. She doesn't have a fever. She isn't lethargic. She has the energy and 'spark' to engage in her normal activities. She's eating. The pain level has decreased, and the swelling is slowly subsiding. All indications that she is getting better.

Her dentist is monitoring her condition and her pediatrician did not see a need for additional intervention at this time. They have both left recommendations for follow-up. They know your DD better than any of us. Unless you see a decline or relapse, just follow the instructions you've been given, and continue to monitor her progress.

Thank you. I very much appreciate this!

What you've said is pretty much exactly what our pediatrician has told us.

 

[EMAW_KSU]

I have had a number of root canals done and there were a couple that were worse than others and one had to be retreated also. I agree with the poster above that some do not react to antibiotics as fast as others. I hope your daughter tooth is feeling better.

I just left the dentist office with a treatment plan of 14 crowns and two gingivectomy but no root canals this time.

 

[Pea-n-Me]

OK, I'm going to be the nurse who comes along and tells you not to let the horror stories freak you out. And I'll be the one to tell you that you aren't a bad parent because you haven't taken her to the ER.

Dental infections don't always respond as fast as we might like to antibiotics, but the vast majority do clear. She doesn't have a fever. She isn't lethargic. She has the energy and 'spark' to engage in her normal activities. She's eating. The pain level has decreased, and the swelling is slowly subsiding. All indications that she is getting better.

Her dentist is monitoring her condition and her pediatrician did not see a need for additional intervention at this time. They have both left recommendations for follow-up. They know your DD better than any of us. Unless you see a decline or relapse, just follow the instructions you've been given, and continue to monitor her progress.

That's all fine and good as long as we keep in perspective that this was originally posted two days ago.

What we had to go on, besides descriptions of the lump, was this

She started taking the antibiotics on Friday afternoon. Friday & Saturday were awful w/ no visible improvement, & she was still in lots of pain. On Saturday, she acted very depressed, &, when she spoke, there were tears in her voice. She couldn't really eat - she said even soft foods hurt. She's lost weight, & she really didn't have a lot of extra weight to lose.ALL - on Saturday, I would have labeled her behavior as almost despondent. After she went to bed on Friday, I was crying because I was so worried about her.

and this

Friday evening/Saturday, she was acting not like herself AT ALL- on Saturday, I would have labeled her behavior as almost despondent.

Some of us recognized that as pretty serious stuff, looking at the big picture. Even the non-medical people who can be pretty astute in these matters.

At the very least I think she was probably dehydrated then and likely would have received fluids, if not IV antibiotics. And, having worked in an ER myself, I think she would have gotten those, too, just to be on the safe side with an infection such as this, at least where I am.

 

[Wendy31]

That's all fine and good as long as we keep in perspective that this was originally posted two days ago.

What we had to go on, besides descriptions of the lump, was this



and this



Some of us recognized that as pretty serious stuff, looking at the big picture. Even the non-medical people who can be pretty astute in these matters.

At the very least I think she was probably dehydrated then and likely would have received fluids, if not IV antibiotics. And, having worked in an ER myself, I think she would have gotten those, too, just to be on the safe side with an infection such as this, at least where I am.

DH is a licensed first responder, & he knows what to look for as well.

And we were making sure she stayed hydrated. She was drinking. We were making popsicles & milkshakes. She was eating watermelon. But, of course, a basically liquid diet is going to make you lose weight, & she's thin... she doesn't have that much extra to lose, &, when she does, it's noticeable.

I don't think I misspoke when I said "depressed" & "despondent," but I didn't mean those terms medically. When I compare how DD normally is to how she was on Friday/Saturday, there was a definite difference. She was in pain. She was depressed because of the pain & the swelling & not feeling like herself & not being able to eat & just feeling lousy. And I did describe it as despondent... You could just look at her & tell she felt discouraged & dejected. She looked miserable and felt miserable. And tooth pain is awful. It's hard to get on top of tooth pain. Friday night, I was upset & in tears as well.

But I do understand how words like "depressed" & "despondent" can be words that alert a medical person to a patient's condition.

Had she not turned the corner (even though it was a small turn) on Saturday evening, we would have headed to the ER. When I initially made the post, I was wanting to know how normal this kind of thing was after a root canal (if anyone had similar experiences) & if the dentist's prescribed treatment sounded right - because, again, very limited experience when it comes to dental procedures here.

And I'm not trying to argue or be defensive. I really do appreciate the concern & advice. (Well, maybe a little defensive, because we were staying in contact w/ the dentist & being watchful & making sure she stayed hydrated, & I don't like to be made out as a neglectful parent.)

 

[gwynne]

DH is a licensed first responder, & he knows what to look for as well.

And we were making sure she stayed hydrated. She was drinking. We were making popsicles & milkshakes. She was eating watermelon. But, of course, a basically liquid diet is going to make you lose weight, & she's thin... she doesn't have that much extra to lose, &, when she does, it's noticeable.

I don't think I misspoke when I said "depressed" & "despondent," but I didn't mean those terms medically. When I compare how DD normally is to how she was on Friday/Saturday, there was a definite difference. She was in pain. She was depressed because of the pain & the swelling & not feeling like herself & not being able to eat & just feeling lousy. And I did describe it as despondent... You could just look at her & tell she felt discouraged & dejected. She looked miserable and felt miserable. And tooth pain is awful. It's hard to get on top of tooth pain. Friday night, I was upset & in tears as well.

But I do understand how words like "depressed" & "despondent" can be words that alert a medical person to a patient's condition.

Those words alarmed me, "just" a parent, too. Certainly fine to do what you think best. If you ask, though, you'll get answers. I answered based on what I would do. I know me. And I know that I am not overly confident that I would notice (and mention) everything salient to the obvious medical complication. I wouldn't want to try to explain it on the phone. Once there was a serious issue, I would want mine to be seen.
It's nice you have a first responder in the house. That probably helps in your decision making process. There are lots of ways to handle things, it sounds like you are in a good place. All the best.

 

[Wendy31]

Those words alarmed me, "just" a parent, too. Certainly fine to do what you think best. If you ask, though, you'll get answers. I answered based on what I would do. I know me. And I know that I am not overly confident that I would notice (and mention) everything salient to the obvious medical complication. I wouldn't want to try to explain it on the phone. Once there was a serious issue, I would want mine to be seen.
It's nice you have a first responder in the house. That probably helps in your decision making process. There are lots of ways to handle things, it sounds like you are in a good place. All the best.

Thank you! And I understand what you're saying & appreciate what you're saying. And I also thank you for replying & offering advice.

I'm not upset & really don't mean to come across that way or as defensive/argumentative.

 

[Pea-n-Me]

Same, for sure! Just trying to explain thought process.

 

[HM]

Of course, her well-being is worth any amount of money! I don't even know why you would ask that! We also have good health & dental insurance, so, no, I'm not worried about the money.

I asked because you seemed very reluctant to actually go see someone, when most of the immediate responses were 'go have her seen'. I can tell you this, with the information you gave, I would have been at a doctors office pretty quickly with my children.