Question:

How is the diagnosis confirmed that a root canal is needed? What other problems could these symptoms be confused with? How often do abscesses resolve themselves and what predictors are there for which outcome? Are there any recent studies using only antibiotic treatment? Are there any local (non-systemic) antibiotic therapeutic options?

Answer:

There are many reasons that a tooth may need a root canal, such as:

• infection
• large fillings
• cracks
• need for space to attach a crown

There are many tests and parts of an examination that can be done to determine if a root canal is necessary. Your endodontist or dentist can do an evaluation to determine if you need a root canal and explain the exam/tests necessary for your particular situation.

There are many other conditions that could cause orofacial pain, and they are too numerous to discuss here. Your endodontist is trained to differentiate between other conditions and a tooth problem.

Abscesses do not resolve themselves. Symptoms may disappear (swelling, pain, drainage), but until the underlying cause of the infection is treated, the symptoms will continue to reappear (usually at inopportune times). If a root canal is necessary due to an infected tooth, no type of antibiotic will treat the condition. Antibiotics only treat the symptoms. A root canal or extraction would need to be done to treat the infected tooth.

For more information:

Go to the Dental and Oral Health (Adults) health topic.