Hello!
Three days ago a tooth started hurting (upper left first molar) that had already been treated (dead and filled). Because of the pain my dentist opened the tooth, removed the filling material and put medication inside. She also said that everything should now be fine. But it was not: I developed swelling, so I returned to the dentist, who opened the tooth and said that the pus would now drain out nicely. It did not; instead the swelling increased, so I visited another dentist who prescribed antibiotics and said that the tooth absolutely had to remain open; he also managed to drain some pus. I would like to know when the swelling will go away? I have been taking antibiotics for 24 hours so far, but there is no improvement; in fact the swelling has increased slightly and spread more toward the eye. What else can be done, since the tooth is open and the swelling should be going down! I really do not know what to do — should I go back to the dentist again? Or should I just wait?
Thank you in advance for your answer,
Kind regards

Dear Sir/Madam!

In a case such as the one you describe, it is always necessary to ensure drainage of the pus, which is actually located in the bone near the root tip of the affected tooth. Drainage has two main possible routes:
-through the root canal and the dental crown to the outside (the tooth is opened and, depending on the clinician’s assessment, left open)
-through a drainage opening made by incision (a cut) through the mucosa and periosteum to the abscess (pus pocket), which is usually located in the area of the root tip of the affected tooth). This type of treatment is carried out when the purulent contents have already collected in an abscess and are no longer diffusely distributed through the soft tissue (when it is probably only tissue edema). A drainage strip or tube is inserted into the wound to ensure that the opening through the mucosa does not close immediately. How long the wound remains open is a matter for the clinician to decide.
Antibiotic therapy is added as needed and according to the dentist’s decision (lymph nodes, elevated body temperature, ...). The condition described should improve in approximately one week.

Have a nice day!