I have an abscessed tooth -- NOW WHAT?!?

[cjforrest]

I've been battling CD for almost a year now, after receiving clindamycin for an abscessed tooth that had been previously root-canaled. That same tooth is abscessed again! It's not painful because of the root canal in 2005, but it has to be dealt with. I got CD last July (have had repeated recurrences since) and am still on Vanco, on a very slow taper since January, just started on one (125 mg) pill per day dosage. I was feeling very positive that this taper is working, and now this!

Has anyone dealt with this? I don't want to take antibiotics! My dentist didn't seem very knowledgeable about CD. When I told him I was battling CD since he last prescribed clindamycin, he didn't seem to know what I was talking about -- until I specifically said CD colitis. He still wants me to take antibiotics (he also mentioned taking steroids to see if they would stimulate my immune system to fight the infection). Other options are a new root canal procedure or oral surgery to clean out the infection. He thinks those are too drastic at this time, but I'd rather have a new root canal or the surgery than spend another year on the toilet! I don't want the drugs. If I have to take antibiotics, does it help to increase the Vanco dosage? Would that help prevent another recurrence of CD? (I'm also currently taking 4 different probiotics, and eat DanActive and Activia, along with 2 yogurts every day)

I gave my dentist the phone number to my ID specialist so they can discuss my case. I'm also going to call my ID tomorrow morning to speak with him directly.

Please, does anyone have any suggestions?

CJ

[Bobbie]

cjforrest,
You might mention using PenVK to your dentist. Although it, too, can cause C. diff. it isn't one of the major offenders & can sometimes work against bacteria in the mouth. (See FAQ-Antibiotics.) Also, there is an antibiotic mouth rinse called Peridex that can be helpful -- but usually not with major infections. Check this out with a pharmacist -- in fact, I'd call several.

Using Vanco. with another antibiotic has helped some people against a reoccurence of C. diff. Good idea to check with your ID. When it comes to medications, they are more knowledgable than most docs.

I would ask your ID about getting another opinion from an endodontist -- a specialist in root canals/absessed teeth.

I had osteomyletis (bone infection) of the jaw when I had C. diff. (Ground my teeth from stress, broke several teeth, & developed a major infection after an oral surgeon botched surgery.) My ID eventually put me on IV Vanco. after several weeks of strong Penicillin. (I was already taking oral Vanco.) The IV Vanco. eventually cleared the oral infection. (Ask your ID about using it.) I learned how to administer the IV, flush it, & then go to work.) I had some major dental work done afterwards.

Good luck. You are between a "rock and a hard place."I know how you feel.

[Vikingjeff28]

I had same issue, Clyndamicin for throat infection, Got Cdiff twice, then 3 months later, bad tooth. I chose root canal and will every time. If they have to pull the tooth I will let them do that and get a fake one or something. I am not puring AB's into my body again unless my life is a stake, especially Clinda. I may take Cipro or something like that to calm it down for a couple days until they can pull it or root canal the tooth. That is me though, won't apply to everyone.

[Nancy1]

After I got cdiff, and learned from this board that many people get cdiff due to antibiotics used by dentists, I talked to my dentist about it. I specifically said that many people get cdiff after taking clindamycin prescribed by their dentists. He said that the first thing he does for an abscess is to clean out the area. That generally gets rid of the infection. He only uses antibiotics as a last resort. Antibiotics would certainly be a last resort for me.

[TheVike]

hell with it and the cost of a root canal and pull er out!

[crissiej]

Do you really need the antibiotics since you are on Vanco?? I would ask your dentist.

[cjforrest]

Thanks for your input everyone. I haven't decided what to do yet, so I'm still open to your suggestions. Keep 'em coming, please.

My ID is out of town until Monday and I want to talk to him before I do anything. (I presented your suggestions to his back-up and he seriously considered each. He was helpful, but since there's no pain and things aren't getting worse, he suggested I wait to speak with my ID because he knows me and my case best.) The back-up ID spoke with my dentist and both spoke to me after their conversation. The only things that appear certain are 1) steroids aren't a good idea with CD; and 2) a new root canal procedure probably won't help because the infection is under the tooth -- the tooth itself isn't infected.

There's a lot to consider, and each option has its pros and cons. It's so hard to know what's right. I'm just waiting to talk to my ID and then I'll have to make a tough decision. So if you've been in similar shoes, or know of someone who has, please tell me what worked/what didn't work. The more ideas I can present to my ID, the better.

Thanks everyone!!
CJ

[cindym]

While on vanco I had oral surgery done to remove a tooth and they did not give me any other antibiotics. This particular dentist said that although vanco is not suppose to be systemic that he believed it would have to be somewhat. WHO KNOWS? I did okay and nothing bad happened but it was a bit scary. I have taken antibiotics several times during my plight with cdiff and each time they increase the dosage of vanco and although I have slight symptoms they usually do not last very long. Good luck as I can imagine how frightened you must be.

[ClDif]

Hi CJ,

I would have the tooth pulled out if I were you. No matter what that means financially... I have had so much trouble from repeated root canals and when I didn't have the tooth pulled out, infection spread to the jaw bone and I had to have surgery even after I had the tooth pulled out - the last time, after c diff, without ABs. It still doesn't feel right, but xrays show no more inflammation. These bl...y teeth just cause so much trouble and hardly any ABs get into the bones as well - once infection speads to the bone, if it does. Clindamycin in one of the only ones that penetrates bones well, which is why dentists love it I think... It's a tough choice, I agree...