Combined Root Canal & Gum Problems

Tooth pain.When you experience pain in your mouth, it's sometimes abundantly clear which tooth is causing it. At other times, the sensation of discomfort is more diffuse, generalized or hard to pinpoint. On occasion, it can even be challenging to determine exactly what problem or combination of problems is causing the symptoms you're experiencing. This may be the case when an infection exists in the root canals of a tooth as well as the gum tissue adjacent to it.

In this situation, the infection may have begun in the pulp of the tooth itself; or, it may have started in the gums. Over time, it has spread from one location to the other — and now it's causing a confusing set of symptoms that are difficult to sort out. Regardless of where the problem started, a thorough analysis will be necessary before treatment can begin, to give you the best chance of saving the tooth.

Confusing Symptoms

Root canal infection leading to gum disease.

From time to time, many people experience oral discomfort that's dull or intermittent. Occasionally, a more insistent pain may be triggered by a stimulus like temperature (from hot or cold foods or beverages) or pressure (from biting down on something). Sometimes, it may feel as though the ache is coming from a group of teeth rather than one single tooth — or even from the sinus area above the back teeth.

These symptoms can indicate a number of dental issues, including root canal and gum problems, and shouldn't be disregarded. However, if you manage to ignore the acute pain, in many cases it will fade in time. But this isn't good news: It generally means that the infected tissue in the pulp of your tooth has died, and the nerve is no longer functioning. That's when the problem may become more serious.

Chicken or Egg?

Gum disease leading to root canal infection.

When the pulp tissue inside your tooth becomes severely infected, it's possible for the disease to move through openings at the end (apex) of the root, and outside of the tooth. It can then spread to the periodontal ligament, which anchors the tooth to the surrounding bone and gum tissue. From there, the infection may extend to the gum tissue and cause periodontal disease, or even result in a painful gum abscess. At that point, you may have pain — even severe pain that will let you know exactly which tooth is affected.

But it's also possible for the infection to be spread by the exact opposite pathway. In this case, an infection that originated in the gums (commonly due to periodontal disease caused by a buildup of plaque) may have has traveled through small passageways called accessory canals, which are located in between a tooth's roots, or on the sides of the roots. The infection can then extend into the tooth's pulp. If your teeth are fractured, it's even easier for disease to spread.

Treatment Methods

When dental problems involves both root canals and gum disease, saving the affected tooth can prove challenging. This is when it matters where the infection started: If it's primarily a root-canal problem that later moved into the gums, the outlook for the tooth is reasonably positive if it receives immediate treatment. If gum disease came first, however, the prospects often aren't as good; by the time the infection has moved into the tooth, it's possible that much bone has already been lost, making the tooth's long-term prognosis poor.

In either case, the cause of the tooth pain will need to be diagnosed and an effective treatment plan developed. The sooner that happens, the better: Root canal and gum problems simply don't get better on their own.

Related Articles

Confusing Tooth Pain - Dear Doctor Magazine

Confusing Tooth Pain It is occasionally difficult to pinpoint the origin of tooth pain, which can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Nevertheless, it's always important to sort out what's going on so that the right treatment can be selected and the tooth saved... Read Article

Dr. M N95 mask

**IMPORTANT CORONAVIRUS UPDATE 4/01/2020**

Dear Patients,

 It’s April 1st and our family at Metsger Dental were so hoping to have been serving your dental appointments by this time; however, this health crisis is still ongoing and controlling both our business and personal lives.


I am very happy to let you know that myself, Dr. Clark, and each of our staff and all our families have remained healthy throughout this ordeal. That accomplishment came at the expense of you (our patients) in the form of social distancing.

We have processes in place at this time to make it up to you when we are able to return.

What to do if you have a current appointment scheduled:

We anticipate most or all of our April appointments will need to be rescheduled. We are very disappointed but our staff and your health and safety come first at this time. No need to call and reschedule. When things begin to clear a member of our staff will contact you.

What to do if you have a dental emergency:

I have secured the proper (PPE) personal protective equipment including the N-95 masks necessary to see patients. These emergencies, as defined by the ADA, must include: swelling,
or bleeding with pain involvement. If you fall into these categories, please call the office number. The answering service will contact me.

I truly look forward to seeing everyone soon. We plan on returning strong with an extra clean and sterile environment and safety protocols.

I really appreciate your understanding and of course from our work family to yours we hope you stay safe and healthy.

P.S. Brush and Floss at least one or more times per day!

See You Soon.

L. Kevin Metsger

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Questions About Dental Services in Greensburg, PA


520 Pellis Rd Ste 4000
Greensburg, PA 15601

We encourage you to contact us whenever you have an interest or
concern about dentistry procedures such as porcelain veneers, dental implants, and tooth whitening in Greensburg. 

 Contact us by phone at 724-837-5009.


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