Dental abscess (failed root canal); CBC, CRP, ESR results

[Matt]

Hello all!

For just over 2 years now I've had a tooth (2nd premolar on my bottom right) that has had a mostly asymptomatic apical abscess. Here and there it will start to flare up but within a day or so, very mild soreness or pain, and then it's gone again. Generally this would only be apparent in the morning until I start chewing. Only very mild pain when tapping the tooth (still present), but otherwise the tooth is very secure and not moving. 

I've had a couple blood tests now over the past few months and I've had higher WBC levels than I'd like and my CRP seems to be on the high end for someone like myself who eats healthy and does CR. Although, for whatever reason, my WBC does tend to higher than many on CR (Although I should be testing a lot more...)

Some concerning results:

My last C-reactive protein was 3 mg/L. However, my ESR was just 2. My RDW% was 13.2%, up from 12.2% a few months prior. I did have some post infectious IBS for a couple months (cleared up now), so I'm not sure if this is the reason, as my diet was certainly not as good. And I know inflammation can increase RDW%.

How to interpret these results?

Perhaps I was just unlucky on that day and had some kind of residual inflammation from subclinical infection? 

Or rather, this could be because of the tooth abscess from the failed root canal? I've found one study that shows C reactive protein can be significantly higher with periodontitis, but what about just 1 tooth and localized inflammation? 

I remember having a tooth abscess a long time ago, sometime around 2007/2008, and around that time my CRP was 3 mg/L and ESR was 4. It was under <1 mg/L shortly after I took out the tooth.

Asymptomatic apical infections are very common and rarely serious. But as I understand it, there are links with dental health and diseases of aging over a long period of time.

At some point this year I want to finally get this sorted, but I am also scared of getting dental implant due to possibility of nerve damage. That would be a nightmare by the sounds of it... I don't know how much assurance they can give that this won't happen. Or do I try to save the tooth and get it treated again, which will probably cost around £500 and could fail.  Last time I had it done was by a regular dentist, not someone that specializes in root canals.

Any opinions?

Blood results:

https://docs.google.com/spreadsheets/d/1V6gvGoCnZGqcr-sR5TuFY4TKLr4mj_X6f7TlXJaLwk4/edit#gid=0

I definitely will be more frequently monitoring with blood tests from this point. It's difficult to get them at GP since COVID especially, so I'll just pay privately every 4-6 months.

Edited August 14, 2022 by Matt

[Dean Pomerleau]

Hi Matt,

I wouldn't be surprised if the infected tooth increases your inflammation markers, which is obviously suboptimal for long-term health. When I had a root canal (probably 15 years ago), I was referred to a specialist by my dentist, who sometimes does them but for some reason I don't recall, mine was a tricky case. I had no lasting negative effects. If I were you I'd definitely go ahead and get it done.

--Dean

[Matt]

On 8/14/2022 at 11:43 PM, Dean Pomerleau said:

Hi Matt,

I wouldn't be surprised if the infected tooth increases your inflammation markers, which is obviously suboptimal for long-term health. When I had a root canal (probably 15 years ago), I was referred to a specialist by my dentist, who sometimes does them but for some reason I don't recall, mine was a tricky case. I had no lasting negative effects. If I were you I'd definitely go ahead and get it done.

--Dean

Thank you for the response, Dean. 

So I'm assuming, even with this root canal, you've seen consistently low levels of inflammation while on your vegan / CR diet and no issues since?

I was convinced by my regular dentist to try to save the tooth, so I've been referred to a specialist for consultation next Friday. And then probably get it retreated by the end of this month. I saw the infection on the x ray and it appears that the tooth was filled beyond the apex and that's the reason for the failure. 

The studies I've read so far seems to indicate that root canal treatments on infected teeth significantly reduce inflammation markers like CRP.

Does anyone else have low inflammatory markers despite having 1 teeth having a root canal treatment done?

I was about to just get this tooth removed the other day but changed my mind when I got the clear x ray of the problem.

[Saul]

Hi Matt!

I've had root canals; they were all completely successful; doesn't affect CRP.  (Mine has been consistently excellent forever.)  However, root canals can be painful.  Also, it's important to have them done by a competent specialist -- which you appear to be doing.

There is another option -- you can have a bridge constructed.  For that, they pull the tooth, and an artificial tooth replaces it -- not by digging into the jaw, but by attaching it to the too surrounding teeth, by what's called a "bridge" (the replaced tooth is also part of the bridge).  Getting a bridge is probably less painful, and possibly less expensive.  But there is a downside -- there are holes at the bottom of the bridge, thru which you have to thread your floss when you are flossing.  (This isn't a problem if you use interdental brushes instead of floss, as I do.)

I just had a bridge installed last week -- the frontmost tooth in my lower had cracked, due to pressure from my front upper jaw teeth.  I had the option of a root canal or a bridge.  I chose the bridge.  I've just ordered extremely thin interdental brushes from Amazon to fit easily into the holes at the bottom of the bridge.

  --  Saul

 

 

[Dean Pomerleau]

Matt,

I'm not sure what you are getting at when you say:

2 hours ago, Matt said:

Does anyone else have low inflammatory markers despite having 1 teeth having a root canal treatment done?

I'm wondering why you say "despite"? My understanding is that while you've got an active infection (in a tooth or elsewhere) you are likely to have elevated markers of inflammation, since the body is trying to fight the infection which triggers inflammation.

If the infection is eliminated (in the case of a tooth via a root canal procedure), the inflammation should subside reasonably quickly. And yes, my inflammatory markers are consistently low "despite" (or because of!) having eliminated my tooth infection via a root canal many years ago.

--Dean

[Ron Put]

20 hours ago, Dean Pomerleau said:

If the infection is eliminated (in the case of a tooth via a root canal procedure), the inflammation should subside reasonably quickly. And yes, my inflammatory markers are consistently low "despite" (or because of!) having eliminated my tooth infection via a root canal many years ago.

Yep. That.

For what it's worth, I've had several root canals (many years ago, long story) and my current CRP is 0.02 (basically unmeasurable by LabCorp).

In other words, Matt, take care of it and all will be fine again.

[Mike41]

On 10/8/2022 at 3:04 PM, Saul said:

Hi Matt!

I've had root canals; they were all completely successful; doesn't affect CRP.  (Mine has been consistently excellent forever.)  However, root canals can be painful.  Also, it's important to have them done by a competent specialist -- which you appear to be doing.

There is another option -- you can have a bridge constructed.  For that, they pull the tooth, and an artificial tooth replaces it -- not by digging into the jaw, but by attaching it to the too surrounding teeth, by what's called a "bridge" (the replaced tooth is also part of the bridge).  Getting a bridge is probably less painful, and possibly less expensive.  But there is a downside -- there are holes at the bottom of the bridge, thru which you have to thread your floss when you are flossing.  (This isn't a problem if you use interdental brushes instead of floss, as I do.)

I just had a bridge installed last week -- the frontmost tooth in my lower had cracked, due to pressure from my front upper jaw teeth.  I had the option of a root canal or a bridge.  I chose the bridge.  I've just ordered extremely thin interdental brushes from Amazon to fit easily into the holes at the bottom of the bridge.

  --  Saul

 

 

I had a bridge placed in the center of my lower jaw 20 years ago. Absolutely no problems with it. Zilch!!!  Chewing is great and Maintenance is FAR LESS then real teeth. The simple floss procedure you mention Saul is a piece of cake. Takes 10 seconds once a day. Works for me!

[Saul]

OK.  I prefer interdental brushes -- they also clean better than floss between teeth with gaps.

Also:  The bridge I just had installed has very small holes at the base between the teeth -- the dentist gave me a sample of "superfloss" that will fit.

No thanks.

  --  Saul