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

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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:


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 by Matt
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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.


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