A Phoenix reaction occurs in dentistry when we have a long-term infection in the bone at the end of the root that our body has been keeping under control with minimal symptoms, if any, that suddenly bursts into a rapid pain/swelling situation. How does this happen? Well, sometimes our body loses the battle controlling the infection and suddenly it gets out of control and a rapid swelling will occur. It also can happen when we see an area at the end of the root on routine radiographic examinations but no symptoms. If we leave it alone, eventually the patient will get pain/swelling and possibly lose the tooth. We must do endodontic or root canal therapy on this dead tooth and hopefully prevent this rapid swelling but sometimes doing so can wake up this sleeping giant and the chronic, or pain free abscess turns into an acute/painful abscess rapidly.
If this occurs, we have to use antibiotics and anti-inflammatory medications to try and control the rapid, spreading infection and sometimes we may even have to drain the area in order to help get the infection under control. Usually, a routine endodontic or root canal treatment will heal it though sometimes a surgical root canal or apicoectomy may be necessary. Patience is the key to treating this and multiple treatment visits are usually the case.
See if you can see which tooth in this radiograph has the chronic abscess. Infections in the bone from teeth usually show up as dark areas. In this case, the young woman had facial trauma over ten years prior and tooth had died from it, and it is just appearing on the X-ray before any symptoms have occurred.
(The information contained in this article is strictly for educational purposes and is not meant to replace the professional knowledge or advice of your personal dentist.)
