Root Canal 6 months ago - still have tooth pain

[Phillyfish]

6 months ago I had a root canal treatment for a previously crowned lower molar.  The root was abscessed and I was given a week of antibotics.  The tooth was checked/taken out of occlusion by both the endodontist and family dentist.  Pain continued.  At 6 weeks post root canal I took another week of antibiotics.  Pain continued.  Saw the endodontist two more times since original treatment.  He advised I needed to wait 6 months post treatment to give the abscess time to heal and the bone time to regenerate.  I am just shy of the 6 month waiting period and the tooth still hurts although not as bad as before.  My regular dentist checked the tooth and has recommended I get an apicoectomy on that tooth.  He and his collegues can not see any crack in the tooth and say the x-ray of the root canal itself looks good.  There is still a "pocket" by the one root.  Pain now is not severe, just there, a dull ache, especially when I brush my teeth or touch/move the tooth.  No swelling.  It's just that the tooth is not right.  What should I be asking/looking for when discussing further treatment?  Is apicoectomy my only option besides extraction?  Is the 6 month waiting period long enough?  Is an apicoectomy a better way to go than redoing the root canal?  I am 57, in very good health but with a past history of breast cancer (chemo/radiation).  If it were breast cancer bone metastisis would it show on the x-ray?  Thanks.

[Jerome Bogin, D.D.S.]

I do not believe that this problem is related to your breast cancer. I have become more conservative over the years in referring patients for apicos especially in the molar areas. The success rate has not been high enough for my liking. I much prefer to have the tooth retreated as my first option. There are other options here-- one is to let the tooth remain as it is as long as you are not in any discomfort. Then you can consider extracting the tooth (as a last resort) and placing an implant or bridge. I can not give you a diagnosis for either one without more infomation. It is possible that the tooth does need a longer period of time to heal. Only you can decide how much discomfort this is causing .