Oral and Maxillofacial Surgery Expert Forum
What is the best option for me?
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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What is the best option for me?

There is a swelling above my last right top tooth  (I will call it No 1 from the back).  I went to see the dentist and he did some work on the filling.  The x-ray did not show any sign of concern at the time.  However over Chistmas the swelling came back - initially just red and later filled with white puss.  The tooth itself is not hearting.  I clean it thoroughly and use mouthwash at all times.  I went back to my dentist who took another x-ray.  The outcome was that the tooth would either have to be extracted or a specialist root canal treatment undertaken and this cannot be done locally at my dentist - would need to be referred to Manchester. The other only option would be to leave it as it is.  I am now in a dilemna what to do.  The tooth next to it (No 2 from the back) has a large filling in it and the tooth No 3 from the back has been extracted for the same reasons, now creating a gap.  I am now wondering whether it is worth for me to attend a specialist who may or may not be able to clean the canal and may/may not be able to rescue my back tooth? Or leave it as it is and hope for the best? I have antibiotics but have been told that this is only temporary measure.  Or should I just have it extracted but then tooth No 1 from the back and No 3 from the back will both be missing.  Alternatively I could concentrate on the tooth No 3 first and arrange an inplant for this and then re-assess again.  Unfortunately even although I am young and despite my best efforts to clean teeth even with an electric tooth brush, my teeth have been deteriorating rapidly and all fillings are very large.  I am planning to get pregnant and hoping to have teeth sorted.  I want to rescue my tooth if possible and of course save to have the correct treatment but on the other hand don't want to waste money if after all it is not worth it.  Please advise.
Many thanks
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373693_tn?1324489102
What you have described is an active infectious process which will only get worse and destroy more bone and perhaps involve other teeth or your sinus.  Leaving it is a very poor option.  See the root canal specialist and ask them for their option on the long term prognosis as well as the costs involved.  Also ask your dentist how much it will cost and how long it will take to have the tooth restored after the root canal.

You will probably need to make a decision on either saving the tooth with all those procedures or removing the tooth and then eventually replacing it with a dental implant or bridge.


Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
4 Comments
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Thank you for your advice, I appreciate it.  I will be going back to my dentist next Tuesday again and make a decision whether to extract or root canal. Am now worried this is destroying my bone each day - how much time have I got before it starts attacking the bone, other teeth etc?  I did not realise it can affect other areas.  The whole thing started on and off in October when my dentist thought it was filling related.
Many thanks
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373693_tn?1324489102
It is impossible to predict the progression of any infection.
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Thank you for your advice.  I did decide to have my root canal treatment undertaken by a specialist and the operation was very succesful.  The dentist managed to clear all three canals all the way and fixed a temporary filling.  I will now go back to my local dentist to have a proper filling but I was also considering a crown given that the tooth now has a very large filling area.  In your view would the crown protect the tooth on a long term therefore worthwile the investment?  Many thanks
Anita
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Michael H Kirsch, DDSBlank
Dr. Michael H. Kirsch
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