Abscess and infection

[needham86market]

I have had an abcess and infection at the tip of a front tooth root for four years.  I knew that I had problems and this is what showed up on the x-ray.  Two weeks ago I had a root canal treatment on this tooth.  It was fine for about 10 days but now feels painful and just the same as it did prior to the treatment.  Will it be possible for the dentist to re-do the root canal treatment, and if this does not work are there any other options to try and save the tooth?

[Jerome Tsang, DDS]

If there's an abscess, root canal treatment should resolve the problem.  If not, a re-treatment of the root canal is possible or an apicoectomy in which they remove the tip of the infected root along with the infection in that area.  

Referral to a specialist for the procedure may be necessary.

[preli]

For an abscess going on 4 yrs, wouldn't associated bone loss perhaps dictate need for extraction?

Does root canal or apicoectomy resolve all such abscess cases?

[Jerome Tsang, DDS]

It can.  It depends on the extent of damage of the alveolar jaw bone at the time that treatment is rendered.  Additionally, since its a front tooth, I would be more willing to take a risk to try to preserve the tooth for cosmetic reasons as well.  If there is a fistula that allows the pus to drain, it can remain somewhat stable over long periods of time but if that fistula is blocked, it can result in rapid spread of infection elsewhere.