Dental Abscesses and Gum Recession: Expert Insights

Q: Dental Abscesses and Gum Recession: Expert Insights

Hello： <br>1. <br>There is a common belief that when a tooth undergoes root canal treatment, it becomes dead and more prone to brittleness and fracture. <br>Therefore, if the tooth is still functional, root canal treatment can be postponed. <br>For younger patients or if the dent

Dental abscess and gum recession?

Dear Dr.
Lin,
I am writing to consult you on two issues as follows:
1.
Regarding the dental abscess: Several years ago, I had a large cavity that was treated with a filling.
Recently, I noticed a black mark on the surface of the tooth and a small dental abscess (pus) above it.
An X-ray indicated that the tooth has experienced nerve necrosis and inflammation.
The attending dentist recommended root canal treatment (nerve extraction).
However, the tooth currently has no sensitivity or pain and functions normally.
My questions are:
1.
There are claims online that undergoing a root canal treatment means the tooth is "dead," making it more brittle and prone to fracture.
Therefore, if the tooth is still functional, is it advisable to postpone the root canal treatment? What is your opinion on this?
2.
Is it possible for the dentist to perform drainage on the small dental abscess above the tooth to alleviate the inflammation?
2.
Regarding gum recession: I recently noticed that brushing one of my teeth causes a soft, sensitive feeling.
Upon closer inspection, I found that the gum tissue next to that tooth has receded, exposing some of the tooth root.
My questions are:
1.
Will the gum tissue that has receded gradually grow back to cover the root area?
2.
How should I currently address this issue? Should I seek treatment or simply observe it?
Thank you, Dr.
Lin.

Axiang, 30~39 year old female. Ask Date: 2019/01/04

Dr. Lin Jiayong reply Dentistry

Hello:
1.
There is a common belief that when a tooth undergoes root canal treatment, it becomes dead and more prone to brittleness and fracture.
Therefore, if the tooth is still functional, root canal treatment can be postponed.
For younger patients or if the dental pulp has not been directly invaded by bacteria from cavities, I believe it is reasonable to delay root canal treatment.
However, if the dental pulp has already been compromised by bacterial invasion leading to necrosis or even pus formation, then aggressive root canal treatment should be pursued to clean out the necrotic pulp tissue to prevent complications such as sinusitis or deep neck infections.
2.
Regarding the small abscess above the tooth, can a dentist perform drainage to alleviate the inflammatory condition? Yes, under local anesthesia, the abscess can be drained, but this is only a temporary solution.
The fundamental approach should still involve the removal of the necrotic dental pulp.
3.
Will the gum tissue that has receded grow back to cover the root of the tooth? As we age, the resorption of alveolar bone and gum tissue is an inevitable condition.
If it is not in an aesthetic area, gum grafting or coverage procedures are not recommended, as they may lead to more severe periodontal disease.
For sensitive roots, desensitizing toothpaste or high-concentration fluoride varnish can be used for treatment.
4.
How should I personally handle this issue (e.g., seek medical attention or observe)? I still recommend that you actively seek medical attention.

Sincerely,
Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2019/01/04

More Info

Dear Patient,
Thank you for your inquiry regarding dental abscesses and gum recession. These are common dental issues that can significantly impact oral health if not addressed properly. Let's break down your questions into two main areas: dental abscesses and gum recession.

Dental Abscesses
1. Root Canal Treatment and Tooth Longevity:
It is a common misconception that a tooth that has undergone root canal treatment is "dead" and more prone to fracture. While it is true that the tooth loses its nerve supply, which can make it less sensitive to pain, this does not inherently make the tooth more brittle. In fact, a properly treated tooth can remain functional for many years, especially if it is restored with a crown after treatment. The key is to ensure that the tooth is adequately restored and that you maintain good oral hygiene. If your tooth is currently asymptomatic and functional, some dentists may suggest monitoring it, but it is essential to follow your dentist's advice regarding root canal treatment, especially if there are signs of infection like the presence of a dental abscess.

2. Management of the Abscess:
The small bump you see above the tooth is likely a dental abscess, which indicates an infection at the root of the tooth. While it may not be causing pain now, it can lead to more severe issues if left untreated. Your dentist can indeed perform a drainage procedure to relieve pressure and remove pus, which may help alleviate inflammation. However, this is often a temporary solution. The underlying cause, such as the need for root canal therapy, should still be addressed to prevent recurrence.

Gum Recession
1. Regrowth of Gum Tissue:
Unfortunately, once gum tissue has receded, it does not typically grow back on its own. Gum recession can expose the roots of your teeth, leading to increased sensitivity and a higher risk of decay. While some treatments can help manage the condition, such as gum grafting, it is essential to consult with a periodontist for a thorough evaluation and treatment plan.

2. Management of Gum Recession:
If you are experiencing gum recession, it is crucial to maintain excellent oral hygiene to prevent further recession and associated complications. This includes gentle brushing with a soft-bristled toothbrush and possibly using a fluoride toothpaste to help strengthen the enamel. Regular dental check-ups are vital, as your dentist can monitor the situation and recommend treatments such as scaling and root planing, which can help manage gum health. If the recession is significant, surgical options may be necessary.

Conclusion
In summary, both dental abscesses and gum recession require careful management. While it may be tempting to delay treatment for a dental abscess, it is advisable to follow through with your dentist's recommendations to prevent complications. For gum recession, proactive measures and professional guidance are essential to maintain your oral health.

Please consult with your dentist or a specialist for personalized advice and treatment options tailored to your specific situation. Taking these steps will help ensure the longevity of your teeth and the health of your gums.

Best wishes for your dental health!
Sincerely,
Doctor Q&A Teams

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