Concerns About Tooth Mobility and Root Canal Treatment Delays

Grade I mobile tooth with root canal issue?

Hello, doctor.
I have a question.
I have a tooth that has no cavities but has been developing an abscess for about two years.
Recently, I noticed that the tooth feels loose, so I went to Taipei Veterans General Hospital for an examination.
The examining doctor said it has about a grade one mobility.
After taking X-rays, they found a faint grayish area all around the tooth.
The pulp test showed no significant reaction, so the doctor scheduled me for root canal treatment.
However, due to the high volume of patients at the hospital, the appointment won't be available until around March, which is about thirty days away.
I would like to ask if it is possible for the condition to worsen to the point where root canal treatment is no longer an option and I would have to opt for extraction instead? Thank you.
I'm very worried about the delay.

Xiao Shimin, 30~39 year old female. Ask Date: 2013/01/30

Dr. Zhang Xiangyuan reply Dentistry

Dear online user,
Based on your description of the issue, here is the response: After examination, it was recommended that you undergo root canal treatment.
However, due to scheduling concerns, you are feeling anxious.
As Taipei Veterans General Hospital is a medical center, the treatment processes aim for completeness and quality while also managing a high volume of outpatient visits, which can sometimes lead to such situations.
We kindly ask for your understanding and patience.

Regarding your situation, it is advisable to discuss with your dentist whether a compromise can be reached regarding the timing of the treatment.
Alternatively, you may ask the dentist to evaluate the overall condition and provide other feasible treatment options or recommendations.

This is just a personal opinion for your reference.
Thank you for your inquiry.

Reply Date: 2013/01/30

More Info

It sounds like you are experiencing a concerning dental issue, and it's understandable to feel anxious about the potential for tooth loss, especially when it comes to a tooth that has been problematic for an extended period. Based on your description, it seems that you have a tooth that has developed a pus-filled abscess and is now exhibiting mobility, which can indicate underlying issues such as periodontal disease or infection.

When a tooth is mobile, it typically suggests that there is some degree of bone loss or periodontal involvement. The grayish appearance around the tooth on the X-ray may indicate that there is some infection or inflammation affecting the surrounding bone. If the tooth is not responding to pulp vitality tests, it may suggest that the pulp is necrotic, which means that the nerve tissue inside the tooth has died, and root canal treatment is necessary to prevent further complications.

The concern about waiting for root canal treatment is valid. In general, if a tooth is already showing signs of mobility and has an associated abscess, delaying treatment can lead to further deterioration. The infection could potentially spread, leading to more severe bone loss or even systemic issues if bacteria enter the bloodstream. In some cases, if the condition worsens significantly, extraction may become the only viable option.

However, it is important to note that not all cases of tooth mobility will lead to extraction, especially if the tooth can be treated promptly. The fact that you have a scheduled appointment for root canal treatment is a positive step. In the meantime, here are some recommendations:
1. Maintain Oral Hygiene: Continue to practice good oral hygiene by brushing and flossing regularly. This can help minimize the risk of further infection.

2. Avoid Pressure on the Tooth: Try to avoid chewing on the affected side to reduce discomfort and prevent further mobility.

3. Monitor Symptoms: Keep an eye on any changes in symptoms, such as increased pain, swelling, or changes in mobility. If you notice significant changes, it may be worth contacting your dentist for advice.

4. Consider Temporary Solutions: If the tooth becomes increasingly painful or problematic before your scheduled appointment, you may want to discuss temporary solutions with your dentist, such as a temporary filling or medication to manage pain and infection.

5. Seek a Second Opinion: If you are particularly concerned about the delay, consider seeking a second opinion from another dental professional who may have availability sooner.

In conclusion, while there is a risk of deterioration with a delay in treatment, many factors influence the outcome, including the extent of the infection and the overall health of the tooth. It is crucial to communicate your concerns with your dentist and explore all available options to ensure the best possible outcome for your dental health.

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