Dental root abscess?
Hello, Doctor.
About 8 years ago, I had a dental bridge placed on the last three molars on the lower left side, and the last molar underwent root canal treatment (the wisdom tooth is impacted and has not erupted).
Two thick dental posts were placed inside.
In May of last year, I experienced intermittent pain in the molar, but I ignored it out of fear.
During this time, there weren't any significant issues, but sometimes I felt a tingling or floating sensation near the molar.
Recently, I visited a doctor who took X-rays and informed me that there was pus inside the tooth root and that I needed to undergo microscopic root canal treatment and then redo the dental bridge.
While waiting for treatment, I consulted a dentist who specializes in dentures, as recommended by my mother.
The dentist suggested that it sounds like I have high inflammation, and even if I undergo microscopic root canal treatment, the same issue may occur afterward, advising me not to treat it.
However, I still occasionally feel a heaviness in the affected area.
I also have a poor constitution with a congenital autoimmune issue (allergic constitution) and autonomic nervous system dysregulation.
I'm unsure if this is a psychological factor or if there is a real problem.
I kindly ask for your advice.
Thank you, and I wish you peace and well-being.
Xiao Mi, 30~39 year old female. Ask Date: 2015/10/07
Dr. Zeng Guanghui reply Dentistry
The possible causes of the above situation could be a bacterial infection in the tooth root or inflammation of the periodontal tissue surrounding the tooth.
If it is the former, the dental bridge may need to be removed, and root canal treatment should be redone.
If it is the latter, periodontal treatment will be necessary.
It is recommended to consult a dentist for further evaluation and treatment.
Reply Date: 2015/10/07
More Info
Tooth root abscesses are a common dental issue that can arise from various factors, including untreated cavities, trauma to the tooth, or complications from previous dental work such as root canal treatments. Understanding the causes, symptoms, and treatment options for a tooth root abscess is crucial for effective management and relief from discomfort.
Causes of Tooth Root Abscess
1. Bacterial Infection: The primary cause of a tooth root abscess is a bacterial infection that occurs when bacteria enter the pulp of the tooth, often due to untreated decay or a crack in the tooth. This infection can lead to the formation of pus, resulting in an abscess.
2. Previous Dental Procedures: As noted in your situation, prior dental work, such as root canal treatments or the placement of dental bridges, can sometimes lead to complications. If the root canal was not entirely successful, or if there are remaining bacteria in the tooth, an abscess can develop.
3. Gum Disease: Periodontal disease can also contribute to the formation of abscesses. Inflammation and infection of the gums can lead to the exposure of tooth roots, allowing bacteria to enter and cause an abscess.
4. Trauma: Any trauma to the tooth, such as a fracture or severe impact, can compromise the tooth's integrity and allow bacteria to invade the pulp.
Symptoms of Tooth Root Abscess
The symptoms of a tooth root abscess can vary but often include:
- Severe Toothache: This is typically a throbbing pain that can radiate to the jaw, neck, or ear.
- Sensitivity: Increased sensitivity to hot or cold temperatures, even after the stimulus is removed.
- Swelling: Swelling in the gums or face near the affected tooth.
- Foul Taste or Odor: A bad taste in the mouth or foul odor can occur if pus drains into the mouth.
- Fever: In some cases, a fever may accompany the infection.
- General Discomfort: A feeling of pressure or heaviness in the area surrounding the tooth.
Treatment Options
1. Root Canal Treatment: The most common treatment for a tooth root abscess is a root canal, where the infected pulp is removed, and the interior of the tooth is cleaned and sealed. In your case, a microscopic root canal treatment may be necessary to address any remaining infection.
2. Antibiotics: If there is a significant infection, your dentist may prescribe antibiotics to help control the infection before or after the root canal treatment.
3. Drainage: If there is a significant amount of pus, your dentist may need to drain the abscess to relieve pressure and pain.
4. Extraction: In cases where the tooth is severely damaged and cannot be saved, extraction may be the only option. This is often considered a last resort.
5. Follow-Up Care: After treatment, follow-up visits are essential to ensure that the infection has cleared and that the tooth is healing properly.
Psychological Considerations
Given your history of autoimmune issues and autonomic nervous system dysregulation, it’s important to consider that psychological factors can influence your perception of pain and discomfort. Anxiety about dental procedures or past experiences can exacerbate feelings of discomfort. It may be beneficial to discuss these concerns with your dentist, who can provide support or refer you to a specialist if needed.
Conclusion
In summary, a tooth root abscess can be a painful and complex issue requiring prompt attention. It is essential to follow through with the recommended treatments, such as microscopic root canal therapy, and to communicate openly with your dental care provider about your symptoms and any concerns. If you continue to experience discomfort or have doubts about the treatment plan, seeking a second opinion from a specialist in endodontics or oral surgery may provide additional clarity and options for your dental health.
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