Extraction of a rear tooth due to abscess.

[ashks73]

Hi,

I am currently experiencing recurring pain from a rear lower number 7 tooth and have been told the there is an infection, and abscess at the root of the tooth. I have an impacted wisdom tooth behind this that has apparently made cleaning the adjoining tooth difficult and caused decay.

I first experienced pain and discomfort about 1 month ago and was prescribed anti-biotics and pain relief. The pain re-occured after about 3 weeks and i was this time prescribed metronidazole and ibuprofen. A week after this course the pain re-occured and i was today prescribed Amoxycillin 500g and further pain relief.

I was told by a dentist after xrays that extraction was the best solution. Another recommended extraction of the 7 and the wisdom tooth. I have had digital x-rays and am told that root canal treatment may be very difficult as the tooth is unstable, moving and decayed. So far extraction seems to be the consensus.

I am desperate not to lose my tooth and wonder if it is still possible to save this tooth? I would like any feedback and suggestions.

Is it possible to treat the abscess and decay without removing the tooth and do any sort of root canal treatment? I was not given any treatment for the abscess itself i.e draining or whatever so i am curious as to why not.

I hope you can answer my queries as i am very worried and do not want to lose my tooth but i also don't want to risk further serious problems developing as a result of this.

I have tried to explain things as best i can and would appreciate any help you may be able to give me.

Thanks
Ash

[Dr Mohsen J. Esfahani]

Thank you for your post.

As you know we cant give advice without seeing your tooth and your xray. Broadly speaking if an impacted wisdom tooth has caused decay of the number 7 tooth due to difficulties in cleaning, then the best thing would be to restore the number 7 tooth and remove the wisdom tooth.

Now this is not a rule that always holds, and there are times when this approach is not recommended. For example if the number 7 tooth is in a very poor state and not likely to be saveable with restorative treatment, then it might be best to remove the number 7 tooth instead. At that point keeping the wisdom tooth or not depends on if the wisdom tooth is itself sound and likely to be able to provide function for the patient or Not. If the wisdom tooth is not sound and cant provide function, then its better to remove the wisdom tooth as well.

To confuse things even more, with extraction of wisdom teeth one must be mindful of the position of the ID nerve relative to the root of the wisdom tooth. If the two have a very close relationship, then possibilities of nerve damage exist and in that situations it might be best to leave the wisdom tooth as it is at least for a while. The wisdom tooth may erupt further once the number 7 tooth is removed and this could reduce the chances of nerve damage with a future wisdom tooth extraction.