1. #1

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    Sep 2009
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    Default May need to have tooth removed and restored (advice/suggestions) help

    Hi, I have had an reacurring abcess under one of my teeth for quite some time now (approx 3-4 years) when i say reacurring its proberbly never healed fully, when its ok the dentist says its very very small. the molar is in my lower right hand side jaw (T6 or number 19 I think) I have had two root canals done to the tooth one at first signs of symptoms and another 1-2 years ago, the tooth has a gold inlay on top of a special epoxy resin material as over two thirds of the visible tooth has been destroyed.

    Two weeks ago I went on holiday and the abcess flared up again for reasons unknown, I could not get medial treatment for around 5 days, as you can imagine it was quite painfull. After getting treatment (clyndamycin and nimesulide) the abcess subsided. Upon returning to the uk and seeing my dentist he has given me amoxycillin and a codine/nsaid treatment and said I "may" have a cracked or fractured root causing the abcess to not heal fully, and he suggested that removing the tooth is the best soloution.

    Now I do not want to get the tooth removed but the dentist says I have a quarter of an inch of material under the root and if the abcess gets down to that depth (the main nerve i think) in future it could cause more problems. Plus he has said the germs in the abcess might get resistant to the antibiotics.

    I know I could have done more to aid the tooth in healing and I try but when the pain is gone i soon go back to my old habits (smoking/drinking) and I am a VERY bad tooth grinder at night (well my girlfriend tells me anyway) I am thinking that my bad habits have caused my abcess not to heal as much as anything?

    I there any alternatives I can try, maybe an antibiotic targeted specifically at the germs in my abcess as I understand amoxycillin is a broad-spectrum drug and as such might not have enough punch to knock out a germ that might be getting resistant to it? the only alternatives I have are a dental bridge which would sacrifice a healthy tooth (the other one is crowned) or a dental implant which would be two thousand pound according to my dentist.

    By the way my dentist is very good, but im on the NHS so price may be a factor in what work I have been offered?

    Thanks for reading my long winded question


    EDIT: by the way im willing to have private treatment to save the tooth, I would just like some suggestions as what MAY be done.
    Last edited by mcfly666; 09-22-2009 at 05:04 PM.

  2. #2
    prosman's Avatar
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    the tooth sounds unrestorable. best take it out now and if you find you want to replace it, once it has healed then you can look at the various options
    Dr Nick Fahey BDS (NZ), MCLIN DENT PROS (London), FRACDS, MRD RCS (Edin) Pros, MFDS RCS (Eng)

  3. #3

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    Sep 2009
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    Hi prosman, thank you for your answer.

    After going back to my dentist he says that he cant see any cracks or damage to the tooth in the xrays, but he said that they might still be there anyway. After this we have decided to do a little experiment...

    After many years of smoking and generaly not looking after myself my dentist thinks my gums are in a poor condition, this may be letting bacteria/crappy stuff down the side of the tooth and the only way to reverse the damage to my gums is to stop smoking.

    I've been told that its only a small chance that its the cause of the infection but i'm willing to try anything and as the xrays have shown that the infection is down the the level that it was after my rootcanal (very small) im not in any immediate danger.

    The only other options I have is another root canal which according to my dentist has an even less chance of working that the other two times. Or a procedure where a flap is cut into my gum and the root of the tooth is removed all this whilst cleaning out the infection (dont ask me to remember the name of it) but its dangerous as my nerve could be affected.

    My dentist joked with me that stopping the smoking is a "win win" situation as i may be able let my body heal itself naturally or the money I save from not smoking in twelve months would be a fair chunk of the cost of an implant. Not only that but an implant would have a greater chance to take without my nicotine addiction. Whatever happens i have a good chance to save the function of the tooth.

    thank you.
    Last edited by mcfly666; 10-03-2009 at 12:48 AM.

  4. #4
    prosman's Avatar
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    good luck

    let me know how you get on
    Dr Nick Fahey BDS (NZ), MCLIN DENT PROS (London), FRACDS, MRD RCS (Edin) Pros, MFDS RCS (Eng)

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