For the past two years, I’ve had swelling above my top left premolar. It’s tender but not painful. My dentist has labeled it a chronic abscess, suggesting we could either leave it or consider removal. Recently, a specialist evaluated it for a potential root canal, estimating a 70% chance of success. He mentioned the risk of an underlying cyst, which an X-ray’s dark area might indicate.

How do I choose between a root canal or extraction? I’m concerned about the possibility of a cyst affecting my health. Both professionals have mentioned a more invasive gum procedure (apicoectomy) as an option if other treatments fail, involving cutting and peeling back the gum to address the issue directly. I am anxious and already have dental anxiety, so this doesn’t help. Whose diagnosis can I trust? Thanks. Juan Carlos from El Paso

 

Juan Carlos,

Most dentists encounter various oral health issues, but cysts are rare.

The Rarity of Cysts in Dental Practice

In my years of service, cysts were notably absent, suggesting that, while possible, the likelihood of such complications is minimal. Some dental professionals may overstate potential risks as a precautionary measure. While there’s a slight chance of developing a cyst, addressing the infection with a root canal often resolves the issue without more invasive treatment.

An Apicoectomy or a Root Canal?

The suggestion of an apicoectomy, a significant gum surgery, seems excessive for many cases. Aggressive interventions are not always necessary. Generally, root canals have a high success rate, mainly when performed by specialists (endodontists) equipped with advanced technology. However, if root canal treatment doesn’t work, you still have the option of an apicoectomy.

Observations on Your Dentist’s Care

Monitoring swelling without immediate intervention, especially for an extended period, raises concerns about your dentist’s managing the infection. Continuous exposure to bacteria from an untreated abscess can have systemic health implications.

We recommend getting a third opinion from another specialist. If you need treatment, talk to your dentist or specialist about your anxiety and whether you can benefit from dental sedation.

 

Baton Rouge accredited cosmetic dentist Dr. Steven Brooksher sponsors this post.