Should I get a second opinion or switch dentists if my current dentist cannot save a furcation involvement tooth? After rescheduling my dental exam and cleaning for over two years, the office recommended coming in to prevent me from being considered a new patient after three years. I spoke to the dentist one evening, and she assured me that my anxiety would be better with sedation. That encouraged me to schedule an appointment, so my dentist prescribed triazolam, which helped so much. I was surprised that I was so relaxed, and so was my wife. I suspected that I had gum disease because of my puffy gums that ooze pus and bleed. I didn’t know it was so bad, though. My dentist said I have furcation involvement, which I’ve never heard of. She showed me an x-ray that showed the furcation affects a root canal tooth. So now I am afraid that I will lose the tooth. I don’t know what treatment the dentist will recommend, but I wonder what to do if she can’t save it. I dread talking to another dentist about my anxiety and seeing if their sedation options will work for me. I regret waiting so long to see my dentist. Should I plan for a second opinion now? – Thanks. Esteban from Saginaw, MI

Esteban,

We are most concerned about your inflamed and bleeding gums. Gum disease causes bleeding and inflammation in its early stages. If your gums ooze pus, the infection is advancing.

Only deep dental cleanings from a hygienist can clean the deep bacteria-filled pockets between your teeth and gums. Sometimes, a periodontist will make an opening in the gum tissue to access and remove bacteria. You will also need a diligent oral hygiene routine at home to help control gum disease. You didn’t mention whether your dentist is treating your gum disease or referring you to a specialist, but you can experience tooth loss from untreated gum disease.

What Is Furcation Involvement?

A furcation is a place where tooth roots separate because of gum disease. Only premolar and molar teeth have more than one root, so furcation only affects molar teeth. Furcation involvement is bone loss beneath the furcation, or where a tooth’s roots have separated. Bone loss or gum recession can make the furcation visible above the gumline, as shown in the picture to the right.

What Are the Effects of Furcation and Furcation Involvement?

Some effects of furcation and furcation involvement include the following:

• Ten to twenty percent bone loss. Most of the bone around the tooth is still intact, enough to prevent tooth loss.
• Plaque buildup. The furcation leaves space for plaque buildup, making it more challenging to keep the area clean.
• Treatment intervention. A periodontist or dentist with advanced gum disease training will develop a treatment plan for cleaning a restoring your gum tissue. A dental hygienist will maintain the area during regular appointments. The hygienist will show you how to use an interdental brush to keep the place clean at home.

Is Your Root Canal Tooth at Risk?

Your description sounds like the root canal treatment on your tooth is still effective. Although root canal failure can occur, it is usually evident within the first two months after the procedure. After the tooth heals, it is no longer at risk.

Gum disease treatment is the priority for you. The risk of losing a tooth is low if you seek prompt treatment. Otherwise, gum disease can destroy teeth and the supporting bone. You are welcome to get a second opinion from another dentist. However, if your dentist does not have advanced training in gum disease treatment, schedule an appointment with a periodontist (gum, teeth, and bone specialist) immediately. When you schedule the appointment, you can ask to speak with the periodontist about your anxiety and options for sedation to keep you relaxed during treatment.

 

Baton Rouge dentist Dr. Steven Brooksher sponsors this post. Read about his education and training, and learn what he does to provide some of the best dental care in Baton Rouge.