Hello,

I'm a male in late 20s and recently I've had a surgical extraction of tooth 46, which was endodontically treated 15 years ago and recently diagnosed as probably vertically cracked. It's my day two post-extraction and I'm still on pain killers, feel sick, I probably had fever, my hearbeat was crazy, I was shaking, and I am left with a giant hole in my mouth along with swelling on a lower jaw. It sucks.

I am bit sceptical about the diagnosis, used approach and the results, and in this regard I'd have few questions for you. But before asking, I'll write the whole story:

It all begun a half of year ago, when the gum around my first molar (46) got some kind of periodically appearing pimple on it, which occasionally released a bizzare tasting pus. At first I assumed it's a problem with a gum and that it'll go away. Unfortunately problem persisted, so I decided to visit my dentist. She said that the tissue around my tooth is inflamed. Then we tried with a week of applying and exchanging some kind of disinfection stuff in and around the tooth, along with putting needles in canals (RCT?) - while pus draining may have decreased, the pimple returned so eventually the problem was still there. She suggested that the infection may be due to fractured tooth, especially because tooth is dead, but such diagnosis can not be confirmed by xray. She proposed tooth extraction and sent me to oral surgeon to do the work, just in case, if there would be a complication as this can be only managed by an oral surgeon.

Then I visited oral surgeon. I asked him what he thinks about the problem and if we can save the tooth, but he didn't say much, except "that's a thing to be solved between your dentist and you, and I'm here just to do what I'm ordered to do". I still insisted to check the situation and he commented that tooth is likely cracked and if that's the case, it has to go out. Then he continued that I can get 2nd opinion by visiting endodontist.

So I decided to get a 2nd opinion and visited endodontist specialist. He said that in my case the inflammation around tooth can have two causes: periodontal disease or cracked tooth. He quickly excluded the periodontal disease and said that it's 95+% of chance that my tooth is vertically cracked, but this can not be seen on xray. He continued that situation is pretty much lost, as he can only fix problems sourcing from tip of roots, while he can't fix vertical fracture of tooth. He said that situation is lost and that the 46 has to be extracted.

Now the most suspicious part. I reported back to oral surgeon for extraction. The procedure took suspiciously long and it seemed to be very complicated just to get one 46 out. Soft tissue cutting, bone cutting and I got a feeling that I was on that chair for ages. For comparision - I already had surgical extraction of tooth 36 and it was way shorter and simpler. In the time of my elementary school, tooth 36 was surgically removed due to failed endo treatment (tooth cracked as my young dentist apparently made a mistake while she was playing with those little needles). Then I was sent to surgeon. He took one big scarry drill that one can use to drill a channel for electrical cables, but we were done in few minutes. Waiting anaesthethic for an effect was the longest part. It didn't hurt much in the next days, neither there was much swelling and the occured gap was way smaller. I didn't need any painkillers. Everything was very smooth and the surgeon got that "just another day in the office" expression.

But this time, the procedure lasted way longer and surgeon (other one) used some bizzare tools which apparently didn't have any rotary parts (I didn't see them, as I was blindfolded), but sounded like air blowing. I didn't hear anything like pliers. And when I read, which were the steps undertaken in the procedure as described in post-op report, there were bunch of scary words: tooth separation, osteotomy, buch of cuts..etc. For my understanding, guy dismantled the whole tooth and the bone, and this sounds way too much of work for a such straightforward task.

When the procedure was finished, I asked surgeon which part of tooth was cracked in order to confirm theory set up by my my dentist and endodontist (again, they diagnosis was based on prediction). He only replied with: "Probably the left-back root, as it came out the easiest." Probably? This word again?This quickly rose a potential redflag for me, because whether tooth is cracked or not, should be obvious, so I was left without confirmation of initial diagnosis.

Now the questions:
1. Was the tooth extraction truly neccesary?
2. Werediagnostics of vertical fracture done correctly?
3. Why surgeon didn't know or didn't want to tell whether tooth was broken or not?
4. Have surgeon used too agressive approach to get the tooth out?Honestly, I expected only a simple extraction, while (complex) surgical removal would be undertaken only in a case, if some piece of tooth would stay below gums.

5. What should I do with my gap in the teeth? What functional and aesthethic consequences can develop, if I leave the gap as it is?

Please tolerate my english, because i'm not a native english speaker.

xrays can be found here: ***