PJ,

I just saw your threads with x-ray and the responses to it and felt compelled to respond.

I am a retired oral and maxillofacial surgeon of 35 years practice. I do not generally advise people on the internet as even with x-rays, I cannot possibly diagnose without undertaking a full oral examination of the patient.

However, I feel that you've been given a mix of good and not so good advice here. There is undoubtedly infection in the molar and I can also see a communication with your sinus. You obviously know this from the purulent discharge from the area. I would also concur that the 2nd molar appears beyond repair.

Regarding the treatment though, I see no reason why, with careful planning by an experienced surgeon, the extraction cannot be done and with natural healing proceeding thereafter. It is not likely that you'd need follow-up surgeries to clear necrotic tissues etc, and the chances of a brain abscess from dental infections are very very slim.

However, the risks increase the longer you leave the infection and I think contributors are trying to make that point so that you do not delay in getting it treated.

To make a better judgement you will almost definitely be required to have a full panoramic x ray as this will allow the surgeon to view the sinus region and the whole infected area. Your x ray is only of the local teeth and it can be seen that the infection goes up beyond that point.

Get yourself referred and treated but don't worry about complications or things going wrong. Experienced surgeons would not struggle to treat this promptly and efficiently.

Regards