On the xray of two of my teeth my dentist showed me the infection and it was between the two teeth not at the root. The dentist would like to do an apicoectomy to remove the infection. I had an issue last September with these two teeth and the antibiotic cleared it up. It returned about two weeks ago after I had my 6 month cleaning of my teeth. I was put on the same antibiotic again and it cleared up. What should be my next step to clean this infection up?

Hi bethpage,

Are the teeth (one or both) root canaled? One root canaled tooth can infect the tooth next to it because root canaled teeth always harbor some degree of infection and it commonly spreads to the adjacent teeth. This type of thing is referred to as a perio/endo abcess. These infections cannot be cured by antibiotics. It might seem that way when you take them, but in reality the antibiotics temporarily reduce the symptoms of the infection but they do not get rid of it because the culprit of the infection is actually inside the tooth. An apicoectomy procedure will not cure this infection either because there is no access to the source of infection inside the tiny microscopic canals and it will only recur again... sometimes worse than before. Apicoectomies are considered a barbaric procedure amongst a growing number of dentists who realize that the invasive procedure is non affective. It is very seldom done anymore. Unfortunately, the only sure way to get rid of this infection is to remove the teeth.

I know this is not what you want to hear.... but it is something that your dentist should be talking to you about for the long term benefit of your oral health. There are replacement options if you decide to remove that tooth/teeth and perhaps in discussing those ideas with your dentist, the issue will become more clear to you.

I'm very sorry for giving you this news..... if it helps at all, your dental situation is very common and dentists deal with it every day. Of course, that doesn't make it any easier...... but just want you to know that you are not alone by any means.

Bryanna

The two teeth are numbers 7 and 8. Number 8 has post in it and a fixed bridge is attached to it and number 9.

Hi bethpage,

Ok, so #7 has a post so that means it also has a root canal since you cannot put a post in a tooth without doing a root canal first. Sometimes the post perforates through the tooth into the bone. This could happen at the time the post was first put in or after the crown was put on. It doesn't always show up on a dental xray because of the angle of the film placement being perpendicular with the post. A perforated tooth from a post would also cause a perio/endo abcess. To do an apicoectomy on this tooth would not close the hole in the tooth that was made by the post. The perforation is not perfectly round, it is usually splintered and cannot be closed over.

How many teeth altogether are included in the fixed bridge?

Bryanna

The two teeth that are part of the bridge are # 8 and 9. I miss spoke the post is in number 8 not 7. I did make an appointment with a root canal specialist and will be see him on Monday for a second opinion.

Bryanna: Any other thoughts at this time?

Hi beth,

So you have a two unit bridge on #'s 8 and 9? It is very unusual to have that type of dentistry on the front teeth. Are you sure they are not separate crowns? If they are bonded together, then that most likely means that at least one of those teeth has moderate to severe both loss and was not stable enough to be crowned on it's own. It also means that there has been a long standing infection in that area and treating the tooth/teeth with root canals or apicoectomies is not going to cure the problem.

An endodontist is a "specialist" in doing root canals. However, that doesn't mean that his root canal treatment is better or beyond anyone elses or that he does something special to the tooth to make it healthy again. He may be faster and more efficient because he does them day in and day out ... but the procedures themselves cannot make a sick tooth healthy because there is no access to the microscopic canals which harbor infectious bacteria. He may use a microscope to see into the large canals and/or a laser beam to debride the large canals.... but a microscope cannot see into the tiny, curvy canals and the laser beam cannot divert from a straight line. His credentials simply mean that he only does root canals and apicoectomies for a living.... an that's all.

Let us know how your visit goes.........make sure you ask which tooth/teeth are involved.... how severe is the bone loss... how large is the infection... what are the chances of successful replacement of these teeth with implants if you were to retreat them with root canals or apicoectomies??

Bryanna