[MarkusTims]

Hi. I have a root canal that was done bad ten years ago. Since then, have never had any pain, swelling, or discomfort. However I always saw a dark area around the root when x-rays were taken for other reasons.

A few weeks ago I started to have tenderness in the area. Went to the Dentist and to the Endodontist. They told me I need a root canal. I wonder whether I was diagnosed OK; from what the doctors say, a root canal will be enough to get rid of the dark area on top of the tooth. However I wonder whether this has become a cyst. It would be great if you could take a look at the x-ray I attach and let me know what you think. I'm a male in my 40s.

[Bryanna]

Hi MarkusTims,

Thanks for posting the xray.

You have a large infection in the jaw bone around that root canaled tooth. You could very well have a cyst there also. It's important that you understand that this infection is not limited to just the end of the tooth, it surrounds the tooth. That black area is bacteria and it has caused the bone to deteriorate. So when the tooth is removed you will have moderate to severe bone loss in that area. The longer you wait to remove it the more extensive the infection and bone loss will become. To re treat this tooth will not cure the infection. The only way to cure the infection is to remove the source, which is the tooth. The bone would need to be thoroughly debrided after the tooth was removed.

Only see an oral surgeon for the removal of this tooth as a general dentist is not likely going to clean out the bone as thoroughly as it should be.

You should speak to your general dentist about replacement options. Dental implants placed in bone that has been diseased for quite some time often fail. So your other options would be a removable partial denture or a permanent bridge that would include the adjacent teeth an acnhor teeth.

I hope you find this information helpful.