Hi there

I had RCT on tooth 46 about 20 years ago. About 5 years ago, I had a crown put on that tooth as the filling had a crack. About a year ago, I developed a cyst - visible on the outer jaw below the tooth. It felt hard like bone. I had a CT and it confirmed a cyst.

I was then told by a maxillofacial surgeon I needed to have the tooth extracted, the cyst removed, bone graft then an implant. All up it would cost thousands of dollars. I then shopped around and went to an implant dentist who was recommended by a friend. He extracted my tooth and told me the cyst would just go away. He did no bone graft and said in a few months to come back to start the implant.

A week after extraction, I still have pain - not severe but I need to take painkillers regularly. My family dentist told me that the cyst shouold have been curreted out when the tooth was pulled and that bone graft should have been placed as well - neither of which were done.

The lump where the cyst is/was is no longer visible but is tender now whereas before I had the tooth pulled I had no pain.

can someone advise whether the implant dentist did the wrong thing by not curetting out the cyst? Why do I still have pain a week later?

Thanks

Hi Bern_dv,

I am not sure which tooth you are referring to as most people only have 32 teeth, including their wisdom teeth. Where in your mouth was this tooth? Was the implant dentist an oral surgeon or a general dentist?

The majority of the time the cyst is removed at the time of the extraction because it will not resolve on it's own. The only time it might not be removed entirely at the time of the extraction is if it were in an area that made the removal a high risk for paralysis or neurological damage. Otherwise, it is not okay to leave the cyst.

FYI.... Anytime you are going to have an infected tooth extracted, especially a root canaled tooth and/or one that has developed a cyst, it is best to have an oral surgeon perform the procedure. General dentists have limited training in oral surgery and frequently are not as thorough with the procedure as they should be. Someone who claims to be an implant dentist is not necessarily an oral surgeon. They could be a general dentist who took a class or workshop on implantology.

Thanks so much for your reply Bryanna - I have only just come to look back at this site (I thought I would be emailed if an answer was posted to me}.

The tooth was my second last molar on the bottom. (they labelled it 46???)

The pain that I had seemed to go away after about a week and a half (I think I must have had dry socket). Following this, I ended up with pus oozing out of a soft lumpy area on the extraction site. My dentist put me on Amoxil which made it all look better (less red and less pus) but now I am on my second course and still there is a small amount of pus. I need to go back and I am worried that he did not actually remove the cyst. He told me it would just go away (I can't see or feel the lump where it was anymore but is it possible this is the source of the pus I am seeing?)

btw he is a dentist - not an oral surgeon.

Bern_dv,

The cyst is a constant source of bacteria and is always removed when the tooth is extracted. There are some extenuating rare circumstances when the cyst if left in the bone.... but they are very rare.

Consider consulting with an oral surgeon and bring all of your x-rays with you or have them sent to him ahead of time.