This xray picture is of my top front right side center tooth. It became grey and died after a motorcycle crash 28 years ago. I had it capped about 12 years ago. About 2 years ago I noticed a (fistula ?) pimple like bump on my gum in this area. I popped it and white stuff and blood came out. During the last 6 months the pimple keeps coming back. Now it has got bigger. I had a dentist check it earlier this month. He recommended a root canal. He stated it is a chronic infection. He stated that the tooth has already had a previous root canal as there is no root there. He said there is bone loss. As I have been reading your posts it is obvious that a root canal is a bad option. I therefore think I need to see an oral surgeon a.s.a.p to get an extraction. Please share your opinion and secondly what to replace the tooth with if its extracted. I think an implant is not good as the infection is long standing.

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Hi iankikesgolf,

Thanks for posting the xray.

You have a large infection in the bone possibly concerning both #8 and 7 teeth. The original infection could have occurred from #8 (the front right tooth) and spread to #7 (the right lateral). Or both of these teeth could have died due to the trauma from your accident and #8 just had more obvious symptoms. The paper point that was used by the dentist to track the infection does not determine if both teeth are involved or not. So that is something that needs further evaluation by an oral surgeon.

Yes, there is bone loss as this is long standing, chronic infection. This bone loss may cause some complications with replacement of this or both teeth as you may not be a good candidate for dental implants... even if a bone graft was placed in that area after the extractions. Again an oral surgeon needs to evaluate the bone loss as it relates to the severity of the infection.

I want to re post this one statement and answer it in bold type as it needs clarification.

<<He stated that the tooth has already had a previous root canal as there is no root there. He said there is bone loss. >>

THE ROOT IS STILL PRESENT. THE ROOT CANAL PROCEDURE "SOMEWHAT" DEBRIDES THE INTERIOR PORTION OF THE LARGE CANALS THAT ARE VISIBLE AND ACCESSIBLE LEAVING THE ROOTS INTACT IN THE JAW BONE. THE INFECTION BREWING INSIDE OF THE MICROSCOPIC CANALS THAT ARE NOT VISIBLE TO THE EYE OR ACCESSIBLE IS WHERE THE BACTERIA PROLIFERATES FROM AND ONCE IT ENTERS THE BONE, THE BONE BECOMES DETERIORATED, THUS THE BONE LOSS.

I concur that a dental implant may not be the best long term choice here. However, it is imperative that when you consult with the oral surgeon..... express your concerns about the long term health of the bone.... is it wise to place dental implants in bone that has had a long term infection AND ALSO at the same time what are the systemic health risks if implants are placed and the bone remains unhealthy. It is up to you to be your own advocate and bring up these topics if you are concerned about them.

I think it is wise to have all of your upper teeth and bone evaluated for any infections, fractures or other issues that could have resulted from your accident. Many times the injuries are not apparent until years later and the best replacement options will depend on the health of the other teeth and the bone.

I hope this info was helpful to you..... please keep in touch.

Bryanna

Hello Bryanna.

Thankyou very much for your action of kindness. I am very happy to read your post. It is an answer to my prayers. It has calmed my mind a lot. My home country is New Zealand. I am living and working in Japan. It can be hard to find the correct information at times for health matters here. I am now looking for an oral surgeon. I will print out your post and take it with me when I go for treatment.
May you be blessed in in your comings in and goings out. May the Lord shine His face upon you and keep you in peace. I pray. Amen

Ian

Hi Ian,

Thank you for the kind words

It is important to see an oral surgeon who comes highly recommended. I hope you are able to find one soon. In the meantime, rinse 3-4 times daily with warm salt water to keep the bacteria down and keep that fistula soft. I do not recommend that you keep popping the fistula as that can cause bacteria to enter the opening and become worse.

Ian, please keep us posted

Bryanna