Sometime late in the spring of 2014 I first noticed a bump on the outer surface of my gums by #19. It popped and bled a little but there was no discomfort and I waited until my October check-up to discuss it with the dentist. He called it a fistula and expressed concern that the root may be cracked. He took an x-ray after inserting a point in the fistula and did not see damage at the root. Since I had already maxed out my dental benefit on a root canal and crown earlier in the year on #31 (I really wish I had found this sight and learned about root canals before that) and had no pain I opted to wait and do nothing until after the new year. It didn't take that long; in late November #19 broke right down through the root and the tooth extracted (with a socket preservation). At the follow up on December 8 my dentist said the healing looked real good and I made plans for an implant in a few months.

Around Christmas I noticed a couple of bumps on the gum where the tooth was. Again there was no pain and the dentist was closed for the holidays so I did nothing. These actually got quite long and popped (again with a little blood), but bumps have reappeared a couple of times now. Yesterday I went back to the dentist who confirmed the fistula and took an x-ray which he said showed no visible problem under the gum. Right now I am on a one week course of penicillin.

Reading various posts at this site has made me concerned and raised a lot of questions. In addition to the root canal last spring I have had two others but this is the first one on the lower left side so my thinking is that the infection really stemmed from the problems with #19 (which was first filled in 1963). Is that logical or is it more likely that could rogue bacteria from the two upper root canals or the one on the lower right have spread, indicating a wider scale problem? I am otherwise in good health (for age 63 at least) and have never had problems with immunity issues.

If these new fistulas cannot be cleared up with antibiotics should I even be considering an implant? Can x-rays do an adequate job of evaluating the condition of the bone and identifying an infection?

Thank you for any insights you can offer.