[Mr_Outsider]

Try and be brief as possible here whilst including as many details as I feel might be relevant. I'm a bit of a worrier with health issues so any studied advice would be welcome.

This goes back to about 17 years ago, when I had a deep filling in a lower molar. The dentist at the time said that as the filling went so close to the nerve that it might become irritated and require a root canal. She said it might be 3 months, might be a year. In actuality the tooth remained sensitive to pressure and hot and cold for a couple of years but never caused significant discomfort and then settled down. Around 3 years ago the same tooth started to cause mild pain so I visited a dentist who said the nerve was still vital and simply refilled it.

About 3 weeks ago I developed pain in the same tooth again, this time more severe and throbbing than previously. I visited a different dentist who said I needed a root canal, which was booked for nearly a month after this initial appointment. He prescribed me antibiotics which he said it was up to me if I wanted to take or not, which seemed a little weird to me, but since reading a lot on the internet since, it seems that the prescription of antibiotics for tooth infections is indeed sort of optional, though it should be at the discretionary advice of the dentist not the patient surely!

Anyway, I didn't want to take precautionary antibiotics and in any case the pain was still manageable with standard doses of pain killers, and even sometimes without. However I didn't really feel happy about maxing out daily on ibuprofen / paracetamol for a month nor just allowing an active infection to progress that long and the dentist had mentioned an 'open and med' procedure that could be undertaken to alleviate pain etc. I called again and went on the standby appointment list and got one to have this done. The dentist opened the tooth, cleaned out some of the infection, injected the nerve to finally kill it (though he said he could only find two canals and would need to check later for a third), and also some medication to help with the infection.

As far as the pain went, this was as instantly effective as I had hoped. The pain subsided greatly and I was generally happy, although the temporary filling tasted intensely of medicinal clove oil for 3 days solid, which was almost as bad (it also seems to have worn down and left 'jagged edges' of tooth quite rapidly).

The dentist sent me on my way and said I still had the prescription for metronidazole 'should I need it', otherwise, see you in 3 weeks for the root canal. Since then the pain has mostly gone, though the tooth is still tender to touch and pressure, possibly increasingly so as the days go by but still not at a level which I need to take antibiotics.

My main concern now is that I've noticed the formation of a bony lump underneath the tooth at the base of the gum which I'm fairly sure wasn't there before the open and med, and either way the dentist hasn't mentioned to me or pointed to on the x-ray etc. It isn't itself painful, except for very mildly if I apply pressure with my finger. Internet searching seems to suggest this is a granuloma, but would it be normal for this to form so quickly? Does it mean that the infection is spreading dangerously or that my body is effectively isolating it (as one article I read seemed to suggest). And will it likely be solved by the root canal procedure (as also seemed to be suggested).