Gum fistula: To Pull, or Not to Pull
 

Lower-right molar, #30. Emergency root canal about 4 years ago. The tooth has continued to be problematic, requiring Amoxicillin shortly after the initial RC. A gum fistula appeared about two cleanings ago(1 year), with the most recent one being the 2nd, my dentist prescribed Amoxicillin again, requested a CareStream CT, then follow-up with the Endo.
My dentist said the infamous words about "saving the tooth", highly praising the referred Endo. Based on readings within this forum, I am confident that it will be a tooth extraction, bone growth packing, and implant. My first implant(right-side, #31) went perfectly. But because this one has been so troublesome, I am very, very, very hesitant to take any actions because of feared results. Thoughts are welcome.

Hi tri65,

Glad to see that you have been reading this forum and educating your self on the truth about root canaled teeth.

I have been in dentistry for 35+ yrs... the term "saving a tooth" has never and will never mean "curing the infection". It simply means "retaining a tooth". Every dentist is aware of this and yet it is one huge area in dentistry where it is vastly acceptable for dentists and their staff to intentionally use this term in a very misconstrued manner. After all, when the dentist tells you ....."your tooth failed in spite of the root canal(s)".... "your body rejected the root canal treatment"... "the rc was done text book and I don't know what happened"... "the rc was not done properly"...... how is the patient to know that the rc procedure was never intended to "cure" the infection in the first place and that all of these excuses are the cause of the "failure"?

You are correct in being concerned about this tooth being a bit more complicated to replace than #31 given the lengthy history with it. But the important health issue at present is the infection, not the replacement. I can tell you that to keep this tooth means you may be compromising the health of the dental implant in the #30 site as the bacteria continues to spread from this tooth. Again, chances are your dentist will not offer that information to you.

I wish you well... I know this is not a good situation to be in. I just wish that your dentist, most dentists, would be more forthcoming with the information that I have provided here. Let us know how you are doing.

Bryanna