Gum bump
 

Hi! For about 2 months I have had this bump on my gum against a tooth that I had a root canal on 2 years ago. It does not hurt at all. It will fill up and get big and I will push on it, and it will pop and pus and some blood comes out. It then shrinks down for about a week and a half then fills up again until I pop it. I went to my dentist, and he did xrays on the tooth but found no infection on xray. However, the bump wasn't filled up when he did the xray. He said he really didn't know what was causing it and prescribed me antibiotics for 7 days. I took all 7 days (finished it today), but it is still there. It has not filled up again, but the bump is still visible (flat and whitish). After reading other posts, is this a fistula? I am so scared I have oral cancer, though my dentist assured me it was not because oral cancer wouldn't have a sore that has pus that fills up and then goes down. Is this true? Why didn't he see an infection on the xray if it is an infection? I have an appointment with an oral surgeon to look at it, but that isn't for another week. Please help. So scared it is cancer.

Lenzi,

Based on your description, yes the bump is a fistula and it is caused by the infected root canaled tooth. It is common for root canaled teeth to develop a fistula when the bacteria inside of the tooth has proliferated beyond the tooth. Dental xrays are only 2 dimensional and may not pick up this infection until it becomes a full blown abscess. However, your problem is VERY common and your dentist should have explained the reason for the fistula.

The fistula appears from the gum but it is actually a very deep bone infection that has burrowed a hole from the tooth through the bone and is now coming through the gum. When the bacteria gets backed up inside the bone it swells up to the the fistula (drainage hole) as a way to release some of the pus. This in no way means that the infection is going away or becoming less severe as it is the tooth that is chronically infected and causing the infection to remain virulent. Antibiotics, re-treatment of a second root canal, an apicoectomy surgery or extraction of the tooth are the options that you would have. The only option that cures the problem is the extraction has it removes the source of the chronic infection. The other options do not favorably alter the infection status inside of the hundreds of microscopic canals which keep the tooth infected. I will attach a diagram of the anatomy of a tooth so you can see the impact that these infected microscopic canals can have on a tooth.

The dentin tubules on the diagram are the thin brown lines that encase the tooth and are marked dentin tubules. They contain dead infected nerve tissue and are not accessible rendering the tooth chronically infected.

It is wise to see an oral surgeon and explain the fistula to him and how long it's been occurring.

BTW.... it's not cancer but it can become a very severe infection which could travel beyond the tooth into the adjacent teeth and so on.

I'm sorry to deliver this news to you..... your dentist really should have been the one to inform you more thoroughly.

Bryanna

Thank you! I have an appointment next week with an oral surgeon.

Thank you! I will see my oral surgeon next week. I have one more question. Last night, I noticed when my 8 month old daughter grabbed my face near my chin there was a tender spot. I felt around on my face and a certain spot hurt to touch, though there was nothing on my face (a pimple or something). I felt inside my mouth and there was a small lump (smaller than a pea) when I rubbed under my gum line right about my jaw bone. You can not see it, only feel it. And it only hurts when i press on it. Is this a cyst? Or something to do with an infection spreading? Thank you for your help!

Lenzie,

Is the sore area of your jaw bone in the same arch as the root canaled tooth? Or is it in another arch that has another root canaled tooth? Which tooth has the fistula and do you have other root canaled teeth?

Bryanna

No the sore spot it is on the opposite side of my mouth than the fistula. I had one other root canaled tooth which is on the same side as the sore spot, but that tooth is farther back than the sore spot. Like I said, I cannot see it when I look in the mirror (no white or red lesions). Everything looks normal. I have to press pretty hard for it to hurt. I only noticed it because my daughter squeezed my face. Otherwise, I probably wouldn't know it was there. The bump is very very small. In fact, I had to question whether it was even a lump, but I'm pretty sure it is. Regardless, it hurts when i touch it.

Hi Lenzi,

The lump could be due to a number of things. It may have been there for a long time and you didn't know it.... it could be a normal part of your anatomy ... or something could be brewing. Try not to worry about it and refrain from touching it as that could just make it more sore. When you see the surgeon make sure he evaluates the sore lump and if you have not had an xray done of that other root canaled tooth, it would be wise to have one done.

Please keep us posted on how things are going.
Bryanna

I had such a bump years ago. It was an infection that was deep inside that eventually spread to my face. I felt it when it just exploded and went from my upper jaw , down to my lower jaw in a line of eruptions that last for years. My face was infected for years. It was something that just would not stop. I did have that tooth extracted but the infection stayed in my face and jaw. I still have remnants of it. It has been about 15 years.

Wow this sounds like me, I just posted about a similar issue. I had one of my front teeth root canaled and crowned, years later I noticed this puss filled bump above the tooth that I could pop as well. My dentist did an x ray and couldn't find anything so I was referred to the oral surgeon, who said it was an infection and I had an apicoectomy done, although it was a 60% chance it may work. I had the apico done a year and a half ago and now I am noticing a hard bump which is larger and seems to be spreading to the gums above the surrounding teeth as well so i'm worried the infection has not just come back but is spreading. I left a message for my dentist today who is out of the office but i'm pretty sure I'm going to have to go back to the oral surgeon to get the tooth removed and an implant done.

An exray won't show it. :(