Pustule and Inflammation Of The Gum Above A Tooth

“I bit down on something rather hard and lost a piece of my tooth as a result. The tooth had previously been filled. This is how we realized that the tooth was in bad condition. The tooth was of course root canaled. I noticed a raised area underneath my tooth a little while later. This went away on its own, but came back later, and I took the problem to a dentist. The dentist gave me an appointment to see an endodontist. The specialist took a new x-ray, and the signs of an infection on a rather large area became apparent. According to the x-ray, he suggested getting a new root canal treatment and a course of antibiotics, but he could only get me an appointment in April. As I was expecting to visit Budapest in April anyway, I decided to get the treatment done there. My question would be the following: do I have that much time, or should I go and get it done right now? Can my tooth become too far gone to be saved in that much time (we are talking months, after all)? My Hungarian dentist is not sure if he can save the tooth, but I am hoping that I will not need to have this tooth extracted!”

We thank you for your trust, but your dentist was right; we cannot diagnose a case that is this complex without seeing the infection and some recent x-rays first.

You seem to have trouble with a tooth that has been previously root canalled, and the infection came about at the apex of the root. You may find a small pustule, or raised bump on the apex of your tooth, this is a fistula opening, and the pus that is a by product of the infection can find its way to the surface through this opening. This is why you are not experiencing any pain, as there is nothing pressing down on your nerve, as the pus is exiting into your mouth.

The raised area you mentioned is most likely a fistula, and this means that the bacteria contained in it are not just exiting into your mouth but also into the bloodstream as well, and this can cause problems. The infection itself can cause your jawbone to deteriorate, so thats one more reason to get treatment as soon as possible.

If your x-ray says that the area is healthy enough, then the root filling can be removed, the root canal can be cleansed with a laser, and a new root filling can be put in. If the infection is particularly serious, this may need to be repeated several times. This definitely is a long procedure, and will require complex treatment, and as such, it cannot be handled with just one visit to the dentist. Time is also a factor, as whether or not the tooth can be saved depends on how quickly you can get treatment, wait too long and you risk losing your tooth!

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