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Question
Dear Dr. Spindel

I had root canal done twice on tooth #14 with a few years apart in between. It has been good for 5 years since the second treatment. Recently my primary dentist told me during the routine cleaning that she saw some abscess on this tooth from the xray and suggested me to take it out. I have no symptom, no pain, no drainage, and my gum is in good condition. She said since I had root canal, I would not feel the pain. Then I went to see an oral surgeon to seek second opinion. He took a panoramic and found this tooth was in no worse condition compared to the one taken a few years back. He also told me that some patient will always have abscess shown in their X-ray.

My question is shall I start planning on taking this tooth out now or can I wait until my have pain, gum infection or other symptoms? There is a possibility I may need bone graft and sinus life as my sinus is low. It is always my preference to preserve my nature tooth.
Your insight will be very much appreciated.
Thank you!

Answer
Dear Wendy,

Although I haven't had the opportunity to examine you or your radiographs, I can give you some general information that you may find helpful.

Sometimes when evaluating a failing root canal on a molar that is assymptomatic and has a small radiolucency that is visible on radiographs but is not apparently enlarging over time a decision is made to watch and wait. Periodically once a year or so a periapical radiograph is taken of the tooth to see whether the "area" at the apex of the tooth is enlarging. If it shows signs of enlarging a decision maybe made to extract the tooth, since an enlarging area indicates that bone around the tooth is being destroyed and can make future implant placement more difficult and also is an indication of an enlarging infection.

If the radiograph shows no changes then often watchful waiting is a viable option since the situation has showed no obvious signs of deterioration.

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Lawrence Spindel DDS, www.lspindeldds.com

Expertise

Cosmetic Dentistry, Endodontics, General Dentistry, Preventive Dentistry, Comprehensive Dental Care

Experience

Former Clinical Instructor of Comprehensive Dentistry, and Prosthodontic Department New York University School of Dentistry. Also former instructor of Preventive Dentistry Columbia University School of Dentistry.

Publications
Ask Dr Spindel Dental Blog also numerous articles on http://www.lspindeldds.com (over 100 pages of original content)

Education/Credentials
1980 DDS New York University College of Dentistry 1981 GPR Manhattan VA Hospital

Awards and Honors
OKU 1980 Honor Society 1980 Long Island Academy of Odontology award for highest combined Academic and Clinical Achievement.
In 1997 he was elected to Fellowship into the International Academy for Dental Facial Esthetics

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