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Dentistry/20 year problem

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Question
My issue with my upper right 2nd molar started 20 years ago after an accident and fracture to the tooth below the gum line.  Dentist thought he could save it.  Root canal and surgery to remove some tissue and bone so the crown would fit over the fracture.  Two  years ago  continued sinus infections showed infection of the tooth, root canal repeated, 1 year later infection came back and endo removed apex and did a bone graph.  Significant infection noted.  Last week at routine dental cleaning xrays showed a shadow and significant bone loss to distal.  Oral surgeon recommends removal.  Having the tooth removed next Friday and I am terrified.  Never had dental problems.  Only wisdom teeth have been removed.  Why such bone loss?  Will the extraction be more difficult as a result of root canal and previous bone graph?

Answer
Helen -  Of course, without examining the area I cannot be sure of the cause, but bone loss in a tooth such as yours often indicates a fracture of the root of the tooth.  Bone loss could also be from a chronic periodontal infection.  

Root canal teeth are more fragile due to the loss of living tissue from the root canal treatment and extractions need to be done carefully to prevent fracturing of the tooth.  So, for that reason, it is important that only a skilled surgeon do the extraction to insure a healthy extraction.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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