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Question
I have a molar that has deep pockets and was told 2 years ago by a dental specialist that it most probably will need extraction.
I was recently told I have a radiolucency in that area around the same tooth which has discomfort also.  I also use a night guard for grinding of my teeth.  Yesterday, I went to a maxillofacial surgeon who just filmed the dark spot but said nothing about the tooth; he said I needed a biopsy to determine the cause.  Would extraction of the tooth be a solution, should I get the biopsy, should I get another opinion?

Answer
Lyn -  Of course, without seeing the xray or examining you, I cannot be totally sure.  A biopsy of the area is not a bad idea.  Without seeing that xray, I cannot tell you if the dark area is a nerve problem in the tooth or from a periodontal problem.  You have nothing to lose with the biopsy.  If it shows up as infected or inflamed tissue, then it is from the tooth or the periodontal tissues around the tooth.  If, however, there is no infected tissue, then the area is inflaming the tooth and a biopsy and removal of the lesion is appropriate.  

So if infectious or inflamed tissue and extraction should be correct an a solution.  I cannot tell you if the biopsy alone is warranted.  Because you were previously told of the necessity for an extraction previously, I would probably suggest the extraction and have the surgeon remove the tissue and submit it for a biopsy.

If you have additional questions, feel free to contact me again.

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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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