Expert: Jeff Dalin DDS - 10/5/2004

Question
For a year, the gum near the tip of tooth 13 has been a little red and swollen, but no pain to speak of. The tooth was root-canaled and crowned long ago. My endodontist say he wants to cut away a part of the bone to examine the tooth and see what the problem is. My regular dentist, a smart prosthodontist, says that the root canal material may have deteriorated, allowing bacteria to grow in there, and that the bacteria are coming out the root tip and thru the bone. He recommends going thru the crown and redoing the root canal. I am not asking you to diagnose my problem, since these two can't agree on what to do. But can you shed some light on this? Antibiotics didn't solve the problem.

Answer
Don,
I am inclined to listen to the endodontist, because he/she does nothing but these and has a better feel for what works better than a prosthodontist. I would ask him/her point blank why he/she is saying to do the apical surgery rather than retreating it through the crown. See if you get a good reason by directly asking. Another option is to get a second opionion from a different endodontist and see what is told to you then. See what a 3rd person says. Sometimes you end up going with the majority opinion. Something should be done. So first talk to your endodontist and ask the direct question. Second, get a second opinion from a different endodontist and I am sure you will get a better feel for what to do.
Good Luck!!

Jeff Dalin, DDS