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Oral Surgery/fistula on the gum


I have had a fistula on my gum for 4 months.  I have taken amoxicillan twice and had the filling changed out in case of a crack.  It is above the third tooth from the back on the upper teeth.  This tooth, however, is not sore or sensitive to hot or cold.   My gum is a tiny bit sore if I push on it hard through my cheek.  Now my dentist is recommending a root canal.  Is this the next best step?  My dentist said he can feel the tooth is starting to get a tiny bit loose.  I can't feel that yet.  How will this clean up all the infection?  Is it only another step and then I might need further surgery if that doesn't work.  I hate getting a root canal and cap if the infection has nothing to do with this tooth.

A fistula indicates that an infectiion is present. Usually it will begin from an infection within the nerve of the tooth, but actually most fistulas occur from the infection within the tooth spreading to the surrounding bone and then draining thought the gum. Root canal treatment alone, if done early in the process, can resolve the infectionbut occasionally  the only way to eradicate the infection in the bone is by some type of surgical drainage. The dentist can do a root canal treatment but if the fistula remains then a minor surgical procedure called an apicoectomy will be needed to clean the infection in the gum and bone. It might be best to get a second opinion from a root canal specialist (endodontist).
My suggestion is to get that second opinion before the root treatment is started. If you have any further questions, please feel free to contact me again.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon 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.


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

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

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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