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Oral Surgery/Radiolucency on dental x-ray


Thank you for providing this service.  A few weeks ago, I went to my dentist for a regular check-up.  They noticed a dark spot on my x-ray below tooth #27, and referred me to an endodontist.  I went to the endodontist 3 days ago, who did some testing, said the tooth was vital and that I did not need a root canal, and referred me to an oral surgeon who has scheduled me for a 3D Cone Scan for tomorrow.  He has said that after I have the scan done, it will take 2-3 weeks for him to get back with me.  In the meantime, I'm worried!  An internet search of my circumstances only serves to terrify me.  None of the dentists have given me any indication of what they think it could be, or how serious it is.  Any thoughts?  I'm a 38 year old female, have no pain, swelling, etc in the area of the tooth, and the tooth has never had any work done on it.  
Thanks again.

ANSWER: Cara -  Without examining you or viewing the xray it is a little difficult for me to give you an exact diagnosis.  A dark spot below a tooth, especially #27, could be the following an infection, a cyst within the bone, a nerve or blood vessel.  You don't say what symptoms you had.  From what I gather, you really had no symptoms.  Another possible cause could be thinning of the bone in the area.

You don't say the shape of the dark area.  Is it round or irregular shape.  You also didn't say if you had any discomfort or sensitivity in the area.  Get back to me and tell me the shape of the dark area, the size or if you had any symptoms.  If you could describe the above, maybe I could help more.  So get back to me with that description.

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x-ray tooth #27
x-ray tooth #27  
I am attempting to attach a copy of the x-ray.  I haven't had any symptoms at all, and wouldn't even know this spot existed if it hadn't been picked up on the x-ray.  I had a 3D scan this morning, but won't have those results back for a week or so, and am just looking for a little piece of mind in the meantime!  
Thanks again!

Cara- You did a good job including that xray.  There is definitely an area at the end of the root, but I cannot be sure what it is.  The surgeon's 3D might help, but it is difficult for me to tell you if anything needs to be done.  I know, if I did not have the 3D, I would probably open the area to evaluate it, but hopefully the surgeon will get more information from the 3D.

I'm sorry I can't give you a more exact answer as to what is there.  The surgeon should have an answer.  What needs to be done or if anything needs to be done should be shown on that 3D evaluation.  I'm sorry I can't give you a more definitive answer.  So wait until the surgeon gets the evaluation.  

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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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