I have had a swelling on my top right premolar for about 3 years now. It doesn’t pain me – just a bit tender. My dentist has always said we can leave it or take it out and have always said it is a chronic abscess. My dentist sent me to and I have now seen a specialist in hope of doing root canal which he has given a 70 per cent success rate but he said there is a possibility there may be a cyst, but no way of knowing. I would have thought an X-ray would show it up. All I know is that there is a dark area (shadow) there. I am so confused what to do – a root canal or extraction. I just want this lump gone now. I don’t really want to lose the tooth but my biggest worry is what if it is a cyst and it has been there all this time what it’s doing to me. Surely there’s a way of telling, and also if I choose root canal will the lump go away? Both my dentist and the specialist have mentioned a gum procedure to cut the gum, peel it back, and go into the bone to trim the tip of the root, remove whatever is under there, if it doesn’t heal after extraction or after root canal. I look forward to hearing from you as I am really confused and it is making me ill with worry.
– Susan from Kingswinford, UK
(See Dr. Hall’s answer below.)
We thank our advertisers who help fund this site.
I think I can help you here.
First, about the cyst. We were taught a lot about cysts when I was in dental school and about the possible problems they could cause. But in my decades of dental practice I never saw a single cyst. It’s a common practice for some dentists to exaggerate risks to protect themselves in case something goes wrong. So yes, there is a chance that this could be a cyst, but the chances are going to be pretty small. Get rid of the infection by doing the root canal treatment and I’ll bet you’ll be just fine. I wouldn’t do the gum procedure they are suggesting. This is called an apicoectomy, and my opinion is that would be overkill.
Then I have a comment about your UK dental care. I guess your dentist and the specialist seem to be trying and well-intentioned, but I am surprised that your dentist was just watching this swelling for three years. This is an infection and you’ve been having bacteria spilling out of this abscess into your bloodstream for these three years. My guess is that when you get this root canal treatment done you will start to feel better. These infections in your body tend to sap your strength a little and it’s a good thing for your general health to get rid of them. And giving this procedure a 70 percent chance of success is really lowering expectations. Root canals in general have at least an 85 percent success rate and, in the hands of specialists who have the latest technology, the success rate is considerably higher than that. And if you do end up with a root canal failure, you can always have them later try the apicoectomy that they mentioned.
Best of luck,
Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.