Tooth fracture on tooth and pimple-like bump on gum? Extraction?

[Ren2day]

Hi,

I was experiencing little pain when chewing / biting on that side that prompted a visit to dentist. I was sent by my dentist to an Endodontics for evaluation for a lower right second molar tooth (#31), as she believed it may need root canal to save tooth. There was also pimple-like bump that showed on the buccal side of gum on said tooth.

The Endodontics said there was deep vertical defect/crack on distal aspect of tooth observed on radiography and bone loss; and recommended extraction for implant or partial denture versus root canal. The vitality test conducted was normal response. I am attaching the x-rays taken. It was not specified how deep the crack was, if beyond the gum line.

Currently, there is no pain when chewing on this tooth after my regular dentist advised me to not chew on that side for awhile. I also popped the pimple-like bump on gum and gum seemed normal for about a week, then flared up again with pimple-like bump today after lunch.

Can this tooth be saved with a crown? Or can the crack be bonded/sealed? Or will a visit to a periodontist help resolve the pimple-like bump that seems to resurface after a few days when tooth is used for chewing? Though, there were ocassions the gum looked normal even after chewing on said tooth. Am not on any antibiotic, other than prescribed to gargle with peridex mouthwash.

Thank you for any input.


-Ren

 

[MattKW]

An endodontist took those X-rays? They're not good enough for a general dentist be proud of.
The signs and symptoms doesn't make a lot of logic. If the tooth was vital, then the pimple-like bump (with pus?), can't come from that 2nd molar. Was the 1st molar tooth in front tested for vitality too? And there's a darkness between the roots of the 1st molar that isn't totally encompassed by the X-ray.
Certainly there is some bone loss around 2nd molar, but not enough info to judge more. You need vitality test of both molars, and better X-rays.

 

[Ren2day]

The first molar has a crown on it. The endo did a tapping of tooth test on a few teeth before the second molar, and I did not feel any pain except for when tapped and poked the bump on gum of toothe #31.

The endodontist said that food might have lodged into the crack on distal aspect of tooth, that caused the gum problem. When I poked the bump, there was little bit of light creamy substance (pus I think) and blood came out. During this time, whenever I run floss on the back of this tooth or touch the edge of this tooth, there will be slight pain felt. Below was the finding by endodontics on March 13:

"normal response to vitality testing, lamina dura at apex appears intact, deep vertical defect on distal aspect observed radiographically, draining sinus tract on buccal keratinized gingiva, 12mm probing depth on distal aspect, crack on distal aspect."

This morning, there is no pimple like bump on gum on buccal where tooth 31 is. I have not made appt to extract tooth yet, as the pain when chewing on that side went away. Also, the pain when running floss or touching edge of tooth went away these past couple days. I've also started drinking a cup or two of milk every day since my visit to endodontics on March 13. And, added taking vitamin K2, Curcumin, Coq-10 daily. I've also made a mixture of coconut oil, calcium bentonite and calcium carbonate and rub/brush it on back of this tooth. So, not sure if these help why pain seems to have dissipated when running floss or touching edge of this tooth. The pain when chewing was gone too, after a month of not chewing on the right side of mouth.

The main problem I am having now is the on and off resurface of pimple-like bump on buccal side of gum where toothr #31 sits, usually when I heavily use this side for chewing. There was, however, no bump for 7 days, after I had popped it. And it resurfaced yesterday after a meal, albeit smaller bump than when I first popped it. What is happening on this tooth? To extract or not?

 

[Ren2day]

Here is the defect highlighted by the Endo office when I requested to highlight where the vertical clefting defect shows in the x-ray. Endo said, "You can see it on the original image as a darker area adjacent to the root. It goes far below your gum line and extends to the very tip of your tooth"