Advice for my tooth


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May 12, 2019
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There was a pustule at the gum in my lower right first molar for years, which caused the tooth's surrounded jaw bone melted. My current dentist had performed endodontic treatment last year. And I was told if the treatment is successful, the jaw bone will recover over time, but periodic follow up is needed. Before that 2 times of Endodontic treatments were performed at the same tooth in the past decade. According to my dentist, there wasn't any crack in the tooth while he was doing the treatment with the microscope. However, after a year past of the very last treatment I still feel so uncomfortable with my tooth. Recently there was pustule formed again. Blood and pus came out after breaking it. My dentist told me that possibly there is a crack at the outside part of the tooth by looking at the X-ray (there is shadow around the tooth). However he will need to cut open my gum skin to confirm where the crack is and how the crack is like for further treatment. One of his suggested treatments is cut half of the tooth (the side that has a crack), keep the other half, and then put a bridge over there. Another suggestion is move my wisdow tooth to replace this broken tooth. I am just wondering do both of these suggestions really work? Another of my concern is can melted jaw bone really recover overtime?
 
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Dec 6, 2017
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I won't comment on the suggested solutions as even though I am not a dentist both sound unfeasible, but if you have an abscess pustule you should always have it seen to immediately if you want to save the tooth and reduce bone loss. If you do have root canal treatment the recommendation is that the tooth is crowned following treatment as removing the nerve makes the tooth enamel more brittle and prone to fracture. It is my understanding that bone can heal to some extent. It does not seem that your root canal treatment was successful. I hope you find a solution that will bring you back to dental health.
 
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MattKW

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  1. A crack in an endodontically treated tooth is usually diagnosed by using a bright light, and by feeling for a periodontal pocket down the side with a probe. I haven't heard of opening the gum; sounds unnecessary intervention for about 3mm of vision.
  2. Splitting the tooth in half is called a hemisection. Not a favoured technique anymore since implants came on the scene. And I certainly wouldn't connect it to a bridge as it will be far too weak.
  3. Moving a wisdom tooth forward? Damned hard to do, and wisdom teeth don't often have good root shapes - they're usually short and twisted.
  4. I would extract this overworked and failing tooth, allow healing, and then consider an implant. Maybe you'll need bone grafting, but can't tell.
 

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