Chronic Abscess

Dec 31, 2013
New to forum and as a last resort for advice.

For maybe now 8 months I have what I have been told is a chronic abscess that started at tooth 21. It is not painful and hardly bothers me at all. It started at the gum level outside the tooth and quickly moved up under the nose. I am only barely aware of it if I apply pressure to the gum area (no pain). Applying any pressure to the tooth is just a regular sensation and not indicating any issue.

Every few weeks I become aware of it draining (assumption) to the sinus. This is when I feel a very mild head discomfort as well as a little sinus activity, like a very mild flu symptom. This will last a couple of days but in no way constant.

I have seen a few dentists now as I also want implants. Teeth 11 and 21 were capped about 30 years ago and had the bare minimum of tooth left for that procedure. A root canal on 11 fifteen years ago snapped the natural tooth and the crown was posted back on. This has now failed and the tooth is below the gum and beyond repair, so I would now like implants for 11 and 21.

Dentists want to do the implant for 11 and don't seem too concerned about the adjacent abscess, except for one. I'd rather forget about 11 for the moment and resolve the abscess. The abscess did not show up on the x-ray the last dentist did.

Dentists seem to think (except another one) that 21 can just be re-crowned. I very much doubt this tooth can withstand the removal of the existing crown and stay intact, so I don't mind it being extracted.

This is what I need advice for, I don't want to see a periodontist to be told extraction of 21 will resolve the abscess issue when I already think it needs removal anyway (implants to 11 and 21). Another concern is that the professional who deals with this could well end up running a 'round trip' of unnecessary investigative procedures to resolve something that has such a mild symptom. I don't know if this thing can heal itself (and it only ever seems to get better rather than worse) or if it will continue to drain to the sinus. I am also unaware if this draining is causing other problems down the track.

By the way, there is no bad taste, swelling or anything external to indicate this abscess. I did reluctantly try an anti-biotic but it had zero effect.

I would also appreciate some additional advice about the method of implants to 11 and 21 done simultaneously (convenient). I was told a better outcome for the gums would be if they are done at separate times, being adjacent teeth (inconvenient).

What to do is doing my head in!


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