Need advice - have a abscess in my tooth but only minor to no pain

[DanDaMan]

For the last 3 weeks I have a minor pain in one specific section of my upper jaw only when I press on it - it is on the left side of my face beside my nostril - when I blow my nose I put pressure on this section and I feel a slight pain - it is not a large pain but noticably.

I went to the dentist 2 days ago and they did full xrays - they said I have a abscess in the root and he suggested root canal - he did prescribe antibiotics which I have now been taking for 1.5 days. He is suggesting to do the root canal in about a week.

I have done some googling and I'm starting to feel uncomfortable about a root canal (keep hearing health horror stories). So looking for advice. In particular, if the antibiotics kill the infection, is there any chance that my tooth and pulp will heal back to normal? If there is a chance, any advice on home remedies to help the healing. Or being the xray confirmed I have a abscess on the root, is there 100% no chance for this tooth to heal and is my only 2 options truly a root canal or extraction? What is I left the tooth as-is after/if the antibiotics kill the bacteria? As mentioned I have little to no pain - so maybe waiting is the right answer for me until things either heal or start getting worse????

To make things more complicated, the infected tooth if the 3rd from centre (no the middle tooth or the one next to it but the 3rd pointy tooth). I have a permanent bridge, which is held in by that infected tooth and my middle tooth. So if I get a root canal, the bridge will be held by that root-canaled tooth - will that make the bridge weaker? Dentist said he will drill through the bridge at first to do the root canal and then after week (if all is good) he would replace the bridge with a new one. I'm a little scared to get the bridge removed since I thought the adhesive is permanent - could it break the 2 supporting teeth when it tries to remove the bridge? FYI - the bridge is 4 years old now, and the dentist said the bridge is under warranty for 5 years so the bridge replacement would be free, since he said he sees some gaps in the bridge where it connects to my teeth so he is recommending the bridge replacement anyways.

If everyone suggests the tooth is beyond saving and if a root canal is bad, what are my options due to the bridge I have? Would you suggest to remove the bridge, extract the infected tooth (which is grinded down to hold the bridge), and then get a new bridge which means I'd have the grind another tooth and have 2 fake teeth in the bridge - would that not weaken my bite???

Need advice please

 

[MattKW]

1. Consider a 2nd opinion before you have the bridgework redone. It concerns me that he sees gaps in the bridge that was only done a few years ago. There are risks to all treatment, and although sometimes things don't always work out, the degree of "warranty" is held to be judged by the standard of treatment expected by dentists in similar situations. My insurer would not cover me me if I ever gave anyone a "warranty".
   
2. RCTs themselves are no problem. They will resolve your abscess completely if properly done. The cause of the abscess is within the tooth, and the abscess is the body's defences at the tip of the tooth where the gunk comes out. Antibiotics cannot penetrate the tooth and will only relieve an emergency situation for a short while.
   
3. Yes, the access through the back of the tooth will weaken it. Just how much I can't say without the benefit of more information (X-rays, photos, clinical examination). Sometimes they can be strengthened enough to continue.
4. However, since he recognises there are problems with the bridge and is going to redo for free, I would suggest that the bridge be removed before the RCT is commenced. This will allow fuller assessment of the chances of long term strength of this tooth before you do the RCT. The bridge will be removed by cutting through it with a drill, it is not pulled off. Then, if all is OK to proceed, it's simple enough to make a temp bridge and do the RCT through that.