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Infection in jaw bone at site of extraction

  • 15-11-2019 10:21am
    #1
    sudzs
    Registered Users Posts: 8,718 ✭✭✭


    I had a lower molar extracted around 20 ears ago and never had a problem until this year. A few months ago I developed an abscess there, in the bone, and was treated with Penicillin and it cleared up. But it has happened again so am a bit concerned. According to the dentist the bacteria could be getting in via the adjoining crowned molar. That tooth was first crowned around 10 years ago and was replaced around 4 years ago. There is not much tooth left under the crown.

    I have an appointment later today but am a bit of a (actually huge) dental-phobe and get in a panic in the chair so could anyone tell me the possible longer term treatment for this so I have an idea of what advice I might expect today.

    The dentist did previously mention opening up the gum and filing in the tiny pocket in the bone which is where the infection is occurring.

    I'm probably verging close to asking for medical advice but hopefully not too close! Really just interested in what are the various possible treatment options for such a problem.

    Many thanks :)


Comments

  • #2
    Oral Surgeon
    Registered Users Posts: 3,240 ✭✭✭Oral Surgeon


    sudzs wrote: »
    I had a lower molar extracted around 20 ears ago and never had a problem until this year. A few months ago I developed an abscess there, in the bone, and was treated with Penicillin and it cleared up. But it has happened again so am a bit concerned. According to the dentist the bacteria could be getting in via the adjoining crowned molar. That tooth was first crowned around 10 years ago and was replaced around 4 years ago. There is not much tooth left under the crown.

    I have an appointment later today but am a bit of a (actually huge) dental-phobe and get in a panic in the chair so could anyone tell me the possible longer term treatment for this so I have an idea of what advice I might expect today.

    The dentist did previously mention opening up the gum and filing in the tiny pocket in the bone which is where the infection is occurring.

    I'm probably verging close to asking for medical advice but hopefully not too close! Really just interested in what are the various possible treatment options for such a problem.

    Many thanks :)

    With respect, I don't think that you have all of the info, or your dentist doesn't have all the info or there is a communication error...

    The extraction 20 years ago is likely irrelevant...
    The infection is likely coming from a tooth (a heavily restored/ crowned tooth is a good culprit). The infection is either caused by gum disease and a pocket of bone loss or the tooth being dead.
    If caused by gum disease, a periodontist may undertake heroic measures to fill in the bone loss but IMO this is fire fighting in most patients and often leads to the eventual removal of the tooth anyway.
    If caused by a dead tooth, then the treatment is root canal or removal depending...

    Good luck
    OS


  • #3
    sudzs
    Registered Users Posts: 8,718 ✭✭✭sudzs


    Thanks for the very informative reply Oral Surgeon.

    I was back with the dentist earlier on and she asked for a more senior colleague to have a look. She wasn't sure the infection was in the bone but maybe in the soft tissue. I think the extraction site has a small pocket where it didn't heal over entirely and that's the area where the abscess happened to be.

    No gum disease at all, never had. But that old crowned tooth does show "something funny" right at the tip of one of the roots so I think you are right about it probably being the culprit. For years there has been a niggle around that tooth every so often, but it was never established if it was the tooth itself, the impacted wisdom tooth that is right beside its roots or even "swimmers ear".

    Anyway, the infection seems to be subsiding without the help of antibiotics this time and I've been referred for further investigations.

    Just another quick question, if I have to lose the crowned tooth I would be considering an implant but where the current gap is rather than where the crown is. Would it be possible/advisable to do that where the unhealed pocket is? I think it is a very very small pocket.

    Many thanks again! :)


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