Do I Have a Cyst or an Abscess?

I have had this lump above one of my premolars for close to four years. My dentist called it a chronic abscess and said I could leave it or get rid of it. While it doesn’t hurt, it is a bit tender. I asked if we could do something about it. He sent me to an endodontist to get a root canal treatment. That dentist said there was a possibility that there was a cyst there. He’s giving the root canal treatment about a 70% chance of succeeding. He offered to extract the tooth if that is what I prefer. I don’t want to lose the tooth, but if I’m going to do a root canal and it doesn’t work so I’ll have to lose it anyway, should I just get it over with?

Martha

Dear Martha,

I’m glad you wrote. First, I’m going to say I do not think you are with the best dentist. I am having trouble understanding why he left a tooth abscess untreated for so long. All this time you have had bacteria spilling out that abscess and into your body. He should have dealt with it years ago.

Dentists learn a lot about cysts in dental school, but rarely encounter them. While you could have a cyst, I think the chances are rather small. I would go ahead and get the root canal treatment. You will likely find that your general health feels better, too.

The 70% odds he’s giving you are rather small. He’s hedging his bets in case it doesn’t work. A good dentist can have at least an 85% success rate. But, if it does happen to fail, you can retry the root canal treatment.

Even if you end up losing the tooth, it is very worth it to try to save it. Natural tooth structure is the best for. you. Go to a good endodontist. You’ll have a better chance at a successful outcome. You don’t have to go to the one who gave you 70% odds. Check his reviews. If they’re not great, look for an endodontist with good reviews.

This blog is brought to you by a compassionate San Antonio Endodontist Dr. Scott Janse.