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Can a large non-healing abscess above a root-canalled tooth affect your general health?

  • Thread starter Thread starter Annie364
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Annie364

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I had a big abscess form over the roots of UR6 but unfortunately didn't know it was there. I had bad facial pain and was diagnosed with trigeminal neuralgia and had recurring bouts of it for over 10 years.

The abscess was then found by x-ray and I had the tooth root-canalled in 2021. The trigeminal neuralgia pain stopped.

It was a big abscess that had been there a long time, so it was expected to heal slowly. The root canal itself was done really well, so there is no problem with the dental work done.

I had a 2nd CBCT scan a year later in 2022, and the endodontist said that although there is some healing of the abscess, around the roots it is almost as large as it was originally. He recommended another scan 18 months later to check it again.

It's now over 2 years since the 2nd scan and I will be getting a new CBCT in a few months time with my new dentist. I do get pain around the tooth area from time to time, but not that bad pain. I think there is still infection and inflammation in there and I suspect the abscess will have healed up some more but still be there.

I would like to know if this kind of chronic unhealed abscess, as shown in the 2nd CBCT in 2022, can affect general health and the immune system, and make you feel not as well as you could be?

And could it be worth considering extracting the root canalled tooth, cleaning out all the infection as much as possible and then letting the body clean up all the rest of it, and then placing an implant?

These are two different views of the same tooth UR6, showing the abscess in 2021 just before the root canal, and the same abscess a year later in 2022:



Many thanks.
 
I would like to know if this kind of chronic unhealed abscess, as shown in the 2nd CBCT in 2022, can affect general health and the immune system, and make you feel not as well as you could be?
In theory. Your body has some chronic infection to deal with so this will obviously use up some resources to control it, but I think for a normal healthy person this would be almost un-noticeable. Looking at the films though, it's almost completely healed in the second one so I think extraction seems a bit drastic.
 
Thanks so much, I didn't realise it was almost completely healed in the 2022 scans, that is good news. The endo seemed to think that the healing isn't so marked above the outer roots and that the size of the 2022 radiolucency looked similar to the 2021 size. But if the healing is pretty much there, then that's very good.

I do get pain around UR6 sometimes, and the pain is not terrible at all, but in intensity equivalent to a mild/moderate headache I'd say. It's not enough to take pain killers for, I just notice it. So the pain isn't enough to lose a tooth for (unless an implant was indicated), and I can put up with it fine.

But I wonder whether as there's pain around the tooth, does that mean that something needs to be done dentally to fix the cause of that pain, to stop it causing further issues or to remove lingering infection deep inside above the roots? (The gums are all firm/fine/non-infected around it so the mouth-side of it is fine.) Or is it generally accepted to be OK to have a root-canalled tooth in your mouth that sometimes gives some pain?
 
It's hard to generalise, needs to be looked at on an individual case basis, with discussion between clinician and patient.
You need to look at the long term prognosis of the tooth (gum health/bone levels) how much risk of a flare up the patient is happy with, the prognosis of further treatment etc.
 
Thank you very much Gordon, much appreciated.
 
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