Feeling hopeless, health anxiety has pushed me to the edge regarding cyst

[dustybaer]

I posted to this forum previously about a cyst they found at the end of one of my top front teeth. I had a root canal in 2017 and x-rays were taken 10 months later. I will attach a picture of what it looked like in late 2018. I thought it still looked bad, but Endo said x-ray showed some "healing" and we would just have to wait.

Not long after I started to have some strange sensations on the tooth. Not pain at all, but sensation I could activate by pushing my tongue on the roof of my mouth. The sensation would happen for a second and stop. I proceeded to obsess for months on this, back and forth. Is the sensation just part of a root canaled tooth feeling different? Or am I feeling the cyst that is still there?

I contacted the Endo and told them about the sensation. They wanted me to come in and do a CT scan. As soon as I heard that my health anxiety went into over drive. I kept repeating: "If they want to do such a serious scan, they must think it's serious." "And what about the radiation from those scans."

So my fear about what they "might" find was too strong and I declined. I just shut down and hoped it would go away somehow.

Flash forward five years to now. Never got worse symptoms other than that sensation. I had sort of just ignored this mouth thing for all these years. I just "didn't want to know how bad it's gotten." The consequence of that was I would not even go to my regular dentist for cleanings, thinking they will have to take x-rays.

It's now all come to an head as my teeth are showing the effects of 5 years without cleanings. And that has brought the dormant cyst issue back front and center. "How bad of a mistake did I make not letting them do the CT scan five years ago?" "How much damage have I done by just not thinking about this for five years?" "How many any other teeth has this cyst killed?" "And how will I ever get a cleaning done when I won't go into dentist because they will force me to take x-rays first?"

Do you professionals think it's possible I have been walking around with a hole in my jaw for six years? This past week has been especially rough. I have been spending the large part of each day in bed putting an ice cube on my teeth over and over and over to try and prove they are still alive.

 

[Gordon]

"How many any other teeth has this cyst killed?"

NONE. It doesn't work like that. Worst case scenario, the cyst will have grown enough to push the roots of other teeth out of the way a bit, it hasn't happened to you though because you'd notice the change in appearance.

Dental CT scans use a very small amount of radiation, especially for a single tooth sized area, about the same as you'd get from 15-20 days sunlight.

FWIW that x-ray you posted looks pretty good, there are no sharp edges to the cyst area, which would suggest that bone is starting to fill in the area...

 

[gentledental]

That looks quite a big lesion. I think you should have that investigated. A CBCT scan is necessary.

 

[dustybaer]

@Gordon Thanks for your reply Gordon. I am a good Oregon kid who's just trying to to deal with my "other" sickness in my head so I can properly tackle this 7 year old cyst issue.

The x-ray I attached here is from 2018, about 10 months after the root canal. You may be right that that it does look "better". Although another dentist on here thinks it doesn't look great.

Before I ran away away from the request to do the CBCT in 2018, the Endo looked at this set of images and said she saw "healing". If I showed you the x-ray from right before the root canal, the lesion was much more universally dark.

To be perfectly honest, I am looking for any reassurance I can find which will then help me get past this block to finally get to the Dentist and have new x-rays done. In your opinion, do you think if this thing was going blow up on me, it would have happened over the last 6 1/2 years? As I mentioned, I had sort of forgotten about it over the years because the only symptom I have had is the minor sensation I can trigger by touching the area on top of my mouth where root of tooth is. Is there any chance when they take new images they are going to show "massive" bone loss over these 6 years?

 

[dustybaer]

@gentledental Thanks for your thoughts. As I mentioned to Gordon, the image is from 2018, about 10 months after the root canal. The image from right before the root canal showed the circle as much more universally dark.

When you mentioned about the lesions size, this is what scares me. Like I have something "unusual" that most Dentist's have never seen. That's the health anxiety flaring again as my brain is saying, "if the professionals are surprised by it, it must be something rare and really bad that no one's ever seen before."

Is there a chance that the findings of how it looks today are not totally horrendous, considering I haven't had a major symptom from it over many years?

 

[gentledental]

I have a lot of experience treating cysts like these. An x-ray will only give an image from one angle. A CBCT will give a clearer 3 dimensional shape/size of the lesion and usually it is a lot bigger. Like what Gordon has pointed out already this cyst may affect the teeth next to it.

It really needs to be investigated properly.

 

[dustybaer]

So even though it was “healing” in 2018, you’re saying it’s possible that that healing could have reversed and it could have started growing again? Would that indicate the root canal failed somehow?

 

[gentledental]

How could you or your doctor tell it was healing? If that xray you took was from 2018 then it's unlikely it would have healed with a lesion that size. Judging by how black that lesion i think it may have extended the full width of the bone. Apical surgery should have been performed straight away. I could be wrong.

 

[dustybaer]

I think you’re not understanding. The Endo said in 2018, when this xray was taken, that it showed healing when compared to the 2017 xray that was taken right before the root canal procedure.

 

[Gordon]

There's a lot to unpack here. A cyst is your body's attempt to seal off an infection. Basically it builds a wall of cells around the infected area to prevent it from spreading. Sometimes it works and things remain frozen for ever. Sometimes it doesn't and the bacteria in the cyst keep going. The cyst expands, usually pretty slowly and into the soft bony spaces around it. The slow pressure acting on the roots of adjacent teeth will cause almost orthodontic movement of them, but it doesn't actually damage them.

Treatment varies depending on the size of the cyst, simplifying it a lot, small ones are just removed in their entirety, larger ones are normally treated by removing them in stages. The surgery is similar to an apicectomy, not as bad as it sounds.

I'm sorry if I'm putting words into your mouth here, but you seem to be imagining this to be some terrible disfiguring lesion which will eat away your face. A dental cyst isn't like that.

Getting another x-ray done at least will allow your dentist to tell if this is getting better or if you need to get the cyst treated surgically. As above, the surgery is not bad and definitely won't cause you massive scarring etc.