Nervous about dental abcess

[anony_727282]

I'm experiencing anxiety about a dental abcess in tooth #4 root tip. The tooth has had a root canal for at least 15 years, very old and the apex abcess has probably been there for many years too. Seems to be a moderate size. I don't think it's draining. Endo wants to do an apicoectomy but I'm terrified of the surgery. Another dentist suggested getting it pulled would be the best option.

My fear is the abcess and the bacteria spreading. Thinking about blood vessels in the area...is removing the abcess via apico or extraction safer to prevent the bacteria going into blood stream or causing further infection? Or is it the same?
I am 31 and not the healthiest person but don't have any major problems. I don't want to take antibiotics either as I've had bad experiences.

Is one of those options safer than the other to remove the abcess? What are the chances of those complications?
Thank you

 

[letsconnect]

Hi @anony_727282, the question about bacteria going into the bloodstream seems to come up every week, so we’ve put it in the FAQ section:

Can infections from teeth spread to the body?

Had an abscess over a year now. Probably closer to two. Cause me no bother at all and I have one of those little gum books next to the tooth so I know it’s draining. I am terrified of getting this tooth removed as I went to have it removed when it first abscessed. The dentist injected it about...

www.dentalfearcentral.org

 

[anony_727282]

@letsconnect I think that thread talks about periodontal abcesses and dental infections. My concern is about a upper periapical abcess which is deeper, cause a bone loss hole and not draining, and it's very old so I'm wondering if that's more dangerous than an acute gum abcess that drains.

Could the root tip abcess infect healthy bone or spread to the gum tissues or into the body when it's removed with apico or extraction?

 

[Gordon]

Could the root tip abcess infect healthy bone or spread to the gum tissues or into the body when it's removed with apico or extraction?

No. Absolutely not. The thread is talking about periapical abscesses which is what you have.

 

[anony_727282]

@Gordon maybe I'm looking at the wrong thread. I see comments about an abcess draining, doesn't that mean it's a periodontal abcess? Mine is not draining

Have you ever came across a case with a 15 year old periapical abcess getting removed?

 

[Gordon]

No, a periodontal abscess is a whole different beastie. Any abscess at the top of a root canal is a periapical abscess. The drainage or otherwise doesn't matter much.

Yes I've seen ones a lot older than 15 years. They can sit there quietly for decades before something sets them off hurting.

 

[anony_727282]

@Gordon thanks for your response. You wrote in the thread that bacteria doesnt spread into the body but also that when bacteria get in the blood, its cleared by immune system. So it DOES get into the blood?
Do you think removing it via apico makes it less exposed to the blood? Or does it even matter (extractions vs apicos)

I would like to just pull it because it's cheaper but I'm afraid that it could drain straight into the socket and some bacteria could get closed in there and cause infection too.

Have you dealt with cases like mine where the patient didn't do antibiotics?
I've taken so many in the last several years so I don't know how that affects the immune system but I've dealt with a resistant uti in the past because of it so I trying to avoid that happening again so I really would like to avoid them as I'm working on my microbiome.

 

[Gordon]

You wrote in the thread that bacteria doesnt spread into the body but also that when bacteria get in the blood, its cleared by immune system. So it DOES get into the blood?

Yes, some bacteria will get into the bloodstream but dental abscesses are caused by fairly weak and feeble bacteria which are easily dealt with by the immune system.

Do you think removing it via apico makes it less exposed to the blood? Or does it even matter (extractions vs apicos)

It really doesn't matter.

I would like to just pull it because it's cheaper but I'm afraid that it could drain straight into the socket and some bacteria could get closed in there and cause infection too.

Nope, more likely oral bacteria will enter the socket after the extraction but it doesn't matter. Again oral bacteria are easy meat for your immune system.

Have you dealt with cases like mine where the patient didn't do antibiotics?

Antibiotics are vastly overprescribed in some parts of the world, for the majority of dental cases they aren't necessary.