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Silent Abscesses and Root Canals

A

Annie364

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Aug 15, 2021
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I have a large silent abscess on each side, very high up, hidden away pushing into my sinuses. They were only found recently on a CBCT scan and had been there for years without me knowing. The pulp had died a long time ago.

My teeth and gums look OK in my mouth, with no swelling or inflammation, and no swelling visible on my face either. The abscesses are completely hidden away and inaccessible, up above the roots on each upper arch.

I am undergoing a root canal on the tooth on each side causing the problem. The 1st half is done where the pulp was removed and temporary dressing put in. I will be going for the 2nd and final half soon.

I was told the abscesses will take up to one year to go down. Because of their location they can't be drained.

The bacteria are affecting me systemically and have done for a long time. My endodontist did not think antibiotics are needed. I can see that a course of 5 days of antibiotics is not going to do anything, as the abscesses would still be there after the course ended.

I am concerned about the long term effects of having this infection around the new root canals, for up to a year. The two slowly healing abscesses will surely be leaking infection into the area around the newly done root canals. Won't this infection for up to a year affect my newly done root canals and infect them, causing long term problems with low level infection in the root canals?

I have spoken about this to my dentist and he said the abscesses would just heal on their own, but I would really appreciate some more opinions on this as it's been bothering me. Please be kind, as I'm having a pretty bad time at the moment.
 
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Gordon

Gordon

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Your immune system is obviously holding its own fine against the bacteria present at the moment, hence lack of symptoms. It can't completely eradicate the issue because your white cells etc. can't get to the source of the problem, the dead nerve space inside the tooth.

So if your dentist removes the dead nerve and associated gubbins from inside the tooth then your immune system can be left to get on with the job. So the abscesses will heal on their own. Antibiotics are not necessary at all.
 
A

Annie364

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Location
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Thank you very much I do appreciate it a lot. The only thing I don't understand, is won't there be a route from these abscesses to the gums around the root canalled teeth, and wouldn't the infection travel from the abscesses to the new root canals and cause them to get infections around the root?

I totally see that antbiotics are not going to help. But why finish the root canal with active abscesses still going on? Wouldn't it be better to do a few more temporary clean/fills, while waiting for the abscesses to go down, then only do the final stage once the abscesses are clear on a new CBCT scan?
Thanks again for your help.
 
Gordon

Gordon

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Nope. There is little to no active infection in the abscessed areas, they are being kept going by the bacteria exiting from where they are feasting on the decaying remnants of the pulp tissue in your root canal spaces. Remove them, sterilise the canals and fill them up to prevent any more bacteria getting in and the abscesses will clear up quite nicely.

You can't "clear" the abscesses while they're still being replenished from the canals, so your approach will never work.
 
A

Annie364

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Aug 15, 2021
Messages
10
Location
UK
Thank you so much for replying, I really appreciate it so much!

I'm fine about the abscesses going down on their own, but I was more concerned about the other way around going wrong :unsure:! ... That once my root canals are finished and filled with gutta percha, then the bacteria in the still-present abscesses could come down to my nice freshly cleaned-out root canalled teeth, and infect the gum around them or even get inside. This is why I was wondering about the idea of delaying the final clean-out and gutta percha fill, until the abscesses have resolved. I was just thinking about the long term health of the root canalled teeth themselves, wanting to avoid a root canal failure in the future.

Especially as I was told the abscesses can take a whole year to go down (as they are not being touched as they are inaccessible). So I'd have up to a year of the abscesses of bactera being present next to the freshly root canalled teeth.

But this scenario of re-infection would not happen?

(I'm assuming that because I've had Stage 1 of the root canals done (all the diseased pulp removed, the teeth thoroughly cleaned out with sodium hypochlorite etc, and the canals filled with temporary calcium hydroxide), that the source of infection is completely gone and the abscesses are not being replenished with infection from the canals any more. And I see that the abscesses are just repositories of bacteria and not a source of infection.)

Thank you again for your help.
 
Gordon

Gordon

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Basically the abscesses will be full of dead/inactive bacteria. The root fillings seal the root canals up and will prevent any bacteria from re-entering the canal spaces.
 
A

Annie364

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Location
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OK that makes sense thanks ever so much
 
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