I have a tooth that has a large filling in it, and has not caused me any trouble since the filling was put in about 7 years ago. I’ve now been told there is an abscess on the tip of the root and that the tooth seems dead. Do I really need a root canal? I certainly don’t want to have work done that doesn’t need to be done. Thanks, Dan.
Hi Dan,
If the tooth is dead then the pulp of the tooth will have died too, and this would explain why you haven’t felt any pain as the pulp contains all the nerves. However the tooth can still be infected, and abscesses can be very serious. The abscess is caused by pus collecting in the tooth due to bacterial infection, and is often a result of dental decay. It could be that your filling has become leaky and has let in bacteria resulting in this infection. At the moment your abscess is only in the tip of the root. The trouble is that if you leave the abscess untreated it will get worse, and could spread to the surrounding bone, resulting in its destruction, which is very painful. Even though your tooth is dead it could still be saved by having root canal treatment.
Root canal treatment is a very simple and straightforward procedure and isn’t painful. Once the area has been anesthetized the dentist will remove the filling and will drill into the tooth to access the infected area. This area can then be thoroughly cleaned out before inserting a root filling or post to prevent further infection. If the infection is especially bad the dentist may decide to place medication directly into the tooth, and may place a temporary filling before replacing it permanently to ensure all the bacteria have been killed.
It is quite possible your tooth may need a more extensive restoration such as a crown, as it could have become weakened by the infection and decay. The alternative would be to have it removed completely and an implant placed, but it is always better to try to preserve natural teeth for as long as you can, and root canal treatment is a lot less expensive than implant surgery.
Cheers,
Dr. Penchas
