My dentist and a specialist don’t know whether a lump near my top left premolar tooth is a cyst or an abscess. After my six-month exam last month, the dentist said it is probably a chronic abscess – chronic because the lump has been there since 2020. The lump is tender but does not hurt. It shows as a dark shadow on my X-ray. The dentist said I probably needed a root canal, which the specialist recommended. What if the tooth doesn’t heal after the root canal? Does that mean I have a cyst? The other option is to go through the bone to trip the root tip and remove the cyst or abscess if the root canal doesn’t work. Why are we treating something when we don’t know what it is? Will this end with an extraction and dental implant? Thank you. Elise
We understand your concerns about the lump near your tooth.
Is a Lump Near Your Tooth a Cyst or an Abscess?
There is a small chance that the lump near your premolar is a cyst. but it’s probably an abscess. According to an October 2022 article in Today’s RDH it can be challenging to distinguish a cyst from an abscess. A referral to an oral surgeon or endodontist can ensure you get the right treatment. You will probably be fine after root canal treatment to get rid of the infection. The process of accessing the root tip through the bone is an apicoectomy but would likely be overtreatment. With prompt care, you probably won’t need an extraction and a dental implant.
We are surprised that your dentist watched the infection for three years without treating it. The bacteria from an abscess can travel through your bloodstream, causing malaise and fatigue. After root canal treatment, you may feel more energetic because an infection in your body can decrease your strength. Root canal therapy has at least an 85 percent success rate. Specialists with the latest technology have even greater success with a root canal. Still, if the root canal fails for any reason, you can get an apicoectomy to clear the infection.
If your dentist or the specialist cannot resolve your concerns, we recommend getting a second opinion from a root canal specialist (endodontist).
David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.