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Suffer sensitivity teeth. X-ray showed periapical cyst, removed. Have pain. Feel tooth is tender. What to do?

May 2014
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Practicing since : 2002
Answered : 6503 Questions
I have been having a lot of trouble with my teeth. I am 63 and they have like over night gone bad. They are so sensitive. I have one molar#14 the only one left on that side. It throbs but not continually. I saw a dentist and upon panoramic xraY he found a periapical cyst which he removed, he could not tell from the xray if it was actually touching the root of #14, he was hoping this was the problem, but I still have some pain in that tooth. He wants me to wait another month to see if it heals. I have to leave the country Aug 9 and be gone for a month. I think I should have the tooth extracted. I am terrified of being in another country with a toothache. Now the molar on the other upper side of my mouth is tender.
Posted Thu, 4 Jul 2013 in Dental Health
Answered by Dr. Vivek Chail 1 hour later
Hello XXXXX,
Thanks for writing in.

This is Dr Vivek, a radiologist with 10 years experience answering your question.
As you have said, at 63 years of age, you have a molar #14, the only one left on that side.
Previously you had a periapical cyst in the same place and was suspiciously touching the root of #14.
Your present problem lies with the occasional throbbing of this tooth. You have also mentioned that the molar on the other upper side also is tender.

In my opinion, if you are put through a course of anti biotics, we could clearly assess if there is an underlying infection.
A conservative treatment is always better over tooth extraction.
If unfortunately, the toothache doesn't show features of healing and the pain progressively increases, you can get it extracted rightaway.
At the moment there's enough time for your month long trip. Please request your dentist for an appointment for probable tooth extraction. For this you could consider getting a medical fitness for tooth extraction done well in advance.
Also please allow yourself 2 weeks rest after tooth extraction and before starting your trip on 9 August, allowing time for the wound to heal.

Further questions welcome.
If you are satisfied with my reply, may I request you to please close the thread and leave a feedback.

Wish you a wonderful forthcoming trip this August.

Dr Vivek
Above answer was peer-reviewed by
Follow-up: Suffer sensitivity teeth. X-ray showed periapical cyst, removed. Have pain. Feel tooth is tender. What to do? 20 hours later
I have been on antibiotics for this and the other molar just started hurting. I don't want 2 have two teeth extracted. I am going to Greece, they have dentists there. What would you do? Thanks
Answered by Dr. Vivek Chail 3 hours later
Thanks for your queries.

The antibiotics you are taking must ideally be working on both molars and bring down the infection. A deep seated infection may not respond well. Getting two teeth extracted would not be a wise decision for you at the moment.

As you have asked my personal opinion, keeping both the molars in picture and with a little amount of time and planning, I would suggest you to discuss the feasibility of endodontic therapy (root canal treatment). The infected pulp of the tooth is removed and filled with inert material. The tooth is saved from any further infection and destruction. Many elderly people are opting for this nowadays. There is a bit of a challenge for the dentist if the roots are narrow but end results are wonderful.

However, if you and your dentist in agreement, choose to proceed with the tooth extraction, I would advise getting rid of the more infected one first.

If you haven’t got any curative treatment by the time your trip starts or are apprehensive of having your trip affected because of toothache, please do not worry. You could take along some clove oil (available in most pharmacy shops) to treat any toothache troubling you on your trip. Please ask your pharmacist for proper directions of use. The taste and smell may not be likeable to all but it does work well as a self medication.

Wishing you Bon voyage for your Greece trip. It’s a great place and many things out there to see.

I hope that I’ve been able to satisfactorily answer your queries.
Further queries are always welcome.

If you do not have any more questions, I request you to kindly close this thread and post a feedback.

Get well soon,
Dr Vivek
Above answer was peer-reviewed by
Follow-up: Suffer sensitivity teeth. X-ray showed periapical cyst, removed. Have pain. Feel tooth is tender. What to do? 1 hour later
I have thought about the root canal treatment but both of my teeth have crowns on them. I am concerned that the root canal will work but since I would have to have new crowns put on, these would be the second ones. I know they have to shave your tooth down to get the crown on and they have already been shaved once. I don't know how much tooth is left. I want to do implants buy they are expensive. Isn't it true every time you have a restoration on your tooth it weakens it.
Answered by Dr. Vivek Chail 8 hours later
Hello XXXXX,
Thanks for your queries.

Its great that you have already considered root canal treatment. I see that you have certain facts on root canal treatment and would like to clarify that.

1.     Both teeth have crowns:
It doesn’t matter if there were crowns on your teeth before root canal treatment. Root canal treatment in itself does not always require crowns in all teeth, but since your teeth are the molars, a crown is always necessary to increase success rate of the procedure. The molars as you know help in grinding food and a lot of wear and tear may be there without crown placement. Hence putting new crowns should not be something troubling you. Root canal will work as well in any tooth which did not have a crown.

2.     You are worried that the tooth has had a restoration work for crown placement earlier and second procedure will make it weaker:
For just crown placement, the dentist doesn’t have to work much into the tooth. I suppose your dentist would have done minimum shaving to your tooth, as much required for crown placement. But yes, x XXXXXXX will show how much of your tooth was shaved and give your dentist an idea. As you know, any dental procedure has its advantages and pitfalls. Sometimes it is a challenge for a dentist to perform root canal treatment as the tooth may already be weak and you must have a detailed discussion with your dentist on the outcome.

3.     You want to do implants but they are expensive:
Implants are getting more acceptance world over because of its more hassle free maintenance. After getting root canal treatment, you still need to see your dentist regularly and get x rays to check your tooth as and when suggested. Apart from that you have to observe good dental hygiene. You must avoid chewing hard food material with your restored teeth.

4.     Isn’t it true every time you have a restoration work on your tooth, it weakens it:
You are right but one must also consider the amount of restoration work done. Putting crown and root canal treatment are two different procedures and crown placement done with root canal treatment is to provide extra protection for your tooth against early wear and tear. Please discuss this point with your dentist further because the risk and benefit must be known to your before you decide on a procedure.

I hope that I’ve been able to answer your queries.
Further queries are always welcome.

If you do not have any more questions, I request you to kindly close this thread and post a feedback.

Dr Vivek
Above answer was peer-reviewed by
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