failed root canal

[ljd]

Hi
I had a root canal last year in top molar 14.  A few months later I went to for my cleaning and mentioned a pimple like object on my gum.  I was told it was normal.  Now at my next 6 month checkup I again mention my pimple and was told it is a fistula from the root canal.  I was referred to an oral surgeon for an apicoectomy.  My question is should I have been referred long ago?  I have had this infection for just about 1 year.  Do you think the surgery has a chance of being successful?  My appointment is next week.  Thanks for your help.

[ljd]

Thank you so much for your input.  I had just switched to this dentist and was regretting my decision.  

[Jordy]

Actually, also, you mentioned that you first brought it up when you went for your cleaning.  Often, I find that if you are ONLY seen by the hygenist they really are not the best judges of how to diagnose something.  There were times when my hygenist completely missed things that I finally had to question my own dentist about directly.  There have even been a few that I had to explain certain things to (my last hygenist didn't even KNOW what an apico was; she asked me to explain it to her when I told her I'd had one since my last appointment!)

So, if you are at your regular cleaning and have anything questionable, make sure to talk DIRECTLY to the dentist and don't trust the hygenist's judgement.

[Jordy]

I do have a fistula that has not grown or become inflamed for ten years, and both my dentist and oral surgeon (who did two other apicos on two teeth that had large, inflamed fistulas) said that it is okay to leave it be.  It appeared BEFORE a root canal on an overall infected tooth; my dentist did the root canal first and said he'd watch the cyst, and in ten years it has not only not given me trouble but has even shrunk a bit.

But the other two, they were getting worse and worse and worse and my dentist just kept wanting to "watch it" and finally I'm the one who took myself to an oral surgeon who agreed that both of those two (not the third) were in definite need of apicos.  The procedures went great and those two teeth haven't felt so good in years and years.

That oral surgeon, and another before him (I went to while living elsewhere for something else) both said when I'd questioned them about it that a lot of general dentists like to take the "wait and see" approach but in the long run usually oral surgery like apicos are needed.  My dentist was right about one (the first one above my front tooth) but wrong about the other two, because they ended up needing it.

[Matthew Baron, D.M.D.]

A fistula is not normal and should have been dealt with at your earlier appointment.  The surgery does have a good chance of being successful.  Good luck.