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Thursday, January 19, 2017
Healthy Mouth, Healthy Kids
Chronic abscess treatment of choice
My 5 year old son had a baby root canal a year ago. We chose that route to avoid any future abscess. Right now, he`s not complaining of any pain or discomfort, but his gums has a pimple-like spot on it and it`s reddened. We took him to one dentist who says that we need to re-do the root canal or pull it out. Another dentist said that it was a chronic abscess and to just leave it alone since a root canal has already been done, he will lose this tooth in a year or two anyways, and he`s not in any discomfort. Which dentist should we listen to? And if we do leave it alone, will this abscess cause any damage to his permanent teeth?
Thank you for the question. There are several variables that impact the best treatment in this situation. There are different types of "baby root canals":
- part of the nerve tissue inside a tooth is removed and
- the whole nerve is removed.
A pimple-like spot may be indicative of a fistula that is a draining infection. My concern is that this infection stops draining and could possibly cause a facial swelling as well as disrupt the growth of the permanent tooth underneath. If it is a back tooth (molar), I would not expect it to be lost until between 9 to 11 years of age, so there is still quite a long time.
If the tooth is removed, a space maintainer should be placed if this is a back tooth (molar). I cannot give a recommendation without clinically examining the patient or looking at x-rays, but the above are issues that need to be considered. I hope this helps.
Sarath Thikkurissy, DDS, MS
Director, Residency Program, Division of Pediatric Dentistry and Orthodontics
College of Medicine
University of Cincinnati