Need some second opinion. What are my options for this tooth? Is this savable?

[Stackflow]

I have severe pain in second molar 47 which is mostly around the gums margin.

The gum is throbbing so much and very painful for 2 years now. Probing that gums and touching with hands all hurts so much.little swollen and inflamed. I took X-rays and they are ok as per dentist. When he pressed 47, it was so painful. He probed& rubbed that gum and i just screamed in pain.

Gums are so painful than the tooth. He said I can extract this tooth as it shouldn't be painful for pressing down. I have pain in the lower jaw end where the jaw line ends Been having this pain for 3 years now.

After the jaw pain started, #46 was hurting for pressure and nothing seen on that xray and cbct scan. So they did RCT and retreatment & nothing changed.

I extracted #46 few months ago and still have pain in that socket area and jaw pain near ear. Now I have severe throbbing pain in gum around the tooth 47. Do I need to extract it asap? Or RCT will help? Dentist told to do SRP. Whether that will take away pain?

Dentist said tooth shouldn't hurt for pressing with fingers. So he suspect I might have some hidden infection underneath like I had it on #46. So he forcing me to do immediate extraction.

Saw another dentist and he said to do SRP.

What are my options here? Is this tooth not savable with root canal?

Do I need to do extraction first and then deep cleaning ?

 

[Dr M]

I would definitely start with a cleaning. There is a lot of plaque and calculus build up, and this can lead to severe gum inflammation and bone loss.
If there is no relief, I would suggest maybe getting a CBCT scan to rule out a crack on the tooth, due to it being a lone standing molar.

 

[Stackflow]

I would definitely start with a cleaning. There is a lot of plaque and calculus build up, and this can lead to severe gum inflammation and bone loss.
If there is no relief, I would suggest maybe getting a CBCT scan to rule out a crack on the tooth, due to it being a lone standing molar.

Thanks for the response @Dr M . Appreciate it.

Can we do deep cleaning on that molar when they suspect a hidden infection underneath? Zac we still do deep cleaning even if that tooth is infected at the bottom?

I have chronic jaw pain for 3 years without any relief yet. Then CBCT and MRI of jaw and neck without any definite answers.

I had this tooth 30( first molar) which was painful for tapping and biting pressure. Had around five CBCT scans on that tooth with different Endodontist over the last 3 years. No issues or nothing seen on that scan.

Since Tooth was painful, that suspect that tooth could be causing my lower jaw pain near the ear lobe where the mandible ends. Had root canal on that tooth to see if it gets better.. Unfortunately it didn't help and more pain on that Tooth 30. I had different Endodontist did several retreatments of root canal on it. It didn't help at all and more pressure pain on that tooth.. Even when that tooth was there, I was having gum pain in tooth 31( now paining gums second molar). I even saw a periodontist to check tooth 30 and gum of 31.

I ended up pulling that tooth 30 and surgeon said it was infected at the bottom when he took it out. Infected at the bottom and at the jaw bone. Didn't know it was infected and wasn't seen on any of the cbct scans.

Unfortunately extraction didn't help with my jaw pain. All pain remains the same once the anesthesia wears off. Same jaw pain and pain in socket area of#30. And gums of 31. It's been 9 months after the extraction. It just hurts in the socket gum.


The next tooth gum#31 hurts for around 2 years now. Dentist just dismiss everytime by seeing the x-ray that it looks ok. But it hurts like throbbing in the gum margin surrounding that Tooth..I just scream and jump off dental chair when they probe that tooth gum 31.


Definitely something is wrong but don't know what's the issue on it. I do floss but this tooth 31 always get bad tartar buildup on it. I had deep cleaning for the first time in my lungs in Feb 2021 on the right side of the mouth only because tooth 31 had tartar buildup and severe gum pain.

It didn't help and I ended up feeling more tartar buildup now. I am scheduled for deep cleaning in June but the surgeon said I can remove this tooth since it was painful when he pressed with fingers during evaluation. So he said it shouldn't be painful and something wrong, that's why it was painful. He wanted to extract it rather than deep cleaning.

I am yet to see the dentist after the surgeon visit. Dentist said tooth looks ok during my last visit.. But he said he don't have any answers on why this gum is so swollen which is not normal.

Do I need to see the Endodontist first to ask if root canal will help to save this tooth? Does gum swelling indicates infection?

I have deep cleaning appointment only in June. Severe throbbing pain in gum everyday and pain increases in lower jaw near the ear( my usual pain spot ) and that gum immediately after I lay down. Pain just throbs in the gum margin on right and back side of that gum. Right distal side and back side of the Tooth gum always throbbing.

 

[Stackflow]

My old x-rays.

 

[Stackflow]

I would definitely start with a cleaning. There is a lot of plaque and calculus build up, and this can lead to severe gum inflammation and bone loss.
If there is no relief, I would suggest maybe getting a CBCT scan to rule out a crack on the tooth, due to it being a lone standing molar.

My dentist didn't agree for a normal cleaning @Dr M . I have to do deep cleaning on both sides because of tartar buildup on #31.
Can we do deep cleaning when the tooth was painful and suspecting a crack/ issue underneath it? Can we still do deep cleaning on it? Please let me know your thoughts as I have that deep clean appointment this week.

 

[Dr M]

My dentist didn't agree for a normal cleaning @Dr M . I have to do deep cleaning on both sides because of tartar buildup on #31.
Can we do deep cleaning when the tooth was painful and suspecting a crack/ issue underneath it? Can we still do deep cleaning on it? Please let me know your thoughts as I have that deep clean appointment this week.

Just to clarify, when I mentioned cleaning I did actually mean a deep cleaning due to the fact of the tartar build up. If there is no improvement, continue with the investigation for a crack.

 

[Stackflow]

Just to clarify, when I mentioned cleaning I did actually mean a deep cleaning due to the fact of the tartar build up. If there is no improvement, continue with the investigation for a crack.

Thanks for the response @Dr M.
If there's a crack identified, what should be the next step, ext or RCT for crack? And if no crack identified, what should be the next step with respect to this tooth?

I have pain in the gums throbbing surrounding that tooth.

Thanks for your inputs sir