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Is the Tender Spot on My Gums a Tooth Abscess or a Cyst?

Posted by AllSmiles

I’ve had tenderness above my top left premolar since late 2022. My dentist knows about the issue but has always said that we won’t disturb it if it doesn’t hurt. Although the tooth doesn’t hurt, my dentist says I have a cyst or a chronic abscess and may need a root canal or an extraction if that doesn’t work. My dentist referred me to an endodontist who recommended an apicoectomy to access the abscess through the gum and bone. What if the tooth doesn’t heal? Will I lose it anyway? Doesn’t getting an extraction and dental implant make more sense if the abscess is chronic? I am concerned about repeat treatment and unnecessary dental appointments. Thanks. Jabin from Georgia



Cysts beneath your gumline are rare. Based on the information you provided, root canal treatment can likely remove the infection without the need for an apicoectomy.

Six-step root canal diagram: infection, opening the tooth, removing infection, filling and sealing, post, dental crown
Root canal therapy removes infected tooth pulp

It is alarming that your dentist saw the swelling in your gums but decided to do nothing. The infection leaks out of an abscess and into your bloodstream. Symptoms of the infection in your bloodstream include:

  • Swelling
  • Neck or ear pain
  • Fever
  • Fatigue
  • Tender lymph nodes around your jaw or neck

After root canal treatment, you may feel more energetic.

Root canals have an 85 percent success rate, and when an endodontist (root canal specialist) performs the procedure, it increases the success rate. If the root canal fails, the endodontist can perform an apicoectomy.  You can consider getting a second opinion from another endodontist to verify whether an apicoectomy is necessary. Talk to the specialist about sedation options if you have dental anxiety.

Chandler, Arizona, dentists Dr. William Walden and Dr. Tyrel Beavers sponsor this post. Read how they strive to give patients some of the best dental care in Chandler.

2425 S Stearman Dr.
Suite 111
Chandler, AZ 85286
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