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Dental and Oral Health (Children)

Chronic abscess treatment of choice

11/24/2008

Question:

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?

Answer:

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":

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.

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Response by:

Sarath  Thikkurissy, DDS, MS Sarath Thikkurissy, DDS, MS
Professor
Director, Residency Program, Division of Pediatric Dentistry and Orthodontics
College of Medicine
University of Cincinnati