Hello,
After I mentioned occasional problems, my doctor sent me for an X-ray of the lower right tooth 6. The tooth otherwise does not hurt, but the gum next to it is occasionally slightly swollen. About 5 years ago another dentist treated the tooth with posts and an artificial tooth. The X-ray showed that there is indeed some process taking place around the root and at the same time that the tooth has no root filling, which surprised the dentist. I was advised that, if the tooth does not hurt, because of its important function in the bite I should leave things as they are and have an X-ray once a year to check whether the process is progressing. If it spreads, I would supposedly need some kind of operation. If the tooth starts hurting, it will have to be extracted.
For the last 3 months I have also had problems with my right ear — a feeling of pressure in the ear and poorer hearing. I have already had an ENT examination, which found nothing unusual, and I am still waiting for a hearing test. Could this inflammation be the cause of my problems, and what would you advise? Is it better to remove the tooth as soon as possible? Could the inflammation spread to neighbouring teeth if we insist on preserving it? Is there any other private-treatment approach to this problem?
Thank you very much for your answer and kind regards.

Dear Sir/Madam!

Root canal treatment of multi-rooted teeth is often very difficult, and the results can be uncertain despite treatment according to accepted principles. There is little point in trying to determine why the canal in question is not filled to the radiographic foramen (the end of the root), because the reasons may be different and are most often objective and impossible to overcome at the time of treatment. If it were possible to remove the root post, I would recommend repeat root canal treatment, which sometimes gives a positive surprise despite a poor clinical and X-ray appearance. If this is impossible, removal of the tip of the affected root, or apicoectomy, follows. Without prior root canal treatment, the procedure has relatively low reliability and therefore a poor prognosis. Premolarization, or removal of only the affected root, is also on the list of "emergency options". After such a procedure, only one root of the tooth remains as a supporting element for an individual crown or bridge. Ultimately, unfortunately, we often have to decide to extract the tooth and replace it with a dental implant or a conventional bridge. Based on the information you have provided (I have not examined the X-ray or the tooth), I believe the best option would be to remove the tooth and replace it with a dental implant.

Have a nice day!