Hello!
I am 51 years old. I have had periodontal disease for about 5 years (since it has been treated). I underwent curettage, I am invited for check-ups, and they say that my oral hygiene is satisfactory. At that time both lower central incisors were the most mobile, almost to the point of falling out. I managed to keep them; the inflammation temporarily calmed down and the teeth were somehow cemented together, so they are fixed and no longer mobile. The problem is that pus accumulates every day in the gum between the two teeth. There is a small hole in the gum that does not heal, and when I press the inner side of the gum with my tongue, foul-smelling pus comes out. What do you advise — extraction of the teeth?! I am worried whether this could lead to other problems (bone pain, etc.). I intend to have crowns placed over these teeth!? I want to keep the teeth, but not at the cost of other problems. Thank you for your answer!

Dear Sir/Madam!

Judging from your description, there is a fistula or sinus tract next to the tooth, which could indicate chronic inflammation at the root tip that occasionally flares up acutely, manifesting as a small discharge of purulent fluid through the sinus tract. We always decide on treatment of the tooth in question after reviewing an X-ray.
The described tooth, as well as advanced periodontal disease, represent persistent chronic inflammations or foci that could theoretically affect disease processes in distant organs (joints). A discussion of this is complex and lengthy, but this possibility should certainly be taken into account. The decision to place crowns on existing but periodontally compromised teeth is made after reviewing an orthopantomogram, measuring periodontal pockets, determining clinical mobility, assessing the history of the disease, adherence to oral hygiene and, ultimately, the patient's wishes, and after considering all other options. To answer this question, we need to invite you to the practice.

We look forward to your visit!