Dear Sir/Madam!
I have terrible frustration and fears regarding the following issue. My upper right second molar is completely destroyed. About three years ago it hurt terribly, but because I had an exam the next day I did not let my dentist extract it. She therefore opened the tooth and removed the nerve (vital trepanation?). The tooth has been open ever since and generally does not hurt if I leave it alone. There is also no visible or palpable abscess, but the tooth really is completely decayed :(. Before that I once had a syncope when I received a local anaesthetic, so I am EXTREMELY afraid of going to the dentist. This is especially because I am a radiological engineer and know just enough about these things to create terrible scenarios in my head. I am afraid that the problem has "eaten" deeply into the bone or that I will find out I have a cyst or something similar. Please tell me whether there is cause for alarm and whether a normal extraction will most likely be sufficient. I think I have already overcome my fear of the extraction and of having another syncope from the anaesthetic. The only thing still stopping me is fear of what I can expect. Please advise me. Thank you very much for your answer.

Question

Accepted Answer

Dear Sir/Madam!
From what you have written, I could conclude that we will no longer be able to perform adequate root canal treatment on the tooth (I can confirm this only after reviewing an X-ray), so you can expect extraction of the tooth. If a periapical cyst has developed above the tooth, it must be enucleated at the same time, which usually does not present a more serious problem. You experienced the syncope because of excessive fear and not because of the anaesthetic. If extreme fear is still present, we suggest prior sedation with medication (sedatives). There is no reason for alarm!
We look forward to your visit!

Dentist Tomaž Rotar answers: