This question is more than six months old, so the information in the answer may no longer be accurate.
Visitor asks:

Dear Mr Tomaž,
Around 10 December my face suddenly became very swollen overnight in the area of the mouth and nose. I visited a dentist, who under anaesthesia made an incision into the swelling above the upper left lateral incisor and inserted a drainage strip, which I changed every day for eight days. I did not receive antibiotics. After eight days the condition calmed somewhat, so an X-ray of the upper left central and lateral incisors was taken. The dentist told me that something was happening in the root of the lateral incisor and that root canal treatment was necessary. On 12 January 2010 I went to the scheduled appointment and the dentist told me that the tooth (upper left lateral incisor) was dead, that there were bacteria in the root of the tooth which had already started causing decay of the gums and loss of bone in that area, and that I had a cyst above the root of the upper left lateral incisor, which I can also feel and which is palpable right next to the nostril, up to about 1 cm in size. The dentist drilled into the root of the lateral incisor (I had no pain), pus poured out, he rinsed it and placed medication in the tooth, which will be changed in 15 days. In the evening I began to feel throbbing and pus started draining from the channel in the gum that had been incised one month ago (is it normal that the channel in the gum has not healed in one month???). A drainage strip was again inserted into the same channel, which I have now been changing for five days, and I was given 10 Amoksiklav tablets to take every 12 hours. The dentist also told me that if he succeeds in treating the bacteria in the tooth, he will close the tooth and I will have a check-up in six months; if the cyst has not disappeared by then, he will refer me to specialists.
What I am mainly interested in is whether the dentist's approach is professionally sound, whether it is normal that the incision between the gum and the face has not healed in one month, whether it is possible to eliminate these bacteria through a dead tooth and whether it is normal to wait so long with a cyst.
Thank you in advance for your answer and kind regards.

Dentist Tomaž Rotar answers:

Dear Sir/Madam!

Based on what you have written, I believe the tooth should be removed; however, I would certainly like to see the X-ray and of course the actual condition in the mouth before confirming my proposed solution. My opinion does not mean that the dentist acted incorrectly; our approaches are simply different. In my opinion, a cyst cannot be eliminated by root canal treatment, at least not when treatment is accompanied by complications as frequent as those described.

Have a nice day!

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