Can I leave an abcess after antibiotics

Yes I am fearful you are right.

It just seems so wrong to have a tooth out that is now not painful at all.

The bone lump or swelling is quite big though.

Ali

I really don't like the sound of that "bone lump". I hate to think what's going on there.

Aside from the bone lump, antibiotics don't cure an abscess anyway. The abscess always has to be evacuated one way or another - by drilling down through the root canal, entering the socket via the gum or extracting the tooth.

Antibiotics will damp it down for a while but it will always come back eventually. An abscess forms when bacteria start growing in dead tooth matter inside the socket. Antibiotics will kill the bacteria but they won't remove the dead matter, which will eventually be colonised by another relay of bacteria. You can kill off the bacteria again with antibiotics, but the problem is that every time the bacteria become active in the socket they destroy yet more of the tooth, leaving more dead matter for the next relay of bacteria to feed on. You'll end up with such a massive abscess in there, it'll start getting into the bone.

This happened to me, although through no fault of my own. One day I got a terrible toothache in an upper molar. I saw my regular dentist, who X-rayed the tooth and told me there was nothing wrong. I found this hard to believe, so on a visit to the UK a couple of weeks later I consulted my father's dentist. He also X-rayed it - same thing, nothing wrong. The pain eventually died down after a couple of months, but recurred a few months later.

This went on for an unbelievable 10 years. Two or three times a year I'd get excruciating pain in the tooth, which would die down after a couple of months. During this period I also had one attack of sinusitis after another on that side. I saw five different dentists in two countries in those 10 years. All X-rayed it, said there was nothing wrong.

Eventually, one of them spotted something and referred me to a maxillofacial surgeon. He found that the infection had started out on the inside root (invisible on normal X-rays) which had been completely destroyed before it spread to the outer, visible roots. The actual tooth was completely untouched - it was just the root that was infected. The extraction was very difficult, as the tooth had become ankylosed (i.e. stuck!) into the badly infected bone. The surgeon thought he was going to end up through the bone and into my sinus, but he managed to avoid that. He scraped out all the infected bone and I managed to get away without a bone graft. That was 19 years ago, and I still get shooting pains in the socket, which my current dentist says are due to inevitable nerve damage done during the difficult extraction. Apart from that, I'm fine - and I haven't had a single attack of sinusitis since then!

I was lucky to get away with that - and I think I should probably have sued my then-regular dentist, who I saw the most often in all that time! He should have listened to a patient who was repeatedly coming back complaining of severe pain in the same tooth, even though he couldn't see anything.

You might not be as lucky as I was, so please get something done about your tooth! These things have to be taken seriously.

Thanks so much for your reply.

I am sorry you went through such a tough time, sounds horrible.

It's interesting you say about ten years as that's what has happened to me, pain on and off for ten years.

I have decided to be brave and go for the root canal if it can be done.

If it can't then I guess I will have to have it extracted.

Thank you so much for taking the time to read and reply to me.

Ali