Suggest Remedies For A Gum Boil On The Upper Right Tooth

Posted on Mon, 18 Jul 2016

Question: Hello doctor,
I have a Gum boil above my upper front Right Tooth from the last one month. Actually the front two teeth are a bridge Crown which was done after a surgery about 8 years back.
In fact the crown was fixed a few years before the surgery and there was severe infection and pain and also gum boil and so the surgery was done and the Crown was removed and fixed back after fixing a new Cone (or core I am not sure) (8 years back)
Now from one month I have this gum boil above the Right side Front Top tooth and when I asked the local dentist he said you can just massage it and go in for Surgery only if there is bad smell or pain etc. But the fact is that the boil is not broken and there is no pain. Only a slight feeling of pressure inside the tooth area.
Please advise what is the best course of action and is it ok to leave it as it is if there is no pain or bad smell etc. as Surgery is not a desirable option.

Answered by Dr. Honey Arora (37 minutes later)

Brief Answer:
Dental abscess, re-infection, needs x- ray, shouldn't be left untreated

Detailed Answer:
Hi XXXXXXX .

Welcome to HEALTHCARE MAGIC.

I have gone through your question, had detailed reading of your past dental history and the images you have sent along with your recent complain..

Being your Dentist I would like to tell you that the boil that you have over the gum that is in reference with the upper right Central Incisor tooth appears most probably be a Periapical abscess/Dental Abscess..

As the tooth is already treated with Post and core followed by placement of a bridge, there seems that you have an infection recurring at the area below the root tips of the tooth leading to pus formation and ultimately an abscess is formed..

As it is small and not opened up to release pus and is even not painful, but it should be treated to prevent further spread of infection..

I would still advice you to first of all get an x ray of the tooth done and the x ray should involved both the central incisors and also lateral incisor of right side, that is the tooth next to where the boil is present.

It will help in ruling out that which tooth is actually involved as the boil is somewhere in the mid area of the roots of the two front teeth on right side..

Revert back with x ray so that I can guide you further..

As of now you can start gargling with warm saline solution..
Do betadine mouthwash gargles..
You can also apply antiseptic ointment like Chlorohexidine gel over it..

Any further questions are welcome..

Hope this information helps..

Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Honey Arora (48 hours later)

Hello Doctor,
I am uploading X Ray of the Tooth as requested by you.
Regards,
XXXXX

Answered by Dr. Honey Arora (15 minutes later)

Brief Answer:
Infection evident in the capped tooth, take a course of antibiotics.

Detailed Answer:
Hi XXXXXXX .

I have examined the x-ray you uploaded and also
re-evaluated the previous images of the boil..
Well, the infection is evident in the right upper central incisor and the root canal filling in the canal is also not properly packed and there are spaces in the filling that can cause place for bacteria to grow and accumulate..
Also there is loss of bone between your right Central incisor and lateral incisor ( the next tooth)..
So my suggestion is as you do not have any pain at present, so to reduce infection take a script of antibiotics by consulting a local dentist..
Do betadine mouthwash gargles..
Do warm saline gargles..

In case if still there is no improvement then there is no other option other than repeating root canal treatment for the tooth after removing the bridge and replacing the bridge after treatment..

Any further questions are welcome..

Regards.

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Above answer was peer-reviewed by : Dr. Prasad