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FAQ:  Cyst

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I'm 21 from Iran and I have a cyst on the outer left part of my gum (up) where a filling had been done before. About 2 months ago, for the first time, it swelled and my dentist gave me antibiotics and told me I should have surgery to pull out the cyst!

Now it's swelled a little again.. is it neccessary to have surgery? I'm really afraid of losing my tooth! Please help me ... Visitor from Iran

Maryam, it is very difficult for me to know exactly what you are dealing with in this situation without any x-rays to view. I can go over the most likely things from the information that you have provided.

Gum swellings that occur after having dental work done (a new filling) are usually a sign of an infected nerve in a tooth. Upper teeth that have a infected nerve will usually show swelling on the outside of the gum in the area of the tooth that has the infection and usually near the root area and not the gum edge.

You mentioned that someone has looked at this and said that you have a cyst and may need surgery. This will be evident from the x-ray and from testing to see if the nerve in the tooth is still alive. A tooth that has a dead or abscessed nerve will not respond to cold testing, heat testing, or electrical testing like a normal nerve will. It may also look darker in color than the surrounding teeth.

If this is the case, the standard dental treatment is to do a root canal to remove the dead nerve and bacterial infection. Sometimes if a very large cyst is present at the root tip, you will need a small surgery to clean out the cyst and seal up the root. This is very standard care for a root canal specialist.

You should not be afraid to have this small surgury done if it means saving your front tooth. If this is the case, you should contact an endodontist (root canal specialist) to treat your tooth if you want to save it. If you continue to take antibiotics over a long time, the bacteria in the infection will become resistant to the medicine and it will no longer work. The longer you wait for treatment, the more bone you will loose around this tooth and the more difficult the treatment will be.

It does sound to me like an infected nerve and not some other type of gum growth because you inferred that an antibiotic made it go down and now it has returned. Gum growths, other than infections, usually do not respond well to antibiotics. At any rate, it would be in your best interest to get it treated and not just use antibiotics over a long time.

Editorial Staff

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