QUOTE(a-y @ Mar 29 2021, 12:43 AM)
Based on your xray, I could see a lot of issues here. So lets begin
1- You have generalised periodontitis, meaning you have gum problems, you seriously need to improve your oral hygiene. Your dentist should focus on it immediately.
2- There is generalised loss of bone between your teeth, thus indicating periodontal diseases aka gum disease. Elaboration of my 1st point.
3- Now lets address your big red arrow.
a- Your last tooth might have developed secondary caries, for this you need another type of xray known as PA view, which focuses closely on 2 or 3 teeth only, unlike your current one which is an OPG. There are several reasons why secondary caries develop, so I wont go in their details but it doesnt reflect nicely on who ever did your filling in the first place.
b- There is widening of space between bone and roots of your teeth, its known as widening of Periodontal ligament space or PDL space. Few common reasons for that are, Occlusal trauma (from over filled filling), Periodontal disease and lastly Pulpo-periapical lesions. In your case its most likely overfilled tooth and presence of gum disease.
c- The dark spot you see on the xray is very diffused, meaning its borders are not well defined hence the infection is not active and might be transient, a PA xray would make things more clear here.
Did your dentist conducted pulp vitality test, meaning did he touched your tooth first with hot stuff, then cold to see if the tooth is vital (alive). This test is very important to establish if the pulp had developed necrosis hence needs to be removed via RCT, if not then you need a new dentist.
Here is my recommendation, get a second advise from a more competent and experienced specialist before getting RCT from your current dentist, I will refrain from making any further comments on the competency of your current dentist. Best of luck.
Thanks for your reply.
1- You able to detect the periodontitis from the xray? So far, I been scaling every one to two years.
2- How to identify the generalised loss of bone between teeth? None of my dentist mention any about this.
3-a- I have get the second advice from another dentist, which commented the same. It could be developed secondary caries based on the horizontal line from side. That could be during my extraction of my wisdom teeth. But my wisdom teeth been surgery out more than 20 years. I’m not sure still possible?
b- Anything I can do to improve it? I did notice every time I floss there is some small hole stuck my floss. It located quite deep, nothing can do about it.
c- I show this xray to the dentist, he did say the same, not really clear and hard to judge. However, he managed to see the borders should be still well.
He did say the same on the vitality test, just before this, I still have feeling when touch or even with the cold air blow.
So his conclusion is monitor it, unless I have chewing problem or pain then only go for further checking.
After that recent filled, it still have some discomfort on and off, not pain level. And is improving this few days. Hope it will go off. So worry on the RCT.
oh ya, if worst scenario happened, can it be just extract rather than go through the tough and not guarantee process?
Anyway, really appreciate your time and advice.