Cyst on gum

lolly5648

A couple of weeks ago I had a cracked tooth filled and since then had toothache. Went back and dentist filed it down and gave me a course of antibiotics, still had toothache so next time he x-rayed it and said I had a cyst. I am now taking more antibiotics and he said he has referred me to local hospital.

As I am in a bit of a state at the dentist I didnt query this but could someone tell me why I should be referred to the hospital and why he isnt able to treat me. (I know I should ring and ask but dont want to appear stupid as he probably explained at the time).

What does a hospital oral dept do that a private dentist doesnt?

Thanks

gustav

Hospital is allowed to use more sophisticated anaesthetics (useful for nervous patients and complicated work) , and has more expensive and complicated equipment, and can take more time, and has more staff available, and generally has more resources available, and the consultants are more familiar with complicated work (as thats what they do more often).
Downside - you might have a bit of a wait.
Phone him each day to check he has written the referral letter.
After about a week phone hospital to check they have received referral letter, and that you are in the system.
Then hassle the dentist and hospital every other day to find out where you are in the queue.
Regular contact means you might get a quick cancellation appointment.
Make sure hospital has your phone number.

Dora_the_Explorer_5

If you're in pain and your dentist isn't prepared to do any more work on your mouth either see your GP immediately, they may be able to prescribe a more effective antiobiotic or if you're in severe pain go to A&E.

Davidboy

lolly5648 wrote:

A couple of weeks ago I had a cracked tooth filled and since then had toothache. Went back and dentist filed it down and gave me a course of antibiotics, still had toothache so next time he x-rayed it and said I had a cyst. I am now taking more antibiotics and he said he has referred me to local hospital.

Oooooh ouch! Can't help much, but hope it gets sorted soon, sounds really painfull!


Dx

Teerah

Hi Lolly, I would advise you to go back to your dentist and ask him to explain everything to you again. He should be willing to do this. As for hassling the hospital for appointments, I dont think this will do you any favours. Waiting lists tend to be quite long though you may get lucky and it depends on how urgent he has made your referral when you will get seen. Do you know if this tooth has already been rootfilled in the past? If not then he should be able to put a sedative dressing in the tooth and this along with the antibiotics should settle the tooth until definitive treatment can be carried out.

Teerah

gustav wrote:

Hospital is allowed to use more sophisticated anaesthetics (useful for nervous patients and complicated work) , and has more expensive and complicated equipment

If you mean that sedation is available, then this is also an option at many general practices. Other than this there is no other "more sophisticated anaesthetics" And regards the equipment, you are more likely to come across state of the art equipment in some private practices than you are in some dental teaching hospitals, it has to come out of the NHS budget after all.

lolly5648

Thanks everyone

This is a tooth that has had root canal work (with a previous dentist). I know nothing can be done until the cyst has gone but still not sure why my dentist cant do the work. He does sedation or I take valium - thats why I am not really sure what is going on.

My referral letter is sitting on the desk in the Oral Dept of local hospital but according to the secretary has not been dealt with.

I guess I will hear after Christmas. I am not in pain but I have a constant ache.

Toothsmith

Hi Lolly,

If a root filling fails, and infection starts up again, there are a few options.

Take the tooth out
Re- root fill it
Apicectomy.

If a cyst has developed above/below the tooth, then apicectomy is the best option if you want to save the tooth.

The difference between an abscess and a cyst is really only one of size. If an abscess gets to a certain size, it is called a cyst. Nothing scary about that!

Some dentists who have an interest in oral surgery like to do their own apicectomies in their surgeries. They are quite straight-forward things. Some don't like doing them, and refer them to Oral surgeons in hospitals, for whom it is bread-and-butter stuff.

If a dentist only sees cysts occasionally, he may feel that he's not 'practised' enough at them! It is also possible that the tooth may be in a tricky area and the sinus, or a nerve is close by, and he'd prefer the expertise of the oral surgeon to see it.

An apicectomy is a minor surgical proceedure, where the cyst is accessed through the gum. The area is cleaned out, and the root of the tooth is sealed at the end.

There is a good Advice Sheetfrom the BDA here.

lolly5648

Thank you so much for your reply Toothsmith - that explains it perfectly. My old dentist was also a surgeon at a private hospital and he did the root canal work. My new dentist is much younger and probably finds it easier to refer patients on. If he hasnt got the experience I would rather he didnt practice on me!

Could I ask you if this is something that can wait until whenever the NHS give me an appointment (assuming it doesnt become too painful) or should I try to get an appointment with my old dentist?

Lolly

Toothsmith

The cyst has probably been there for ages without any trouble. Antibiotics usually calms them down, and it should then be trouble free for a fair while again.

If you have private health insurance, this proceedure is usually covered by it and so you could be seen privately in hospital.

As for going to see your old dentist, I'd never really recommend people chop & change about too much. Every dentist has their own way of doing things, and if you get caught between 2 different ways, it could really confuse things more.

lolly5648

Thanks again Toothsmith. I do have private medical insurance so its good to know that it might be covered.

My old dentist is near to where I used to work and I changed to a local one for convenience. I am far too nervous a patient to keep chopping and changing.

Cheers