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A 39-year-old female asked:

How to treat a cavity under the gum line i have a small cavity under the gum, is there a way to treat this? my dentist is giving me confusing information. for example, he'll say "we cannot root canal it and set a crown" but then he'll say "we can root can

3 doctor answers8 doctors weighed in
Dr. Felicia Mata
Cosmetic Dentistry 26 years experience
It : It wasn't mentioned if you have symptoms, e.g. Severe pain, why a root canal was recommended. Assuming the tooth is healthy, if you are my patient, i will use my laser to do gum reduction (gingivectomy) after application of a strong topical anesthetic, provided it won't violate the biologic width (which is within 3mm), to access and restore the small cavity. In case there is already a pulpal involvement, (e.g. A narrow opening but deep enough to communicate to the pulp), a root canal has to be done. I will recommend implant vs. Bridge to preserve the bone integrity, easier flossing, and capacity to chew hard foods without traumatizing the abutments where the pontic (floating crown) has to be connected. The success and longevity of this treatment will depend on a number of factors including your occlusion (if the bite is balanced), oral hygiene, habits, and diet.
Dr. David Schleimer
A Verified Doctor commented
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Just a perspective: Walter Cohen, my Dean at U of Penn was/is a pioneer in periodontics, and he coined the phrase "biologic width" I can say that I learned from the source that it is of course a range, but widely believed to be 2.04mm. Violating the zone means you will have loss of connective tissue such that a "new" biologic zone can be re-established.
Feb 20, 2013
Dr. David Schleimer
A Verified Doctor commented
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I do not know how a small cavity under the gum line and ROOT canal are mentioned together. It sounds like a miscommunication.
Feb 20, 2013
Dr. John Thaler
Prosthodontics 42 years experience
Try dental school: You might try to get treatment at the nearest dental school. The care is usually very good , and the cost much less than at a private office. Also, some hospitals have training programs for advanced education and oral surgery training. Check them out as well. Chicago is a good place to be for this. Good luck.
Dr. Kara Rosenthal-Fraiman
Endodontics 32 years experience
To root canal or not: In most cases a cavity under the gum line can be salvageable. Depending on how deep the cavity may go down the root under the gum line a root canal can be done. The only question will be if your dentist can be able to fit a crown on the tooth . Many dentist may suggest having a extra procedure done called "crown lengthening " which is done by a periodontist.

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