Is this a tooth abscess or root canal?

Hi,

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How are you doing? I have seen the images (attachment removed to protect patient identity) and based on that, I would say that your wisdom tooth has caries (cavity) that seems to be deep. Secondly, it has not erupted (come out) completely into the oral cavity and the gums or flap covering it is inflamed and enlarged. A few questions, do you have pain, especially while chewing or sleeping? Is there any painful swelling, especially below the angle of the lower jaw (lymphadenopathy)? The permanent solution for this is tooth removal (extraction or surgical removal, which can be confirmed after seeing X-ray: OPG or IOPA). Again, an X-ray only can confirm whether any abscess is there or not. If you do not have pain, then you can delay the removal a bit. But, get it removed as soon as possible. Yes, a tooth with such a cavity can receive a root canal treatment if the cavity reaches pulp (blood supply) of the tooth. But, this wisdom tooth is advisable for removal only. I will explain why. This tooth is not completely erupted into the oral cavity and does not have space too. Secondly, maintaining oral hygiene in this area is difficult and access to the dentist for the treatment is difficult too. Even after root canal, placement of crown (cap) in this area is difficult and a total waste. So, why to waste your money and the dentist's efforts. Thirdly, this tooth, by evolution, has become non-functional, so its removal is not going to affect you much with mastication. So, keeping all this in mind, removal is the only best option for this tooth. You can attach the X-ray and answer regarding the pain (if you have) so that I can help you further. Take care.