Huge shadow on dental X-ray

[Flickum]

Hi, I’ve just got back from the dentist and I’m a bit freaked out. They did an X-ray and found one of my teeth (molar right at the back)has a huge dark shadow. There’s no sign of infection, no swelling and no pain etc. the dentist has referred me to the hospital for a “second opinion” and said I should get an appointment quite quickly. Am I right to be as freaked out as I am about this? My mind has gone straight to some horrific jaw bone cancer.

Internal decay would be my first thought. They're processing you urgently, so they can at least start dealing with whatever it is ASAP.

Silent abcess probably. I wouldn't panic but you may end up having a root canal or that tooth out.

If they thought it was “just” an abscess would this be an urgent referral? I think the speed I am going to be seen is what’s causing my panic

I had a very similar experience. Dentist arranged an urgent referral and I was seen the next day. I was totally freaked out. I can't remember what the technical term was but they decided to monitor it rather than remove it. They monitored it with regular xrays for a couple of years. Now the dentist does an opg every couple of years to check it hasn't grown.

Abcesses can flare up and be quite dangerous if not dealt with.

That must have been scary for you at the time. Do you know what they were originally looking for?

That sounds worrying for you. To be honest, if it was me, I’d call the Dentist back and explain that after you got home and reflected, you are worrying about it and would like to know what the second opinion would be looking for. At least this way you can get a bit more information up front.

Try not to worry - a large shadow in the bone could be a cyst or infection. There are many causes of radiographic abnormalities in the jaws. It's quite normal to refer to an oral surgeon for a second opinion .

Yes. Tooth infections can be dangerous and their close proximity to the sinuses can make them urgent.

@ihatethewordhubby thank you, you seem very knowledgable. Is the reason for the specialist second opinion to check or rule out if it’s cancer/ something sinister?

I assume at my age (30) it’s more likely to be a cyst or infection given I have no symptoms. Would you expect a malignancy to cause symptoms beyond the X-ray finding?

I think I’m feeling particularly vulnerable because my dad had oral cancer and I saw what he went through.

General dentists are trained to treat the basic stuff and to know when to refer for the rest. A dark area that's picked up on an OPG X-ray can be many things. Unlikely to be an infection attached to the root of your tooth as you would likely have symptoms. However this isn't always the case. Possible that this is what we call an incidental finding of something that's been there for years and only just picked up. Most findings are benign. Occasionally they are something more and Im so sorry to hear about your Dad. Oral cancer is so so hard to go through. All the symptoms and treatment are so close to all of the important functions of eating and speaking etc which can make the lasting effects so hard to live with. Good luck - please update me and let me know how you get on . PM me if you need to talk.

It sounds like a large abscess. If it bursts or it gets into your blood it could cause secondary infections, even septicaemia, that would be the reason for the urgent referral.

If that is what it is, they may have to extract the tooth to drain the abscess.