A Root Left Behind in 2009 Finally Surfaced

Quick answer: Root fragments left in the jaw can sit quietly for decades and then work their way to the surface, usually under a denture, where they cause an ulcer that will not heal. An ulcer in the same spot for more than two weeks needs an x-ray, not another course of ointment.

The call

Shulamit, 72, from the older part of Beit Shemesh, had a sore spot under her lower denture that had been there for four months. She had had the denture eased twice. She had used two different gels. The ulcer kept coming back in exactly the same place.

She had also started to feel "something sharp" with her tongue.

What we found

A small ulcer on the ridge, about 5mm across, with a firm white point in the centre of it. Under gentle probing, that point was hard and immobile — bone or tooth, not tissue.

The x-ray settled it: a retained root fragment about 6mm long, lying in the ridge, with its tip now poking through the surface of the gum.

Her records from another clinic showed a lower molar extracted in 2009, with a note that a root tip had been left. That decision may well have been correct at the time — a small fragment near the nerve canal is often better left than chased. What matters is what happened afterwards, which is that she was never told, and nobody knew to look for it.

Why it surfaced now is straightforward. Wearing a denture applies constant pressure to the ridge, and over years the bone underneath resorbs. As the bone level drops, a fragment that was once buried deep gradually becomes shallow, then superficial, then exposed. Fifteen years of denture wear had brought the ridge down to meet it.

There was one more finding worth checking. Any non-healing ulcer in the mouth needs proper assessment, because oral cancer can present exactly this way — a persistent ulcer that does not heal in a denture-wearing older adult. In her case the cause was mechanical and obvious once the x-ray was taken. That does not mean the question should be skipped, and we examined the whole mouth and the neck lymph nodes as a matter of routine.

What we did

Removed the fragment surgically. Local anaesthetic, a small incision over the exposed tip, elevation of the fragment out of its socket — it came away easily, being already partly exposed — and two dissolving sutures.

Ten minutes.

Two weeks later, once the site had healed, we relined the denture so it seated properly against the new ridge contour. That step matters: putting the old denture straight back onto a healed but changed ridge creates the next sore spot.

The outcome

The ulcer healed completely within three weeks and has not returned. The relined denture is comfortable.

Four months of ointments and adjustments were spent on a problem that an x-ray would have identified in ten minutes.

What to do if this happens to you

1. Ask for an x-ray if a denture sore spot returns to the same place more than twice.
2. Any mouth ulcer lasting more than two to three weeks needs examining, without exception.
3. Do not just keep easing the denture. Adjusting around a hidden cause never resolves it.
4. Ask for your old records if you have had extractions elsewhere. Retained fragments are often noted.
5. Have dentures reviewed yearly, even when comfortable. Ridges change continuously.
6. Expect a reline after any surgery on the ridge, not an immediate return to the old fit.

A denture sore that will not heal? Ramat Beit Shemesh Urgent Dental Care x-rays before adjusting again. 055-985-8845 · WhatsApp https://wa.me/972559858845 · Harav Kook 28/1, Beit Shemesh.

Based on real cases treated at the clinic. Names have been changed.