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Old 06-27-2016, 05:36 PM #11
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Bryanna Bryanna is offline
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Bryanna Bryanna is offline
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Hi Meera,

Okay so tooth #29 was extracted within the last month. That's why the jaw bone appeared to be wide open on the panoramic xray. I am still a little concerned that the ligament is still intact in that site. But time will tell as the site heals.

Regarding the placement of the dental implants....
Tooth #29 site needs to heal more first. Two months is not really ample time. If you can wait 4, closer to 6 months that would be better.

Prior to the oral surgery to place the implants, your dentist or oral surgeon will use a 3D scan and computer to create what is called a Computer Generated Surgical Guide. This guide acts as a template for the surgeon to know the proper preparation of the bone and placement of the implants before he starts the surgery. This is in of itself is NOT a surgical procedure.
Here's a link to the imaging and fabrication of those guides to help give you a visual of what it is...

http://www.oralsurgeryny.com/files/2.../sroms1-10.pdf.

Regarding tooth #4 ... It is very possible that this tooth has been overly traumatized. It has a large filling ... it's been inflamed due to the fit of the Carlson bridge ... it is not lined up that great with a lower tooth... etc. It is possible that the nerve is inflamed and the prognosis could go either way. If it were me, I would avoid chewing on that tooth and eat a soft nutritious diet for about 2 weeks to really give it and my jaw a rest. Then see how it feels at that point. If it is not getting worse but rather improving ... but not completely better, I would continue for another 2 more weeks. I would also supplement with nerve regenerating vitamins like B complex, Vitamin D3, Vitamin C. I would add these natural anti inflammatory herbs to my diet ... ginger and turmeric.

I would also consult with a homeopathy practitioner to get some guidance on what homeopathic remedies would be appropriate for my individual body type, etc.

I agree not to root canal tooth #4 .... but be sure that it needs to be extracted before you do that. Consider the recommendations that I have offered you ... feel free to discuss them with me further if you want to.

Bryanna






Quote:
Originally Posted by Meera Dasi View Post
Hi Bryanna,

Thank you for the detailed explanations.
I saw my oral surgeon today, and he took half an hour (originally I only had a 10 minute follow-up to see how extraction site 29 was healing, which had only been extracted 3 and a half weeks ago) to talk to me about my symptoms, and also about how to proceed for possible implants.

He has a 3D Scan from a month ago and looked at that thoroughly as well as at the newest x rays (the ones I sent you), and said, extraction site 5 looks good to him, gum looks perfect, feels perfect... his only concern was, that I may be hitting the area hard or clench due to 29 now missing. He though that maybe clenching due to the recent extraction of 29 could have caused Nr4 to bruise.He suggested I see an orthodontist, to get some further evaluation of tooth nr 4. He gave me a referral, and I was able to see the orthodontist today, as well. She took some very thorough tests of nr 4 plus the teeth around the area, with cold test and also some electric current testing, she said, x rays looked clear, gums as well, tooth responded to all testing - also, bite test and knocking the tooth did not really give much of a reaction from the tooth. I say, not much, since it did feel a tad more tender when banged with the metal hammer than the surrounding teeth, but not painful really, just kind of bruised maybe?
She did not recommend a root canal at this point, as all her testing did not reveal the need for one at this point, and she wants me to see her again for a (free of charge) follow-up in a month (unless pain worsens).

I also got an email reply from my general dentist, and he again said, he does not see anything wrong with the tooth or the filling apart from the filling being very deep :-(. Which makes me wonder - he suggested, maybe it was "dying slowly".

In regards to the implants, my surgeon did say that I should speak to the dentist who will be making the crowns to see whether he would suggest any othodontia. He did agree that my lower spaces especially, are smaller and the crown would have to be made a bit smaller than my original teeth in those spaces. He also said that sometimes, it is still very well possible to do it and it might only be an aesthetic issue. So, will have to speak to the dentist about that.
He further said that they do this thing (sorry, I don't know the professional term) some weeks before the implant surgery, where they do a computer generated surgery first and this will be sent in to certain specialists, who then will determine the best way to do the surgery (to prevent accidental nerve-damage etc). He said it was not absolutely necessary in my case, but he said if financially it was not too much of an extra burden, he would suggest me to include this step.

He also suggested to do the implants in about 2 months from now, but hold off on tooth nr 5 until it is figured out what is going on with 4 (and in case I will have to remove 4 as well - since I will not opt for root canals anymore, ever).

You know what, I just rememberd that tooth nr 4 was the tooth that the Carlson bridge was attached to for 9 months - and it had always caused me a great deal of pain and discomfort, it had moved my jaw and teeth out of alignment and I remember when I had it, the gum around 4 would feel irritated on and off all the time! I never knew that 4 had such a big filling in it, because I would have asked my dentist whether he really thought it was a good idea to attach a bridge to an already compromised tooth .

Anyways, I am not really sure at this point what to do next... just wait it out and take some ibuprofen (I don't tolerate anything stronger very well)? I kind of just wish something WAS wrong with the tooth so I could get it pulled and be done with this pain. I am also scared due to the fact that it has such a big filling already - does that not mean it is headed for a root canal sooner or later, which for me would mean extraction?

I am so grateful for your advice, Bryanna, I really feel you "know your stuff" and you seem so genuine, open and honest. It is so good to be able to openly talk about these things!
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Bryanna

***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 04-30-2019, 08:39 AM #12
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Quote:
Originally Posted by Meera Dasi View Post
Hi Bryanna, and hi everyone :-)
I have posted on here before and am an active reader of this forum, and would love your valuable input on my most current situation:
I just went to see a new dentist (who lives closer to me than my regular one) and explained to her that I am experiencing a very sore gum around tooth Nr 4 (next to an extraction side, but it is painful on both sides of the tooth, not just next to the extraction area). Basically, I have had issues with soreness of the gum off and on for a good year or more now, but it would always clear up after a week or so. Now, I can feel the soreness all the time. It feels as if one had a popcorn skin or something stuck between both sides of that tooth and the adjacent gum, and it feels very irritated and sore :-(. I don't eat popcorn and even the dentist said, nothing stuck there. It just feels like it.
Anyways, the new dentist is convinced I need to get the filling on that tooth re-done (the filling is on the side of where Nr 5 would be).
I decided to drive the extra hour to my long-time regular dentist to get a second opinion. She said, she could not see anything wrong with the filling at all! Also poked around my gums in the area, which was painful, but she said no visible swelling, infection, and no blood, so she is not sure why I would experience this pain! I am oil pulling, putting Neem oil on it, do salt-water rinses, take very good supplements every day, don't smoke, drink or eat processed foods... I am at a loss and would appreciate if you could take a look and tell me if you can see anything on the X-rays. Also, I should add that there is some material still stuck to that Nr4 as I had a Carlson Bridge for a few months which then got taken out as it was too tight and caused pain. So, you may see some extra material on the x-ray that is from the bonding or something.
Thank you so much, I really appreciate any input as I am not sure what to do next! Just replace the filling as per the first dentist? But would that make my gum on BOTH sides of my tooth feel better, I wonder - second dentist says, no, it would not most likely. ??? What now ???
Meera

Hi I'm not sure how to send a direct message but I'm wondering what happened in the end with the tooth that always felt irritated? I also recently (5 weeks ago) had a really deep filling on a tooth around that area and have been feeling the same sensitivity and gum discomfort and was wondering how it turned out... My dentist suggested that if I could tolerate it - I just wait it out as they dont (3 dentists) see any problem with it on xray. They also suggested I could take out the filling and put in a medicated one and then redo the filling after 1 month..... I'm not sure what to do
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