Hi Ilona,

I am in the dental field and can offer you some information here. I know you are baffled by what is happening and scared about what is going to happen. I am going to give you information that your dentists have probably neglected to share with you. It is not pleasant for me to tell you these things or pleasant to hear them, but you have the right to be properly informed. So do not panic when you read this. Just know that you need to take action asap with an oral surgeon to remove the source of the infection which is your tooth as this is the only means of attempting to eradicate the infection.

It is very common for a root canaled tooth to end up with a fistula and for that fistula to keep returning, irrelevant of the apicoectomies, because there is a chronic infection brewing inside of the tooth. There are many hundreds of tiny canals inside of every tooth that contain nerve tissue. These canals are not accessible during the root canal procedure so their contents remains the source of the chronic infection. When the infectious bacteria proliferates beyond these small canals it travels into the jawbone often resulting in a fistula. Because the bacteria is not able to be removed from the tooth, the infection never really goes away. The rc and apico procedures may temporarily subside the acute symptoms but they do not cure the problem. Thus the recurrence of the fistula.

It is important for you to know that with every fistula occurrence and with every apicoectomy you permanently lose more of the jaw bone. This type of bone loss is generally not successfully replaced with graft material because the surrounding bone is often unhealthy too. The fistula is the result of bacteria that has burrowed a hole (tunnel) from the tooth, through the bone and through the gum tissue. In it's path it creates infected, necrotic, diseased bone.

Another thing you should know is that the bacteria is not limited to just this one area or your mouth. Infection in the bone, anyplace in the body, is considered a serious infection as the bacteria travels through the bloodstream. This can result in a systemic infection elsewhere in the body, cause or contribute to chronic illness and more.

After 30+ yrs in dentistry I still find it unbelievable how many dentists do not inform their patients of these facts. They treat jaw bone infection as if it were a scraped knee. Ask an orthopedic surgeon about jaw bone infection and he will tell you exactly what I have told you here.

The only way to attempt to cure the infection is to remove the source of the infection which is the tooth. There is no procedure or medication that will cure or stop this infection from proliferating. It is wise to have the adjacent teeth evaluated thoroughly prior to the extraction of this tooth to rule out infections in those teeth. By any chance are the adjacent teeth currently root canaled?

I am sorry to deliver this news to you.... I apologize for the lack of information that you have been given by your dentists. They are completely aware of all of this but as I said..... they treat it like a scraped knee.

Please do not delay in the removal of this tooth. If you can, please check back with us and let us know how you are doing.

Bryanna