I've been reading this thread for a few months now--am living through a dental nightmare, as it seems are many have who post here. I'm hoping for some advice regarding what to be alert to at this point as my situation is still unfolding. Until last summer I would say I've had very good dental health, and have practiced very consistent dental hygiene, so I have records (X-rays etc) to document that until recently I didn't have any chronic dental problems. Here's my scenario:

In July 2014 I developed a toothache on the upper right side of my mouth. My dentist (biological) took X-rays and pulp tested tooth 2, 3, and 4. All the teeth were alive, and no decay was visible on X-ray. I did have a gold filling in both 3 and 4. I was advised it could be sinus-related, was treated with Amoxicillin, ozone, and a laser. On day six of the TX, I had a reaction to the Amoxicillin and was advised to discontinue it. I sought a second opinion from another biological dentist and he repeated the pulp test, looked at the X-ray, and concurred with the approach. The toothache resolved.

In October 2014 while traveling, I had a second toothache and abscess in the same area. I went to a dentist in an emergency and he pulp tested 2,3, and 4 and took an X-ray. Tooth 3 was dead. He lanced the abscess. I wanted an extraction but he insisted an RC was the better option. I consented. After the RC, I was advised that the tooth was cracked and might need a second root canal by an endodontist.

In mid-November 2014, after returning home, I consulted with my biological dentist about the RC. He looked at the X-ray from October, did an exam, and advised extraction of #3. He was willing to do the procedure but only if I didn’t fly for two weeks. I was preparing to move in a week so I opted to wait until after the move.

In December 2014 I established care with a new biological dentist after moving. He reviewed the X-rays from October, did a visual exam, and advised a mouthguard. He did not take any new X-rays or pulp test any teeth.

In January 2015 I returned to get the mouth guard. I asked about extracting tooth #3. He advised waiting to see if the mouth guard would calm things down and suggested I schedule an extraction a few months out. He did not take any X-rays or pulp test the teeth at the time of this suggestion. I signed a consent in January for extraction, and scheduled it for late March.

On the day of the procedure (March 2015) I told him that I thought I was getting another abscess above #3—as I had recently returned from a trip to San Francisco and flying seemed to have upset things. He did not ask any questions about my symptoms, nor did he take any new X-rays, nor did he pulp test tooth 4 or 2. He extracted #3. After the procedure I asked his assistant if #3 had been infected and she said “yes. That is why you felt all that scraping. He was cleaning it out very thoroughly. “ I asked if he was prescribing antibiotics, and she said “No. He doesn’t like antibiotics.” The assistant gave me a clove oil substance to squirt on the extraction site for pain and cleaning. I had to ask for Tylenol before leaving. There were no written aftercare plans.

The next day the dentist called me to follow up, and I asked about pain meds and antibiotics and was told they were not necessary. The following week I returned for a follow up. When I reported that I was not feeling well, the dentist's response was “that’s probably just the healing process.” He did not ask me any other questions about my symptoms, nor did he take any new X-rays or test any other teeth. He glanced in my mouth for about 10 seconds, said, “Well, it looks a little pus-sy, but I’m not going to over-react.” He then snipped out the stiches, said “just put a little extra clove oil on that and come and see me in 3 months” and left the room.

The next day, I felt very flu-like and by 11 pm my lower right leg was going numb. I went to the emergency room. They evaluated me for a blood clot in my leg, noted that my tooth extraction site appeared infected and recommended that I discuss AB TX with my dentist. I placed several calls to the dentist's office and got voicemail. I didn’t leave a message, assuming that at some point I would reach a live person, but I was unable to do so.

Friday I was ill with flu-like symptoms. Late Friday night/early Saturday morning (4 am) I called the dentist's office and was referred to the dentist on call. I relayed my symptoms to him, told him what the ER doc had said the day before, and stated my concerns about not having antibiotics. This dentist stated “Look, we are conservative in biologic dentistry but if you have an infection we HAVE to treat it.” This was the first time I had heard that a dental infection REQUIRED treatment. He offered to prescribe antibiotics over the phone but I opted to return to the ER because by that time the right side of my face was swelling and I was in severe pain. The ER doc diagnosed cellulitis in my face, an infected tooth extraction site, and prescribed pain meds and clindamycin.

The following Monday, feeling even worse, I requested a referral to an oral surgeon from the dentist who extracted #3. The OS took X-rays on the first visit, did an exam, and recommended watching to see if things would improve. They did not. A week later she suggested that #2 might be cracked. She referred me back to the original dentist's office for concurrence. The doc who was providing care at that point (not the one who pulled #3) took a series of X-rays and pulp tested tooth #2 and tooth #4. (This was the first time any diagnostic images or exams had been done of my mouth since coming to this office in December.) Based on the pulp test, tooth #2 was dead. According to the dentist I saw at that point, there was a black area above #2 on X-ray (cone beam) that according to him, suggested it had been infected for at least 3 months.

I had#2 extracted by the OS the following day and was put on a second course of clindamycin. I was unable to work the rest of the week due to the pain and swelling and spent six days in a dark room with ice on my face praying for this to resolve.

In late April 2015, as the surgical sites appeared to be healing, I developed shortness of breath. I returned to the OS, who referred me to my PCP for a chest X-ray. Upon hearing the full story of what had transpired, my PCP ordered a full battery of tests, including blood cultures (which were negative at that time) and an echo-cardiogram to test for bacteria in my heart valves. I continued to get worse, with shortness of breath, high blood pressure, and pain in my right chest area, right shoulder, and right arm. In May 2015, I was transported to the ER (my third ER visit) with a BP of 188/145 (my BP is normally 110/80). A CT of my chest revealed a nodule on my right lung, another one on my thyroid, and enlarged lymph nodes on my left side of my neck. I was referred to Cardiology and Pulmonary medicine for further workups, all of which have come back normal (thankfully). Throughout May, pain and tenderness in my mouth continued, along with severe aching in my right shoulder, arm, and chest, a low-grade fever, and general malaise. At a certain point, the OS told me I needed to be worked up for auto-immune issues, as none of this had anything to do with my teeth, so being a compliant patient, I did this: all tests were negative, at which time even my PCP began to act like I was a psychiatric case.

In early June, my face began to develop a severe redness on the right side, to swell again, and the pain increased in my right sinus, along with reddening and mucus in my right eye in the mornings and marked stiffness and congestion on the right side of my neck. In desperation, and not wanting to deal with the dentist or the OS again (both of whom seem to be circling the wagons for their colleague who pulled #3 at the outset of this mess), I went to an ENT. He did a CT with contrast and a culture of the extraction site (which is still unhealed) and diagnosed osteomyelitis. He put me on a course of Ceftin (500 mg 2x a day) with plans to follow up in a few weeks, at which time he will decide whether or not to debride the area.

When I reported the ENT diagnosis to the dentist who is treating me at this point, his response was that ENTs often confuse healing with bone infection and that I should think carefully about another surgery. He suggested that perhaps the second graft is being rejected (both were grafted with cadaver bone). When I took the results to the OS, she started off by lecturing me (again) about 'normal healing' and then, when she looked in my mouth she changed tack and insisted I come in the next day for debridement: however, when I objected to that on the grounds that she hadn't seen the CT (her office staff couldn't open the disk) she stated that she wanted to follow up after seeing the scan. However, after seeing the CT, she relayed that she thought things "looked normal" and that other than continuing on the AB, nothing else needed to be done for the time being.

At this time, I am operating at 10% of my normal energy--the pain in my face and mouth is being held at bay by 500mg of Ceftin 2X a day--and I have a sense that both the dentist and the OS are just trying to get rid of me. In contrast, the ENT doc seems genuinely concerned--he told me he will probably need to debride the area, but first he wants me to complete 2 weeks on Ceftin while he consults with an infectious disease doc.

So, after all this background, here are my questions:

It seems to me to be at least possible that #2 was dead before #3 was pulled. If so, it may have been the source of a LOT of bacteria during the 11 days that I walked around with an untreated infection and an open extraction site in my mouth. While I will never know since the dentist who extracted #3 did not do any X-rays or pulp tests, if this had been the case, what is the likelihood that my sinuses are now infected, and are driving this ongoing illness? Is there anything else going on that could be causing these symptoms to recur? What, besides potential debridement, should I be asking the ENT to consider? Are there any other specialists I should be bringing into the picture? (I have a great ND and have been doing liver cleanses, getting Myer's cocktails to sustain my energy, taking probiotics and other supplements, and being very careful about my energy output.)

I am desperate to be well again. Any thoughts would be appreciated--especially from Bryanna--who is clearly very knowledgeable about these types of situations--but I am also open to hearing from anyone else who has been through something similar.

Thank you, in advance.