Hi friendlyd52,

Oh my goodness.... you have been on a horrible journey but I am so glad to hear that you are health conscious and under the care of an ND. Biological dentists have a broader knowledge of the oral and systemic connection but as with most dentists, they often back each other up like a pack of rats. Especially when the dental issue is complicated.

A few things instantly come to my mind....

1- Do you have a clenching and/or grinding habit? In someone who has a healthy dental history but has cracked or fractured teeth it tends to indicate a bruxism habit. This can cause minor or major cracking of the teeth, inflamed periodontal ligaments, abscesses, tooth mobility, unnatural wear patterns on the teeth, misalignment of the bite and even TMJ issues. So if you do have a bruxism habit, then it needs to be evaluated and addressed.

2- Tooth #3 (and most likely #2) was evidently cracked long before it was diagnosed. Initially the crack is a crazing line and does not pose any problems. But if and when that crazing line becomes deeper into the dentin of the tooth, bacteria is able to get into that opening and make its way to the pulp. This tooth would test vital until the pulp becomes infected. At which time an abscess is likely to develop.

3- Root canal therapy simply adds insult to injury in a cracked tooth. The procedure itself is very traumatic and injurious to the tooth causing the crack portion to become more fragile. Add to that the toxicity of the disinfectants and the filling material..... you get the picture.

4- It sounds like the dentist who removed #3 debrided the site and bone thoroughly. Antibiotics are not always prescribed for extractions and he obviously didn't feel it was necessary at that time. I wonder what his findings were when he extracted that tooth... did he mention anything about the tooth being perforated through the apex during the root canal and that there was root canal filling material pushed beyond the apex? Did he mention anything about the sinus or a sinus communication? What were the surgical findings with tooth #2..... the black area on the xray was a cyst, was it removed? Any mention of a sinus communication with that tooth?

5- Bone grafts are very beneficial when they are placed in healthy stable bone as they encourage the growth of new bone cells. However, they are not useful and can be detrimental when placed in unhealthy bone. So I wonder if the either or both sites, #2 and 3, were not stable enough to receive the graft and if this is contributing to the infection??

6- Cellulitis is a serious condition and can spread to the lymph nodes and blood stream. Osteomyelitis is also a serious condition. So no wonder you feel so lousy!!!

7- What is the outcome of the nodules that were found on your lung and thyroid? Do you have any auto immune disorders?

8- Regarding the dentist comment about the ENT mistaking bone healing with infection... if the culture came back osteomyelitis, then there is no mistake, it is infected.

9- There are some considerations about re surgerizing the areas of which are too complicated to get into here. However, your systemic symptoms indicate a serious infection. Oral antibiotics may or may not be sufficient. They also will lower the effectiveness of your immune system so you can feel worse before you feel better.

10- Perhaps your best option is to stick with the ENT and encourage a consult with an infectious disease specialist. Also ask the ENT and ID Dr for a referral to an oral surgeon that they are familiar and comfortable working with. Because you may need complemented care from all of them.

11- It would behoove you to request all pre and post op xrays from all dentists and the surgical notes of every dentist that performed surgery and root canal therapy on you. It would be helpful to see what the written findings were so that the ENT and ID Dr have some clarity on the history of that area of your mouth.

Hopefully your ND has encouraged you to eat healthfully and organically, avoid sugar, sugar substitutes, processed foods, soft drinks, alcohol, etc. Your nutrition is imperative during this time and diligent supplementation of probiotics is essential for the health of your digestive and immune system.

Check back when you can..... not sure how much I can help but I want you to know that you are not dealing with this alone.