Hi ctfromnh,
Welcome to Neurotalk and our dental forum ...and thank you for visiting
I am going to re post some of your thread and reply to you in bold type as it just makes it easier to follow. Your dental case is extensive due to the lengthy time frame (number of years since first rc procedure) and due to the events that took place at the same time as the extraction of #8 and 9. It's important for you to know that your case is not unusual and is actually a typical occurrence given the dental history. That does not mean it's not problematic or systemically healthy to remain status quo. It just means it's typical. Therefore additional information is really not necessary unless you want to disclose and specifically discuss more about the systemic issues that you have been dealing with as they may relate to your dental issues. The information that I will provide is not a diagnosis. It is actual information that will confirm why this is all happening.
<<I had 2 old root canals, in both front top teeth. (#8 and 9, I believe.) #9 was when I was 10 years old and developed a painful abscess on the tooth, that had been chipped and not repaired three years earlier. #8 root canal was a few years later, no abscess, another chipped tooth.>>
THAT STATEMENT INDICATES THE ONSET TO THE LENGTHY HISTORY OF THE PATHOLOGY OF BACTERIA IN AND AROUND TEETH 8 AND 9. THE INFORMATION I PROVIDE HERE WILL HELP YOU UNDERSTAND WHAT THAT MEANS AND WHY IT IS SIGNIFICANT.
CHANCES ARE THE CHIPPED AREA OF THE TOOTH DECAYED, BACTERIA SPREAD TO THE PULP AND THINGS PROGRESSED FROM THERE. THE ABSCESS IS CAUSED BY BACTERIA WHICH BECOMES INFECTIOUS CAUSING AN ACCUMULATION OF PUS TO BUILD UP RESULTING IN INFLAMMATION. OVER TIME THE INFLAMMATION AND BACTERIA SPREADS TO OTHER AREAS THAT ARE DIRECTLY OR INDIRECTLY CONNECTED TO THE ORIGINAL PROBLEM VIA BLOOD, NERVES OR OTHER FLUID.
<<Had flare ups and abscesses on #9 (if that is the tooth on my left side) when I was 40, then again at 42, then again at 45. The first time I had a dental procedure to drain the abscess - I don't think this was an apicoectomy, but it was a re-treatment. Second time was the apico.>>
IT IS IMPORTANT TO NOTE THAT INFECTED TEETH CAN GO FOR YEARS WITHOUT BEING PAINFUL.. THIS DOES NOT MEAN THAT THE TOOTH WAS HEALTHY OR THAT THE INFECTION WAS NOT SPREADING.
ALL ROOT CANALED TEETH TYPICALLY AND THEREFORE ARE BASICALLY EXPECTED TO HAVE FLARE UPS AND MORE ABSCESSES FOR SEVERAL REASONS.
ONE IS BECAUSE THE HUNDREDS OF TINY CANALS, CALLED DENTIN TUBULES, ARE NOT ACCESSIBLE LIKE THE LARGE CANAL AND WILL THEREFORE ALWAYS CONTAIN INFECTED NERVE TISSUE. SECONDLY A ROOT CANAL TREATMENT SEVERS THE BLOOD SUPPLY TO THE VESSEL THAT WAS FEEDING THE TOOTH NUTRITION CAUSING THE TOOTH TO BECOME MUMMIFIED/NON VITAL. THIS MUMMIFICATION SETS OFF A SERIES OF PATHOGENIC BIOLOGY TO TAKE PLACE IN THE DENTIN TUBULES AND ALSO IN THE SURROUNDING AREAS THAT ARE STILL VERY MUCH ALIVE. FOR EXAMPLE THE PERIODONTAL LIGAMENT, THE JAW BONE, THE SINUS CAVITY, ETC.
AN APICO IS A SURGICAL ROOT CANAL. IT IS DONE VIA THE END OF THE APEX (ROOT) WHEREAS AN RCT IS DONE VIA THE OCCLUSAL (BITING) SURFACE OF THE TOOTH. THE ONLY DIFFERENCES BETWEEN THE TWO PROCEDURES IS THEIR ENTRY WAY AND THE APICO INVOLVES AMPUTATING THE END OF THE ROOT AND THEN PLUGGING IT UP WITH A MERCURY OR SIMILAR TYPE FILLING MATERIAL. AS FAR AS THE ABILITY TO CURE AN INFECTED TOOTH, NEITHER PROCEDURE IS CAPABLE OF DOING THAT BECAUSE OF TWO REASONS. ONE IS THE INACCESSIBLE DENTIN TUBULES AND THE OTHER IS THE PATHOGENIC BIOLOGY ASSOCIATED WITH THE MUMMIFICATION OF THE TOOTH.
<<Third flare up was now 3 years ago - I had started to feel the same symptoms as I had the two previous times: tenderness, swelling, sensitive to heat and cold, low grade fever and constant headache. I researched my options and did not want another apico or re-treatment. Decided to have both root canal teeth removed and dental implants.>>
SO AFTER BEING GIVEN THE PATHOGENIC BIOLOGICAL INFORMATION, YOU CAN SEE HOW THIS 3RD FLARE UP WAS JUST A CONTINUANCE OF THE CHRONIC NATURE OF THE INFECTION. THE DIFFERENCE NOW IS THAT YOU ARE HAVING SYSTEMIC RELATED AILMENTS ASSOCIATED WITH IT.
<<There was a bacteria-filled "sac" at the root of #9 when they removed the tooth. Implants were placed at the time of the extraction. All seemed to heal properly over the next several months and I got the crowns at about 6 months.>>
THE PUS FILLED SAC WAS A CYST THAT TYPICALLY FORMS AT OR NEAR THE APEX OF A ROOT CANALED OR APICOED TOOTH. THESE CAN BECOME QUITE LARGE AND QUITE EXTENSIVE INTO THE BONE,THE SINUS, THE VARIOUS BUNDLES OF NERVES, ETC.
THE CYSTS INDICATE DEFINITIVE PROLIFERATION OF THE BACTERIA BEYOND THE TOOTH. WHICH MEANS THAT THE BONE WAS NOT HEALTHY AND DUE TO THE LONGEVITY OF THE INFECTION, THERE MAY HAVE BEEN SIGNIFICANT BONE LOSS.
IDEALLY, DENTAL IMPLANTS SHOULD BE PLACED IN HEALTHY, VIABLE BONE ONLY. IF THERE IS LONG TERM INFECTION AND/OR DETERIORATION OF THE BONE DUE TO INFECTION, THEN THE RISK OF FURTHER INFECTION AND FAILURE OF THOSE DENTAL IMPLANTS IS ELEVATED. AGAIN, SYMPTOMS ARE NOT ALWAYS APPARENT RIGHT AWAY. THEY OFTEN DO NOT SHOW UP UNTIL THE CROWNS ARE PUT ON WHICH MAKES IT SEEM LIKE THE CROWNS WERE AT FAULT. NOT SO.
<<I have now been experiencing the SAME symptoms as the other three times of the infections at tooth #9. I didn't recognize the symptoms at first, (too many details to list at the moment, but I can elaborate further if necessary). The initial symptoms I focused on were (I believe) secondary to what may actually be going on. I now have the constant headache and sinus pain, low grade fever and general feeling of unwell. I don't have much tenderness when pressing or tapping the crowns, however. But the left side of my face, nose, temples, and jaw are constantly aching now. I had swollen lymph glands along my jaw a few weeks ago that were very painful. I also have had multiple cold sores on my face in just a few weeks, and in odd places that I have never had them before. >>
RE READ MY REPLY ABOVE.
DENTAL INFECTIONS CONCERNING TEETH, IMPLANTS OR CROWNS DO NOT HAVE TO SHOW SYMPTOMS IN THE MOUTH WHEN SOMETHING WRONG. THE SYMPTOMS CAN BE "SYSTEMIC" JUST AS YOU HAVE DESCRIBED WHICH MAKES IT SEEM LIKE THEY ARE NOT DENTAL RELATED.
<<I usually get 4-6 cold sores a year, and now I have had severe outbreaks, at least 6-8, in just the last month. That was what I was focused on, initially, until I realized that the virus might be secondary to a deeper infection.>>
FREQUENT COLD SORES, MORE THAN ONCE A YEAR MAX, INDICATE AN IMBALANCE WITH THE IMMUNE SYSTEM AND POSSIBLY THE ENDOCRINE SYSTEM AS WELL. CHRONIC INFECTION AND INFLAMMATION WILL CAUSE THE IMMUNE AND ENDOCRINE SYSTEM TO FUNCTION LESS THAN OPTIMALLY. THE MORE CHRONIC THE PROBLEM, THE MORE DEPLETED AND EXHAUSTED THE SYSTEMS BECOME.
<<I have an appointment with general physician next week, (to deal with the secondary issues, of the cold sore outbreaks and general fatigue, etc.) and then an appointment with the oral surgeon who performed the extractions and implants 3 years ago.>>
THESE PHYSICAL ISSUES ARE NOT REALLY SECONDARY ISSUES. THEY CAN BE DIRECTLY RELATED TO THE CHRONIC INFECTION AND INFLAMMATION THAT YOU HAVE ENDURED SINCE YOU WERE 10 YEARS OLD. YOUR PHYSICIAN IS NOT GOING TO BE ABLE TO KNOWLEDGEABLY DISCUSS YOUR DENTAL SAGA AS HE HAS NO EDUCATION IS DENTAL HEALTH WHATSOEVER. IF YOU TELL HIM THAT YOU HAVE HAD AN ONGOING DENTAL INFECTION SINCE YOU WERE 10 AND IT HAS RESULTED IN NUMEROUS DENTAL PROCEDURES, SURGERIES, MEDICATIONS, NOW DENTAL IMPLANTS.... HE MAY BE ABLE TO CONNECT THE DOTS BETWEEN THE ORAL AND SYSTEMIC CONNECTION.
<<My implants do not feel loose at all, and last year when I asked my regular dentist about some mild symptoms, the x-rays showed that the implants were setting well in the bone, etc. >>
THE IMPLANTS MAY NOT BE LOSE. BUT THAT DOES NOT NEGATE THE POSSIBILITY OF PATHOGENIC BACTERIA PROLIFERATING THAT AREA OF YOUR MOUTH, BONE, SINUS, ETC. ARE THE CROWNS INDIVIDUAL UNITS OR ARE THEY SOLDERED TOGETHER?
<<So what could this be? And what might happen? I don't necessarily want the implants removed unless that is causing the infection? Could the infection be in the bone/jaw from the old root canaled tooth, all these years later? How can it be treated, if that is the case?>>
THE CHOICES ARE TO KEEP THINGS THE WAY THEY ARE AND SEE WHAT HAPPENS OR REMOVE THE IMPLANTS. YES, THE INFECTION COULD STILL BE IN THE BONE FROM THE OLD ROOT CANALED TEETH. YOU ARE EITHER READING A LOT ABOUT THIS OR YOUR INTUITIVENESS IS KICKING IN!
You may find that you have to gather your dental records and radiographs from all of the dentists who have treated you to seek a consult with a new oral surgeon. This would include the surgical report of the extractions and implant placements. Was bone graft material put in when the teeth were removed? Are the implants titanium or zirconia? Are the laterals, adjacent teeth to 8 and 9, root canaled?
Bryanna