Much thanks for you effort and in-detail answer.
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Originally Posted by Bryanna
Hi toothless,
... A rapid heartbeat is typical of an oral infection such as yours. But it can also occur from medications, anxiety and exercise. ...
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What is the cause of so fast heartbeat? It made up woke up few times per night. Honestly I think I didn't take that much painkillers (2 tablets per day) or any other medication. In the past I have consumed larger quantities, but have never had so fast heartrate, so I'd guess that the crazy heart rate occured due to other factors. All what I can tell is, that based on post-op report, I have received 3 remedies (Xylocain spray, 3ml Ultracain, 1ml Ultracain), if this is relevant information.
I still feel the slight pressure or beter said some kind of discomfort in my chest area, and occasionally some short spike of something that may be considered as small pain, especially if I do some fast moves.
Other than that, I am following all post-op protocol as you have describe it.
The pimple on the gum that exuded pus was called a Fistula. This is NOT an infection of the gum. It is the result of a severely infected tooth. A Fistula is the opening of a tract of infection that is draining from the inside of an infected tooth. Meaning, the infection overwhelms the tooth and proliferates beyond the tooth. The infection burrows a hole through the bone from the tooth, and will often come through an opening of the gum which is called a Fistula. There is no palliative care or topical treatment that can cure the fistula because the source of the fistula is the infected tooth.
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Endodontic (root canal) therapy, is not a cure for an infected tooth. It is a temporary measure, at best, to try and retain an infected tooth. Every tooth has many hundreds of microscopic canals that contain nerve tissue. These canals are not accessible, therefore, irrelevant of what is done to the tooth, the nerve tissue inside of these canals remains infected. Eventually, the infection overwhelms the tooth and proliferates beyond the tooth.
Not all tooth fractures can cause pain. Not all tooth fractures can be seen on dental xrays. Here are a few ways a tooth can fracture:
1) Direct injury to the tooth but also frequently occurrs during a root canal treatment.
2) Infection, certain medications, poor diet, and nutrient deficiencies can lead to a deterioration of the integrity of a tooth making it weak and prone to fracture upon chewing.
3) A bruxism habit can cause various types of tooth fractures.
GIVEN THE EXPLANATION THAT I DID ABOVE PERTAINING TO ROOT CANAL THERAPY, TOOTH #46 WAS ACTUALLY INFECTED FOR 15+ YEARS FROM THE TIME IT WAS ROOT CANALED. IT IS NOT UNUSUAL FOR AN INFECTED TOOTH TO HAVE LITTLE TO NO SYMPTOMS UNTIL THE INFECTION OVERWHELMS THE TOOTH AND BONE.
A VERTICAL FRACTURE TYPICALLY CAUSES NO SYMPTOMS AT THE ONSET OF THE FRACTURE BUT EVENTUALLY CAUSES THE EXACT SYMPTOMS YOU BEGAN HAVING 6+ MONTHS AGO. VERTICAL FRACTURES THAT ARE NOT DISPLACED CAN BE TOUGH TO DIAGNOSE VIA A DENTAL XRAY BECAUSE THE XRAYS ARE ONLY 2 DIMENSIONAL. EVEN A MULTI SLICED CT SCAN MIGHT NOT PICK UP A NON DISPLACED VERTICAL FRACTURE IN A TOOTH.
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So if I try to compile the above information to get the whole picture of my case:
If a tooth undergoes RCT, this by default means, that tooth is infected and
an attempt is made to save the tooth. RCT won't heal tooth, but it will only remove high portion of infected tisssue so that a chance of a large scale infection is decreased (but not prevented!), and that tooth is (temporarly) retained. After successfull RCT, there would be still some infected tissue remaining in tooth (the large number of tiny nerves), but as the amount of this tissue is small, tooth can function normally without causing any troubles, as long as the infection doesn't spread. However, this small infection can spread out of nowhere any time, and if that happens, it's game over, as large scale infection may be IRREVERSIBLE? So eventually, any RTCed tooth may be like a time bomb.
As I had RCT treatment of tooth 15 years ago, this means that 15 years ago tooth was already infected. But as the large scale infection occured only recently, the "root cause analysis" would be (pun intended
):
a large scale infection occured in the tooth, without any fracture being present. Still not sure how that would be possible, because you probably need a hole in the tooth so the infection spreads on the sorrounding bone.
b1) Tooth was already fractured during 1st RCT (15 yrs ago) or during any other following RCT (if there was any, but I can't recall). During all this years fracture was progressing (mechanical stress, nutrition, detoriation of dead tooth...) until it was big enough, or until it caused a larger crack to occur, which triggered a major infection.
b2) Tooth was fractured/cracked only recently, which triggered a major infection.
d) tooth wasn't infected, but only the bone around it was (pariodontal disease?). However this point was immediately ruled out by endodontist, so it's either a), b1) or b2)
But regardless of reason a) or b1) or b2), the end result is the same - the large scale infection in the tooth. At this state, no amount of disinfection/RCT attempt could be able to scale down the infection back to initial state. Or in other words, the state became irreversible, therefore an extraction was the only option.
Again, to make things crystall-clear: Infection of such scale is irreversible and can not be scaled down to initial state?
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<<5. What should I do with my gap in the teeth? What functional and aesthethic consequences can develop, if I leave the gap as it is?>>
YOU SAID THIS WAS TOOTH #46. IN THE FDI TOOTH NUMBERING SYSTEM THAT IS YOUR LOWER RIGHT FIRST MOLAR. YOU ALSO MENTIONED THAT YOU HAD TOOTH #36 REMOVED WHICH IS YOUR LOWER LEFT FIRST MOLAR. DID YOU REPLACE #36?
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No. Maybe that was a big mistake. But honestly, nobody ever came up with idea to replace it (meanwhile I have changed 2 dentists).
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REPLACEMENT OPTIONS DEPEND ON THE REST OF YOUR PERMANENT DENTITION AS TO WHAT OTHER TEETH ARE PRESENT AND WHAT OTHER TEETH ARE MISSING. IF YOU HAVE YOUR 2ND AND 3RD MOLARS ON THE BOTTOM AND YOU LEAVE THE FIRST MOLAR SPACES OPEN, THEN THE SECOND MOLAR WILL EVENTUALLY TILT TOWARDS THE OPEN SPACE. THE 3RD MOLAR MAY MOVE OR MAY NOT MOVE. IF YOU HAVE UPPER FIRST MOLARS, THEY MAY TEND TO DRIFT DOWNWARD INTO THE OPEN SPACE BELOW. USUALLY THE UPPER TEETH WILL EVENTUALLY STOP DRIFTING DOWN IF THEY ARE IN DIRECT CONTACT WITH THE THE OTHER LOWER MOLARS.
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And what's the final effect on facial appearance and function? Assymetry? Crossbite? Harder chewing? Bone loss? Etc...
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YOU HAVE TO ATTACH YOUR XRAYS OR PHOTOS AS AN ATTACHMENT. SO THAT WOULD MEAN DOWNLOADING THEM FIRST TO YOUR COMPUTER AND THEN ATTACHING THEM AS SUCH.
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At this moment, I can't, as I'm not sure whether I'd be able to remove them later or not. I'll just send you a PM with pics.