Hi Dana,
First let me say that this is not an easy fix irrelevant of what treatment option is chosen because with her medication history and age, every option is a gamble on what the outcome might be. I think you would agree that the main concerns are her health and dealing with this infection before it proliferates. Putting a bandade on this situation really concerns me when thinking of what this infection could become in the long run. An apico is a surgical bandade and nothing more than that. It will not remove the source of the problem, which is the tooth.
I could be wrong but I have a feeling that the dentists are getting the impression that your mom does not want to lose this tooth. Could that be?? If so, then that is part of the reason why they offer the option of an apico. The other part is once the tooth is removed, what will she have to chew on? Is she a candidate for a removable partial denture.... has anyone spoke to her about that?
<<They said extraction would prevent a much more serious problem for my mother, because healing might not occur.>>
(IN CAPS JUST TO DIFFERENTIATE MINE FROM YOURS)
I'M NOT SURE WHAT THIS STATEMENT MEANS OTHER THAN THEY BOTH ARE CONCERNED AND ACKNOWLEDGE THAT HEALING FROM SURGERY MAY BE AN ISSUE..... DUE TO (IN PART) THE BISPHOSPHONATE DRUG? REMOVING THE TOOTH NOW IS SAFER THAN REMOVING IT LATER WHEN THE INFECTION HAS PROLIFERATED AND THE BONE HAS BECOME NECROTIC. THERE IS A VALID CONCERN ABOUT HEALING.... BUT IT APPLIES TO ANY ORAL SURGERY, EXTRACTION OR APICO.
I can offer you what my personal decision would be if this were my 84 yr old mother. I would not hesitate to remove the infected tooth simply because it's the only way to eliminate the source of the infection. Then deal with the outcome as it presents itself. Better to deal with it now than later when the problem has become worse. I would not want to risk her health by keeping this tooth only to be extracted anyway. That is what makes sense to me.
You and your mom have to do what you feel is in her best interest. I know this has been very stressful and you are trying so hard to make the best choices for her. I feel the answer will come to you sooner than you think and it will be the right choice.
Keep me posted... and keep your chin up =)
Bryanna
Quote:
Originally Posted by DC02
Hi Bryanna,
Here's where we are. We had two consults with oral surgeons who treat patients taking bisphosphonates. Both spent substantial time explaining what the drugs can do to the jawbone and outcomes they've seen with their patients. And both oral surgeons, who work in neighboring states and don't know each other or the endodontist, said an apico should clear the infection.
I had many questions and both were patient; both said I can't link my mother's infection to bisphosphonate use because many people develop infections after oral procedures. They said extraction would prevent a much more serious problem for my mother, because healing might not occur.
I have a feeling they want to buy time...
We're taking a break, and I'll update when we continue.
Thanks,
Dana
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