Hi Terry,

I'm in the dental field and can offer you some help here. I am going to list some significant issues that need to be addressed PRIOR to your bariatric surgery. It may be in your best interest to postpone that until your mouth is in better health because the overall infection (from the teeth and your periodontal disease) are a systemic concern and the bacteria could compromise your surgical outcome. Antibiotics are NOT enough to bring your situation under control. So please understand that irrelevant of how much antibiotics you are taking, the infection is still present until it is physically removed.

1) ALL of the teeth that are to be extracted, should be done ASAP and definitely before any periodontal treatment. Infections in the teeth, especially long term, are not limited to just the teeth... the bacteria rapidly spreads to the jawbone and surrounding tissue which means it is also in the blood stream.

2) Periodontal disease is not limited to just the mouth. When left untreated, it becomes a systemic infection in which the bacteria flows through the bloodstream throughout the rest of the body. Various organs can become affected over time and often symptoms of that go unnoticed or misdiagnosed. So it is imperative to get this disease under control especially BEFORE undergoing any other surgical procedure or you risk systemic complications.

3) The physical problems you are having associated with tooth #2 indicates the spread of that infection. In order for it to travel into the palate, the sinus and the tonsil means it is has become systemic. Removing the tooth is an integral part of the treatment to reduce this infection because the tooth is the original source. Some of your symptoms may temporarily subside once this tooth is removed. However, the bacteria from your periodontal disease and your other infected teeth will keep the infection active.

With regard to the injectable antibiotics that are done following periodontal treatment..... these are given via a syringe but they are not "shots" as you may imagine. A cartridge of the medication is loaded into a syringe that has a skinny tube at the end. This tube is gently placed in the pocket between the tooth and the gum. This procedure is done after the root planing procedure.

I know this information is not easy to hear and I'm pretty certain your dentist has not gone into such a descriptive explanation. I believe patients have the right to be properly informed. It is the only way for you to understand your situation and make smart decisions that you believe to be in your best interest.

In your case regarding the extractions... an oral surgeon is most experienced at dealing with these cases. With the proper radiographs he will be able to see the relation between the tooth, the infection and your sinus cavity.

Ideally it would behoove you to get a game plan down with your dentist. Discuss the removal of the infected teeth and get yourself scheduled to have them removed. The spaces caused by these missing teeth is really a secondary concern at this point. Then treat the periodontal disease... let everything rest for about 3 months then follow up with your dentist for a professional cleaning and see where everything is at. This allows time for unexpected issues to arise and be treated with regard to the infection. If your oral health is stable, then go forward with the bariatric surgery.

It has been my professional experience (30+ years) that patients who treat their oral health first generally recover very well from future surgeries. On the opposite side of the coin, those who have long term untreated perio disease and/or infected teeth generally have a more difficult or complicated recovery with their surgeries.

I hope this information is helpful to you and rather than being alarmed by it, hopefully you feel empowered by it and will seriously consider treating your oral health first.

I wish you the best of health.
Bryanna