[adimaria]

So after 3 Dentists, 2 Oral Surgeons, 3 Endodontists, and 2 Nuerologists...I decided to see a holistic dentist. I was diagnosed with Atypical Trigeminal Nueralgia from the Neurologost and the Gabapentin medicine helped the excrutiating pain. However, I still have lingering issues along that side of my teeth, neck, jaw and under the ear since the removal of tooth #31. The holistic dentist tells me she sees something going on where the tooth was removed and feels that there is bacteria that need to be removed. She wants to perform surgery to go back in and scrap out the possibe bacteria. Nothing is 100% for sure but I'm not sure what to think since I was diagnosed with ATN and all these other practitioners missed this? I'm worried about the chance of having this procedure done and if it's not the cause of what is still lingering and makes it worse then what? I'm not ready to make this decision and I saw the x-ray. I just don't know. How could all these other people miss this? She feels that this probably started when they removed my wisdom tooth #32. I got a dry socket on both removals and she said that's due to bacteria. I should have had them re-cleaned out right away. She knows that I'm not ready for any type of surgery after everything I've been through this year. MRI's, CT scans, doctors, dentists, etc. I'm just very confused and wondering if anyone knows of any type of equipment that could give me a more accurate answer that yes in fact I have NICO. My worry is her going back in and perhaps nicking the nerve b/c she said the bacteria looks like its laying on the nerve irritating it. There is no more pain just bad taste in other teeth on that side and sometimes dull ache. I am overwhelmed and completely confused. Any thoughts?

[Bryanna]

Hi adimaria,

I know you are terribly concerned about the possibility of having this problem. I can tell you from my professional experience (30+ yrs in dentistry) that only a fraction of dentists (compared to the number of dentists in the US) can recognize NICO on a radiograph. If a patient presents with a massive radiographic area in their jawbone, then any dentist will diagnose the obvious. I know this sounds bizarre but it's true. I think to some degree that since many dentists have never treated NICO, they don't know how to recognize it radiographically. For those who have treated it, they know what to look for on the radiographs.

The things that the holistic dentist told you are very accurate. There could be a small necrotic area in the jawbone that was caused by the infection (dry socket) after the removal of the wisdom tooth. There is no definitive way to know if it is NICO unless it is surgically opened. Necrotic bone looks very different than normal healthy bone but necrotic bone can also be microscopic in some areas which are not visible to the eye. During the surgery, she would take some bone and tissue for a biopsy which would help determine the pathology present in that area.

The decision to do the surgery or not is a tough one because:
1) If you have NICO and do nothing, it can spread.
2) If you do the surgery and have NICO and she cannot remove it all (for any number of reasons) you are still left with the problem and treatment options would be discussed.
3) If you do the surgery and no NICO is found, you had the procedure for nothing.

If the dentist were to see that she was close to the mandibular canal (nerves) during the surgery, she would back off before entering the canal. However, any lower posterior oral surgery can irritate the nerves in that canal.

So, this is definitely a troublesome issue without any question. NICO is very difficult to diagnose definitively radiographically. Here is a website with some interesting information about how this is diagnosed, treated, etc. I'm giving it to you for informational purposes only as it really spells it out pretty well.
http://www.fosamaxjawdeath.com/lawye...formation.html

I wish I could be of better help to you..... please keep in touch here.

Bryanna

Originally Posted by adimaria

So after 3 Dentists, 2 Oral Surgeons, 3 Endodontists, and 2 Nuerologists...I decided to see a holistic dentist. I was diagnosed with Atypical Trigeminal Nueralgia from the Neurologost and the Gabapentin medicine helped the excrutiating pain. However, I still have lingering issues along that side of my teeth, neck, jaw and under the ear since the removal of tooth #31. The holistic dentist tells me she sees something going on where the tooth was removed and feels that there is bacteria that need to be removed. She wants to perform surgery to go back in and scrap out the possibe bacteria. Nothing is 100% for sure but I'm not sure what to think since I was diagnosed with ATN and all these other practitioners missed this? I'm worried about the chance of having this procedure done and if it's not the cause of what is still lingering and makes it worse then what? I'm not ready to make this decision and I saw the x-ray. I just don't know. How could all these other people miss this? She feels that this probably started when they removed my wisdom tooth #32. I got a dry socket on both removals and she said that's due to bacteria. I should have had them re-cleaned out right away. She knows that I'm not ready for any type of surgery after everything I've been through this year. MRI's, CT scans, doctors, dentists, etc. I'm just very confused and wondering if anyone knows of any type of equipment that could give me a more accurate answer that yes in fact I have NICO. My worry is her going back in and perhaps nicking the nerve b/c she said the bacteria looks like its laying on the nerve irritating it. There is no more pain just bad taste in other teeth on that side and sometimes dull ache. I am overwhelmed and completely confused. Any thoughts?

[adimaria]

Originally Posted by Bryanna

Hi adimaria,

I know you are terribly concerned about the possibility of having this problem. I can tell you from my professional experience (30+ yrs in dentistry) that only a fraction of dentists (compared to the number of dentists in the US) can recognize NICO on a radiograph. If a patient presents with a massive radiographic area in their jawbone, then any dentist will diagnose the obvious. I know this sounds bizarre but it's true. I think to some degree that since many dentists have never treated NICO, they don't know how to recognize it radiographically. For those who have treated it, they know what to look for on the radiographs.

The things that the holistic dentist told you are very accurate. There could be a small necrotic area in the jawbone that was caused by the infection (dry socket) after the removal of the wisdom tooth. There is no definitive way to know if it is NICO unless it is surgically opened. Necrotic bone looks very different than normal healthy bone but necrotic bone can also be microscopic in some areas which are not visible to the eye. During the surgery, she would take some bone and tissue for a biopsy which would help determine the pathology present in that area.

The decision to do the surgery or not is a tough one because:
1) If you have NICO and do nothing, it can spread.
2) If you do the surgery and have NICO and she cannot remove it all (for any number of reasons) you are still left with the problem and treatment options would be discussed.
3) If you do the surgery and no NICO is found, you had the procedure for nothing.

If the dentist were to see that she was close to the mandibular canal (nerves) during the surgery, she would back off before entering the canal. However, any lower posterior oral surgery can irritate the nerves in that canal.

So, this is definitely a troublesome issue without any question. NICO is very difficult to diagnose definitively radiographically. Here is a website with some interesting information about how this is diagnosed, treated, etc. I'm giving it to you for informational purposes only as it really spells it out pretty well.
http://www.fosamaxjawdeath.com/lawye...formation.html

I wish I could be of better help to you..... please keep in touch here.

Bryanna

Thanks for responding. If in fact it is NICO, would the Gabapentin have helped? In addition, she said she wouldn't do the surgery. She referred me to Dr. Shankland that is based out of Ohio and I saw that he was considered a quack and on suspension for 5 years. This is why I feel so confused. I have 2 possible diagnosis. Both terrible...ATN or NICO. No one knows the exact source, both are dangerous to investigate and attempt surgeries etc. I wish I could find a Dentist, Oral Surgeon that is competent or has knowledge of both. Perhaps, he could steer me in the right direction. The holistic dentist wants me to have a 3-D scan I believe.

I also have another question. I was told that the trigeminal nerve endings are underneath the teeth. Is this correct? If so, what happens if I have another tooth that has problems that the dentist can't see. I was told there is slight decay under another tooth. Could this cause additional problems if it is ATN. And if the drill can irritate the nerve affecting the trigeminal nerve. Why doesn't this affect all of us at some point. Thanks again for your response.

[Bryanna]

Hi adimaria,

Dr Shankland is an expert in the dental field, especially when it comes to NICO and ATN. Integrative (some Biological) Dentists from all over the country have studied under him to learn how to perform "A Traumatic" oral surgery. When doing this type of surgery, excessive force is never used, operatory conditions are very sterile and the patients overall wellbeing both during and after surgery is of the utmost importance. He has been shunned and mistreated by many of his peers in the conventional dental community because he does not conform to the cookie cutter dentistry that so many continue to practice long after they graduate dental school. He is more respected by the medical community because of his outspoken concerns about the connection between dentistry and medicine.

Dr Shankland is not a quack at all and he did have his license temporarily suspended, which is not an uncommon incident for any healthcare professional that does not conform to the system of things. That would not deter me from consulting him......because I have the knowledge of what typically goes on from the other side of the chair.

He would be the one to answer your questions properly. Would it be a hardship for you to travel to Ohio?

Bryanna


QUOTE=adimaria;629868]Thanks for responding. If in fact it is NICO, would the Gabapentin have helped? In addition, she said she wouldn't do the surgery. She referred me to Dr. Shankland that is based out of Ohio and I saw that he was considered a quack and on suspension for 5 years. This is why I feel so confused. I have 2 possible diagnosis. Both terrible...ATN or NICO. No one knows the exact source, both are dangerous to investigate and attempt surgeries etc. I wish I could find a Dentist, Oral Surgeon that is competent or has knowledge of both. Perhaps, he could steer me in the right direction. The holistic dentist wants me to have a 3-D scan I believe.

I also have another question. I was told that the trigeminal nerve endings are underneath the teeth. Is this correct? If so, what happens if I have another tooth that has problems that the dentist can't see. I was told there is slight decay under another tooth. Could this cause additional problems if it is ATN. And if the drill can irritate the nerve affecting the trigeminal nerve. Why doesn't this affect all of us at some point. Thanks again for your response.[/QUOTE]