Hi Bryanna,

More delay and incompetence..... and they are just not coming through with getting a radiologist report for me. I guess it's been at least a month now. Mood is exasperated. ;-)

Would an ENT have some kind of xray or noninvasive test to get helpful information as to whether or not it is okay to proceed with crown or flying....or better to wait and not do those things yet? I know they like to use a scope and look in your nose. I'd rather not have that done. If they are looking for inflammation etc. I know the sinuses are very clear from the other xrays that were done, and also feel very clear. I thought I read something about an xray of the nose that ENT's might do. Is that useful at all for this?

Thanks! Carol

Hi Carol,

This is crazy! Legally, they have to supply you with this information and any scans that were done have to be of diagnostic quality. You could file a complaint with the dental board simply stating that they have been uncooperative in providing you with this information. The board will send them a letter requesting their side of the story. Ultimately, they will have no choice but to provide you with the information. Other than that, you are living in limbo of what to do!

An ENT can take a sinus scan that may be helpful. But these scans are not without radiation. So if you don't have to expose yourself again... why should you?

I cannot tell you if it would be ok to fly or not. It does sounds like your sinus perf is healing. But whether it is healed enough to fly, I don't know.

If you don't want to go to the dental board, then perhaps a personal unexpected visit to that office requesting the copy and report might be worth a try???

Hang in there.... keep me posted.

Bryanna

Hi Bryanna,

Well, I finally got the radiologist's report. Not sure if I need to see an oral surgeon or if anything needs to be done.

Here are the radiologist's comments:

The area of interest is a possible sinus perforation involving the area of extraction site #16. The tooth
was extracted 4-6 weeks prior to the first scan on 9/9/2010. The floor of the sinus is uniformly corticated
but the lower lateral wall of the sinus demonstrates what appears to be a small perforation. There is no
thickening of the lining mucosa that would suggest an inflammatory process. There is an otherwise
normal healing response noted in both scans.

The following incidental findings were noted:
 Tooth #3 with an associated periapical radiolucency with superior elevation of the floor of the
maxillary right sinus, consistent with apical rarefying osteitis.

I could email you the scan privately if you wanted to see it. It definitely shows a break in continuity.

I don't know what that means about tooth#3. That tooth was extracted about 4 years ago, and not replaced.

Would appreciate your input! Thanks. Carol

Hi Carol,

Well, as you probably can tell from the report the sinus perf associated with #16 site appears to be healing well and there is no indication of inflammation, so that is good. It could take several months for that perf to close completely.

With regard to the #3 site.... Osteitis in the jawbone is inflammation within certain sections/areas of the bone. Rarefying means the bone in that area is less dense, thinner than it once was and that is typical bone healing after a tooth has been extracted. However, Rarefying Osteitis following a tooth extraction could be an ongoing infection that either originated from the tooth itself (prior to the extraction) or infection post operatively as in a dry socket and/or bone trauma during the extraction. Did you have a dry socket after that tooth was extracted?

However, what is a little odd is that the term Apical means end of the root. So I'm wondering if you or the radiologist have the teeth numbers mixed up and either you had a different tooth extracted and thought it was #3 or he's making reference to an Apical Rarefying Osteitis associated with an existing tooth perhaps #2?

To help determine what is going on in the area of 2/3, I would have an oral surgeon look at the scan and radiology report. Do you ever have any pain, achiness or swelling in that area?

I will try to IM you my email address. I am curious to see the scan. Thanks.

Bryanna

Hi Bryanna,

I had the surgeon who did the extraction look at the scans, and the place who ordered the scan called me with info. So of course, two different opinions about the apical rarefying osteitis on #2/3.

The surgeon who did the extraction is a jerk. When I went to him 3 times after the extraction about the perforation symptoms, he kept telling me that he didn't understand the symptoms, there was no perf, and I wanted something to be wrong. About tooth #2/3 he said it doesn't show up on his panoramic scan, so it's nothing to be concerned with. Pretty amazing, huh? There was some justice in showing him the scan with the perf when he had been such a jerk about everything.

The other opinion about #2/3 was that it was mentioned for future possible extraction info. He said tooth #2 is attached to some bony fragment, and that is good info to have if tooth ever needs extraction. Since there was a difficult extraction of infected #3, do you think that infection is still there or could spread to #2 area? I started thinking though.....if the radiologist thought it was an immediate problem, he probably would have suggested a consult with an endo or oral surgeon.

Thanks! Carol

I edited this post but, it did take. When I showed the scan to the OS, he floored me. His response was that it was a "possible perf". I said there are 3 views of it, so it does exist. (nevermind my symptoms) He then realizes it's real, he can't get around that fact......then he adds that he didn't work any where near the location of the perf, so he didn't cause it. FLOORED AGAIN! Assuming that the radiologist would suggest a referral is assuming that he has higher technical and moral standards than this OS. One can hope. ;-)

Hi Carol,

Well I can't agree with you more..... I've known many a jerky dentist!!
I also have seen so many patients repetitively given the wrong or inaccurate diagnosis only for the problem to become far worse before any admittance of wrong doing or incompetence on the dentists part. I could write a book on that subject alone..... but no one would read it!

I am a bit puzzled about the finding of the "bony fragment" that tooth #2 is attached to. Is it a piece of root that broke off during the extraction of #1 or 3? Or is it a piece of splintered jawbone that may have occured during either extraction? My concern is that if an osteitis is forming around that bony fragment, then that might be indicative of inflammation and/or infection.

To answer your question about residual infection from tooth #3..... yes, that is possible. Could it progress to other teeth and possibly contribute to a systemic problem, yes it could. It is not uncommon for the bacteria from inside a root canaled tooth to burrow through the tooth and go directly into the jawbone. In fact, that is most likely what happened to your tooth #3. This type of infection is referred to as an abcessed tooth. If the infected and necrotic jawbone is not removed thoroughly during the extraction of the infected tooth, then post operatively the necrotic bacteria is going to continue to thrive and proliferate.

Believe it or not....... and I say this in all seriousness..... many dentists rely on symptoms before they recommend definitive treatment. In some people, infectious bacteria grows and spreads very rapidly making a minimal problem very aggressive. In others, the bacteria proliferates more slowly.

The radiologist may be thinking, well her symptoms of a perf are diminishing and she is not complaining of any symptoms on tooth #2. So let's wait and see what happens. It is difficult to know what that bony fragment is based on the scan or xray. The only sure way would be to have it removed. If it is attached to tooth #2, then most likely the tooth would be removed as well.

If you are comfortable with monitoring the site, then let the perf heal...... have another panorex done in 6-12 months from now to see if there are any changes. If you develop any swelling, pain or unusual symptoms in that area or with tooth #2, then have the panorex done sooner.

How does that sound to you?

Bryanna

Hi Bryanna,

The dental office that gave me the opinion that tooth #2/3 is attached to a bony fragment is just a general dentist office. When I look at that bony fragment on the scan.....I don't think that is the area that is magnified to be the problem area of apical lesion.

I was thinking of possibly showing the scan to the oral surgeon who I saw for a second opinion regarding the perf, to ask him about the osteitis. The appointment I had with the surgeon who did the extraction was a useless opinion. I have the email of the radiologist who read the scan, but maybe it wouldn't be the right thing to ask him for more info. I do sometimes have a bad flavor of infection coming from that area. It's not very often but happens infrequently. It's the same bad flavor I had when tooth #3 was infected and needed a root canal.

Thanks for all your great comments and insight. Carol

Hi Carol,

Sorry, I misunderstood who saw the bony fragment. Cyber communications can be ...... interesting =)

It's funny that you mention about having a bad flavor coming from that area of your mouth. Did you mention that to the dentist or oral surgeon? It may behoove you to take it to that second oral surgeon for his opinion. I would definitely mention the bad taste and ask him to give you some idea of what that fragment could be.... root tip... splintered root or bone. Also, if you emailed the radiologist asking him to be more specific, the least he could do is not reply! Again, I would tell him also about the bad taste.

Bryanna

Another case of sinus perforation
 

Bryanna,

I'm not sure if it's appropriate to revive an old thread - but I found this thread on a Google search and it seems to be directly inline with my situation. I hope you're still around. I've been extremely impressed with your knowledge and willingness to share it.

Today I had an extraction of an upper tooth (#3 I believe). He also did an "alveolar ridge graft" and a "sinus elevation graft". It seems clear that there is a perforation of the sinus floor and sinus membrane. I can feel air pass easily between my mouth and sinus during relatively normal activities such as swallowing. I heard the doc talking about placing collagen (gel?) - which seems consistent with the discussion I've seen here. He did not suture the membrane, and seems to be acting as if he's not sure it's perforated - but it seems absolutely obvious to me that it is.

Since this all happened just today, I'm not sure if I have any cause for concern. Is this fairly common? Would I normally expect it to heal on it's own in a matter of days or weeks?

I'm just about to buy tickets to fly east 5 weeks from today. Would that be a concern at this time?

Thanks so much for any advice you can offer.

Hi spork,

It is perfectly ok to post on old threads....anytime!

I'm assuming based on the surgeries that you had today that you are planning on having an implant put into that space in a few months... yes?

The alveolar ridge graft is typically done after an extraction when either an implant is being planned or when bone replacement is important. Bone grafting simple encourages the growth of new bone to form into the graft so eventually the graft material actually becomes your own bone.

It sounds to me like the wall of the sinus in the area of #3 was considerably low, which is not uncommon, but this means it was taking up too much room in the jawbone to place the bone graft or implant. And/or the root of number 3 was very close to the sinus wall and it may or may not have been perforated during the extraction. OR the tooth was infected... (was it a root canaled tooth?).....and the infection proliferated the sinus wall which required a surgical intervention to repair and elevate it.

Your dentist may feel that the perforation was closed during the surgery OR it may just be that the area needs some time to heal closed. This is something only the surgeon can determine based on his surgery, clinical findings and your symptoms.

You said he did not suture the membrane...... but did he suture the wound closed?

Some sinus perforations heal on their own, others need to be repaired. It is best to call him on monday and tell him your symptoms and just ask him why he needed to elevate the sinus. In the meantime, do not drink through a straw.. do not blow your nose...do not smoke.... do not suck on hard candy, mints, cough drops, lifesavers... avoid hot foods/drinks and spicy foods... do not rinse with any mouthwash, and make sure you drink plenty of water throughout the day. Follow his surgical post operative protocol to the "T".

You should be ok to fly in 5 weeks.... but check with the dentist about your current situation just in case he needs to intervene.

Please keep us posted on how things are going...and always feel free to come here and share your questions and concerns.

>>>>Also, thanks for the kind words>>>> ~;0>

Bryanna

That's correct. I should have explained that at the outset.

Yes, I was shown the X-rays and it was clear that the root were very close to the sinus cavity. The doctor said he might have to build up some graft into the sinus - but wouldn't know until the tooth was out. He sectioned the tooth and removed it in three pieces. Once the root was out he determined that he would have to graft into the sinus cavity. It was my impression that he hoped to get some "bone" into the sinus cavity without damaging the membrane (though I could be mistaken).

It seems certain it was perforated (because air would pass easily between my mouth and sinus). But I'm not certain whether it happened during the extraction or during the subsequent drilling and chiseling into the sinus cavity. I didn't notice the air passage until after the drilling and chiseling, but there was a lot going on there. I'm not sure if the tooth itself was infected, but there was an active infection at the site. I had a fistula that had been active for months. My regular dentist told me I'd either need another root canal on that tooth or an implant. But he didn't seem to feel it was an emergency. There was no pain prior to yesterday's procedure.

Yes. If I recall correctly, that tooth had the root-canal re-done a few years after the initial root canal. It also had an apicoectomy and a second apicoectomy some months later. All of that work was pretty old by this time (5-10 years?).

Not sure about that. He definitely felt he needed to graft into the sinus - I think just to provide enough purchase for the eventual implant.

I'm nearly certain he didn't take steps to close it. When I discussed it, he acted as if he wasn't certain that there was a perforation. But I can tell you that there was a clear passage of air from mouth into sinus.

That's correct. I was still able to feel the passage of air after that. However, I have not noticed an air passage today. I am of course being careful to try and avoid any differential pressure.

He called last night and I told him of the symptoms at that time. We already had an appt set up for Wednesday.

Thanks. I don't smoke and have been as careful as possible to follow all directions. I'm not using mouthwash, but he did prescribe a mouthwash-like rinse which I'm to use twice/day. I trying my best to avoid sucking, but I feel that I sometimes produce suction in the normal act of swallowing, eating, etc. - moreso than drinking a soda through a straw.

Thanks very much. I'm somewhat encouraged that I have had essentially no pain today and have not noticed the air passage today. I'll post an update after I see the doctor again.

Thank you! Having an expert available and willing to share their time and experience is an amazing thing. Not long ago the *only* way to get even a hint about what was going on was to get an appointment to see the doctor in person.

I had the same thing and started taking COQ10 and wow did things start healing quickly. You can try it and see if it works for you

Thanks for the tip. I haven't heard of that, but just did a quick Google search. It looks like a safe enough over-the-counter supplement. I think I might wait though for Bryanna to weigh in on it's use.

Hi spork,

Glad to hear that you're feeling ok and that the air communication between your mouth and nose have significantly decreased. You have made things very clear with your reply and I am very glad that you have posted here. I'm hoping many others who have had or currently have very similar if not identical experiences to yours are reading this post. Whether you know it or not, this is a very typical commonality seen in every day dentistry. That is not to say that it should not be taken seriously because it is in fact a serious infection and can have many systemic risks associated with it.

Hopefully you won't mind if I repeat the sequence of events while elaborating on what you have stated to not only inform you but to confirm my numerous posts here regarding the typical frailty of root canaled teeth and apicoectomies:

In your case.... over the course of 5-10 years....

1) Tooth #3 upper right first molar, root canaled....infection
2) Re root canaled....infection
3) Surgical Apicoectomy....infection
4) Second Apicoectomy.... infection
5) Fistula forms on the outside of the gum above tooth #3 (= draining pus from the infected tooth that proliferated to the jawbone)
6) Tooth #3 surgically extracted, meaning it was taken out in pieces to avoid further bone damage and tissue damage... required an alveolar ridge bone graft to replace the missing jawbone that was deteriorated by the chronic infection and the invasive (twice done) apico surgery.
7) A sinus graft elevation surgery needed to remove the decayed sinus wall caused by the chronic infection...also needed to repair and rebuild a new sinus wall.

The main reason you had no pain or swelling was because the bacteria inside of the tooth had become so prolific that it literally burrowed a tunnel through the jawbone to the outside of the gum, resulting in what is called a fistula or pimple appearing on the outside of the gum above the tooth. If that fistula had not formed or it had closed off, you would have experienced significant pain and swelling. The repeated root canals and repeated apicos did nothing to eradicate the infection from the tooth and both procedures aggravate the situation attributing to more deterioration and collapse of the bone making it easy for the infection to travel through to the outside of the bone.

Spork, to be completely honest and informative with you...this area of your mouth will not be ideal for a dental implant. The reason being is the tiny crevices within the jawbone commonly harbor necrotic tissue from the lingering, long term infection resulting in a compromising, or at minimum unfavorable condition for the placement of a dental implant. Even though the surgeon removed the diseased bone that he could see and feel with his surgical instrument, there is no way to know what is still remaining or exactly where it is. This also means that the success of the bone graft may also be compromised and will need to be monitored once a month for a few months to see how it is healing. Did your dentist mention this to you at all?

Your other replacement option for tooth #3 would be a permanent bridge or possibly a removable partial denture. Did your dentist discuss other options with you?

I hope you are still appreciative of my honesty after you read this post! ~:?

Bryanna

Bryanna,

Thanks again for all the good info. To make matters worse, my regular dentist had sent me back for a 3rd root canal on that tooth. I saw the endodontist, and he was ready to schedule it. But he was telling me it was a 50/50 proposition at best. It was the hygienist that suggested I forget the 3rd root canal and go for the implant. When I asked the dentist about that option he then agreed.

Flash forward to today. I'm doing well, but I now have enough fluid in my sinus that my wife can hear it when I shake my head. The doc that did my extraction and graft asked me to come in tomorrow for a look-see.





Agreed. The dentists have all agreed on that point. That first appeared all way back in 1995. I had the apico's and root canals each time it re-emerged.

D'OH! I thought that was the whole point of getting in my head with chisels and drills. I was under the impression that cleaning it out and taking antibiotics was supposed to eradicate the infection. But I see that it didn't work out that way.

That does not make me happy. Both my dentist and implantoligist did mention a bridge, but both felt that was an inferior option as it compromises the neighboring teeth (and I guess it's harder to take care of?). But it sounds like you'd opt for not doing the implant even at this point - is that right?

He said it would be 3-4 months before he could do the implant as he had to wait for the graft to take, and he does seem to want me to come in during that period (I don't recall how often). But I don't think he told me anything quite so definitive as you are.

Both talked about the bridge as an option, but neither thought that was the best option.

Very much so. But I'd have gladly paid you twice as much for good news. :)


And now onto one more complication. The implantologist tells me I need Osseous surgery (laser gum treatment I believe) in two areas. Interestingly, my dentist has never mentioned it. Given that the implant would tap out my insurance for both 2011 and 2012, would you guess that could wait a full year?

Thanks again.

Hi Spork,

Root canal therapy cannot remove the bacteria or cure the infection inside the dentin tubules (very curvy microscopic canals within the anatomy of a tooth) because there is no way to access them with any dental instrument including a rotary drill, any laser (which can only shoot in a straight beam) or liquid medicament. To give you a visual of what the inside of the tiny canals look like at the onset of the first root canal treatment as seen under a microscope.... the nerve tissue which when healthy is white is now black, severely necrotic, and pungent smelling bacteria. The tooth becomes over whelmed with this bacteria and eventually proliferates from the tooth to the jawbone and beyond. There are no exceptions because the anatomy of a tooth is, what it is ... just varying times of when the symptoms begin to appear.

The fact that you had a fistula form at least 3 different times and was told to retreat this tooth every time plus 2 apicos....... is beyond comprehension. This tooth has cost you (your insurance) many, many thousands of dollars and your immune system has been dealing with the infection since the get go.

The fluid that you hear and feel in your head, could be infection and/or a large perforation. I'm curious what the dentist will tell you about that. If it is infection.... that could mean that the bone graft material has been compromised which will interfere with the growth and integration of new bone. I sure hope it's not that!

The replacement option other than the implant would be a bridge. Yes, both anchor teeth would have to be cut down which compromises their integrity. Yes, it can be a bit annoying to keep clean, but it is very doable providing the bridge is made properly. Are either of the adjacent teeth currently root canaled? If so, then within the realm of the information that I have given you, that tooth/teeth would not be healthy enough to be an anchor for the bridge. Of course, many dentists will build bridges using root canaled teeth as the anchor teeth just like they repetitively retreat with root canals. The irony is that if tooth #3 had been extracted when it first became infected, you would have been a perfect candidate for a dental implant and would never have had to deal with any of this other stuff.

It is always best to wait 6 months before placing a dental implant. Especially when the bone has been compromised from infection from a root canaled tooth. Taking an xray once a month is wise to monitor the area for infection, graft failure and bone integration.

Osseous gum surgery with a laser can be quite effective in reducing deep pocketing. Do you have periodontal disease? What areas of the mouth is he referring to?

Keep me posted......
Bryanna

Well I saw the implantologist yesterday, and he felt it was looking very good. The huge amount of sloshing fluid in my sinus had gone down quite a bit by then, and has reduced to almost nothing now. He's had me on antibiotics from the start - perhaps this has helped? I know he's planning to wait and watch the bone graft progress, but I don't know if he plans to wait as long as 6 months and do monthly X-rays. Hopefully so.

He says I have areas on the lower left with pocket depths up to 5, 6, and 7, and pocket depths on the lower right of 5 and 6. From what I understand, this "is" periodontal disease - but it's possible I don't have the correct understanding.

I will say that I'm not always consistent with my flossing. Sometimes I'll be pretty consistent, and sometimes I get lazy. There's no question that my gums are happier and healthier when I'm consistent. They're less inflamed and my hygienist makes comments both ways that are consistent with my own assessment. I'm hoping that simply dedicating myself to some serious flossing every single day will stave off this problem.

I contacted my regular dentist to see if he thought I had an acute gum problem that required treatment. He thought not and contacted the hygienist to check. She felt not also.

Your thoughts on this would be appreciated as well.

I don't want to tell you how to go with this - but some good news would be nice. :D

Hi spork,

Glad to hear that the fluid has decreased to almost nothing and the area looks good clinically! Monthly monitoring would be ideal.

Pocket depths range from "0" to "10". Any depth larger than a "3" are considered abnormal because bacteria gets trapped so easily in there and the deeper the pocket the more difficult for you to clean. Yes, what you have is considered localized periodontal disease and if it's not brought under control the bacteria will spread to other areas. The laser therapy can reduce the pockets to a more normal depth. However it is imperative that you keep up with a daily oral care routine that includes thorough brushing and flossing because once the gum tissue is lasered away any pocketing that develops will be deep into the root area of the teeth.

So... how was that for positive!!! ;-)

Bryanna

Very good - thank you!

Do you think I can beat the laser rap by going medieval on my gums with a toothbrush and floss?

Hi spork,

I wish it were that easy! Once the pocketing has become a "5 or above" it is usually best to intervene with the laser. The concept behind the laser is to reduce the depth to about "3 to 4". More than that could cause some root exposure and that could cause temperature sensitivity.

It is best to brush and floss thoroughly but not aggressively because that will only cause further irritation to the gum tissue. A soft toothbrush angled at 90 degrees against the the gumline using circular motions to remove plaque while at the same time massaging the gums. Mouthwash is basically unnecessary and should be avoided completely if it contains alcohol as the alcohol dries out the tissue causing irritation... also reduces the salivary flow which contributes to tooth decay.

Hope this info is helpful to you.... have a great holiday!

Bryanna

Thanks for the tips. That will almost surely save me some future trouble as I was planning on going after my gum line like it owes me money. :D

Seems I've heard that electric tooth brushes are the way to go. Do you concur?

Thanks again and have a happy Thanksgiving.

Yes, electric toothbrushes are very good at removing the plaque along the gum line. You would angle the bristles at a 90 degree angle along the gum line using a circular motion just like a manual tooth brush. The exception with the electric one is you don't to press very hard, just guide the brush along and let it do the work for you! It's important to brush for the recommended 4 minutes every time... ;-))

Take care, hope everything goes well .... keep me posted!

Bryanna

Thanks. I'm reading about electric toothbrushes now. Do you have any recommendations?

Have a happy Thanksgiving!

I use the Sonicare Elite. It's an older model, but it works great!

Enjoy the weekend!

Bryanna

I ended up doing some electric toothbrush research and ended up putting the "Sonicare HealthyWhite Power Toothbrush" on my Christmas list. I just can't believe the range of options, features, and prices for these things. I figure this will have to work better than the piece of 100 grit sand-paper I've been using.

I'm also learning that my "technique" is all wrong. I gotta tell you - old age ain't for sissies.

Spork,

Ha Ha... you're funny ;-)

It is not necessary to get an electric toothbrush with all the bells and whistles... not worth the extra $$'s in my opinion. A quality electric toothbrush like Sonicare or Braun that has an on/off switch, is all that is needed.....:)

Bryanna

That was my thinking as well. I kind of like the idea of the timers, because there's no way I'll brush properly without them. It sounds like the research shows the "sonic" feature is a genuine benefit to gum health (if I understand correctly). One feature that seems good (that this model doesn't offer) is a pressure sensor to let you know if your applying too much or too little pressure. Apparently most folks apply too much. So far I've been going with the "more is better" approach. I'll have to figure out how much is right. I guess my hygienist can show me.

I think most electric toothbrushes have a built in timer. Even my old dinosaur has one! The beep is very subtle and it is meant to tell you to go to the next quadrant. In other words, you should spend about one minute in each quadrant of your mouth....x's 4 quadrants... 4 minutes of brushing time!

Yes, some people use the brush too aggressively and this not only ruins the bristles on the brush but aggressive brushing does not remove the plaque any better. It is the thoroughness of the brushing and flossing that is most effective in removing plaque. Also, just so you are aware.... it is easy to tell if you are using the electric brush too hard because the sound will get very loud and become almost distorted. The brush is designed to do the work so long as you angle it properly along the gumline an maneuver it along all the nooks and crannies.

Brush heads on an electric toothbrush just like manual toothbrushes should be replaced every 3-4 months for the most effective oral hygiene. So perhaps you could add a replacement brush head on your list to santa as well!!

I'm glad to see that you are doing your research!!!

Bryanna

It appears I got oral thrush on my tongue from the antibiotics. Any suggestions for that? I'll be seeing the doc this afternoon.

Spork,

One thing you can try is using a probiotic as an oral rinse in addition to supplementing with it as well. I suggest a probiotic called Culturelle. You can purchase it online at vitacost.com (one of many sites) or at many large chain drug stores. Break a capsule open into a small glass of water, stir, rinse for about 30 seconds and swallow. Also take an additional whole capsule several hours later. I would do this regimen for 7-10 days and then continue to supplement with the probiotic for at least 3 months or longer. I've been using culturelle daily for the last 1o years as a nutritional supplement to keep a good balance of healthy bacteria in my digestive tract.

Another suggestion is to buy a tongue scraper and use it at night after you have brushed and flossed your teeth. Gently scrape your tongue several times, rinsing the scraper in between scrapings. Then do the probiotic rinse.

What did your doctor recommend?? Probably an antifungal like diflucan.....??

Bryanna

It's not what I thought. He said this was staining from the mouth rinse he prescribed. He wants me to use it for 2 more weeks, and says there's nothing you can really do about the color or taste.

Spork,

Are you rinsing with peridex or chlorhexidine? They are the same thing, different names and they stain like crazy!

It is still a good idea to supplement with the probiotic as it repelenishes and balances the good bacteria in the entire digestive tract ...... and scraping your tongue should be a part of everyones daily oral hygiene regimen.

Bryanna

Chlorhexidine. Turns out that accounts for the bad taste and discoloration.

The doc says it will also stain your teeth if you use it too long - but that it goes away.

I did that today with the toothbrush. Does that make sense or do I need a scraper?

Hi Spork,

The stain from the mouth rinse needs to be scraped off at your next cleaning appointment as it will not just dissolve on it's own.

Yes, you can use your toothbrush on your tongue. I find it easier to use a tongue scraper.

Bryanna

Please Help
I recently got a upper molar removed after 3hours and many of Dorris from the dentist.Now I have fluid leaking out of my nose the dentist said she can no longer help me and turned me over to a oral surgeon.Now keep in mind I didn't ask for a hole in my sinuses but yet I end up with one?If I knew upfront I would have keep the tooth or had a oral surgeon do it.Now I am being charged to fix a hole that I didn't want nor did she fail to mention.Can I take legal action in this case the sinus became infected I went back three times only to hear I am sorry and for them to think I am sum druggie needing a fix.I am sorry for venting this isn't right

I apologize let me tell you guys what happened I had a abscess apper on my gums the next to the last tooth on the left hand side.I visited with the dentist the next day.She examined me and showed me a x ray and told me there was infection bulit up and I needed the tooth extracted that day.

I did as was told then it started......Hour One...She numbed and began the extract she said should be a simple extract then she pulled and picked and pulled more and said I think this might be a difficult extraction...Hour Two...All of the assistants started coming around like something was serious wrong she would see other patients during the time she would take a break from me she sawed pick pulled picked and pulled more by this time I had a small crowd around me...Hour Three....it was over I just walked out she apologized several times told me to start my painkillers a.s.a.p loratab 7.5 and cindamyacin sorry for mispelled words.

The pain was bad that Saturday she told me to call if it hurted.More painkillers that following Saturday I had a smell in my sinus of a rotted foul stinch like something dead.While driving I noticed a brown liquid coming from my nose it smelled so bad.That Thursday I went to the dentist I had a fever and slight pain the fever was bad and I didn't feel that good the whole week she explained there was a hole in my sinus and it was infected. Z pack and loratab 5 And return on Saturday bad weather came and without notice they cancelled me. Monday she refers me to oral surgeon says she can do no more for me.He comes in first words out of his mouth was you got insurance? Replied no then the numbers started adding up?

Please help I don't have 700 for this guy shouldn't dentist repair this?

Hi Jedijud,

So very sorry you are experiencing this situation. This is not something that your general dentist can treat properly. Without further delay, please seek help from the oral surgeon because the infection may continue to worsen even though you are on the antibiotic.

As far as the payment goes.... the dentist who extracted this tooth is partly to blame for this complication because number one, she should have referred you right over to the surgeon when she saw the difficulty of the extraction and number two she knew she has a major sinus perf and was not able to surgically correct it herself. In good faith she should offer to pay for at least a part of the surgical intervention. I would not hesitate to ask her to do that.

FYI... I am in the dental profession and in cases like yours, the original treating dentist will usually communicate with the oral surgeon and they work out a payment agreement between the two of them.

Please keep us posted on how you are doing!
Bryanna

Thanks Briana
 

Hey thanks for answering briana I've misspelled your name I am sorry doing this on my break don't have much time.I seen the ear nose throat doctor today he said I need surgery ASAP costing me 880 I am aggravated as the dentist that I went to does not want to hand my records over?The person doing the surgery said I could save sum money by using the x rays they performed!The ent doctor said it's a very good sized hole and she should tried at least closed it up some.I have been taking antibiotics till I am blue in the face he said the tissue is rotted and will not grow back until the flesh has been removed.He looked me dead in the eye and said you haves very serious problem and it needs to be fixed.I am scared now this was suppose to a simple extract now I am 950 dollars in the hole and a rotting hole in my sinuses.Please help where did I go wrong will keep informed

Hi Bryanna
 

Glad you are still helping people. I thought to write and let you know how I turned out. I had cleaning done. No pockets at #5 all are reduced now to 3 or better. No lazer, just with gum numbing meds. I have a besnit, and I am very pleased with it. One tooth had decay under the crown. Crown replaced. another I had a fracture in the filling and had a crown on that one. so I am just about finished, and have been doing just fine. The cleaning was not a root scaling, rather just below the gum line, not bad at all. She doesn't like doing that scaling unless it is really severe, which mine was not. I will be back to her for a check up with my gums on the 28th. I hope for some more improvement. all is well, thank you for all you did for me. I got good resolution, and I won't be having any more root canals no matter what in the future. The long range out look for the two I have is not good and I know it. This dentist I found is indeed fantastic and has provided the very best of care. ginnie