Hi Bryanna,

I just lost a much clearer post.... OK, in a huge way, I feel like I've failed. Yet I have to stop pushing my mother. I'm suddenly shouting, and she's acting....old.

My mother wants to have the oral surgeon she likes and trusts do an apico. I said, "Let's have this tooth extracted to remove the source of the infection now, rather than deal with a bigger problem down the road. I'll drive you and stay with you afterward, and later we'll both investigate a bridge/small denture/whatever." I got nowhere. My brothers urged her to continue with consultations, but they think she's had enough and knows enough to make her own decision.

I've decided that many general dentists, endodontists and oral surgeons don't think or admit that root-canaled teeth house bacteria or infections. In fact, I went back and forth with a few about this. They act as if teeth are not part of the body. Ironically, most of the ones we've seen are affiliated with teaching hospitals and are very experienced. So if I'm hearing this, so are many, many others.

The oral surgeons did not recommend an extraction because they said a larger surgical site site might not heal at all or might heal partially in someone who used a bisphosphonate drug. In contrast, all said they could cut out/clean out the infection via an apico, and the smaller surgical site most likely would heal without problems. So my "The tooth is infected - the tooth is the problem" argument fell on deaf ears. I know an apico is a Band-Aid solution and only buys time.

No one would say with certainty that my mothers infection developed after the initial root canal because of Fosamax/Actonel use.

I have to be careful with my mom. She's been through a lot the past four years, more than I could handle in a lifetime. Knowing she has had an infection for so long is keeping her up at night. I have to respect her decision, even though it wouldn't be mine.

Two questions: Is it possible that an endo in this day and age would use formaldehyde during a root canal? If so, how would the patient react to it? Also, where does a jawbone infection typically drain -- down the throat or into the mouth?

Thanks so much! I'll continue to update in hope someone will learn from this specific experience.

D

Hi Dana,

I've read your post a few times and each time I felt your frustration over the whole situation and deep concern for your mother. You can't ask yourself to do anymore than you are already doing. You have not failed your mother at all and I am sure you will continue to be there for her as she makes this journey.

I am fully aware of what dentists tell patients about root canaled teeth and apicos. The fact that they are misinforming patients is not something I am proud of and I continue to fight the fight as I am hopeful that the information will become more and more available to the public. In their defense, the dental profession is subtly trying to come up with ways to inform the public about several controversial topics ... root canals, apicos, fluoride, mercury fillings are the current big ones ....that will not result in pandemonium or financial upset. My personal thought on this... get off the pot and stop misinforming the patient... offer the facts and help the patient to make the best decision according to their individual needs.

One of the most informative internet sites that I have found with regard to the toxicity of root canals and some other dental topics is by a dentist named Orlando Rojas. I have no personal affiliation with him or his practice. His explanations are easy to understand... better than mine!
http://www.southafricadentist.com/YO...CT_391987.aspx

Just to clarify....Your mom's jawbone infection came from the infection inside the root canal tooth, not the bisphosphonate drug. The use of the drug may interfere with the complete healing of any oral surgery that she has. An apico is a surgery to physically go into the jawbone and remove the cyst from the end of the tooth that is filled with infection. The only change that occurs with the tooth during an apico is that the diseased end of the root is cut off and removed with the cyst. The open root end is sealed closed with either a mercury filling; a cement called MTA (Mineral Trioxide Aggregate); Zinc Oxide and Eugenol; or a composite resin material. The apico does not rid the tooth of the infection. So what the dentists should be telling your mom is that she is going to have to heal from the apico and then again from the extraction of the tooth sometime in the near future.

Formaldehyde was supposedly banned from dentistry use in live patients several years ago. However, some dentists still use the supply that they have on hand. Another concern is about root canaled teeth that were done about 10 or more years ago as the majority of them had formaldehyde used during the root canal procedure. This chemical never leaves the body, in other words it can't be washed off. To make matters worse, dentists would frequently soak a cotton pellet in Formaldehyde and pack it inside one or more of the large canals and put the filling material over it. The thinking was that this chemical would kill remnants of bacteria. Never did they think of the toxicity aspect of doing this. Formaldehyde has many ill effects.... you can do a google search on that.

To answer your last question... an infection in the jawbone as well as in root canaled teeth drains directly into the bloodstream. The mouth is very vascular and the bacteria that lives in the mouth, lives in the bloodstream. If there is an open wound that is infected, it will also drain into the mouth, the throat and the entire digestive system. I know, a bit gross....sorry.

I hope you have not fainted by now.... seriously... and I hope you have learned what you came here to find out. You are doing all you can to be her advocate and you are fighting the tide especially since she is under the impression that she can hang onto this tooth. There comes a point where you have to accept that you have done all that you can... her choice may not be a wise one, but hopefully it will eventually have a positive ending.

I'm here to listen, to help if I can and to remind you that you are not a failure by any means.

Bryanna

Hi Bryanna,

Thank you for your thoughtful and kind post. I finally feel somewhat better about everything, and know my mother's decision is the right one for her - for now.

Thanks, too, for the link. The South African dentist shares some invaluable insight.

Don't worry - I have a very strong stomach! I wondered about the drainage because my mom has complained of an allergy or sinus infection for months now.

During a consult, I think I overheard an oral surgeon say the endo used formaldehyde. I hope I'm wrong. My mom sees that endo this week so he can finish the root canal before next week's oral surgery, and I'd like to find out what he's used.

Thanks again for all the info and support. I'll be back.

Dana

hi dc,

I agree with Bryanna, get that tooth extracted. That is the best option from info i received. Did the oral surgeon do a 3d scan? My grandma is 92 years old and she did have an extraction a couple years ago and she is fine but i know that everyones situation is different and that she doesnt have jaw bone infection. Hope everything goes well for your mom.

One question for Bryanna,
If someone had a jawbone infection, what would you prescribe to get rid of it and for how long? how often should we see the oral surgeon? Also, ive got vitamin d defiency and have been taking vitamin d3 2000 ui from natures made. Is that a good vitamin to take? thanks

Dana,

I totally respect what you are saying and understand that your goal is for your mom to do what is in her best interest. I also know the seriousness of her situation and would not want her to become ill because of this infected tooth.

With regard to her sinus issues... yes, the culprit could be this infected tooth irrelevant of whether it's draining in her mouth or not. In an upper posterior tooth, the sinus wall is in close proximity to the roots of the teeth. So the infection will perforate that sinus wall and spread to the sinus cavity. In a lower tooth, the infection draining into the mouth is not only going down the throat but also up into the distal (back) nasal passages. An common example of that would be... a cold is in your throat AND your nose ....or an upper respiratory infection causes sinus pressure and sinus drainage. My point is, if the tooth is the culprit of her sinus problems, as long as the tooth is present, the infection will be present. Remember, root canals or apicos do not cure tooth infections.

I can also interpret that comment you overheard by the oral surgeon as I have heard it 1000's of times.....He is <<concerned>> that the endodontist used formaldehyde (Sargenti Paste) which is a health issue because it is extremely toxic. It cannot be removed from her tooth and if it has infiltrated her jawbone via the infection, it may not be able to be removed from their either. I'm so sorry this is disturbing information, but this is what he should be telling you and your mom. Unfortunately and unethically (IMO), dentists usually cover up or make light of a colleague's usage of a sargenti product.

Please read this paragraph that I took from the following link... it says ALOT.
http://mediasyndicate.com/index.php?...icle&sid=13800

<<<<For decades, the FDA has been notified of the continued manufacturing and sale of this unapproved material by compounding pharmacies (who sell in bulk across state lines) but, since the early 1990's, has done nothing to enforce their own laws regarding it. They have been notified of false claims of FDA approval by the proponents, including a claim in 2003 that the material had passed "Phase III (final testing)". The FDA has told Sargenti proponents that this material is not approved and has sent letters stating such. Yet, to this day, members of the American Endodontic Society along with the President of N2 Products, the company pursuing FDA approval, continue to falsely tout some form of FDA approval and nothing is done to stop them or alert the public otherwise. The FDA is aware that many patients have been seriously and permanently injured. They are aware that dentists frequently conceal their Sargenti Paste usage and therefore the vast majorities of injuries go unreported. Injuries can range from chronic sinus infections to life altering permanent numbness and/or burning nerve pain to the most severe - anaphylactic shock and chronic bone infections that have destroyed jaw bones requiring surgeries to rebuild and repair. These bone infections are often unstoppable.>>>>

I have a huge question...........
Isn't the root canal already done??? They want her to do a root canal and then an apico????

Dana, I've given you (and others reading this) alot of information... not to alarm you or your mom or anyone else... just to arm you with enough knowledge to question the lack of information you have been given by the dentists.

I wish your mom all the best of care and a healthy outcome.

Bryanna



QUOTE=DC02;811731]Hi Bryanna,

Thank you for your thoughtful and kind post. My father died earlier this year, and I'd like to hang on to my mom a while longer. I finally feel somewhat better about everything, and know my mother's decision is the right one for her - for now.

Thanks, too, for the link. The South African dentist shares some invaluable insight.

Don't worry - I have a very strong stomach! I wondered about the drainage because my mom has complained of an allergy or sinus infection for months now. She wonders if she's allergic to the materials in her bridge; I'm thinking, noooo, try that root canaled tooth. The endodontist told her the infection was draining, causing her to feel it in her throat.

During a consult, I think I overheard an oral surgeon say the endo used formaldehyde. I hope I'm wrong. My mom sees that endo this week so he can finish the root canal before next week's oral surgery, and I'd like to find out what he's used.

Thanks again for all the info and support. I'll be back.

Dana[/QUOTE]

The original root canal had two parts to the procedure, as did the first revision. This is the second part of the second revision -- packing. Then comes a quick seal/filling on crown the next day. (Sorry if I'm unclear - I just flew back here today.)

Maybe I need to find out what the endo used/is using. I've read about Sargenti Paste. Should I talk to the oral surgeon? This is a tough situation.

Thanks,
Dana

ETA: Bryanna, I don't sound like I get it, but I do. The bottom line: Problems will persist unless that infected tooth goes. I'm talking to my mom about that now. Thank you very, very much.

Hi Dana,

So this tooth had been root canaled, then re-treated a second time with another root canal procedure and before that one is even completed, the dentists already know that it's not going to take care of the infection so she's already scheduled for an apico? This is outrageous! I cannot believe they are going to put your mom through this knowing full well that the infection will continue and she will inevitably lose this tooth.

My experience tells me that the endodontist has packed this tooth with cotton pellets soaked in formaldehyde or glutaraldehyde (slightly less toxic but should never be used in the mouth) in an attempt to kill bacteria. This is what they use to do in the "olden days" when they didn't know how systemically toxic this stuff was to the patient. She may have had the same thing done during the first root canal procedure. If that is what has happened, then this tooth is far sicker than anyone can imagine and it makes no sense to put her through all of this.

Dana, why is your mom wanting to hold onto this tooth? Does she realize how infected it really is or is she just holding onto hope? I can totally imagine how upset you are over this whole thing. I know that you understand the concerns regarding her health if she keeps this tooth. She needs to hear it from the dentist and I doubt that either of them are going to be totally truthful with her.

I could give you questions to ask either dentist, but I already know the BS they are going to give you as a reply which would leave you feeling helpless. However, I do believe they will listen more carefully at this point if you seriously make it perfectly clear to the endodontist and the oral surgeon that you believe this tooth is very ill.......all of this treatment is just putting off the inevitable removal of this tooth which at that point could result in more bone loss from the chronic infection, the toxic chemicals used during the root canal procedure and her history of bisphosphonates....and you are very concerned that retaining this tooth may not be in her best interest because of possible systemic consequences such as chronic sinus problems, unhealthy/necrotic jawbone which could be difficult to treat....not to mention the strain this could put on her vital organs.

I think you have to go by what you have read and learned and allow your intuition to guide you and hopefully you can convince your mom to reconsider her options. Do not hesitate to question or repeat yourself.... this makes the dentist think twice about the situation if for no other reason than how any negative consequences could negatively affect him in the future. A bunch of BS, I know... but that's the way it is....unfortunately.

Dana, at this point, I will not offer anything further without you directly asking for it. I've given you enough information to empower yourself with knowledge and I respect your intelligence and compassion for wanting the right thing for your mom and the decision of how this is handled is between you and her. THANK YOU for being so open to all of this unpleasant stuff!!

Please let me know what happens....
Bryanna

This has been my point for a while now. I'll emphasize "systemic consequences" and the strain on all organs.

To clarify: one root canal, followed by first retreatment, followed by Part 1 of <second> retreatment.

Thanks much.

Yes, just so you know your clarification was clear on your other post. Two individual root canal procedures done on the same tooth (second stage of second one in the process)... got it. Apico already scheduled because the dentists know the infection will still be present after the completion of the second root canal procedure.

The dentists need to explain what happens to the jawbone from a chronically infected tooth.... perhaps that could be on your list of questions.

Also, your mentioning systemic consequences will either rattle their bones or they will brush it off as insignificant. It is better if it rattles them because they will see that you are seriously concerned.

This months dental journal just had a several page article about the systemic connection to oral problems. It focused on periodontal disease... but the main topic was any oral infection. I'm sure they've seen it.

Keep me posted...you are a tough cookie!!

Bryanna

Hi Bryanna,

I'm working on my questions in preparation for the endo visit. I just need to remain calm. Hah. Let's hope I don't get violent. Thanks for posting the journal article. I'm printing it out.

Will let you know what happens. (Unless I'm in jail...)

Dana