Hi, I have just joined this forum to learn from other members expertise.
I have a broken lower left molar that cannot be extracted. It cannot be extracted due to the high dose of radiation given to cure squamous cell cancer at the base of my tongue.
My lower left jaw under the broken tooth stays infected and results in severe general debilitation.
Oral surgeons will not extract the tooth as they feel that it would not heal.
What is the best treatment to cure the infection or at least keep it under control?

jpp7928

I am really sorry you are experiencing such difficulity. I want to welcome you to Neruo Talk, and maybe say a few things regarding the problem you have.
My father had that same cancer in his throat, so I know a little about the radiation treatment you had. I am not sure if I were in your situation I would give up just yet about having that tooth extracted. Living with a permanent infection will lower your immune response. This can't be good for the all over well being of your body. Do all of your doctors, your oncologist, PCP, and Oral surgeon all agree? There are also degrees of specialities within the oral surgeons themselves. Maybe you can do a little research on line for specialists in your area. I do hope you will contact Bryanna. She is the most knowledgeable on this site about dental issues. Please post to her. I know your situation is serious, and I do care. I will be here to listen, and would gladly help you with research if you need me. I really hope you can find better resolution than what has been presented to you. ginnie

Hi Ginnie,
I've gone to my local dentist and the oral surgeon at Sloan Kettering Cancer Center and none of them will do an extraction even though, when I had the radiation, I was told by Sloan that "if I ever needed an extraction to go to them". Rather frustrating.
Right now, I'm looking for what antibiotic is best short term.
I will post Bryanna as you suggest.

I have no doubt you are fustrated, especially since they told you to got to Sloan. That institute does have a good reputation. I sincerely hope Bryanna can suggest something. I do know that Levaquin is one of the best antibiotics on the market. It is used to treat very stubborn infections. I will be thinking about you, and hoping that a resolution can be found, where you will not get a repeat infection, and can heal. ginnie

I am not one to give up easily. I just got on line and goolged in "best oral surgeon in USA. What came up was a maxillofacial surgeon in Mayo clinic in Mn. I have been to that clinic myself. Perhaps it would be worth your time to call that clinic. I think you do need a referral to get in, but they may have information. This clinic specializes in the most difficult cases. Your sucess probably hinges on the degree of speciality you can find. Not all oral surgeons are maxillofacial surgeons, if I understand correctly. Worth a thought. ginnie

Hi jp,

Well, your situation is very complicated. The concern about leaving the infected tooth in the jawbone or doing the extraction both pose similar possible complications which can be very difficult to treat. Here is an article from pub med that sites... the use of tetracycline mixed with bone replacement after the extraction which had positive results...
http://www.ncbi.nlm.nih.gov/pubmed/9553886

Another idea might be to have Hyperbaric Oxygen Therapy (HBOT) pre and/or post op the extraction in conjunction with antiobiotic therapy. There is some controversy with doing HBOT and some oral surgeons say yes while others say no. But is would be something to discuss with whomever you consult with.

Here is a possible lead to having your question answered if you can get him to email you back...

Dr. Archie Morrison obtained his MSc in Oral and Maxillofacial Surgery from Dalhousie University and then completed a fellowship in Scotland and Holland, concentrating on trauma, cancer and pre-prosthetic surgery. Dr. Morrison’s research and clinical interest areas are broad and include management of temporomandibular disorders, sleep apnea, bisphosphonate related osteonecrosis of the jaw and reconstruction of the atrophic jaws with bone grafting and implants.

Dr. Archie Morrison is an associate professor in the department of oral and maxillofacial surgery, division of surgery, faculty of dentistry, Dalhousie University, Halifax, Nova Scotia. ......Email: archie.morrison@dal.ca

I wish I could be of more help to you. Please don't give up searching for someone to help you... your situation is not uncommon and it can be treated or managed. I will keep searching.... please keep us posted too!

Bryanna

I also was doing some research for you. The treatment called hilotherapy or a form of cryotherapy is being done on oral situations.
Americal ***. of Oral and Maxillofacial Surgeons
9700 West Bryn Mawt
Rosemont Il. 60018
847-678-6200
800-822-6637
This instituate works with oral cancers and oral maxillofacial surgeries together. ginnie

Hi Ginnie,
Thanks for your reply. I currently am into my third day of a 7 day regimen of clindamycin 125 mg 4 times a day and it seems to be helping but it's a little early to be sure.
I'll check on levaquin and Mayo.
Thanks again.
jpp7928

I sure am thinking of you. I hope one of those medical facilities can help you. I googled in Oral cancer and Dental trauma, and several other medical places come up. There are more than what I put up on NT. I hope you can get rid of that broken tooth, get healed, and have this situation resolved. I do care about you. ginnie

Hi bryanna,

I have tried to post replies to you a few times but I keep getting an error message that I need to remove links to send a message
I don't know how to remove links; please teach me.
Thanks
jp7928