Hi Bryanna

HELP! Here is where I am at the moment and need to make a decision very soon re: removing the graft. I have had the low grade fever for approximately three weeks after an extraction/dental graft. Also have had ear pain on the same side. I'm very concerned about my health.

Just a background reminder...I had a graft put in immediately (same day) after an extraction, which was relatively soon after a root canal. This is the same tooth that has been bothering me for 5 to 6 months.

To see what might be going on, I have had a lot of blood work...16 vials of blood altogether. I took a blood culture x3 at the hospital. This was taken approximately 6 days after being completely off of antibiotics. The preliminary report came back fine (no infection). The final report should be back any day now (they culture it for five days).

My blood work indicated that I have Sjorgens Syndrome (sp?). I've had dry eyes for some time now and dry mouth, actually for a very short amount of time.

The dentist office called regarding removing the stiches...which I did the other day and spoke w/ the doctor at length about my options. He also gave me a shot of Ozone in the area, saying that this might help with inflammation.

He said after 10 days it is hard to take out the graft and he said that the graft should NOT be causing any problems ... it looks perfect. I asked him to take an xray of the graft and he changed the subject and basically refused stating that it looked "textbook perfect," one of the best ones he has done.
However, he stated that he would be willing to remove the graft if I wanted him to.

I am very concerned about MY HEALTH.

I went to an Oral Surgeon for a second opinion and he stated that I justed needed more rest time...give it two more weeks...rinsing with salt water and the fever should abate. That was about a week ago. The fever is the same...perhaps a tiny bit worse.

Questions:
1. Is it possible to have an infection in the gums, tooth or w/i a dental cavity w/o it showing up in the blood work?
2. Have you ever heard of anyone having crazy fevers after a dental procedure and does it usually mean infection?
3. Is the removal of the graft after 10 days likely to be difficult and/or traumatic? Would it be better to go to an Oral Surgeon for this removal? (I'm kinda thinking I might have trouble convincing one to do it under these circumstances).
4. Is my ear pain likely nerve pain or muscle pain? (As a side note: I've been to an ENT twice and he says my ear pain is related to dental issues).

Thank you!!!

Vowel Lady,

I answered this post this morning... have no idea where it went to!

Oh Well, let's try again.

Questions:
1. Is it possible to have an infection in the gums, tooth or w/i a dental cavity w/o it showing up in the blood work?

YES, IT IS POSSIBLE BECAUSE THE IMMUNE SYSTEM HAS AN AWESOME ABILITY TO FIGHT INFECTION AND IT MAY BE MINUTE AT THIS POINT. IT COULD ALSO BE INFLAMMATION AND NOT AN INFECTION. THERE ARE MANY BLOOD TESTS THAT CAN BE DONE TO DETECT INFLAMMATION AND INFECTION. SOME TESTS ARE WBC, ESR, SERUM C-REACTIVE PROTEIN, HOMO CYSTEINE AND SERUM INTERLEUKIN-6 LEVELS.

2. Have you ever heard of anyone having crazy fevers after a dental procedure and does it usually mean infection?

FEVERS CAN OCCUR FROM ANY SURGICAL TRAUMA. SOMETIMES IT TAKES SEVERAL WEEKS FOR THE BODY TEMPERATURE TO BE NORMAL AGAIN.

3. Is the removal of the graft after 10 days likely to be difficult and/or traumatic? Would it be better to go to an Oral Surgeon for this removal? (I'm kinda thinking I might have trouble convincing one to do it under these circumstances).

ANY SURGICAL PROCEDURE IS GOING TO CAUSE TRAUMA TO THE SITE AND THE IMMUNE SYSTEM. DEPENDING ON HOW THE GRAFT WAS DONE AND WHAT MATERIAL WAS USED... IT MAY NOT MAY NOT BE DIFFICULT TO REMOVE IT. AN ORAL SURGEON DEFINITELY... NOT A GENERAL DENTIST.

4. Is my ear pain likely nerve pain or muscle pain? (As a side note: I've been to an ENT twice and he says my ear pain is related to dental issues).

YOUR ENT DR THINKS IT'S DENTAL RELATED. I TEND TO AGREE. HOWEVER, I THINK THE CULPRIT MAY BE THE ROOT CANALED TOOTH NEXT TO THE SURGICAL SITE MORE SO THAN THE GRAFT. THAT TOOTH HAS BEEN CHRONICALLY INFECTED SINCE IT WAS ROOT CANALED. THE BACTERIA FROM THAT TOOTH COULD BE SPREADING TO THE NEWLY SURGERIZED AREA. tHAT TOOTH NEEDS TO BE DIAGNOSED PROPERLY BECAUSE A SECOND SURGERY MAY NOT BE THE ANSWER IF THAT TOOTH IS THE CULPRIT OF YOUR CURRENT SITUATION.

I have had patients who had an elevated C-Reactive Protein for years. Their physicians associating it with cardiac .... never dental. After their root canaled teeth were removed, there CRP came down to normal. The same goes for patients with periodontal disease. This exact serum marker does not elevate with everyone.... it could be a different marker that is abnormal rather than the CRP.

My suggestion is to have the root canaled tooth evaluated properly and consider removing that source of infection. Also, you need to keep in mind that I have not seen you clinically or have I seen any xrays. So the information that I am giving you is the basic facts of what can occur in cases such as yours.

I know this is very scary to you.... what to do, what to do!! I've said it many times... root canaled teeth are a necrotic mess inside the dentin tubules. Any surgery that is done next to a root canaled tooth can be jeopardized due to the chronic state of infection that is living in that area of bone as it continuously shares the same blood supply. It is common sense and unfortunately commonly over looked.

Your dentist may not want to acknowledge the issues with this root canaled tooth. But if it were me, that is what I would be looking at.

Bryanna

November Update
Two neuros, a gp and another doc all strongly suspect nerve damage.
I'm on Lyrica three times a day, which is helpful. I have many days of tremendous pain.
The multiple dental surgeries somehow seem to have exacerbated my Sojourns (sp?) Syndrome, which originally was so mild, I wasn't aware I had it. I did have a hx of Lupus though and prior to all of this, was doing very well with that.
This started In April...I had no pain, no fever, no discomfort of any kind at all, but simply asked a dentist to replace an onlay which fell off and the problems associated with that request were outrageous and led to great pain.
Since then, I've had three surgeries, daily pain, thousands of dollars in dental work, have no dental insurance at the moment (it was all used up for the year) , am on daily medication with nasty side effects, my blood pressure has gone through the roof and my blood pressure meds have been quadrupled and I often have to take Percocet and stay home with a heating pad on my face. Oh, and the other day, a cold chill hit that side of my face, and I was in severe pain for approximately ten + hours.

People: Take any dental surgery, large or small, very seriously and the sad truth is your dental professional may not be best qualified or have your best interest in mind. Check, check, re check and check some more.

Three weeks ago I went to see a dentist for minor filling job; during the procedure my tooth was really sensitive so she was keep poking needle in different places on the inner side of tooth #31. Two days after coming home I started to have many episodes of numbing jaw. I was hospitalized to rule out any possible heart Issues (nuclear test). Results were normal and negative toward any blockage. since then I have developed a low grade fever which stays in 100- 100.5 range and some times goes up to 101. I was on antibio-tics (amoxicillin) for a week and in a third week I have developed hyper sensitive skin ( every hair on my body hurts badly). my Glends on an inner side of my tooth (below tooth) is tasting like salt and other bitter chemicles.

I am having very smelly mouth and very smelly stool. CBC and other blood results came out negative toward any abnormal counts. My second dentist didn't find any infection; my Dr asked me to drop my antibiotic which I did two days ago but my fever is persistent. My ear and the jaw starts hurting badly some times, some times my my tooth start hurting without any reason but when I massage the glends with my tongue, it relieves me. I am exhausted please help me. no one knows whats wrong with me.

Hi zachameen,

I would consult with an oral surgeon since your glands are swollen on that side of your neck and you have a salt taste coming from that area when you press on the glands. You may have developed a stone in a salivary gland or.... it could be be a clogged, inflamed, traumatized or infected salivary gland inside of your mouth.

Keep us posted...
Bryanna

Some of your symptoms are similar to mine. I ended up getting diagnosed with Sjojerns Syndrome, an autoimmune illness. In my case, I had multiple dental procedures, a tooth removed, a bone graft put in and a bone graft removed. After I had the tooth removed and the bone graft put in, I developed a fever, extremely similar to the one you describe. I did not have a salty taste in my mouth. I had many tests at the hospital (was not admitted though). No infection could be found. I had the bone graft removed and the fever went away! However, I was left with more and more pain in my jaw and right ear. In my case, I had nerve damage and was dx'd with Atypical Trigeminal Neuralgia by two oral surgeons, my gp, a pain doctor and two neurologists. I am very sure of my diagnosis. Fortunately (and I am most grateful) I have gotten some relief from the extreme pain with certain medications. However, weird things can set it off badly like a cold breeze against my ear and then I will have the severe pain again for several days and become incapacitated. Since I have Sjogerns (barely know how to spell it), I have read a little about Salivary glands and I know they can become inflamed/infected and that does seem like an area to investigated. I also understand if there is a problem in that area, they are often (if not always) swollen. You might have to see a good Oral Surgeon, who might want to also refer you to an ENT. Be forewarned, my experience with ENT's is they like to blame everything on TMJ Disorder...it is almost laughable. Search for a well respected, highly experienced Oral Surgeon. I was fortunate to find two of the best in my city, who agreed on the dx of Atypical Trigeminal Neuralgia. Fortunately, getting the right dx and right treatment helped with my pain. Keep looking for a good doctor or doctors. Good thoughts for good doctors and pain relief to soon follow.