Firstly, I very much appreciate this forum. I have learned more here in one night than I have in many, many dentist and specialist visits over the past decade.

In a nutshell, my problems began in 2005 (20 yrs old) when I was told I had 40+ cavities and needed two RC's (the two issues I have today and will describe below). RC's were done and cavities were filled. To my horror, after finding a more educated and experienced dentist in 2007, I was told that only 90% of the decay was actually removed before the dentist filled the cavities and that all of those fillings would need to be refilled. They were all refilled and, by this time, the decay was very deep. From 2005 to today's date, on top of all of these fillings, I have had 9 abscesses, 10 RC's, 3 extractions, 6 crowns and 2 "4-tooth" bridges.

At the moment, I have two issues (long standing infections). These are the two RC's mentioned above - completed by the same dentist who only removed 90% of the decay when doing fillings.

1 - Very back top molar on the left (X-Rays attached): Fistula appeared on the gum above the tooth beside the infection about a month ago. Dentist referred me to a specialist who said that a re-treatment of any kind would have a very low success rate. I decided to extract. To further complicate the issue, there is a 4-tooth bridge anchored by this tooth which is going to have to be removed and cut in half. As seen in the X-Ray, my sinus membrane is very close to the infection.
2 - Mid molar on the bottom left: This tooth has been dead and a dark yellow color for many years. My dentist has left it for so long because he didn't want the teeth beside and above to move around and wasn't sure a bridge would work in that location. I have asked him to extract this one as well.

I am very concerned (terrified, in fact) about these two extractions for several reasons, and my questions are:
-- Because these two teeth are infected, when they are extracted, will the collection of infection not go straight into my bloodstream? I understand the infection is likely already in my bloodstream, but will extraction not cause sepsis?!
-- Is there a chance that, during extraction, there could be damage/exposure to my sinus membrane?
-- I do not want to be left with a cavitation but am assuming it's going to be difficult to convince a surgeon to do anything more than a simple extraction considering the fact that they promote RC's as "solutions" and don't even seem to understand the risks. How can I be sure that the surgeon will debride the area and remove all of the infected bone and tissue, etc.? Would the surgeon remove the periodontal ligament as well, or use a drill to remove a portion of it? It seems almost pointless to have the tooth pulled if the infection has gone much further. I want to be rid of the entire affected area.
-- This is the first time I have had to extract a RC'ed tooth. Is this extraction going to be more complicated or risky than a tooth without a RC?

My concern right now is dealing with these two teeth ASAP, but I am also now looking at the bigger picture and trying to decide what's best for my health.

-- I am considering having all of my RC'ed teeth pulled. Is it safe to keep the other teeth with deep fillings but no RC's? They will obviously become infected at some point, but if there is no pain, is it safe to say the nerves on those teeth are okay?
-- If I had all of the teeth pulled and full immediate dentures put in, would that be the end of this madness? Would it be the end of the chronic infections or would I really never be able to fully rid myself of the infection?
-- I am concerned that I have the beginnings of heart disease as a result of the chronic infections. If I remove the source, can I reverse the damage?

Thank you so very much for all of the fabulous, honest information provided here in this forum!

Attached Images

	1 - Dec 13 2011.jpg (177.4 KB, 699 views)
	2 - Jan 16 2012.jpg (169.0 KB, 726 views)
	3 - Jan 30 2013.jpg (201.1 KB, 696 views)