Day 5 after removal of #20 old root canal, and other teeth in the area are requesting attention! Interesting both how painful this still is, and how the other teeth are responding.
That wisdom tooth has been erupted for 25 years, and now and again a dentist will mention it, as did this last one.

This is a healthy (as far as I know) tooth that is quite annoying- the skin flap seems to be perpetually irritated or itchy. It is really hard to clean and food is usually trapped. I wonder if this is a source of constant bacteria...

Is this worthy of extraction?

Hi Jimbo,

Yes...the wisdom tooth probably should come out. The bacteria does get in underneath that flap of skin and there is a good likelihood that an infection is brewing there. The reason it has not swelled up is because it is open and the bacteria is draining. But that flap of tissue can become inflamed to the point that it closes over and then a huge swelling will occur.
When the bacteria migrates down in to the bone it will cause the tooth in front of it to decay along the root surface. Which would mean that both teeth would then have to be removed. So it's worth losing the wisdom tooth which is bothersome and a source of infection to avoid losing both of them sometime in the near future.

You said the site of #20 is still painful. Has the pain increased over the last 2 days? Are you rinsing with warm salt water? Do not use any mouthwash as this will irritate the surgical wound and contribute to cause a dry socket. Also, if you smoke.... stop because that too will cause all sorts of painful problems.

Bryanna

Thanks Bryanna,
Last night it finally seemed to be subsiding, and today (day 7) it is noticeably better and less painful. The pain did have some crazy flashes of pain throughout the jaw and considerable referred pain to other teeth, so I was a bit concerned about dry socket. I have been taking it easy and lots of water, ect, just had hoped the healing would happen quicker
When I was in the chair insisting the periodontal ligament be removed, the surgeon said "well, that will be a little more invasive and involve a little more trauma and time to heal"- to which I replied "Thank you!" He said he believed that infection occurs when the socket is not fully cleaned, but didn't feel the ligament was an issue, hence my earlier concern that he might not have done what I wanted. It is my mouth after all! When I reflect on how long he scraped for, it seemed like 10 minutes, it was pretty uncomfortable and went on for awhile... he probably did just what I asked

Today is the day I begin the irrigation of the socket! Looking forward to that. I think part of the problem is I was mostly using cold salt water to rinse, living on a boat, long story...

I wouldn't consider tobacco use and try to eat mostly an anti-inflammation diet; the result of following guidance from a naturopathic doctor after some serious health issues. A bit of my history, as you seem interested in this stuff and my life kinda reads like a good novel... At 41 years old in Central America, I collapsed with intense abdominal pain and vomiting blood. A tiny clinic declared my appendix had ruptured and after 8 hours of arguing I finally agreed to the operation; when I awoke they had preformed an intestinal re-section - no tests to confirm anything but they said they found necrotic tissue of the small bowel.

Upon return to the US and undergoing every possible test, it was declared I had a bleeding ulcer and probably encountered an intestinal infection. Wow.
I began to re-think some of my life choices...

So I started a really good diet and was amazed how good it felt. I took an interest in my teeth after stumbling onto the mercury scandal, and 3 years ago had 5 bottom molar amalgam fillings removed, mindfully by a naturopathic dentist, but #20 had gotten too bad some 16 years ago and I had a old school root canal on it in Ensenada Mexico, for $80 as I recall The temp filling he used fell out in months, I was a UC student at the time they had a clinic, and they filled it and put a post in it which lasted 10 years, never did get the tooth crowned. It was always sensitive, and dentists agreed that some nerve remained, and lately some "shadowing" underneath. After I once again had it filled and temporarily capped, I had an oral CT scan done (3 years ago) at a dental school and they were concerned about a "lesion" on the tooth, whatever that means.

It has always been sensitive and the last year very hard to eat on. I was going to get work done on it last fall (re-do the root canal) but pressures of work made for a big delay, yuk. I would get crazy throbbing in it..
Fast forward to Feb- I get severe intestinal pain and end up going in- diverticulitis. Heavy antibiotics (which I abhor, but in this case a must) and it goes away, but I notice as it does the pain in my tooth comes and goes too. It is as if when one hurts, the other does not. Then I see that chart about #20 being involved somehow with diverticulitis, and I can't help but wonder what role this tooth has played in my health...
Funny, the old tooth looks healthy and white, except where the post was in, there it is black, no smell to it. Amazing how long a half-dead tooth was in my mouth, while I believed there was no greater good than "saving the tooth." And furthermore how hard it was to find dentists who speak this language of whole-body connection, in the SF Bay area, is unreal.

I do have to think more about this wisdom tooth- and be able to plan a week to deal with recovery if I extract. Money is a huge issue too. The local hospital will extract for free if they deem it infected, and they said all the work is done by oral surgeons, but I think this means they are in training?
Seems better to pay for experience here...?

I see and understand the uncertainty folks have about losing a tooth, but I must say I have zero doubt this was another great move in my quest for a long and healthy life. And I do appreciate you taking the time Bryanna to help folks understand all the options and possibilities, soo nice to meet someone kind and supportive

Jimbo!

Wow..... thank you for sharing a piece of your medical history. I am very glad to hear that you have tuned in to what is best for health. You have had some difficult times, although not uncommon, still difficult.

I am not surprised that you were able to make a health connection between tooth #20 and your diverticulitis after seeing the Meridian tooth chart. I know some people think that chart is hooey and find it hard to connect the mouth to the rest of the body. But the connection is very real and can be profoundly eye opening when someone makes the connection. I wish it was easy to remedy a health problem by removing a (long standing) infected tooth. But the key there is "long standing" and that is why I repetitively stress the importance of not allowing an oral infection to become long standing.

I am glad the oral surgeon removed the ligament! He should never have even hesitated.. he has been taught to remove it without question. When you irrigate the socket.... be very, very gentle... do not use any force what so ever. Use warm salt water only. You are not irrigating to make the socket crystal clean ... you are irrigating to gently remove the visible food debris and encourage the site to heal.

You live on a boat? Does it have warm running water? If not, then boil some water and use it when it is room temperature.

The tooth was not half dead it was very dead as in non vital. The vitality stops with the root canal procedure. When people have pain after a root canal and are told there is still some live nerve inside of the tooth.... that really means whatever remnants of nerve are left including the nerve tissue inside of the dentin tubules is now becoming necrotic and the ligament holding the tooth in the bone which is still live at that point is sending signals to the brain that there is a problem with the tooth. Many dentists expect their patients to be in pain for several days after the root canal because they know that the pain is coming from the death of the remaining nerve tissue. Common sense tells us... this is just not a good thing. The people that have little to no pain after their root canal procedure is most likely due to the fact that the nerve tissue had already died and was necrotic prior to the procedure. This still leaves the tooth in the same condition...chronically infected. So the lack of pain or diminished pain post op root canal therapy does not indicate a "job well done" it just means the nerves were already dead.

Please do not wait too long with that wisdom tooth as it is collecting bacteria and can become an emergency situation. You have experience with health emergencies... they are always complicated and never fun :/

The oral surgeons at the hospital may be practicing oral surgeons who do rotate shifts in the hosptial. If it is a teaching hospital then you may get a student. I would opt for a practicing oral surgeon myself.... just sayin'

Keep us posted on how you're doing! Take care.
Bryanna

Thanks Bryanna,
Day 12 and it finally feels like it is really healing. On day 8 I attempted to irrigate, prior to reading your note, and thought it would feel good, like something was stuck in there- I poked the syringe in and actually saw a white lightening bolt! It was insanely painful. I rode to the bar on my bike and drank 3 pints to try to kill the pain.
Last night I did try again and of course it was easier, though it still looks/feels with my tongue like there is something stuck, I am afraid if I try to pull it out I will discover it is tender flesh..

I am surprised again how long this was so painful for. Maybe dry socket? Didn't expect that on a pre-molar...

Jim,

Please tell me you were kidding about the drinking???? Alcohol is the last thing you should be doing as it will dry out the socket :/

Do not attempt to pull anything out of the socket. Irrigation is just to be a gentle wash and that is it. The lightening bolt pain when you stuck the irrigation syringe inside of the socket.... great explanation by the way.... was from the syringe hitting tender nerves and cells in the bone. Don't do that again :~/

It is typical for an extraction site to take several weeks to heal. Be patient.

Thanks for the humor.... guys often have some sick sense of humor about their teeth.... funny

Bryanna

Hey Bryanna,
not kidding on the brews, it actually hurt so bad I dropped everything (after I writhed in pain for a bit) and got sloppy. I eat mindfully and don't drink often, but I was in misery and felt I deserved it, and it seemed like a healthier option than pharmaceuticals. What I did not do is take vicodin. In my head that was the trade off. Toughed it out, but it was indeed tough. There is something about dental pain that can make wimps out of anyone, but perhaps my jaw is exceedingly sensitive or something, I remember when I had two upper wisdoms removed, it seemed like major surgery too.
I am glad you said not to remove anything, cause it feels like it is a nerve in there. I have pain radiating from the tooth next to it that needs a filling, and am getting that filled tomorrow, not by the dentist who pulled it but a good time for her to have a look nonetheless.

The color looks good, and it did get better every day, but for me, this type of thing requires 10 days min to recover..

i'm half Irish btw, when misery comes a wee bit of a nip seems natural

Jim,

In normal people..... .... it takes a few weeks.
In inpatient people.... it takes the same amount of time.
Just sayin'

Bryanna

Phooey.... you just needed an excuse to have a couple.

I know your type ~','~