Jen,

Yes, please post the xrays.

I understand the story that you are telling. No need to repeat it again, that's okay

The tooth is badly infected and the fistula means that the infection is now in the bone. The sinus problems that you are having may be coming from this and/or some other tooth. I assume that you have not had regular dental care due to fear of the dentists? That's okay..... many people have that fear, I understand.

What do you want to happen? This tooth should be removed. It doesn't sound like you will be a good candidate for a dental implant. The fact that the dentist explained to you that the bone would collapse when they upper tooth is removed .....indicates that he knew how infected this tooth was when he said that. The bone in the upper front of the mouth is more fragile and thinner than the bone any place else in the mouth. When an upper front tooth is badly infected, the bone deteriorates in that area rather quickly. When the tooth is removed, some of that bone will be removed also. This will cause that area of bone to be gone and it is not easily replaceable. If you did not remove this tooth... the bone will deteriorate further along the jaw from the infection.

Your replacement options depend on what other healthy teeth you have remaining in your mouth. Do you have x-rays of all of your teeth? If so, feel free to post them.

Bryanna

Hi Bryanna,
Thanks once again for your help. I have attached one of the x rays the only one i have that shows the dental instrument. I had difficulty attaching it to the post and its not very clear. You can see the instrument but for some reason on the x ray there is a white blank over the tooth, why that is i don't know. I received it like this from the dental hospital. This was taken in 2010.

You asked me what i would like to happen next. I would like the infection gone but if they remove the remaininder of the root of the tooth that is left does that mean my face will collapse? Im really so scared. What other options do I have left? what should i do next?

Thanks

Jen

Attached Images

jen dental 1.jpg (193.2 KB, 131 views)

Hi Bryanna,
this is the second x ray that was taken later after the metal dental object was removed and he refitted another new crown and post.

The first thumbnail x ray was taken on the 10/8/2010
the second thumbnail x ray was taken on 22/03/2011

Hope this helps Bryanna

Attached Images

jen dental 3.jpg (213.5 KB, 114 views)

Jen,

Your case is very clear... the 2 root canaled teeth in the xray are infected. The only way to get rid of the infection is to remove those teeth. The bone will collapse if you keep the teeth because the infection will destroy the bone. The bone will recede to a flatter plane making the level of new bone higher than normal bone but that is not the same thing as collapse.

This is how the x-ray appears to me....
The piece of metal that was in your tooth looks like a piece of a broken reamer or endo file. The main canal in that tooth shows that the nerve material was removed above where this broken piece of reamer is lodged. So if that is correct then that means that the sedation dentist did a root canal on that tooth but did not complete it because he broke off an instrument inside of the canal which blocked the canal from that point up. Instead of removing that metal piece.... he just put in another post and put on a temporary crown. I have seen this countless times.... I believe it is a piece of a metal endo reamer file that was broken off inside of your tooth.

You are fixated on what has happened in the past with this tooth as if it would have some bearing on what is happening now. It actually doesn't have any bearing because once a tooth becomes infected, it remains infected irrelevant of what is done to it. So the broken instrument and the lousy dentistry really did not alter the eventual outcome of these teeth because they have been infected this whole time. So you should focus on the present issue which is the infection and your ill health.

To remove the teeth is to remove the infection. To leave the teeth means to keep the problem. I'm sorry to be so blunt but your case is that clear and the choice to remove them or continue on this same path is up to you. If you have other teeth that need to be removed on the top and/or you already have other missing teeth on the top.... then speak to your dentist about making a removable partial denture to replace all of them. That would probably be the least expensive and most beneficial replacement option for you at this point.

Thanks for posting the x-rays... your case was as I had suspected. I hope I have been clear with my information and I hope I have been able to empower you to be a bit stronger, less fearful as you move ahead with this. You will be better once the infected teeth are removed.... your immune system will thank you. You will need to make some lifestyle changes for the betterment of your overall health but in doing so .... you will be okay!

Check back with us and let us know how you're doing!
Bryanna

Hi Bryanna,
Thank you so much for all your advice and of course taking the time out to look over all of this, I really do appreciate it.

I'm left wondering though, the last x ray was taken in 2011 and you said both root canaled teeth are infected and the bone will collapse if the teeth are kept as the infection will destroy the bone. My worry is that x ray was taken in 2011 and its been a further 2 year with the infection. If the bone collapses what does that actually mean? Does it mean then the face structure can be disfigured if that we're to happen? What type of dentist should I seek for a evaluation about this and also to find out if I have a sinus infection also?

I hope you do not kind me asking you, I really know nothing of what to do next. My anxiety and fear about dentistry was so high before all of this and now it's even worse. If I'm honest my worst fear is if these teeth are removed my face will collapse and I don't know if I'm am being overly exaggerated about this.

Jen


QUOTE=Bryanna;983684]Jen,

Your case is very clear... the 2 root canaled teeth in the xray are infected. The only way to get rid of the infection is to remove those teeth. The bone will collapse if you keep the teeth because the infection will destroy the bone. The bone will recede to a flatter plane making the level of new bone higher than normal bone but that is not the same thing as collapse.

This is how the x-ray appears to me....
The piece of metal that was in your tooth looks like a piece of a broken reamer or endo file. The main canal in that tooth shows that the nerve material was removed above where this broken piece of reamer is lodged. So if that is correct then that means that the sedation dentist did a root canal on that tooth but did not complete it because he broke off an instrument inside of the canal which blocked the canal from that point up. Instead of removing that metal piece.... he just put in another post and put on a temporary crown. I have seen this countless times.... I believe it is a piece of a metal endo reamer file that was broken off inside of your tooth.

You are fixated on what has happened in the past with this tooth as if it would have some bearing on what is happening now. It actually doesn't have any bearing because once a tooth becomes infected, it remains infected irrelevant of what is done to it. So the broken instrument and the lousy dentistry really did not alter the eventual outcome of these teeth because they have been infected this whole time. So you should focus on the present issue which is the infection and your ill health.

To remove the teeth is to remove the infection. To leave the teeth means to keep the problem. I'm sorry to be so blunt but your case is that clear and the choice to remove them or continue on this same path is up to you. If you have other teeth that need to be removed on the top and/or you already have other missing teeth on the top.... then speak to your dentist about making a removable partial denture to replace all of them. That would probably be the least expensive and most beneficial replacement option for you at this point.

Thanks for posting the x-rays... your case was as I had suspected. I hope I have been clear with my information and I hope I have been able to empower you to be a bit stronger, less fearful as you move ahead with this. You will be better once the infected teeth are removed.... your immune system will thank you. You will need to make some lifestyle changes for the betterment of your overall health but in doing so .... you will be okay!

Check back with us and let us know how you're doing!
Bryanna[/QUOTE]

Jen,

Every time a tooth is removed there is bone loss because the bone recedes upwards or downwards into the space where the tooth use to be. This does not mean your face will collapse as you have other teeth in your jaw holding the shape of your face.

When there is infection in the jaw bone, the bone deteriorates (becomes brittle, mushy and necrotic) from the bacteria and as part of the extraction these areas of bone will need to be removed for the site to heal properly. As the site heals, new bone will fill in that space. The difference will be that the new bone level will just be higher (in the upper arch) than normal or lower (in the lower arch) than normal. But there will still be growth of new bone.

Jen, to be honest with you.... the infection is what is the most important issue here not esthetics. You can discuss replacement options with your dentist and come up with an agreeable solution... as I said a partial denture may be best at this time. The bottom line is this.... the longer you wait to remove these teeth the more complicated the surgery becomes, the more the infection will spread and the less bone you will have when the site heals. Am I explaining that well enough?

You would see a general dentist or Prosthodontist (that is a specialist in the replacement of teeth) for an evaluation and treatment plan to replace those teeth. Then an oral surgeon for the extractions who would also work on the sinus if it were infected.

I know you are afraid... I totally understand that and wish I could make you feel more comfortable. The fact is that it is inevitable that you are going to lose these teeth at some point, probably sooner than later because the symptoms are going to get worse. I am so concerned about your health and you have said that you are not well. So to continue with this infection is certainly not in your best interest. That is my whole point in explaining all of this to you.... I think your health is the most important issue here much more so than the what ifs after the teeth are removed. You need to deal with the biggest problem first and that is the infection... and the source are those teeth.

Bryanna




QUOTE=Jenmca42;983797]Hi Bryanna,
Thank you so much for all your advice and of course taking the time out to look over all of this, I really do appreciate it.

I'm left wondering though, the last x ray was taken in 2011 and you said both root canaled teeth are infected and the bone will collapse if the teeth are kept as the infection will destroy the bone. My worry is that x ray was taken in 2011 and its been a further 2 year with the infection. If the bone collapses what does that actually mean? Does it mean then the face structure can be disfigured if that we're to happen? What type of dentist should I seek for a evaluation about this and also to find out if I have a sinus infection also?

I hope you do not kind me asking you, I really know nothing of what to do next. My anxiety and fear about dentistry was so high before all of this and now it's even worse. If I'm honest my worst fear is if these teeth are removed my face will collapse and I don't know if I'm am being overly exaggerated about this.

Jen


QUOTE=Bryanna;983684]Jen,

Your case is very clear... the 2 root canaled teeth in the xray are infected. The only way to get rid of the infection is to remove those teeth. The bone will collapse if you keep the teeth because the infection will destroy the bone. The bone will recede to a flatter plane making the level of new bone higher than normal bone but that is not the same thing as collapse.

This is how the x-ray appears to me....
The piece of metal that was in your tooth looks like a piece of a broken reamer or endo file. The main canal in that tooth shows that the nerve material was removed above where this broken piece of reamer is lodged. So if that is correct then that means that the sedation dentist did a root canal on that tooth but did not complete it because he broke off an instrument inside of the canal which blocked the canal from that point up. Instead of removing that metal piece.... he just put in another post and put on a temporary crown. I have seen this countless times.... I believe it is a piece of a metal endo reamer file that was broken off inside of your tooth.

You are fixated on what has happened in the past with this tooth as if it would have some bearing on what is happening now. It actually doesn't have any bearing because once a tooth becomes infected, it remains infected irrelevant of what is done to it. So the broken instrument and the lousy dentistry really did not alter the eventual outcome of these teeth because they have been infected this whole time. So you should focus on the present issue which is the infection and your ill health.

To remove the teeth is to remove the infection. To leave the teeth means to keep the problem. I'm sorry to be so blunt but your case is that clear and the choice to remove them or continue on this same path is up to you. If you have other teeth that need to be removed on the top and/or you already have other missing teeth on the top.... then speak to your dentist about making a removable partial denture to replace all of them. That would probably be the least expensive and most beneficial replacement option for you at this point.

Thanks for posting the x-rays... your case was as I had suspected. I hope I have been clear with my information and I hope I have been able to empower you to be a bit stronger, less fearful as you move ahead with this. You will be better once the infected teeth are removed.... your immune system will thank you. You will need to make some lifestyle changes for the betterment of your overall health but in doing so .... you will be okay!

Check back with us and let us know how you're doing!
Bryanna[/QUOTE][/QUOTE]