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Old 05-26-2013, 02:51 AM #1
Jerry5 Jerry5 is offline
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Default fistula wisdom teeth extraction teeth numbness

Hi Bryanna,

First of all, please let me thank you for your kind advocacy. You are how I wish everyone would be with their great super powers.

I think I have an interesting problem.

I presented with some strange symptoms (parasthesia in both upper arms, easy bruising, xiphoid hurting, swollen superficial cervical lymph nodes). These are all weird new symptoms to me since I'm a realtively healthy 40 year old but with chronic fear of dentists (5 years) and historically bad teeth.

I also had what I thought to be rampant caries in my upper molar areas (three teeth connected). Based on my symptoms, I thought I either had cancer or a tooth infection (I read "Spread of Dental Infection" by Fehrenbah and Herring- Great read!!), so I went to the dentist since I don't have insurance and everything would be explained by it.

He told me the chips at the base of my molar teeth were not my problem since that can be explained by me grinding my teeth. Also, the chips weren't deep enough to reach the dental pulp.

The bigger problem was my wisdom teeth were impacted and one of them was destroying its neighbor so I had to get them pulled.

I went to the oral surgeon to get the teeth extracted and while I was waiting alone in the patient room, I inspected my x-rays. I thought I saw a fistula wrapping around the outside of one of the impacted wisdom teeth (lower left side) deep in the crevice and and draining through the base of the tooth through the jaw. It was almost like a perfect hairline fracture-looking thing. I mentioned this to the surgeon and he said that he didn't see anything but he wouldn't even look at the x-ray! I hate that some MDs make you feel like only they know best.

In any case, it's been 5 days since my extraction and my symptoms are all reduced or gone. So, I suspect it's not cancer!

Still, I was recovering as expected from the extraction except that I'm getting swelling at the extraction sites that went away as soon as I took two over the counter Ibuprofen. Also, I noticed that some of my teeth (the ones with the chips) were numb.

So, my two questions are:
1) Why would my teeth be numb?
2) What happens to the fistula
3) What would you suggest I do to improve my prognosis, please? Should I keep taking oral antibiotics? For how long? I've been on 500mg Amoxicillin 3X/day for ~2 weeks now.

Thank you so much and I wish there are opportunities for others to help you as you are all of us!!
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Old 05-26-2013, 10:57 AM #2
Jerry5 Jerry5 is offline
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Default infection

Hi Bryanna!

Just to clarify, it's day 6 post-operation.

I woke up with dull pains around both lower molars-the pain being greater on the lower left side (side with the putative fistula). When I said previously that the pain went away with Ibuprofen, I should have mentioned that I had also been taking Hydroco (Vicodin?) and maybe all that went away was the discomfort.

So, I looked in the mirror and there was localized swelling on my gum/cheekline and I could still see the clots. I also don't have the intense pain that I've read regarding dry socket. It's more the type of localized inflammation/swelling pains that I'm used to (as I've said, I've had many tooth issues in the past I repeated the Ibuprofen but that didn't work like it did yesterday. I took a Vicodin 30 minutes later and 5 minutes after that, the discomfort is subsiding.

I have a scheduled appt with the oral surgeon for follow up on Tuesday. Should I go in on Monday to take care of this?

Thank you again for your expertise!

Jerry5




Quote:
Originally Posted by Jerry5 View Post
Hi Bryanna,

First of all, please let me thank you for your kind advocacy. You are how I wish everyone would be with their great super powers.

I think I have an interesting problem.

I presented with some strange symptoms (parasthesia in both upper arms, easy bruising, xiphoid hurting, swollen superficial cervical lymph nodes). These are all weird new symptoms to me since I'm a realtively healthy 40 year old but with chronic fear of dentists (5 years) and historically bad teeth.

I also had what I thought to be rampant caries in my upper molar areas (three teeth connected). Based on my symptoms, I thought I either had cancer or a tooth infection (I read "Spread of Dental Infection" by Fehrenbah and Herring- Great read!!), so I went to the dentist since I don't have insurance and everything would be explained by it.

He told me the chips at the base of my molar teeth were not my problem since that can be explained by me grinding my teeth. Also, the chips weren't deep enough to reach the dental pulp.

The bigger problem was my wisdom teeth were impacted and one of them was destroying its neighbor so I had to get them pulled.

I went to the oral surgeon to get the teeth extracted and while I was waiting alone in the patient room, I inspected my x-rays. I thought I saw a fistula wrapping around the outside of one of the impacted wisdom teeth (lower left side) deep in the crevice and and draining through the base of the tooth through the jaw. It was almost like a perfect hairline fracture-looking thing. I mentioned this to the surgeon and he said that he didn't see anything but he wouldn't even look at the x-ray! I hate that some MDs make you feel like only they know best.

In any case, it's been 5 days since my extraction and my symptoms are all reduced or gone. So, I suspect it's not cancer!

Still, I was recovering as expected from the extraction except that I'm getting swelling at the extraction sites that went away as soon as I took two over the counter Ibuprofen. Also, I noticed that some of my teeth (the ones with the chips) were numb.

So, my two questions are:
1) Why would my teeth be numb?
2) What happens to the fistula
3) What would you suggest I do to improve my prognosis, please? Should I keep taking oral antibiotics? For how long? I've been on 500mg Amoxicillin 3X/day for ~2 weeks now.

Thank you so much and I wish there are opportunities for others to help you as you are all of us!!
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Old 05-27-2013, 04:43 PM #3
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Hi Jerry,

Well gee whiz... thank you so much for your kind words ~'.'~
I wish I had super powers ... but I really don't. I'm a little clairvoyant.... which sometimes comes in handy... or not. Depends on the situation.

So you've read about the spread of dental infections? Brave of you to do that prior to having your teeth removed! Glad it prompted you to take action ;>

I cannot comment on the fistula issue related to the bone without an xray. I would assume that if you had a large area of infection in the bone that the oral surgeon would have informed you of that.... at least I would hope that he would have.

The "odd" symptoms that you had prior to the extractions.... as you may already know, oral infections can cause or contribute to a menagerie of physical problems. The infections don't have to be all that severe either... it just depends on the individual.

Did you also have the second molar extracted that was affected by the wisdom tooth? Where in your mouth was that tooth?

You can expect swelling to occur for several days after impacted wisdom teeth are extracted. Regarding the numb teeth with the "chips"..... I really don't know why that would be happening. Please make mention of it to the OS when you see him.

Regarding the medications.... that is up to your surgeon to determine based on what he's seen radiographically, clinically and surgically.

Some things you can do to help yourself heal...
No Smoking or drinking alcohol. No mouthwash like Listerine. All of which will slow down the healing.
Eat nutritiously...... avoid sugar, processed foods, fast foods, all sodas, foods that require a lot of chewing, sticky foods.....
Eat a soft diet rich in plenty of veggies, fruit and protein. Drink plenty of filtered water throughout the day.
You can make smoothies and add protein powder to it.

Bryanna





Quote:
Originally Posted by Jerry5 View Post
Hi Bryanna,

First of all, please let me thank you for your kind advocacy. You are how I wish everyone would be with their great super powers.

I think I have an interesting problem.

I presented with some strange symptoms (parasthesia in both upper arms, easy bruising, xiphoid hurting, swollen superficial cervical lymph nodes). These are all weird new symptoms to me since I'm a realtively healthy 40 year old but with chronic fear of dentists (5 years) and historically bad teeth.

I also had what I thought to be rampant caries in my upper molar areas (three teeth connected). Based on my symptoms, I thought I either had cancer or a tooth infection (I read "Spread of Dental Infection" by Fehrenbah and Herring- Great read!!), so I went to the dentist since I don't have insurance and everything would be explained by it.

He told me the chips at the base of my molar teeth were not my problem since that can be explained by me grinding my teeth. Also, the chips weren't deep enough to reach the dental pulp.

The bigger problem was my wisdom teeth were impacted and one of them was destroying its neighbor so I had to get them pulled.

I went to the oral surgeon to get the teeth extracted and while I was waiting alone in the patient room, I inspected my x-rays. I thought I saw a fistula wrapping around the outside of one of the impacted wisdom teeth (lower left side) deep in the crevice and and draining through the base of the tooth through the jaw. It was almost like a perfect hairline fracture-looking thing. I mentioned this to the surgeon and he said that he didn't see anything but he wouldn't even look at the x-ray! I hate that some MDs make you feel like only they know best.

In any case, it's been 5 days since my extraction and my symptoms are all reduced or gone. So, I suspect it's not cancer!

Still, I was recovering as expected from the extraction except that I'm getting swelling at the extraction sites that went away as soon as I took two over the counter Ibuprofen. Also, I noticed that some of my teeth (the ones with the chips) were numb.

So, my two questions are:
1) Why would my teeth be numb?
2) What happens to the fistula
3) What would you suggest I do to improve my prognosis, please? Should I keep taking oral antibiotics? For how long? I've been on 500mg Amoxicillin 3X/day for ~2 weeks now.

Thank you so much and I wish there are opportunities for others to help you as you are all of us!!
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Old 05-27-2013, 04:49 PM #4
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Jerry,

Which side is the second molar on that was affected by the wisdom tooth? If that tooth has decay in it and it was not removed, it may start to hurt.

Yea, mentioning Vicodin would make a difference as it would jump start the Ibuprofen. Makes sense.

Try to follow my suggestions on my previous answer to you regarding what you can do to help your self heal well. If the pain intensifies, the swelling gets larger or spreads, if the pain meds do not help.... or you develop anything unpleasant like a fever... see your OS sooner than tuesday. Otherwise you have described typical post op symptoms following impacted wisdom teeth... other than the numb teeth with the "chips" in them.

Bryanna



Quote:
Originally Posted by Jerry5 View Post
Hi Bryanna!

Just to clarify, it's day 6 post-operation.

I woke up with dull pains around both lower molars-the pain being greater on the lower left side (side with the putative fistula). When I said previously that the pain went away with Ibuprofen, I should have mentioned that I had also been taking Hydroco (Vicodin?) and maybe all that went away was the discomfort.

So, I looked in the mirror and there was localized swelling on my gum/cheekline and I could still see the clots. I also don't have the intense pain that I've read regarding dry socket. It's more the type of localized inflammation/swelling pains that I'm used to (as I've said, I've had many tooth issues in the past I repeated the Ibuprofen but that didn't work like it did yesterday. I took a Vicodin 30 minutes later and 5 minutes after that, the discomfort is subsiding.

I have a scheduled appt with the oral surgeon for follow up on Tuesday. Should I go in on Monday to take care of this?

Thank you again for your expertise!

Jerry5
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Old 05-27-2013, 07:05 PM #5
Jerry5 Jerry5 is offline
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Hi Bryanna!

It's really cool to get direct feedback from you. In my eyes, you're famous and really deserve it!

The second molar is in the lower left side, next to the putative fistula. No, it's not removed and there is damage to it. I can feel a sharpness at the base but I don't think it has penetrated to the pulp. It's only mildly cold-sensitive.

I think I'm imagining the fistula, though. I saw some other x-rays online of impacted wisdom teeth and they all seem to have that black line next to the tooth. To be quite honest, I've been experiencing lots of anxiety and hypochondriasm and thus far, my oral surgeon has been great and I respect him lots, so no need to question him...at least not at this point. My latest hypochondriasm is that I have osteomyelitis/cavitation and that the bacterial toxins are killing me.

My pain is dull, constant and excruciating but tolerable. The upper holes are pain-free but the lower ones are still very sore, with local infection-like symptoms. I thank you for assuring me this is typical (good lord! I sympathize with wisdom teeth victims...uh, patients!).

As for the numbness in teeth, that's appearing to lessen, too. However, I get a pulling/pressure feeling in that area and sinuses (upper left, with the chips), kinda that feeling you get as the novocaine shot is wearing off after getting treatment for cavities. I noticed that my bite is much better aligned after the extractions. Perhaps they're all related?

In any case, I will take your recommendations; watch what I eat and mention these symptoms to my OS tomorrow. Thank you again for easing my fears and being so great with your time!

Thank you and may your teeth be eternally healthy!
Jerry



Quote:
Originally Posted by Bryanna View Post
Jerry,

Which side is the second molar on that was affected by the wisdom tooth? If that tooth has decay in it and it was not removed, it may start to hurt.

Yea, mentioning Vicodin would make a difference as it would jump start the Ibuprofen. Makes sense.

Try to follow my suggestions on my previous answer to you regarding what you can do to help your self heal well. If the pain intensifies, the swelling gets larger or spreads, if the pain meds do not help.... or you develop anything unpleasant like a fever... see your OS sooner than tuesday. Otherwise you have described typical post op symptoms following impacted wisdom teeth... other than the numb teeth with the "chips" in them.

Bryanna
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Old 05-28-2013, 08:32 PM #6
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Hi Jerry,

SO.... what did the OS have to say today?
Hope he said all is well

What exactly is wrong with the second molar on the lower left....decay?

Bryanna


Quote:
Originally Posted by Jerry5 View Post
Hi Bryanna!

It's really cool to get direct feedback from you. In my eyes, you're famous and really deserve it!

The second molar is in the lower left side, next to the putative fistula. No, it's not removed and there is damage to it. I can feel a sharpness at the base but I don't think it has penetrated to the pulp. It's only mildly cold-sensitive.

I think I'm imagining the fistula, though. I saw some other x-rays online of impacted wisdom teeth and they all seem to have that black line next to the tooth. To be quite honest, I've been experiencing lots of anxiety and hypochondriasm and thus far, my oral surgeon has been great and I respect him lots, so no need to question him...at least not at this point. My latest hypochondriasm is that I have osteomyelitis/cavitation and that the bacterial toxins are killing me.

My pain is dull, constant and excruciating but tolerable. The upper holes are pain-free but the lower ones are still very sore, with local infection-like symptoms. I thank you for assuring me this is typical (good lord! I sympathize with wisdom teeth victims...uh, patients!).

As for the numbness in teeth, that's appearing to lessen, too. However, I get a pulling/pressure feeling in that area and sinuses (upper left, with the chips), kinda that feeling you get as the novocaine shot is wearing off after getting treatment for cavities. I noticed that my bite is much better aligned after the extractions. Perhaps they're all related?

In any case, I will take your recommendations; watch what I eat and mention these symptoms to my OS tomorrow. Thank you again for easing my fears and being so great with your time!

Thank you and may your teeth be eternally healthy!
Jerry
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Old 05-30-2013, 05:35 PM #7
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Hi B!

Mmmm...well, I never did bring up the fistula issue. He seemed annoyed by my inquiries (he mumbled that if I press by asking questions like the ones I raised, practitioners are not likely to want to deal with me). I agree with his statement to a certain extent but it leaves little room for patients to express any inquiries not consistent with the OS's opinions. I know enough about medicine to know that diagnosis without clear evidence (don't get me started with what evidence entails) is essentially hypotheses. I guess this is why I respect how much of your time you devote to patient advocacy!

In any case, my symptoms have disappeared for the most part, I feel healthier, my gums are still a little tender, I'm off all meds except for the occasional aspirin and healing is just fine!

With respect to my second molar, there was local decay due to wisdom tooth impaction that spawned a rich environment for bacterial growth. You could see it in the x-ray, which is what prompted me to get my teeth extracted. At present, I can feel the crags at the root of the molar but when the OS felt around with a probe, he couldn't detect it. It's enough to cut up my tongue, though. I'm thankful that I don't have to get it removed, though. After reading your philosophy on root canals, I'm inclined not to ever get one, and instead, think about alternatives.

In any case, thank you again for your generosity with your time and expertise!

Jerry


Quote:
Originally Posted by Bryanna View Post
Hi Jerry,

SO.... what did the OS have to say today?
Hope he said all is well

What exactly is wrong with the second molar on the lower left....decay?

Bryanna
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Old 05-30-2013, 09:03 PM #8
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Hi Jerry,

So glad to hear you are doing well!

I really dislike when a dentist thinks a patient is meant to be silent.... they often forget what it's like to be a patient!

It would be wise to have that cavity fixed as soon as the surgical site heals closed. You don't want it to get too deep!

Nice to have met you Jerry! Thanks for sharing your story with us!
Bryanna


Quote:
Originally Posted by Jerry5 View Post
Hi B!

Mmmm...well, I never did bring up the fistula issue. He seemed annoyed by my inquiries (he mumbled that if I press by asking questions like the ones I raised, practitioners are not likely to want to deal with me). I agree with his statement to a certain extent but it leaves little room for patients to express any inquiries not consistent with the OS's opinions. I know enough about medicine to know that diagnosis without clear evidence (don't get me started with what evidence entails) is essentially hypotheses. I guess this is why I respect how much of your time you devote to patient advocacy!

In any case, my symptoms have disappeared for the most part, I feel healthier, my gums are still a little tender, I'm off all meds except for the occasional aspirin and healing is just fine!

With respect to my second molar, there was local decay due to wisdom tooth impaction that spawned a rich environment for bacterial growth. You could see it in the x-ray, which is what prompted me to get my teeth extracted. At present, I can feel the crags at the root of the molar but when the OS felt around with a probe, he couldn't detect it. It's enough to cut up my tongue, though. I'm thankful that I don't have to get it removed, though. After reading your philosophy on root canals, I'm inclined not to ever get one, and instead, think about alternatives.

In any case, thank you again for your generosity with your time and expertise!

Jerry
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