[dbpei]

I had a dental implant of tooth #15 in 2008 that never felt right to me. The tooth had a failed root canal followed by a difficult extraction. When I would bend down, it was as though I could feel the metal in my bone and I would feel sinus pressure. My gum above that tooth has been dark gray ever since the implant. (Could this be necrotic bone beneath the gum tissue?) I have addressed this with both my dentist and oral surgeon but they said the implant looked fine.

It turns out that I have developed a fistula in the roof of my mouth above #14 and #15. The dentist thinks that the tooth next to the implant is infected and it is going to be extracted tomorrow. This tooth had a root canal done in 2011. Sadly, the infection has spread to my jaw bone above the tooth. The oral surgeon is prepared to clean out the infected bone as best he can.

I have some questions:

1. If tooth #15 is infected, is it likely that the jaw bone above the implant on #14 could be infected as well?

2. Is there any way that the oral surgeon can determine if the adjacent bone is infected when he is extracting the tooth and cleaning out the necrotic bone tissue?

3. If it looks like the jaw bone is infected above the dental implant, should the oral surgeon try to remove the implant while he is extracting the tooth next to it?

I am concerned that this infection has spread throughout my jaw and even into my skull. I feel strange sensations in my face and the side of my head as well as my mastoid bones. I am hoping this can all be taken care of with the extraction and antibiotics, but I am so afraid of the damage already done.

I want the oral surgeon to take a culture or biopsy of the bacteria so we know what type of bacteria we are fighting. Is there anything else you would recommend for me to communicate with my oral surgeon tomorrow before he does the surgery? I am going to have conscious sedation for this as I don't think I could tolerate the anxiety!