Hi folks!

First time posting here, although I've been reading this very helpful forum for some time. I'm a 44 year old male with no health issues before this, so here's my story...

Feb 2012, I had root canal treatment done on #24/#25 lower central teeth after an abscess flared up. Prior to that I had no pain, but had noticed that #25 had become a bit loose. I was told I had periodontal disease, and there was a nasty looking black area below both teeth on the x-ray. The endodontist said that it was a 'borderline' case, but that it was worth attempting the root canal in the hope that the teeth could be saved, and hopefully the bone would regenerate and the teeth would fuse back to the bone over time.

Other than that, I had been feeling somewhat light-headed for a couple of months prior to this. I had hoped that the root canal would solve my light-headed symptoms, but I would never have guessed the nightmare that was about to follow!

2 weeks after the root canals, I went out to a party and drank a bit too much (I don't drink often!), so was sick the following morning. For the next couple of days, my throat burned and I could hardly swallow, which had never happened to me before. Over the next couple of weeks, I started to feel really dizzy and had a sharp abdominal pain around the spleen area. I went to my doctor, he reckoned that I might have suffered internal bleeding after the party, and put me on medication. It didn't really help much, and so followed a series of hospital tests (endoscopy, MRI, ultrasound) over the next couple of months, all of which were clear. Blood tests were also clear, with occasional elevated white cell count. The dizziness and abdominal pain continued, other symptoms started to appear (brain 'fog', feeling drunk 24/7, a salty/blood/metallic taste in my mouth, chronic fatigue, and problems focusing my eyes) and I was barely able to function.

Fast forward to August 2012, and another abscess flared up at #14 upper molar, which I'd ignored for a long time, and at that stage, most of the crown was gone. My dentist gave me a course of antibiotics and then extracted the tooth. The morning after, all my symptoms disappeared! I couldn't believe it! I was elated, convinced that the old molar was to blame all along, and my life returned to normal. Until 2 weeks later, when I went for a cleaning with the dental hygienist. By the time I walked back to my car, the dizziness had returned. I was gutted.

I was finally suspicious of the root canals, as all my symptoms had started shortly after they had been done. I saw my dentist, he took another x-ray and said that they were fine, and in fact were healing very well, with excellent bone regeneration. I asked him if he could have missed anything when he extracted #14, and maybe some infection could have been left behind but he said no, that he got it all. I asked him if he could prescribe an antibiotic course, and he put me on a combination of Amoxicillin/Metronidazole. After 7 days my symptoms were gone again, and I was back to normal, but after a couple of weeks the symptoms returned again. This continued through the winter, and I started experiencing occasional throbbing pain where #14 had been extracted.

Fast forward again to March 2013, and after a period of swollen glands in my neck and painful glands in my armpits, I had another round of antibiotics, this time with a violent reaction (shivering/shaking for a week), from which I finally recovered by taking a course of probiotics. This time I asked my dentist to refer me to an oral surgeon to investigate the extraction site. The oral surgeon thought he noticed a dark area on my last x-ray, I asked him if he could do a surgical debridement, and he ordered a CT scan to investigate further. After several weeks waiting, I had the scan in the first week of May. But when I saw him a week later, he said that the CT scan appeared normal, and as there is a risk with any surgical procedure, he was reluctant to open up the old extraction site and debride the socket based on the evidence.

I then made an appointment with a different dentist for a second opinion, which happened last week. He took a panoramic x-ray and pointed out a dark area around #25 (the RC tooth that had been loose in the beginning). He suspected an infection and suggested an apicoectomy, but said that I would have to return to my original dentist and follow up with him. I asked him about extracting both RC teeth and replacing with a bridge/implants, but he refused and just said I wold have to return to my original dentist.

So, back to the oral surgeon again! My most recent visit with him was a few days ago, where we discussed the extraction site again, because that's the reason I had been referred to him. He said that in his experience, CT scans are sometimes only 75-80% accurate, and that a follow-up scan should be done again in a few months time. I then asked him about the likelihood of root canal infection based on my symptoms, and told him about my visit to the second dentist. I explained the understanding I now have of the root canal procedure - that the large canals are sealed up, the small canals are inaccessible and remain infected, and that it's a case of sealing up what they can and 'hoping for the best'. His answer was "essentially, yes".

I told him that I've had such a nightmare ever since the root canals were done, that at this stage I'd prefer to have them extracted. I asked him about a bridge or implants, and he said that in his opinion, he would recommend a bridge based on my previous periodontal disease. He said that implants are the 'gold standard', but are not maintenance-free, and several hygienist visits would be required every year to make sure they don't fail. He went on to say that he had recommended against implants to other patients, but they went elsewhere, had implants fitted, and then returned to him 2-3 years later, looking for help when the implants failed.

So, the final part of that discussion was him saying that I have to return to my dentist, discuss the situation with him, and he can refer me back to the oral surgeon. Oh, I forgot to mention that I ended up in the emergency room 2 weeks ago with a badly swollen submandibular gland, so when I told the oral surgeon about this, he sent me for an ultrasound. I have an appointment with him next week to discuss the result.

I also now have an appointment with my dentist earlier on the same day, and I will be asking him to take fresh x-rays of the RC teeth and the extraction site and to email them to the oral surgeon.

What a mess! And sorry about the long-winded post, but I wanted to make sure I included all the details...

Any thoughts would be very welcome!

Wow - you have certainly been through a lot with your health. I hope the best for you. I would imagine taking those two root canalled teeth out would help you a lot.

Good luck! Gretchen

Thanks Gretchen! It's reassuring to read some of the other posts here and to know I'm not the only one with issues after root canal. Hopefully I'll have the same kind of outcome I've read about elsewhere - remove RC teeth properly (surgically), and health returns to normal.

Although I'm still not sure what part the extraction has played in all this. I'm hoping Bryanna will reply when she has a chance. Maybe she's seen this kind of situation before.

From my last conversation with the oral surgeon, I'm confident that he will do a thorough extraction. He said that for a bridge or implants, he would extract the RC teeth, scrape down to the 'bleeding bone' to be absolutely sure all infection was gone, and place grafts.

I think I should summarize my situation for Bryanna's sake, as it will make replying easier!

Feb 2012 - root canal #24 & #25, onset of many weird symptoms.
Aug 2012 - extraction #14, symptoms disappeared.
Sep 2012 - cleaning, symptoms returned.
Sep 2012 - antibiotics, symptoms disappeared.
Oct 2012 - symptoms returned and have persisted.

Ok, I can't speak to the infections overall, but I can speak to implants/bridges. Bridges cut down healthy teeth and compromise them. As far as implants go, you need to have great hygiene-brushing, flossing, and I also use a waterpik. I get my teeth cleaned every 6 months anyway, so having them check my implants then is no big deal. If you don't think implants are the right choice, perhaps a partial denture so that your remaining healthy teeth aren't compromised?

I've had crazy amounts of root canals. If have to go count, but I want it was 20+. I regret that. I wish I had pulled them instead of keeping them in my body while infected.

I have personally experienced aggravated health issues because of dental issues. There is no doubt in my mind that dental work can thrash your whole body.

Hi dr teeth,

I am in the dental field for many years and I can offer you some help here.

Your dental problem and possibly systemic issues may be linked to these things....

You have a bacterial infection called Periodontal disease (as you stated). What you may not know is that every minute of the day this bacteria filters through your blood stream. That disease can make you systemically sick. If the disease is not brought under control, then every time you brush/floss your teeth, eat, drink, or have your teeth professionally cleaned, the bacteria get stirred up. A routine cleaning cannot remove the bacteria because it is deep in the tissue and in abundance. Some people will react unfavorably (not feel well) immediately after the cleaning.... others it may take a week or so.

Anytime you have dental work such as an extraction and there is active periodontal disease present anyplace in that mouth, the bacteria from the disease goes to the surgical site. This can cause the area to become infected and/or cause it to heal very slowly or incompletely.

Root canaled teeth.......
All root canaled teeth are infected because there is no access to the tiny canals which harbor infectious bacteria. Black areas seen on an xray at the apex or near a root canaled tooth always indicate infection and most often indicate that a cyst is forming in the bone. Re treating a tooth with another root canal or doing an apicoectomy will not reduce or eliminate the infection inside of the tooth. The only way to "cure" the infection is to remove the source which are the rc teeth.

In your case you have infected teeth and periodontal disease. No wonder you are feeling so poorly!

Your drinking event that lead to you becoming ill... sounds to me like your immune system is overwhelmed with your dental infections and since intoxication burdens the immune system you are what is referred to as a "host" for becoming ill which means when something triggers your compromised immune system it responds in the form of ill health.

Antibiotics will temporarily subside your symptoms because what you have is bacterial. However, they cannot cure your problems.

It would not be wise to retain any infected teeth if you are concerned about your overall health because they can make you very ill. Infected teeth also destroy the bone structure that holds the teeth in the jaw which will make replacement of those teeth compromised if not very impossible other than with removable partial dentures.

Have you done anything to treat the periodontal disease? How long have you had it and how severe is it? Do you have regular dental care every six months?

Bryanna

Hi Bryanna! Thanks so much for your reply - I really appreciate your help.

This makes a lot of sense!

I wasn't aware of this, and it too makes a lot of sense. I wonder if this is the reason I'm still getting an occasional throbbing from the extraction site of #14, almost a year later?

Would this be a retention cyst? The oral surgeon mentioned this as a possibility from the extraction last year, but that has apparently now been ruled out based on the CT scan. However, the new x-rays in a few days may show something different again.

Boy am I sorry I ever went to that party! I hardly ever drink alcohol as a rule, maybe once or twice a year... But it sounds like these symptoms would have happened anyway in some shape or form.

Thanks Bryanna. I need to discuss replacement options with my dentist and the oral surgeon.

Yes, I have had regular dental care since this happened last year. But I had allowed the dental visits to lapse before that, which is why I'm in this situation now. As for the periodontal disease, there hasn't been any specific treatment for it, other than the root canals. All I know is that my x-rays from a few months ago looked a LOT better than the x-rays taken before the root canal work was done. The periodontal disease hasn't been discussed since, which had led me to believe it was resolved.

Hi dr teeth,

You could be getting throbbing from the extraction site if there is a infection brewing from a granulomatous cyst (from the original infection) and/or a sinus infection. Did you have a dental cone scan or a routine ct scan? The scan needs to be modified for dental only.

You wrote...<<<<Yes, I have had regular dental care since this happened last year. But I had allowed the dental visits to lapse before that, which is why I'm in this situation now. As for the periodontal disease, there hasn't been any specific treatment for it, other than the root canals.>>>

ROOT CANALS ARE NOT DONE BECAUSE YOU HAVE PERIODONTAL DISEASE. DID YOUR DENTIST TELL YOU THAT? ROOT CANALS ARE DONE TO ALLOW A PATIENT TO TEMPORARY RETAIN THEIR INFECTED TOOTH $$$$. I KNOW THAT SOUNDS HARSH BUT IT IS 100% FACT. TEETH THAT HAVE SEVERE GUM RECESSION CAN BE VERY SENSITIVE. SOME DENTISTS WILL TELL THEIR PATIENTS TO HAVE THESE TEETH ROOT CANALED SO THEY ARE NO LONGER SENSITIVE. THE HUGE PROBLEM WITH THAT IDEA IS THAT THE HEALTHY TOOTH THEN BECOMES UNHEALTHY AND THE BONE NOW STARTS TO BECOME DECREPIT FROM THE SICK TOOTH. THE ALTERNATIVE TO ROOT CANALING THESE GUM DEPRIVED TEETH IS TO PLACE TOOTH COLORED FILLINGS ACROSS THE AREAS THAT ARE EXPOSED AND SENSITIVE.

<<< All I know is that my x-rays from a few months ago looked a LOT better than the x-rays taken before the root canal work was done.>>>

THE THIS MEAN THE XRAYS LOOK WORSE SINCE THE ROOT CANALS WERE DONE?

<<<The periodontal disease hasn't been discussed since, which had led me to believe it was resolved.>>>

PERIODONTAL DISEASE IS NEVER CURED. IT CAN BE BROUGHT UNDER CONTROL BUT NOT CURED. DO YOU HAVE DEEP POCKET READINGS OVER 3 MM'S? DO YOUR GUMS EVER BLEED AT ALL? ARE YOUR GUMS PUFFY AND/OR RED? DO YOU HAVE BAD BREATH?

Bryanna

Hi Bryanna,

I asked if it was a specific dental scan the day I was in the hospital, and was told that it was mouth, jaws and bone structure. The oral surgeon said that the scan showed inflammation in both sinuses, but was otherwise ok. The scan report said that all was normal apart from sinus inflammation.

No, I was told that both teeth were probably dead due to periodontal disease. The endodontist tested both teeth (#24, #25) for cold sensitivity and I felt nothing. I was told that both teeth were dead and needed root canal treatment to be retained.

No, the x-rays looked much better several months after the root canals were done, and I was told that the bone had regenerated very well.

I haven't had any deep pocket readings done. Gums don't bleed, not puffy or red, and I don't have bad breath.

I have an appointment with my dentist and oral surgeon tomorrow. I will be asking my dentist for a written referral to the surgeon for both RC teeth to be extracted, and what my replacement options are. Would you agree with this? Do you have any advice as to what else I should be asking?

Thanks again for all your help with this, Bryanna!

dr teeth,

I didn't see your post yesterday.... what did the oral surgeon say today??

Bryanna