First of all, thank you everyone, for your support and suggestions. I can't tell you how much it means to have a place like this. My friends and family are very supportive, but cannot begin to understand what this feels like, so it's great to be able to come here where people "get" it.

And an extra, very big thank you to Bryanna, for taking the time to parse all my posts for answers. I'm sorry I haven't had a chance to post this sooner, but between work and an extra long visit to the dentist yesterday (he made me a new soft nightguard), there hasn't been any time. I'm also sorry I don't have x-rays to post, but I've been reluctant to ask anyone for them, as silly as that may sound. Anyone who's seen them seems to think they look fine, with no evident areas of infection past or present.

Yes, Bryanna, my gum is still quite sore, though the dentist thinks it looks healthy. Yesterday was a full week after the curettage and the first time I think I didn't feel the additional pain of that procedure. But the original, lingering pain is still there, so I am not sure the curettage worked? That area has been especially sensitive for a long time, and I think in fact was the cause of my thinking I needed a root canal (#1). After the root canal, everything felt worse, but what I really seemed to notice was that the irritated feeling in my gum was still there and probably even more inflamed. The endodontist and my dentist both pushed for a retreatment for that issue (none of which they charged for, to be fair) and I thought maybe the retreatments would solve the problem. (They were strung out of a couple of months, with the endo going in repeatedly and cleaning out more, and using calcium hydroxide, and a third "re-treatment" where the dentist himself opened up the tooth and used used some sort of laser to "sterilize" the tooth. )

But nothing helped. In the weeks following R/C #1 (which was on tooth 18, if that helps; R/C #2 was on 19), the gum got so inflamed it felt like it was trying to physically eject the tooth. It was obviously red and swollen and the dentist recommended some deep cleaning, which did seem to calm it down a bit, at least visually. Still I always felt like it was an open wound, and very sore. It seemed like I could feel liquids (not just cold liquids) following the path of my (ostensibly removed) nerve down to the (dead) root of the tooth. This is when I began to suspect the adjacent tooth (and had the second root canal).

Now, even though they are root-canaled and officially "dead teeth" I still feel substantial soreness in the gum surrounding 18, though the tooth itself no longer hurts. Tooth #19 is still very tender to the touch, though the dentist feels it seems better since he saw me two weeks ago. (Also, seemed more irritated by the new night guard which even though is soft, still allows me to clench.) For the TMJ, which everyone seems to agree I've developed, I am taking ibuprofen (3x/day), using warm wet compresses (whenever possible), doing some jaw exercises and have changed to a soft food diet. This is the place where I've seen the most progress in the shortest amount of time, so I'm hopeful this will help.

The teeth, on the other hand, I have lost whatever hope I had. I don't want to have crown lengthening surgery on a R/C tooth. There is no guarantee it would work, from what I understand, even if I wanted to keep this tooth, which I don't. I would like to have this tooth extracted, but I am still not sure that would solve the biologic width issue. (I assume because the tooth will be gone, the gum will just re-form, but I don't fully understand why this issue is causing me so much discomfort, even after I had the cerec crown removed and a temp placed. Why didn't that help?) Also, the dentist warned me that it is possible that some of my jaw issues may have been caused by all the deep nerve blocks i have had in this area, for all those R/C's and retreatments and crown preps. I still have the plunking chord issue, running along my jaw; it happens a few times every half hour or so. I am now worried about further damage, since I realize I will probably need more blocks for the extraction. I also realize there is no way they will let me pull both 18 and 19 at once, and I don't really have the money to do it. How should I try to manage this?

Sorry for the extra long post. I know many people on this site are in similar or analogous situations, and I hope someone can get something out of this information. I wish I had thought more about all these ramifications of what seemed (each time) like a pretty straightforward decision. And I really wish I had never met an endodontist. Bryanna, I would really appreciate your help with these questions!

I left out one thing that I've been wanting to tell my dentist as well. Not sure if it's relevant to the actual condition of my tooth, but ever since the first root canal I have felt like this tooth has been a foreign object in my mouth. Last week I met a woman at the dentist who was crying about her implant, how much she hated it, how it felt like someone had just stuck something in her jaw in place of her tooth. And I realized that this was the same exact way my R/C tooth feels to me, like a completely foreign object, jammed into my VERY uncomfortable gum.

I don't know if this is how ALL root canals feel (my second R/C tooth is still inflamed so too soon to tell about about that), but I certainly hope I don't have an extraction and get an implant that feels the same way as that poor woman's.

Thank you so much Bryanna for your continued presence here and help with this subject. Do you know where I /we can find a professional who knows about bone infection and just treats them. I am again fighting with yet another oral surgeon who refuses to go there. The one person I knew who was able to help and heal me retired...Mostly he was tired of fighting with oral surgeon also. I would any where on the west coast.


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Hi Sue M,

I do not personally know of anyone on the west coast. Have you tried the IAOMT organization? You would have to do a search for dentists in specific areas and then call their office and ask if they treat bone infections or if they can refer you to someone who does.

Could you try to reach the dentist that retired and ask him if he knows of someone you could go to?

Bryanna

I thought I may have finally talked my dentist into approving the extraction, but now have met further opposition from the periodontist, who thinks I would benefit from seeing a TMJ specialist before any "irreversible" procedures. Just have a couple of questions (Bryanna, I would really appreciate your help here!) before I decide to see him or get another referral:

1. Is this pain I've been feeling really caused by the biological width issue? It feels almost like teething pain (from what I can remember about teething!) and sometimes as if the gum is trying to squeeze the tooth out of my mouth. It hurts 24/7, though it does seem to feel more irritated after eating or drinking. I do think it's the reason I originally (and mistakenly) sought out the root canal.

2. If it IS pain from the biological width violation (and not, say, from the root canal per se, or from a possible fracture of the tooth below the gum line): will the extraction of this tooth solve the issue, or will the gum remain inflamed? Would taking the temporary off (temporarily) really prove that it is or isn't a biological width issue? How long would it take to work? and, if that doesn't work, and I have the extraction,would there be any complications from the gum problem if I had to get an implant in a few months?

3.Is it possible that the TMJ is actually causing this pain in my gum? It seems impossible that even as much as I clench, I am manifesting this "teething" pain in my gum. I do have many of the symptoms of TMJ, the jaw pain, earaches, headaches, numbness in the left side of my face. The soft diet has helped somewhat. Is it worth it to further delay this extraction, and seek out a TMJ specialist? (And spend even MORE money.)

4.Why does NOT ONE dentist (endo, perio, etc.) want to pull this tooth? Why does everyone suggest some other "last ditch" effort I should make beforehand? I feel like Dorothy in OZ; I have finally gotten in to see the wizard, but he makes me go chase down the witch's broomstick before he'll talk to me. I have told the last two dentists that I am ready to have the extraction, but they both have insisted I try "one more thing" before I pull the tooth. Is having an extraction really so horrible?

This is driving me crazy. I feel like that guy who was trapped under a rock by his arm and had to saw it off himself. It's as if when he was finally ready and willing to sacrifice the limb for his life, a doctor came up and suggested he instead try some massage to relax his muscle.

This tooth has been hurting me since last Thanksgiving; at this rate I will see another holiday season without any relief. I'm sure I could just find an oral surgeon online who would pull the tooth, but I'm confused about why my own dentists are so hesitant to agree that it's the best course of action. I would rather have them on board than feel that I am disregarding professional advice. (And it's not even as though these two had anything to do with the original situation.)

I don't get it.

Hang in there Sadie, wait for Bryanna to respond to you. You can also try to PM. her. You do have some real concerns and valid points. she can best direct you in this. Dentists in general like to "retain" a tooth, even if it is infected. Bryanna knows your history. She will be along. I know you are feeling like Dorthy in OZ, it is confusing for me too. I know how anxiety can work a person over. ginnie

Hi sadie,

I will repost your questions and answer in bold type.

<<1. Is this pain I've been feeling really caused by the biological width issue? It feels almost like teething pain (from what I can remember about teething!) and sometimes as if the gum is trying to squeeze the tooth out of my mouth. It hurts 24/7, though it does seem to feel more irritated after eating or drinking. I do think it's the reason I originally (and mistakenly) sought out the root canal.>>

YOU ARE DESCRIBING WHAT DENTISTS REFER TO AS A PERIO/ENDO PROBLEM. THIS IS WHEN THERE IS A PERIODONTAL PROBLEM WITH THE BIOLOGICAL WIDTH AS WELL AS AN INFECTION IN THE TOOTH. IT CAN BE DIFFICULT TO DETERMINE WHICH ONE ACTUALLY CAME FIRST... THE PERIO ISSUE OR THE TOOTH INFECTION.

IN THE FIRST PLACE, THE TOOTH HAD TO BE COMPROMISED TO WARRANT A (CEREC) CROWN... MEANING DECAYED, BROKEN DOWN, HEAVILY RESTORED, OR FRACTURED. PERHAPS IT WAS INFECTED AT THAT TIME AND THE DENTIST DID NOT DIAGNOSE IT AS SUCH? IN ADDITION TO THAT THE CEREC CROWN DID NOT FIT PROPERLY WHICH RESULTED IN A GUM ISSUE.
THAT SQUEEZING SENSATION YOU DESCRIBE IS INFLAMMATION. IT MAY BE BACTERIAL RELATED FROM THE TOOTH AND THE GUM POCKET.

<<<2. If it IS pain from the biological width violation (and not, say, from the root canal per se, or from a possible fracture of the tooth below the gum line): will the extraction of this tooth solve the issue, or will the gum remain inflamed? Would taking the temporary off (temporarily) really prove that it is or isn't a biological width issue? How long would it take to work? and, if that doesn't work, and I have the extraction,would there be any complications from the gum problem if I had to get an implant in a few months?...

IT IS MOST LIKELY FROM BOTH THE TOOTH AND THE GUM. ONE PROBLEM IS FEEDING OFF OF THE OTHER. BOTH ARE CAUSING INFLAMMATORY ISSUES AND THAT IS WHY IRRELEVANT OF WHAT YOU DO TO THE GUM OR THE TOOTH THE PROBLEM WILL REMAIN. EVEN IF IT WERE ORIGINALLY GUM RELATED..... THE ROOT CANALED TOOTH HAS NOW ADDED TO THE BURDEN OF INFLAMMATION WHICH IS IRREVERSIBLE. EXTRACTING THE TOOTH WOULD ELIMINATE ONE PIECE TO THE PUZZLE WHICH IN TURN STOPS THE IRRITATION WITH THE GUM TISSUE. BOTH PROBLEMS WOULD BE RESOLVED. ONCE THE GUM TISSUE IS HEALED AND THE INFLAMMATION IS GONE, THEN SO LONG AS THE BONE IS HEALTHY AND ADEQUATE TO HOLD AN IMPLANT... A DENTAL IMPLANT MAY BE A VIABLE OPTION TO REPLACE THIS TOOTH. THE ONE CONCERN REMAINING WOULD BE THAT THE IMPLANE IS BEING PLACED NEXT TO ANOTHER ROOT CANALED TOOTH WHICH HARBORS BAD BACTERIA THAT WILL EVENTUALLY SPREAD TO THE JAW BONE.

<<<3.Is it possible that the TMJ is actually causing this pain in my gum? It seems impossible that even as much as I clench, I am manifesting this "teething" pain in my gum. I do have many of the symptoms of TMJ, the jaw pain, earaches, headaches, numbness in the left side of my face. The soft diet has helped somewhat. Is it worth it to further delay this extraction, and seek out a TMJ specialist? (And spend even MORE money.) >>>

YOUR TMJ PROBLEM MAY BE RELATED TO MANY THINGS AND MAY NEED TO BE ADDRESSED MORE SERIOUSLY AT SOME POINT. HOWEVER IRRELEVANT OF HOW YOU TREAT THE TMJ YOU ARE STILL LEFT WITH TWO NON VITAL DISEASED TEETH. ANYONE THAT HAS A CHRONIC INFLAMMATION FROM A GUM OR TOOTH PROBLEM WILL TEND TO CLENCH THEIR TEETH TOGETHER AS A NATURAL REACTION TO A FOREIGN OR ABNORMAL ANNOYANCE IN THEIR MOUTH. SO VERY OFTEN PERIO PROBLEMS AND TMJ PROBLEMS GO HAND IN HAND.

<<4.Why does NOT ONE dentist (endo, perio, etc.) want to pull this tooth? Why does everyone suggest some other "last ditch" effort I should make beforehand? I feel like Dorothy in OZ; I have finally gotten in to see the wizard, but he makes me go chase down the witch's broomstick before he'll talk to me. I have told the last two dentists that I am ready to have the extraction, but they both have insisted I try "one more thing" before I pull the tooth. Is having an extraction really so horrible?>>>

BECAUSE THEY HAVE BEEN EDUCATED ON HOW TO RETAIN TEETH WITH LITTLE TO NO EMPHASIS ON THE SYSTEMIC CONSEQUENCES OF RETAINING THESE DEAD, INFECTED TEETH. ROOT CANALS ARE THE MOST PROFITABLE FORM OF DENTISTRY AND MANY DENTISTS WANT PEOPLE TO BE UNINFORMED AS THAT LIMITS THE QUESTIONS THEY HAVE TO ANSWER AND POSSIBLE LEGAL CONSEQUENCES.
YOUR SITUATION IS COMPLICATED IN THAT THERE IS MORE THAN ONE ISSUE GOING ON AND THERE ARE SEVERAL DENTISTS INVOLVED ALL OF WHOM ARE NOT WILLING TO DETERMINE OR DISCLOSE TO YOU WHAT CAUSED THE ORIGINAL PROBLEM. THEY HAVE SEEN YOUR PROBLEM COUNTLESS TIMES AND CERTAINLY HAVE THEIR SPECULATIONS BUT WILL CAUTIOUSLY SHARE THEM WITH YOU FOR FEAR OF STEPPING ON A COLLEAGUES TOES.

HAVING A TOOTH PULLED IS NOT USUALLY A BAD EXPERIENCE. HOWEVER IT IS NOT REVERSIBLE AND YOU HAVE TO BE SURE OF YOUR DECISION. I CANNOT EMPHASIZE ENOUGH THAT YOU HAVE TWO TEETH IN JEOPARDY, NOT JUST THE ONE SIMPLY BECAUSE THEY ARE BOTH ROOT CANALED.

Bryanna

Thanks again for all your help, Bryanna. I guess it's just amazing to me that they act as if this is the first time they have ever seen someone take so long to recover from a root canal/ or someone so sensitive to a breach in the gum margin/ whatever. They keep reinforcing that I may pull the tooth and not have solved the underlying issue that is causing me pain, and I guess that's why I'm fearful.

Also, the problem with the second root canal; it is still bothering me and although I understand what you're saying about it needing to be pulled, I am not sure how to go about it. I'm scared to have both teeth pulled at once, especially given my TMJ situation. I would like to have #18 pulled first and have that situation resolve somewhat (I HOPE) before I take care of the other tooth, which is still inflamed from the root canal last month. Would that be ok?

Meanwhile, I still haven't found an oral surgeon to pull this tooth, or convinced any of the dentists I've seen to refer me to one. How should I handle all this? Any ideas? Sorry to keep coming back with questions, but I am really at a loss here as to how to move forward with 2 adjacent bad R/C teeth (both hurting) and some pretty bad TMJ making it difficult to think clearly.

Just warranted to reiterate from way above in the post: I had no visible infection in either of my root canaled teeth, but when I showed up to the endodontist(s) each time, they declared the root canal necessary in spite of the lack of infection. So I guess that means that any infection I have now in these teeth is BECAUSE OF the root canal itself. I feel even worse for doing this to myself. TWICE.

I had two teeth removed at once. No big deal at all.... in fact I only had to heal once! I had no issue at all, and the whole process was simple and took all of a few minutes. Little pain afterwards, and a big relief mentally..... I also think you should just call around and go to a few specialists. Pick the one that treats you the best. I saw two surgeons and picked the one, that had the best personality, the most confidence, and put me at ease. I was sedated. I wish all proceedures could be so easy... Take care Sadie, this will all turn out OK. ginnie