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Old 09-30-2013, 09:54 PM #1
Ashley13 Ashley13 is offline
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Thumbs down Extraction of 'failed' root canal but the dentist wouldn't remove ligament?? Screwed?

Hello!

I am so frustrated. In April this year I had a sore knot come up on the underside of my jaw. I called my dentist and she called in an Rx for antibiotics and told me to come in 2 days later. At that appointment, she took bite wing x rays and 'found' the problem. A darkened area on the root of tooth 31 (back bottom right). She told me this area had been there since I had a root canal - which she performed) in 2005/2006 and they were "watching it". I didn't know anything of it... noone had mentioned it to me in 8 years! That made me extremely mad, but at the same time, she's been my saving grace when it comes to mouth issues so I sort of let it slide. At that point I was given options of pulling the tooth, or having the root canal done again. By this time in my life I had embraced a more natural lifestyle and knew I would never again have another root canal so the option was to have it extracted.

I contacted a local biological dentist in May and had an initial consultation with him. I felt really good about his practices, but his office was really archaic and they weren't PPO on my insurance so everything would have to be paid upfront and partially reimbursed per insurance limits. We set up a time to have a full eval with all new x-rays and I was excited and anxious to get this taken care of! Well stupid me, I ended up forgetting the appointment altogether (I forgot to set a reminder in my phone) so I called the next day and apologized. I felt so embarrassed that I had wasted his time that I never called back.

Fast forward to last week I started having some health problems, stomach pains, weird numb headaches on the back of my head and it reminded me I needed to get to the dentist and have the tooth removed. I guess I thought I could wish it all away since I had already spent about 1500.00 or more (RC and crown) on the single tooth I would have to have removed. I called into the Dentist this morning and asked for their soonest appointment and told the receptionist my concerns. She ended up getting me in the next hour. She said I would be able to talk to the Dr about my concerns once I got there.

So I get there, they start going over all the paperwork, all the rules, signing papers etc. Dr comes in and numbs me.. I'm like will I be able to talk to you before this is all done? I'm really anxious about how this will be done so she sits me up after 3 shots and we talk. I tell her I am really concerned with the infected tissues around the tooth, the infected bone. I ask her if she plans to remove any of the dead tissues and she keeps pressing me that it's unnecessary that once the tooth is removed the infection will get better etc. I'm fuzzy. Those shots speed my mind and body up and make my extremely anxious so I'm not saying what I've looked into the way I need to say it. I tell her I am concerned about anaerobic bacteria about the dead bone and ligaments but she says the tooth is like a splinter. Even if it's infected once you remove the splinter it will heal. She says she will know more once she's in there. I finally just let her go on with it when it seems I'm not making any headway at all.

She finally gets the tooth out, there is a ball of fleshy material attached to the root. She says that because she's gotten this out completely with the tooth, everything will heal perfectly. I ask about x-rays when I come back in because I am so concerned about getting a jawbone cavitation I need to know everything is healing up perfectly. She tells me it's not a problem.

Fast forward to now, I'm FREAKING out. I really really really wish I would have had an oral surgeon do this extraction because I don't feel as though my concerns were being taken seriously. I really wanted the periodontal ligaments removed. I really wanted all the dead bone to be scraped and I went ahead and let her pull the tooth without doing either.

Do I have any options at this point?
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Old 10-01-2013, 09:36 AM #2
Ashley13 Ashley13 is offline
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Unhappy

Well the receptionist just called and I told her I was still worried. I asked her to ask the Dentist if the periodontal ligament had been removed. I told her I had been on the internet and I just wanted to make sure it didn't need to be removed. I don't think the Dentist likes me questioning her so now I'm worried about the return call I'll probably get.
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Old 10-01-2013, 02:38 PM #3
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Ashley,

At the time of the tooth extraction, it is always necessary to remove the periodontal ligament and any necrotic tissue or bone. Anything that is left behind is a potential irritant and can become infected.

Your statement: <<She finally gets the tooth out, there is a ball of fleshy material attached to the root. She says that because she's gotten this out completely with the tooth, everything will heal perfectly. I ask about x-rays when I come back in because I am so concerned about getting a jawbone cavitation I need to know everything is healing up perfectly. She tells me it's not a problem.>>

That ball of flesh is a cyst that was caused by the bacteria that had spread from the tooth into the bone. Yes, removing the cyst is imperative. Many times it is very attached to the root end of the tooth. However, that cyst has nothing to do with the periodontal ligament. The ligament is wrapped around the circumference of the entire root structure of the tooth. It does not come out with the tooth it has to be scraped out. Some dentists rarely remove the ligament and others follow the proper protocol and remove it. Some people will have incomplete healing of the socket if the ligament is left in there, while others seem to heal okay. No one can predict the outcome. That is why it is IDEAL to remove it so as to decrease the risk of future complications. Your dentist is well aware of this.

She is not going to tell you anything different than she already has. Was she an oral surgeon or a general dentist?

An oral surgeon could go back in and re-surgerize the socket, but you may have difficulty finding someone to do that because no one wants to chime in on someone else's surgery. If there were to be a complication, then you would not know from which surgery it arose.

You are not alone in this situation. Most people will let time tell if there is a problem or not. Unfortunately, this dentist did not listen to your concerns or requests and from what you have described, she rushed into the entire procedure. Feel free to tell her that if that is how you genuinely feel!!

I hope everything heals well for you. Try not to stress too much about it. I understand how concerning this can be..... but there may be nothing you can do about it at this point.

Bryanna





The dentist was being lazy when she
Quote:
Originally Posted by Ashley13 View Post
Hello!

I am so frustrated. In April this year I had a sore knot come up on the underside of my jaw. I called my dentist and she called in an Rx for antibiotics and told me to come in 2 days later. At that appointment, she took bite wing x rays and 'found' the problem. A darkened area on the root of tooth 31 (back bottom right). She told me this area had been there since I had a root canal - which she performed) in 2005/2006 and they were "watching it". I didn't know anything of it... noone had mentioned it to me in 8 years! That made me extremely mad, but at the same time, she's been my saving grace when it comes to mouth issues so I sort of let it slide. At that point I was given options of pulling the tooth, or having the root canal done again. By this time in my life I had embraced a more natural lifestyle and knew I would never again have another root canal so the option was to have it extracted.

I contacted a local biological dentist in May and had an initial consultation with him. I felt really good about his practices, but his office was really archaic and they weren't PPO on my insurance so everything would have to be paid upfront and partially reimbursed per insurance limits. We set up a time to have a full eval with all new x-rays and I was excited and anxious to get this taken care of! Well stupid me, I ended up forgetting the appointment altogether (I forgot to set a reminder in my phone) so I called the next day and apologized. I felt so embarrassed that I had wasted his time that I never called back.

Fast forward to last week I started having some health problems, stomach pains, weird numb headaches on the back of my head and it reminded me I needed to get to the dentist and have the tooth removed. I guess I thought I could wish it all away since I had already spent about 1500.00 or more (RC and crown) on the single tooth I would have to have removed. I called into the Dentist this morning and asked for their soonest appointment and told the receptionist my concerns. She ended up getting me in the next hour. She said I would be able to talk to the Dr about my concerns once I got there.

So I get there, they start going over all the paperwork, all the rules, signing papers etc. Dr comes in and numbs me.. I'm like will I be able to talk to you before this is all done? I'm really anxious about how this will be done so she sits me up after 3 shots and we talk. I tell her I am really concerned with the infected tissues around the tooth, the infected bone. I ask her if she plans to remove any of the dead tissues and she keeps pressing me that it's unnecessary that once the tooth is removed the infection will get better etc. I'm fuzzy. Those shots speed my mind and body up and make my extremely anxious so I'm not saying what I've looked into the way I need to say it. I tell her I am concerned about anaerobic bacteria about the dead bone and ligaments but she says the tooth is like a splinter. Even if it's infected once you remove the splinter it will heal. She says she will know more once she's in there. I finally just let her go on with it when it seems I'm not making any headway at all.

She finally gets the tooth out, there is a ball of fleshy material attached to the root. She says that because she's gotten this out completely with the tooth, everything will heal perfectly. I ask about x-rays when I come back in because I am so concerned about getting a jawbone cavitation I need to know everything is healing up perfectly. She tells me it's not a problem.

Fast forward to now, I'm FREAKING out. I really really really wish I would have had an oral surgeon do this extraction because I don't feel as though my concerns were being taken seriously. I really wanted the periodontal ligaments removed. I really wanted all the dead bone to be scraped and I went ahead and let her pull the tooth without doing either.

Do I have any options at this point?
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Old 10-01-2013, 03:54 PM #4
Ashley13 Ashley13 is offline
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Bryanna, thank you so much for your reply. I joined this site because of your advice - it's hard to find a more naturally minded or holistic dentist or dental assistant that will talk to you. Your advice is truly valuable.

Ok she called me back and said I didn't have periodontal disease. LOL Bad communication between the her and the receptionist Anyways I did ask her about the removal of the periodontal ligament and 1mm of tissue that needed to be scraped and she said she actually did all of that. I made myself pretty clear that I didn't want to leave any infection behind during our talk and because I am so skeptical all I can do is hope my concerns were taken seriously. She is a good/trustworthy general dentist and I trust her, I know it doesn't seem like it but I do. It's just hard for me to trust her completely when she recommends procedures (like RCT) that I've found seriously harmful through my own personal research. I'm like this with almost every allopathic/mainstream doctor. I know that I am my own advocate and I try and research every single thing that pertains to my health and the health of my immediate family.

I guess my only option is to take the wait and see approach. I have bad anxiety when it comes to my health (and I'm still in my 20's) so hopefully I can calm down and just wait. I've read that most cavitations can't be seen on a typical x-ray... is this true? Is there anything in particular I would have to be looking for in case this socket doesn't heal properly?

Thank you so very much for your time!

Quote:
Originally Posted by Bryanna View Post
Ashley,

At the time of the tooth extraction, it is always necessary to remove the periodontal ligament and any necrotic tissue or bone. Anything that is left behind is a potential irritant and can become infected.

Your statement: <<She finally gets the tooth out, there is a ball of fleshy material attached to the root. She says that because she's gotten this out completely with the tooth, everything will heal perfectly. I ask about x-rays when I come back in because I am so concerned about getting a jawbone cavitation I need to know everything is healing up perfectly. She tells me it's not a problem.>>

That ball of flesh is a cyst that was caused by the bacteria that had spread from the tooth into the bone. Yes, removing the cyst is imperative. Many times it is very attached to the root end of the tooth. However, that cyst has nothing to do with the periodontal ligament. The ligament is wrapped around the circumference of the entire root structure of the tooth. It does not come out with the tooth it has to be scraped out. Some dentists rarely remove the ligament and others follow the proper protocol and remove it. Some people will have incomplete healing of the socket if the ligament is left in there, while others seem to heal okay. No one can predict the outcome. That is why it is IDEAL to remove it so as to decrease the risk of future complications. Your dentist is well aware of this.

She is not going to tell you anything different than she already has. Was she an oral surgeon or a general dentist?

An oral surgeon could go back in and re-surgerize the socket, but you may have difficulty finding someone to do that because no one wants to chime in on someone else's surgery. If there were to be a complication, then you would not know from which surgery it arose.

You are not alone in this situation. Most people will let time tell if there is a problem or not. Unfortunately, this dentist did not listen to your concerns or requests and from what you have described, she rushed into the entire procedure. Feel free to tell her that if that is how you genuinely feel!!

I hope everything heals well for you. Try not to stress too much about it. I understand how concerning this can be..... but there may be nothing you can do about it at this point.

Bryanna





The dentist was being lazy when she
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Old 10-01-2013, 04:16 PM #5
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Ashley,

Thank you for the kind words! I am extremely holistic, alternative minded with most every aspect of my health. It is refreshing to hear that someone so young embraces their health in such a positive and healthful manner!!

It's good that she did understand your concerns and hopefully she did debride the socket as she told you.

The signs for post op infections are similar to other infections... you can have one or more of them. The onset of swelling after the 3rd day... elevated temp... increased pain or tenderness.... sudden bleeding or oozing from the socket. The signs of a cavitation can be similar to those above or it can be a chronic aching in the jaw.... on off fevers.... lethargy.... etc. Cavitations generally don't show up until later on after the site has healed closed.

Cavitations can often be picked up on an xray by someone who knows what they are looking for. I know that sounds hokey but in 35 yrs of dentistry, I only know a handful of dentists who can recognize the onset of a cavitation in the jaw bone. Unless it is blatantly obvious and the patient is in dire pain they don't even look for a cavitation.

Bryanna





Quote:
Originally Posted by Ashley13 View Post
Bryanna, thank you so much for your reply. I joined this site because of your advice - it's hard to find a more naturally minded or holistic dentist or dental assistant that will talk to you. Your advice is truly valuable.

Ok she called me back and said I didn't have periodontal disease. LOL Bad communication between the her and the receptionist Anyways I did ask her about the removal of the periodontal ligament and 1mm of tissue that needed to be scraped and she said she actually did all of that. I made myself pretty clear that I didn't want to leave any infection behind during our talk and because I am so skeptical all I can do is hope my concerns were taken seriously. She is a good/trustworthy general dentist and I trust her, I know it doesn't seem like it but I do. It's just hard for me to trust her completely when she recommends procedures (like RCT) that I've found seriously harmful through my own personal research. I'm like this with almost every allopathic/mainstream doctor. I know that I am my own advocate and I try and research every single thing that pertains to my health and the health of my immediate family.

I guess my only option is to take the wait and see approach. I have bad anxiety when it comes to my health (and I'm still in my 20's) so hopefully I can calm down and just wait. I've read that most cavitations can't be seen on a typical x-ray... is this true? Is there anything in particular I would have to be looking for in case this socket doesn't heal properly?

Thank you so very much for your time!
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Old 10-01-2013, 08:58 PM #6
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One more question. How do you feel it might be a good idea to use colloidal silver on the extraction site? I thought about trying 1 teaspoon twice a day, let it sit for a couple minutes and then swallow... Your thoughts?
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Old 10-01-2013, 09:51 PM #7
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Ashley,

I am an advocate of using colloidal silver when it is in the nano particle form. However, you should avoid using anything on the extraction site until the tissue has closed over. Warm salt water rinses are best during the initial post op stage while the tissue is open as the salt will not interfere with the healing.

Are you taking Arnica?? Or any other homeopathic?

Bryanna


Quote:
Originally Posted by Ashley13 View Post
One more question. How do you feel it might be a good idea to use colloidal silver on the extraction site? I thought about trying 1 teaspoon twice a day, let it sit for a couple minutes and then swallow... Your thoughts?
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Old 10-02-2013, 11:44 AM #8
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No, not taking arnica. I did think about buying some cell salts though to help with bone healing? I have very little swelling and no bruising, do you think I need arnica?
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Old 10-02-2013, 01:35 PM #9
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Ashley,

I use Arnica for every bump and bruise. I even use it pre and post op dental cleanings... just because

You can use homeopathic cell salts under the tongue.

Bryanna

Quote:
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No, not taking arnica. I did think about buying some cell salts though to help with bone healing? I have very little swelling and no bruising, do you think I need arnica?
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Old 10-05-2013, 07:35 PM #10
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The Dentist called to check on me Thursday morning. I told her I was feeling a bit more sore than the days prior (had the tooth extracted Monday) so she told me to come in. She said everything looked good aside from some redness and irritation around the sutures. Each day it's gotten worse. So I think it's official I'm allergic to these stupid sutures. I've had 3 other surgeries and the last 2 I had reactions too. It's driving me insane itching and burning. I wish there was a way I could take them out myself but I'm afraid I will knock the clot out.
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