Hi.
I am new here, so bear with me.
I had a filling done on my second to last molar on the top right, about 7 years ago. Dentist said the filling was deep and I had a hairline fracture as a result. He said someday we should cap it. Fast forward to two years ago. I've since moved, had kids, etc. go to the dentist who determines the tooth in front of that molar needs a root canal. Which I do, but don't cap as I cannot afford it.
Meanwhile I've stopped really chewing on the right side because I always have a sharp pain, whether from tooth that is cracked or the root canal one, I don't know.

Last year I start getting facial pain, like sinus, and am spacey and foggy headed. Go to ER. They do a CT, and send me to an ENT. ENT says I have a cyst in my right max sinus and some septum issues. We opt for surgery. Had that May 1st. Facial pain is mostly gone, but still seriously fatigued and foggy.

Follow up with GP who does an MRI. They see white matter scattered spots, indicating auto immune or post infectious. Do blood tests for auto immune, all negative. Now they are referring me to a neuro.

I'm freaked out! Still foggy, still can't chew on right side. Started process to cap those two teeth, but now I'm hesitating. Would it be crazy to think maybe it's all due to these two teeth?? And if so, what do I do??? My dentist says he doesn't see any infection, I asked months ago. So I doubt he's gonna help me!

And seriously google really scares a person.

Thanks for reading.
Molly

Hi MollyW,

I am in the dental field and can offer you some information here.

You asked...Would it be crazy to think maybe it's all due to these two teeth?? And if so, what do I do???

My reply...
No, it's not crazy at all. When a tooth becomes infected and/or the nerve dies allowing bacteria to grow inside of the tooth... a root canal is done. The only reason this procedure is done is to give the patient an opportunity to "retain" the tooth. One of the (many) downsides to root canal therapy which is often not shared with the patient is that it cannot "cure" the infection and does not make the tooth healthy again. Because the microscopic canals (called dentin tubules) are not accessible, they will continue to harbor dead infected nerve tissue rendering the tooth chronically infected. The only purpose for the root canal is to "buy some time" until the tooth is eventually is removed.

There are MANY problems associated with "buying some time" with infected teeth.....
But the most important one is the fact that it is never healthy to retain an infected tooth simply because the infection can easily become systemic. It can and will spread to the jaw bone, to the adjacent teeth, to the sinuses, and possibly to any other organ in the body including the brain.

Let's put the pieces of this dental history together....

...These two teeth are located in your upper right maxilla. They are posterior teeth which means their root system is located very close to your sinus or directly in communication with your sinus making it easy for the infection to spread there.
...The root canaled tooth has been sick for at least a year or longer. The fractured one may also have become infected from the spread of the other infection and/or depending on the location, depth and opening of the fracture bacteria may be getting into that tooth causing an infection.
...You have a history of sharp pain, unable to eat, facial/sinus pain all on the right side.
...The ENT diagnosis' a cyst in the right maxilla. That was surgically removed and has temporarily subsided the pain that you were having from that cyst. However, root canal teeth typically grow cysts at the end of the tooth as the bacteria proliferates beyond the tooth. So another is likely to grow there. I am surprised that the ENT did not discuss this RC tooth with you...??
...You have not been feeling well... MRI shows white matter... yet auto immune testing is negative. All of these signs are indicating systemic infection.

The only true way to "cure" an infected tooth is to have it removed because the tooth is the source of the chronic infection. Keeping (retaining) the tooth means keeping the infection. In your case, you may still need to deal with a systemic problem even after the infected teeth are removed.

It is best to see an "oral surgeon" for the extraction(s) and inform him that you want the periodontal ligament and all necrotic tissue and bone to be removed at the time of the extraction. This procedure is suppose to be done with ALL tooth extractions.... unfortunately it is not. So it is up to the patient to be their own advocate and inform the OS that they want a thorough debridement of the bone when the tooth is removed..... just like the OS would tell his colleague if he were the patient

Also, just in case your dentist tries to tell you that crowning these teeth will benefit you..... not so. A crown simply covers the portion of the tooth that is visible at the gum line. That is not where your infection or inflammation is located and crowns will have no positive affect on the problem.

I am very sorry to deliver this news to you. I know it can be scary and disheartening to hear. I can see that you have already been through a lot with these teeth... not to mention the expense. If you don't want to google randomly, then google Dr Mercola and root canals.....or Dr George Meinig and root canals for logical, factual and specific information.

Don't be afraid to research those sites. They will clarify a lot of your concerns and help you become better informed so you can get the help you need. Please check back and let us know how you are doing.

Bryanna

So, if I have both teeth removed, as they are right next too eachother, will this fix the issue by chance? Do you recommend being on antibiotics prior to the extraction?

I'm really scared! I'm not sure where to turn. I guess I can call an OS and see if anyone will see me.

Thanks for your answer. I will keep in touch.

Hi, I just wanted to tell you to try not to be afraid. Yes an OS would be the best bet. Bryanna did tell you the truth. I had two teeth removed last year that were side by side. If you have an infection, in the bone under the teeth, Bryanna will tell you what that procedure is. I have a nesbit, a very small comfortable device. I had infection, and I am glad it is gone. It will turn out OK. It isn't that bad to have them removed.....ginnie

Molly,

The root canaled tooth is definitely unhealthy for the reasons I posted earlier. But many dentists do not remove rc teeth unless there is swelling and other exaggerated physical symptoms. However, symptoms do not always indicate how severe the problem is... so it is not always wise to just go by your symptoms.

The fractured tooth may also be in jeopardy but that needs further evaluation. Did your dentist take xrays of both teeth recently?

You could call your dentist and tell him you are concerned about restoring these teeth because you feel they may be unhealthy and you would like them evaluated further. Ask him for a referral to an oral surgeon for an evaluation.

I know you are scared... you have been through a lot and of course you just want to take care of the problem and be done with it.
I am concerned that you have not been completely informed by your dentist and possibly the ENT dr. Although this is unfortunate, it is also unfortunate that it is pretty typical.
If they have informed you (somewhat) of the things that I have, then you may not have understood what they were saying. I cannot determine which of those things has happened... but either are possible.

Can you call your dentist and ask him for that referral to the OS?

Bryanna

Ok, saw my dentist today. He took Xrays, and did a few tests where they make you bite on something, blow cold air on you, etc....
He says Xrays look good. He said I had no response on tooth that had a root canal. He said I had some issues with the cracked tooth. I told him I didn't want to do the crown till I had another opinion. So, he is sending me to an OS for a consult.

Quick other question, my GP recently did a lot of blood work, due to the indications of the MRI scan of my brain, which she is referring me to a neurologist for. The blood tests were C Reactive Protein, SED Rate, and CBC. Would any of these be elevated if there is an infection? I can get the results tomorrow if I drop by her office.

Thanks so much! I appreciate your comments. I am a bit wary of all things medical, had a few traumatic experiences before that turned out to be the error of the doctor... so I've turned in to a bit of a hypochondriac.

Molly,

The cold air test will most likely be negative on the root canaled tooth because there is no vitality to cause the tooth to be temperature sensitive. A bite test on the rc tooth is also usually inconclusive unless the tooth is overwhelmed with infection or fractured.

Dentists will often tell their patients that the rc tooth looks good because they cannot see the microscopic canals clinically or radio-graphically. So they wait until the xray shows evidence of the infection spreading into the bone and then tell the patient. ALL dentists know that there is dead nerve tissue inside of those tiny canals. As I said, the rc procedure is done to temporarily retain a tooth. It is not the cure for the infection.

If the xrays that your dentist took today are digital, then make sure he emails them to the OS. A paper copy may not be of diagnostic quality. The OS may also want to take his own xray.... that's ok.

Re the blood work..
The CBC has some markers that indicate infection and/or inflammation. Sed Rate is a marker for infection.... CRP is a marker for inflammation.
However, blood work can be within the normal range even when a person has an infection. The marker generally does not go up until the infection is severe enough to affect the blood. Were the results within normal limits?

Is your GP aware of your root canaled tooth? Is he aware of the sinus surgery to remove the cyst? Unfortunately, physicians are not educated about teeth.... they know very little about dental procedures. So he may not make the connection.

I don't think you are being a hypochondriac at all. You have every reason to be concerned about these teeth especially given your sinus history.

It would be helpful if you did some research on the Dr Mercola and Dr Meinig sites regarding root canals. They would give you information that you could present to the OS when you see him... otherwise, he may just go along with your general dentist.

I cannot stress enough that the patients who are well informed.... receive the best and most honest dental care.

Bryanna