[laurel.1970]

Hey all,

My stupid mouth has been raging a tyranical war on me for months now. I don’t know if there is a way to keep this short and cover everything but here goes;

Age: Started at age 42 (now 43)
Sex: Female
Health: Great other than the mouth!
Diet: Good to excellent, (mostly Gluten Free because of celiac daughter)
One remaining wisdom tooth (bottom right)
Social Drinker, Smoker (3 packs a week at most)

History of Face Stupidity.

May, 2013 (unrelated to dental?)
*Blocked salivary gland right side – sudden massive pain and swelling.
*Walk-in physician referred me to ENT
*Minor surgery performed and was successful.

June, 2013
*Developed sensitivity in molar (top left, second from back.)
*General Dentist attempted to take it "out of bite" (froze me as it was that sensitive)
*Tooth was determined to be cracked and needed a crown

July, 2013
*GD attempted to prep tooth for crown (session terminated when I was still in pain after being frozen; said I needed a root canal.
*Three attempts made over the next three weeks (antibiotics administered) before it was successful. Temporary crown was placed.

** This was the first EVER procedure on teeth; no cavities or fillings prior to compare pain/healing to**

*Noted in days following procedure an awful taste in mouth, and extreme soreness. This continued for several days but I figured this was normal. It got worse instead of better.
*Approximately a week following the procedure, I took a photo with my phone and it showed a 1cm by 2cm white/green/black mass beside tooth that was worked on.
* I made two attempts to visit the dentist to ensure all was healing properly but did not end up connecting with him.
*Ended up going to a walk-in clinic where I was told that the tissue was completely necrotic. Went home and told my partner and he demanded that I visit the ER where the attending physician set me up with an appointment with an oral surgeon.

August, 2013
*Saw oral surgeon, said I had to wait for dead tissue to “slough off” before it could be properly assessed
*Eating, talking and general life was painful
*Tissue finally fell out (gross!!). Another phone picture revealed that tissue had rotted clear down to the bone. I had root and palate exposed.
*Oral Surgeon confirmed this as well as noted that there was already bone loss and may not have enough gum to even support the tooth. Also advised that we had to wait and see how my body would heal itself prior to looking at options
*Mouth started shooting bits of bone out of the roof of my mouth and gums

September, 2013
*Always in a certain amount of pain but the palate was generating new tissue to cover itself
*About half way through the month I woke up with a raging infection in my mouth, had an abscess on that tooth again.
*Went back to the general dentist that started all this and he was at a loss as to what to do so referred me back to the oral surgeon.

*Enter “Neuro-talk”, Bryanna’s posts, and all the informative posts out there in internet land! **

*Met with oral surgeon to discuss options which were to either lift gums up and try and scrape away infection (which wasn’t guaranteed to work) or extraction. Would have rather kept the tooth but because it was dead and harboring continuous infection I chose extraction.

October, 2013
*Tooth extracted, let the healing begin! Yay!

Or not…..sigh!

November, 2013
*About 3 or 4 weeks after extraction, I started getting jaw pain on the other side of my mouth, lower right mandible. Not really in one specific spot just general all over discomfort.
*Follow up post op with surgeon: He is happy with the healing but because of the bone loss the tooth next to it is unstable now. Options for reconstruction are limited because a bridge isn’t possible with that unstable tooth and there is too much bone loss for an implant without a bone graft. I talked to the surgeon about the jaw pain that was presenting but he told me that I needed to see a dentist.
Ahhhhhhhh!!

December, 2013
*Jaw pain has persisted on and off but tolerable with pain relievers.
* I woke up with a hard lump on my jawbone (not on gum line but actually presenting on the outside of jaw). It was painful but seemed to be limited to my jaw.
*Next day I presented with an extremely sore tooth; Lower right, second from last (where the remaining wisdom tooth is). It was cold sensitive and hurt to the touch. Good grief, now what!!
*My hunny hauls my sniffling butt into his dentist where x-rays are taken and everything looked fine. No infection present on x-rays but prescribed antibiotics just in case. About 12-18 hours later tooth completely stopped hurting. Jaw bump and pain still present.
*Went back to the ENT to make sure it wasn’t’ a problem with the salivary gland again, and it wasn’t’.
*Back to the dentist for a panoramic x-ray. Nothing showed on X-Ray. He put me on a tens machine thinking that I was having a facial spasm. Say whaaaaat?
*Did physio, acupuncture and more pain meds
*EVERYTHING CLOSED FOR XMAS*

January 2014
*Still have the visible lump on my jaw it doesn’t really hurt anymore (except for if it is bumped).
*Dentist wanted another look, tested tooth for vitality, repeated hot/cold test and thought it was alive. Still can’t figure out the lump. He referred to endodontist.
*Endodontist appointment revealed tooth had a vertical cracked. He said he could try a root canal but in his opinion he thought the tooth was unsalvageable. He thinks the bump on my jawbone is encapsulated infection. I asked him why said tooth hurt for less than 18 hours then quit (and still doesn’t hurt to this day…he said sometimes it can die quickly.

Questions
• How the heck does a tooth die off that quick? How does one practitioner say it is alive and another seems to think it is dead?
• It doesn’t hurt right now, what would happen if I just left it for a while? It isn’t a case of not having money (I have insurance) but I need a break!! I need to eat. I have dropped to 115 lbs. from all this face crap.
• If I go ahead with extraction, what do they do with my jaw? The bump of pus…..the thought of it makes me wretch LOL!

* The necrotic tissue, why? Epinephrine od? Pulp devitalizer spashed in my mouth? What could have caused it?

I know this is long winded but it has been going on for so long!! I would appreciate any input!

[ginnie]

Welcome to Neuro Talk. I just wanted to say hello. I am sorry you had to go through all those issues. Seems like they put you in a cage like a gerbil running around. We have a great woman on this site named Bryanna. She will be here to help you out. You have many issues going on, and she will help sort it out.
I for one, would quit the first dentist. It just doesn't sound like he did all the right things to me from the beginning. I can't imagine how frustrated you must feel right now. Dental issues are no fun. I will be in touch to see how you do.
Over the course of the last few years, I have learned a lot about root Canals. They never are a good idea, as the tooth isn't really cured at all. It is a temporary fix, for a tooth that will eventually not be viable.

You need good advise, and you came to the right place. Just hang in there OK? People care on this site. ginnie

[laurel.1970]

Originally Posted by ginnie

Welcome to Neuro Talk. I just wanted to say hello. I am sorry you had to go through all those issues. Seems like they put you in a cage like a gerbil running around. We have a great woman on this site named Bryanna. She will be here to help you out. You have many issues going on, and she will help sort it out.
I for one, would quit the first dentist. It just doesn't sound like he did all the right things to me from the beginning. I can't imagine how frustrated you must feel right now. Dental issues are no fun. I will be in touch to see how you do.
Over the course of the last few years, I have learned a lot about root Canals. They never are a good idea, as the tooth isn't really cured at all. It is a temporary fix, for a tooth that will eventually not be viable.

You need good advise, and you came to the right place. Just hang in there OK? People care on this site. ginnie

Thanks for responding ginnie. I agree with you on the dentist. I haven't been back to see him and have switched over to my boyfriend's dentist. He has been pretty good so far, I like that he didn't know what was going on so referred me out to someone he thought could help. Much respect for someone that doesn't try to do exceed their capabilities. Nobody wants a toddler behind the wheel of a car!!
I would agree with you on the root canals too. Because of this forum, I started learning about the root canal issue and then sought out additional information on my own. Interesting reading that is for sure.

[laurel.1970]

Hi Bryanna, I see you have been online and haven't had a chance to look at my issue. Long winded I know but can you weigh in? Skip forward to the november and on for the current issue.

[Bryanna]

Hi Laurel,

I am in the dental profession and I volunteer on this site when I have time. When someone posts a long thread like yours, it takes time to go through it and sort through the dental facts from the emotional ones. I'm sure you are upset about your dental problems and I will try to offer you some information.

I'm re posting a portion of your initial thread ABOUT TOOTH #14 (UL FIRST MOLAR) because it may help you understand the initial problem .... I have responded in bold type:

<<<August, 2013
*Saw oral surgeon, said I had to wait for dead tissue to “slough off” before it could be properly assessed.
*Eating, talking and general life was painful
*Tissue finally fell out (gross!!). Another phone picture revealed that tissue had rotted clear down to the bone. I had root and palate exposed.
*Oral Surgeon confirmed this as well as noted that there was already bone loss and may not have enough gum to even support the tooth. Also advised that we had to wait and see how my body would heal itself prior to looking at options
<<<*Mouth started shooting bits of bone out of the roof of my mouth and gums>>> I DON'T KNOW WHAT YOU MEAN BY THIS STATEMENT.

BASED ON THE REST OF YOUR DESCRIPTION OF THE DEAD TISSUE, THE PAIN AND EXPOSURE OF ROOT,...... THIS WAS MOST LIKELY INDICATIVE OF A LONG STANDING PROBLEM IN THAT AREA THAT WAS EXACERBATED BY THE TOOTH BEING ROOT CANALED AS INFLAMMATION AND BACTERIA RUN RAMPANT IN A TOOTH THAT IS BEING ROOT CANALED. IT'S LIKE PUTTING GASOLINE ON A FIRE. THE OS WAS CORRECT IN THAT HE HAD NO IDEA HOW THIS SITE WOULD HEAL AFTER THIS TOOTH WAS REMOVED DUE TO THE EXTENT OF THE INFECTION AND THE BONE LOSS.

Regarding your tooth problem on the LR side.....

<<Questions
<<• How the heck does a tooth die off that quick? How does one practitioner say it is alive and another seems to think it is dead?>>

TEETH DIE FOR VARIOUS REASONS. IF A TOOTH IS CRACKED, BACTERIA CONTINUALLY CREEPS IN SLOWING DECAYING THE TOOTH INSIDE. AS THIS OCCURS THE NERVE CAN BECOME INFECTED AND DIE.
WHEN A TOOTH IS ROOT CANALED, THE NERVE TISSUE INSIDE OF THE TINY CANALS BECOMES STARVED OF BLOOD AND DIES OFF VERY QUICKLY.

RE THE DIFFERENT OPiNIONS ..... IT IS COMMON FOR DENTISTS TO DISAGREE ON A DIAGNOSIS. SOME ARE JUST BETTER AT IT THAN OTHERS. IT ALWAYS AMAZES ME WHEN A DENTIST HAS DIFFICULTY READING A DENTAL X-RAY.... BUT THAT'S ANOTHER STORY :/
THE CHRONIC LUMP IN YOUR JAW IS INDICATING AN INFLAMMATORY RESPONSE IS OCCURRING AND ALTHOUGH THERE SEEMS TO BE NO INFECTION RADIO-GRAPHICALLY, THERE IS PHYSICAL PATHOLOGY... THE LUMP. THIS WILL EVENTUALLY SHOW UP ON THE X-RAYS AND IT MAY BE VERY PROGRESSIVE WHEN IT DOES.

<<• It doesn’t hurt right now, what would happen if I just left it for a while?>>

YOU WOULD UNDOUBTEDLY END UP WITH A MASSIVE INFECTION AND SEVERE BONE LOSS. IT COULD COMPROMISE ALL OF THE TEETH IN THAT QUADRANT. THE PAIN DISSIPATES BECAUSE THE BACTERIA IS FINDING CREVICES TO MOVE INTO WHICH REDUCES THE PRESSURE.... RESULT IS LESS PAIN FOR NOW. BUT THE FURTHER THE BACTERIA MOVES, THE MORE ADVANCED THE PROBLEM BECOMES.

<< It isn’t a case of not having money (I have insurance) but I need a break!! I need to eat. I have dropped to 115 lbs. from all this face crap.>>

YOU NEED TO UNDERSTAND THAT THIS INFECTION HAS BEEN LONG STANDING. BACTERIA IS BUILDING UP IN THAT AREA AND YOUR IMMUNE SYSTEM IS TRYING TO DEAL WITH IT.

<<• If I go ahead with extraction, what do they do with my jaw? The bump of pus…..the thought of it makes me wretch LOL!>>

THE AREA MAY NEED TO BE SURGICALLY DRAINED PRIOR TO THE EXTRACTION TO RELIEVE SOME OF THE PRESSURE FROM THE INFECTION. THE EXTRACTION TOOTH WOULD BE A SURGICAL REMOVAL OF THE TOOTH, THE PERIODONTAL LIGAMENT AND ANY NECROTIC TISSUE AND BONE. DEPENDING ON HOW ADVANCED THE INFECTION IS, A DRAIN MAY BE PLACED TEMPORARILY OR THE AREA MAY NEED TO REMAIN OPEN FOR A SHORT TIME. IT ALL DEPENDS ON WHAT THE OS FINDS AT THE INITIAL SURGERY. THE BUMP OF PUS IS VERY GROSS AND SURELY YOU CAN UNDERSTAND HOW THAT CANNOT BE LEFT THERE FOR MUCH LONGER.

<<* The necrotic tissue, why?>>
I AM ASSUMING YOU ARE TALKING ABOUT TOOTH #14 THE UL MOLAR?
THE TISSUE DIES WHEN THE BLOOD SUPPLY IS CUT OFF. YOU HAD AN INFECTION BREWING THERE AND THEN HAD THE RC DONE. ISCHEMIA SET IN FROM THE INFECTION AND THE TISSUE BECAME OVERWHELMED WITH BACTERIA.

<<Epinephrine od?>> AGAIN #14?
I DON'T THINK THAT IS LIKELY IN THIS CASE. ALTHOUGH IT COULD HAVE BEEN A CONTRIBUTING FACTOR IN THE DEMISE OF THE TISSUE.

<< Pulp devitalizer sashed in my mouth?>> #14?

ALL ROOT CANALS DEVITALZE THE PULP.

VERY GLAD TO HEAR THAT YOU HAD TOOTH #14 REMOVED AND THAT IT IS HEALING OKAY. I AM NOT SURPRISED THAT YOU NOW HAVE BONE LOSS ON THE ADJACENT TOOTH. IF YOU COULD POST AN XRAY THAT WOULD BE GREAT!

Bryanna

[laurel.1970]

I so respect and admire that you come to the aid of perfect strangers on your own time. Only special souls do that and I am very thankful for your time and advice.

So that jaw bump that had no pain? The one I asked if I could wait on? You were right, last night it awoke me at 2:30am with the feeling lik I had just got beaten. Huge bump on the side of the tooth now.
I have a call into the oral surgeon to see if he can see me. They are talking about an emergency extraction. I called at 9:15 and they want to do it within the next hour. I'm freaking out.....I didnt think they could pull something that is clearly infected?

[Bryanna]

Hi Laurel,

I see that you posted this yesterday..... did you go to the dentist?

Hopefully the surgeon was able to remove the tooth as sometimes they have to drain the infection first.... then go back in at a later time and remove the tooth.

If you are up to it... please shoot a note and let us know how you are doing.

Bryanna

Originally Posted by laurel.1970

I so respect and admire that you come to the aid of perfect strangers on your own time. Only special souls do that and I am very thankful for your time and advice.

So that jaw bump that had no pain? The one I asked if I could wait on? You were right, last night it awoke me at 2:30am with the feeling lik I had just got beaten. Huge bump on the side of the tooth now.
I have a call into the oral surgeon to see if he can see me. They are talking about an emergency extraction. I called at 9:15 and they want to do it within the next hour. I'm freaking out.....I didnt think they could pull something that is clearly infected?

[laurel.1970]

Originally Posted by Bryanna

Hi Laurel,

I see that you posted this yesterday..... did you go to the dentist?

Hopefully the surgeon was able to remove the tooth as sometimes they have to drain the infection first.... then go back in at a later time and remove the tooth.

If you are up to it... please shoot a note and let us know how you are doing.

Bryanna

Yes, I got in to see him, I called the office at 9:15 and was in the chair by 11:00 and put under IV sedation. I made sure I asked him to debride the area well and flush the infection out (as I have read in many of your posts Apparently it was a difficult extract; I was under for almost 2 hours. The tooth was cracked anyway and when he attempted the extraction the tooth crumbled. He assured me that he got it all and judging by how the far the stitches go down, I would say he really tried to flush the infection out. I feel alot less pressure, there is some swelling still but no bruising so far. I have been icing, and today I can use heat too I think? Clindamycin is what they gave me....omg, my tummy feels like crap.

[Bryanna]

Hi laurel,

I am glad that you acted quickly on this and the tooth is out.

I am not surprised that the tooth was difficult to remove. Glad you sought an oral surgeon and had the IV sedation too!

The stitches are far down because the surgeon had to make a large incision so he could flap the tissue open to gain access to the tooth. This also gave him a better view of the bone so he could debride it thoroughly.

Infection cannot be flushed out. It has to be scraped out and it sounds like that is what he did. Hopefully you will not have much pain and everything will heal fine.

Re the icing... only ice for the first 24 hours and no more. After that you can apply MOIST heat NOT a dry heating pad. Also start to rinse very gently with warm salt water after 24 hours and continue rinsing for several weeks. Eat a soft food diet, avoid spicy foods, nothing with seeds or sharp and avoid eating on that side for several days ++.

Re the antibiotic... Clindamycin can cause terrible digestive/intestinal upset. In fact it can cause an intestinal infection. It is best to supplement with a probiotic starting asap. It should be taken twice a day during the duration of the antibiotic and not within 2 hours of taking the antibiotic. The probiotic can greatly help the stomach distress but you have to start it asap. Stay on the probiotic for at least 30 days+ after the last dose of antibiotics.

If the intestinal problem becomes severe, stop the Clinda and call the dentist for a different antibiotic.

Thanks for updating us. Please check in and let us know how you are doing.

Bryanna

Originally Posted by laurel.1970

Yes, I got in to see him, I called the office at 9:15 and was in the chair by 11:00 and put under IV sedation. I made sure I asked him to debride the area well and flush the infection out (as I have read in many of your posts Apparently it was a difficult extract; I was under for almost 2 hours. The tooth was cracked anyway and when he attempted the extraction the tooth crumbled. He assured me that he got it all and judging by how the far the stitches go down, I would say he really tried to flush the infection out. I feel alot less pressure, there is some swelling still but no bruising so far. I have been icing, and today I can use heat too I think? Clindamycin is what they gave me....omg, my tummy feels like crap.