Hello, I had a fistula in 10/12. The dentist, a oral surgeon, did a procedure (apicoectomy)and fixed it. However, in 3/14 I had another fistula in the same tooth - same root. I did not find out it was the same tooth until the insurance company denied coverage due to "frequency". Now, I call the dentist and he says oh yeah it was the same tooth as last time and it is not uncommon for the fistula to reoccur in the same tooth. Had I know that it was the same tooth and likely to recur, I would've had it pulled the first time. This tooth has been through a rot canal and two apicoetomies!!
Is a recurring fistula common? What happend to me? Thanks, Ilona

Hi Ilona,

I am in the dental field and can offer you some information here. I know you are baffled by what is happening and scared about what is going to happen. I am going to give you information that your dentists have probably neglected to share with you. It is not pleasant for me to tell you these things or pleasant to hear them, but you have the right to be properly informed. So do not panic when you read this. Just know that you need to take action asap with an oral surgeon to remove the source of the infection which is your tooth as this is the only means of attempting to eradicate the infection.

It is very common for a root canaled tooth to end up with a fistula and for that fistula to keep returning, irrelevant of the apicoectomies, because there is a chronic infection brewing inside of the tooth. There are many hundreds of tiny canals inside of every tooth that contain nerve tissue. These canals are not accessible during the root canal procedure so their contents remains the source of the chronic infection. When the infectious bacteria proliferates beyond these small canals it travels into the jawbone often resulting in a fistula. Because the bacteria is not able to be removed from the tooth, the infection never really goes away. The rc and apico procedures may temporarily subside the acute symptoms but they do not cure the problem. Thus the recurrence of the fistula.

It is important for you to know that with every fistula occurrence and with every apicoectomy you permanently lose more of the jaw bone. This type of bone loss is generally not successfully replaced with graft material because the surrounding bone is often unhealthy too. The fistula is the result of bacteria that has burrowed a hole (tunnel) from the tooth, through the bone and through the gum tissue. In it's path it creates infected, necrotic, diseased bone.

Another thing you should know is that the bacteria is not limited to just this one area or your mouth. Infection in the bone, anyplace in the body, is considered a serious infection as the bacteria travels through the bloodstream. This can result in a systemic infection elsewhere in the body, cause or contribute to chronic illness and more.

After 30+ yrs in dentistry I still find it unbelievable how many dentists do not inform their patients of these facts. They treat jaw bone infection as if it were a scraped knee. Ask an orthopedic surgeon about jaw bone infection and he will tell you exactly what I have told you here.

The only way to attempt to cure the infection is to remove the source of the infection which is the tooth. There is no procedure or medication that will cure or stop this infection from proliferating. It is wise to have the adjacent teeth evaluated thoroughly prior to the extraction of this tooth to rule out infections in those teeth. By any chance are the adjacent teeth currently root canaled?

I am sorry to deliver this news to you.... I apologize for the lack of information that you have been given by your dentists. They are completely aware of all of this but as I said..... they treat it like a scraped knee.

Please do not delay in the removal of this tooth. If you can, please check back with us and let us know how you are doing.

Bryanna

Wow. I had no idea. Thank you for such a thorough response. What an education. I've got to think this through. Thank you, Ilona

Bryanna, just a quick question on this. If someone had an infection in their body from infected teeth then blood work should show it correct ? Otherwise how would you know ? I read you reply and was just wondering about this. Tom

Hi Tom,

I received your personal message... glad the extraction is done

There are various blood markers that indicate inflammation and infection in the body. Unfortunately, unless you were bit by a snake or had acute appendicitis or something else similar happen that would immediately get into the blood stream or other organ, the bacteria has to be prevalent enough at the time of the blood draw to indicate an unhealthy or abnormal level.

Oral infections can progress slowly over time and not show up in the blood work until enough of the bacteria has entered the blood stream. This does not mean however that the bacteria is not filtering into the blood, because it is. Routine blood work is not sensitive enough to pick it up until it's severe. There are specialized blood tests that are more sensitive than those routinely done, but many doctors are not even aware of them and they are very expensive and most insurance companies do not cover them. I would have to do some research into what they would be but you are probably not going to find someone to do them. Unless you went to an infectious disease specialist.

It can be difficult to determine when an oral infection has caused you ill health or when it has settled in an organ, a joint, or a bone elsewhere. Sometimes the bacteria shows up "unexpectedly" when someone has surgery in another area of their body and pathological cultures identify and confirm the strain of bacteria(s) as being most prevalent in the mouth. I have known many people who went in for a hip or knee replacement and the surgeon found osteomyelitis (bone inflammation and infection often found in the jaw bone with root canaled teeth or long term infected teeth) brewing in the joint which compromised the new replacement. I have known people and actually had a friend of mine succumb to brain cancer called Glioblastoma Multiforme which the tissue cultures of the tumors confirmed the same strains of bacteria as what was found in his extracted root canaled teeth and jaw bone.

This is why I cannot stress enough on this forum how important it is to not retain dead or infected teeth. Pain is not always a symptom until the problem has progressed. We have to rely on our dentists to inform us of any early signs of infection and there often are many, but sometimes they are more visible to the dentist than to ourselves. We also all need to do our part and become wiser patients about the common sense risks associated with keeping dead or infected teeth. Agree...?

I know you are trying to keep yourself healthy and are concerned about your dental health. It's been several days since your extraction, how are you feeling?

Bryanna




QUOTE=threeputt;1091333]Bryanna, just a quick question on this. If someone had an infection in their body from infected teeth then blood work should show it correct ? Otherwise how would you know ? I read you reply and was just wondering about this. Tom[/QUOTE]

I am doing great Bryanna.