[anneva]

I have found a lot of useful information on here but I need some input on what to do next...like tomorrow morning.

History: 2 failed root canals on #3. Extracted by Oral Surgeon on 09/11/2014 placed bone graft. He said everything went well and to come post op 2 weeks. Prescribed lortab for pain as needed.

09/13 continuous pain that I thought was normal but then developed slightly larger than eraser head hard bump above #4. Extremely painful. Touching it makes me feel like i'm going to pass out. Horrible breath, swollen from eye down to neck, swollen lymph nodes. 2 dozen mouth ulcers, I have been dealing with salt water rinse and oragel. I feel that these are under control.

09/15 went back to OS because temp remained low at 96 and I felt I had the flu. Constant throbbing pain at extraction site and bump over #4. OS said sounds like dry socket but it couldn't be because I have a graft. He gave me anti-biotics and sent me home.

09/17 Pain is so bad I can barely function. Bump over #4 is slightly larger. Pain at #4, extraction site, palette where sutures are, and some pain with #1. OS said he could debrive the site and treat as dry socket, but that it was completely impossible that was dry socket and I would have wasted the graph and may not be able to have an implant in the future. He suggested that it was a two-tooth problem to begin with and my problem is the #4 tooth. He recommended I have a root canal done on #4 before I remove the graph.

I scheduled a root canal with an endodontist and called my regular dentist to keep her in the loop. She wanted to see me and take x-rays (since the OS didn't.) She felt the bump over my #4 and said it felt hard like a bone fragment, possibly mine or from the graft. She performed a pulp test on all upper teeth and #4 responded similar to all others and she said it is a viable tooth. She thinks my body is rejecting the graph and that's why I have so much pain and tenderness around the extraction site and the bone fragment is causing #4 to be extra sensitive. She recommended a removal of the graph, an excision of the bump, and to just let the extraction site heel and to worry about a graph or implant later. She spoke with the OS and he is certain that the graph isn't the problem and I should just go ahead and have a root canal. He said removing the graph will almost ruin any chance at a healthy implant and doesn't want to excise the bump because "that's unreasonable to think it's a piece of bone."

I have to make this decision tonight. This is my thinking and my dentist agrees but doesn't know if it's going to be correct.....
1. The bump over #4 is definitely a hard bony-line mass. It's jagged if you press on it.
2. The extraction site and all sutures are very painful 7 days post op

So, if I opt to have the graph removed and insist that he excise the bump, I may not be able to have the implant later (at this point I don't care) but I should be pain free in a few days because there won't be any foreign objects in my mouth. Do I ask him to pack it like a dry-socket with the medicated stuffing or just stitch it up?

If I don't have the graph removed and opt to have a root canal on #4 (a viable tooth) , this is what the OS wants, then I may continue to have the same problem and pain with the graph. I have an apt with OS for graph removal at 9:30 am and root canal apt at 2 pm. So, I have overnight to figure this out.

This pain is a 10 and that's saying something since I've had my spine fused.