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Old 10-10-2014, 12:22 AM #1
chrisc chrisc is offline
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Default Can't decide what to do with my root canal

New comer here and I'm very stuck at what path I should take with my teeth.

I've had several autoimmune markers come up in my blood and I'm wondering if my root canal tooth is involved in it. I'm attaching a pan and close up of the root canal tooth.

Here is what I need to decide:

1) Does tooth #11 which is showing some possible infection related to my autoimmune issues or is there no connection.

2) Should I just leave #11 as is or
a) Perform Apicoectomy
b) Extract

3) If I do extract, I want to get an implant (Zirconium instead of titanium).
a) Should I wait for the bone to heal or implant immediately.


I don't want to lose a front tooth as I'm still young and I haven't found any scientific data that back up an infected tooth with autoimmune issues. Will I just be wasting a tooth or is this a good shot at helping me heal.
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Old 10-10-2014, 10:22 AM #2
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Hi chrisc,

I am in the dental field and can offer you some information here. I am going to repost your questions and answer you in bold type. Thanks for posting the xrays!!

<<I've had several autoimmune markers come up in my blood and I'm wondering if my root canal tooth is involved in it. I'm attaching a pan and close up of the root canal tooth.>>

WHEN YOUR BLOOD INDICATES AUTOIMMUNE PROBLEMS THAT MEANS THAT YOU NEED TO LOOK AT EVERY ASPECT OF YOUR DIET, LIFESTYLE, MEDICATIONS AND ENVIRONMENT AS ALL OF THESE THINGS ARE CONTRIBUTING FACTORS TO AUTOIMMUNE DISORDERS. GENERALLY OUR IMMUNE SYSTEM ACTS UP WHEN WE CHRONICALLY BOMBARD IT WITH IRRITANTS AS ANYTHING CHRONIC CAN LEAD TO A CUMULATIVE AFFECT IN OUR IMMUNE SYSTEM. ANOTHER ANALOGY IS CALLED THE BUCKET THEORY. IF YOU SLOWLY FILL A BUCKET WITH WATER YOU EVENTUALLY REACH THE RIM OF THE BUCKET...KEEP FILLING IT AND THE WATER SPILLS OVER AND THE BUCKET CONTINUES TO REMAIN FULL. OUR IMMUNE WORKS SIMILARLY TO THAT BUCKET.

<<1) Does tooth #11 which is showing some possible infection related to my autoimmune issues or is there no connection.>>

YES THE XRAYS INDICATE NEGATIVE PATHOLOGY GOING ON IN THE BONE WHICH IS POSSIBLY IN CLOSE PROXIMITY TO YOUR SINUS. IN YOUR ANATOMY IF THE PATHOLOGY HAS NOT INVADED THE SINUS MEMBRANE IT PROBABLY WILL EVENTUALLY. ANY INFECTION CAN BE RELATED TO ACQUIRING AN AUTO IMMUNE DISORDER. ORAL INFECTIONS ARE NOT EXCEPTION TO THAT FACT. HERE IS A BRIEF ARTICLE..
http://www.everydayhealth.com/autoim...nfections.aspx

<<2) Should I just leave #11 as is or>>
a) Perform Apicoectomy
b) Extract

TO LEAVE TOOTH #11 ALONE OR TO HAVE IT RE TREATED WITH ANOTHER RC PROCEDURE OR TO HAVE AN APICOECTOMY MEANS TO KEEP THE INFECTION AS THE TOOTH WILL BE THE SOURCE OF THE CHRONIC INFECTION. IRRELEVANT OF HOW MANY TIMES THE RC PROCEDURE IS DONE, IRRELEVANT OF HOW MANY TIMES THE THE APICO IS DONE... IRRELEVANT OF HOW WELL EITHER OF THOSE PROCEDURES ARE DONE... THE TOOTH WILL REMAIN INFECTED BECAUSE THERE IS NO ACCESS TO THE HUNDREDS OF CURVY MICROSCOPIC CANALS CALLED DENTIN TUBULES THAT ARE IN THE TOOTH. THESE CANALS HARBOR NECROTIC AND OFTEN GANGRENOUS NERVE TISSUE. THIS BACTERIA IS NOT SELF LIMITING TO JUST THE TOOTH AS EVIDENCED IN THE PATHOLOGY INDICATED ON YOUR XRAYS.

<<3) If I do extract, I want to get an implant (Zirconium instead of titanium).
a) Should I wait for the bone to heal or implant immediately.>>

I WOULD SUGGEST THAT YOU NOT HAVE AN IMMEDIATE IMPLANT AFTER THE EXTRACTION BECAUSE THE BONE IS OBVIOUSLY NOT HEALTHY WHICH MEANS THE IMPLANT WOULD NOT ONLY BE COMPROMISED BUT YOU COULD END UP WITH A SECONDARY INFECTION. IT WOULD BE BEST TO ALLOW THE AREA TO HEAL FOR SEVERAL MONTHS, HAVING IT MONITORED WITH ONE SINGLE PERIAPICAL XRAY AT MONTHLY INTERVALS TO BE SURE THAT THERE IS NO RESIDUAL INFECTION AND IT IS HEALING WELL.

IT IS IMPERATIVE THAT YOU HAVE AN ORAL SURGEON REMOVE THIS TOOTH AND NOT A GENERAL DENTIST... UNLESS THAT GD HAS HAD ADDITIONAL TRAINING IN ORAL SURGERY AND IS WELL EXPERIENCED IN IT. WHOMEVER YOU SEE FOR THE EXTRACTION BE SURE TO MAKE IT CLEAR THAT YOU WANT THE PERIODONTAL LIGAMENT AND ALL NECROTIC TISSUE AND BONE REMOVED AT THE TIME OF THE EXTRACTION. I KNOW IT SOUNDS STUPID TO HAVE TO BE THE ONE TO TELL THE DENTIST TO DO THIS BUT UNFORTUNATELY SOME ARE A BIT LAX ABOUT IT. LEAVING ANY OF THIS BEHIND WILL PREVENT THE BONE FROM HEALING AND CAN RESULT IN A CHRONIC INFECTION OFTEN REFERRED TO AS A CAVITATION. WHICH MOST DEFINITELY WILL COMPROMISE YOUR IMMUNE SYSTEM. YOU ALSO WANT TO KNOW HOW CLOSE THE ROOT AND THE INFECTION WAS IN PROXIMITY TO THE SINUS AND IF THERE WAS A SINUS COMMUNICATION. THOSE THINGS ARE IMPORTANT AS THEY WILL BE PART OF YOUR DECISION AS TO WHETHER OR NOT TO HAVE THE IMPLANT DONE LATER ON.

<<I don't want to lose a front tooth as I'm still young and I haven't found any scientific data that back up an infected tooth with autoimmune issues. Will I just be wasting a tooth or is this a good shot at helping me heal>>

THERE IS NO QUESTION ABOUT THE CORRELATION BETWEEN INFECTION AND AUTOIMMUNE ISSUES. IF YOU GOOGLE THAT PHRASE YOU WILL COME UP WITH AN ABUNDANCE OF INFORMATION. WHEN EXPLORING THE INFORMATION WHAT YOU NEED TO KEEP IN MIND IS THAT OUR TEETH AND OUR ORAL HEALTH CAN BE HUGE SOURCES OF BACTERIA AND INFECTION. KEEPING A ROOT CANALED TOOTH OR ANY INFECTED TOOTH IS A CHRONIC SOURCE OF INFECTION IRRITATING TO THE IMMUNE SYSTEM.

NO ONE WANTS TO LOSE THEIR TEETH, YOUNG OR OLD. IT IS UNDERSTANDABLE TO WANT TO HANG ON TO THEM FOR AS LONG AS WE CAN. BUT IF YOU PUT INTO PERSPECTIVE WHAT IT IS THAT YOU WANT TO HOLD ON TO AND HOW THAT WILL AFFECT YOUR HEALTH FOR THE LONG TERM... THE DECISION MAY BECOME MORE CLEAR AND A BIT EASIER TO DEAL WITH.

REGARDING THE DIFFERENT DENTAL IMPLANTS.... IT WOULD BE BEST TO GET YOUR BLOOD MARKERS UNDER CONTROL BEFORE HAVING ANY IMPLANT DONE AS THE IMPLANT IRRELEVANT OF THE TYPE CAN BECOME A CHRONIC SOURCE OF IMMUNE BURDEN IF YOUR IMMUNE SYSTEM IS NOT FUNCTIONING PROPERLY.

I HAVE A QUESTION ABOUT YOUR LOWER RIGHT DENTAL IMPLANT....
WHAT WAS THE HISTORY ON THAT TOOTH AND DO YOU TEND TO GET FOOD TRAPPED UNDERNEATH THAT CROWN?

Bryanna
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 10-11-2014, 04:59 AM #3
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Quote:
Originally Posted by Bryanna View Post
Hi chrisc,

I am in the dental field and can offer you some information here. I am going to repost your questions and answer you in bold type. Thanks for posting the xrays!!

<<I've had several autoimmune markers come up in my blood and I'm wondering if my root canal tooth is involved in it. I'm attaching a pan and close up of the root canal tooth.>>

WHEN YOUR BLOOD INDICATES AUTOIMMUNE PROBLEMS THAT MEANS THAT YOU NEED TO LOOK AT EVERY ASPECT OF YOUR DIET, LIFESTYLE, MEDICATIONS AND ENVIRONMENT AS ALL OF THESE THINGS ARE CONTRIBUTING FACTORS TO AUTOIMMUNE DISORDERS. GENERALLY OUR IMMUNE SYSTEM ACTS UP WHEN WE CHRONICALLY BOMBARD IT WITH IRRITANTS AS ANYTHING CHRONIC CAN LEAD TO A CUMULATIVE AFFECT IN OUR IMMUNE SYSTEM. ANOTHER ANALOGY IS CALLED THE BUCKET THEORY. IF YOU SLOWLY FILL A BUCKET WITH WATER YOU EVENTUALLY REACH THE RIM OF THE BUCKET...KEEP FILLING IT AND THE WATER SPILLS OVER AND THE BUCKET CONTINUES TO REMAIN FULL. OUR IMMUNE WORKS SIMILARLY TO THAT BUCKET.

<<1) Does tooth #11 which is showing some possible infection related to my autoimmune issues or is there no connection.>>

YES THE XRAYS INDICATE NEGATIVE PATHOLOGY GOING ON IN THE BONE WHICH IS POSSIBLY IN CLOSE PROXIMITY TO YOUR SINUS. IN YOUR ANATOMY IF THE PATHOLOGY HAS NOT INVADED THE SINUS MEMBRANE IT PROBABLY WILL EVENTUALLY. ANY INFECTION CAN BE RELATED TO ACQUIRING AN AUTO IMMUNE DISORDER. ORAL INFECTIONS ARE NOT EXCEPTION TO THAT FACT. HERE IS A BRIEF ARTICLE..

<<2) Should I just leave #11 as is or>>
a) Perform Apicoectomy
b) Extract

TO LEAVE TOOTH #11 ALONE OR TO HAVE IT RE TREATED WITH ANOTHER RC PROCEDURE OR TO HAVE AN APICOECTOMY MEANS TO KEEP THE INFECTION AS THE TOOTH WILL BE THE SOURCE OF THE CHRONIC INFECTION. IRRELEVANT OF HOW MANY TIMES THE RC PROCEDURE IS DONE, IRRELEVANT OF HOW MANY TIMES THE THE APICO IS DONE... IRRELEVANT OF HOW WELL EITHER OF THOSE PROCEDURES ARE DONE... THE TOOTH WILL REMAIN INFECTED BECAUSE THERE IS NO ACCESS TO THE HUNDREDS OF CURVY MICROSCOPIC CANALS CALLED DENTIN TUBULES THAT ARE IN THE TOOTH. THESE CANALS HARBOR NECROTIC AND OFTEN GANGRENOUS NERVE TISSUE. THIS BACTERIA IS NOT SELF LIMITING TO JUST THE TOOTH AS EVIDENCED IN THE PATHOLOGY INDICATED ON YOUR XRAYS.

<<3) If I do extract, I want to get an implant (Zirconium instead of titanium).
a) Should I wait for the bone to heal or implant immediately.>>

I WOULD SUGGEST THAT YOU NOT HAVE AN IMMEDIATE IMPLANT AFTER THE EXTRACTION BECAUSE THE BONE IS OBVIOUSLY NOT HEALTHY WHICH MEANS THE IMPLANT WOULD NOT ONLY BE COMPROMISED BUT YOU COULD END UP WITH A SECONDARY INFECTION. IT WOULD BE BEST TO ALLOW THE AREA TO HEAL FOR SEVERAL MONTHS, HAVING IT MONITORED WITH ONE SINGLE PERIAPICAL XRAY AT MONTHLY INTERVALS TO BE SURE THAT THERE IS NO RESIDUAL INFECTION AND IT IS HEALING WELL.

IT IS IMPERATIVE THAT YOU HAVE AN ORAL SURGEON REMOVE THIS TOOTH AND NOT A GENERAL DENTIST... UNLESS THAT GD HAS HAD ADDITIONAL TRAINING IN ORAL SURGERY AND IS WELL EXPERIENCED IN IT. WHOMEVER YOU SEE FOR THE EXTRACTION BE SURE TO MAKE IT CLEAR THAT YOU WANT THE PERIODONTAL LIGAMENT AND ALL NECROTIC TISSUE AND BONE REMOVED AT THE TIME OF THE EXTRACTION. I KNOW IT SOUNDS STUPID TO HAVE TO BE THE ONE TO TELL THE DENTIST TO DO THIS BUT UNFORTUNATELY SOME ARE A BIT LAX ABOUT IT. LEAVING ANY OF THIS BEHIND WILL PREVENT THE BONE FROM HEALING AND CAN RESULT IN A CHRONIC INFECTION OFTEN REFERRED TO AS A CAVITATION. WHICH MOST DEFINITELY WILL COMPROMISE YOUR IMMUNE SYSTEM. YOU ALSO WANT TO KNOW HOW CLOSE THE ROOT AND THE INFECTION WAS IN PROXIMITY TO THE SINUS AND IF THERE WAS A SINUS COMMUNICATION. THOSE THINGS ARE IMPORTANT AS THEY WILL BE PART OF YOUR DECISION AS TO WHETHER OR NOT TO HAVE THE IMPLANT DONE LATER ON.

<<I don't want to lose a front tooth as I'm still young and I haven't found any scientific data that back up an infected tooth with autoimmune issues. Will I just be wasting a tooth or is this a good shot at helping me heal>>

THERE IS NO QUESTION ABOUT THE CORRELATION BETWEEN INFECTION AND AUTOIMMUNE ISSUES. IF YOU GOOGLE THAT PHRASE YOU WILL COME UP WITH AN ABUNDANCE OF INFORMATION. WHEN EXPLORING THE INFORMATION WHAT YOU NEED TO KEEP IN MIND IS THAT OUR TEETH AND OUR ORAL HEALTH CAN BE HUGE SOURCES OF BACTERIA AND INFECTION. KEEPING A ROOT CANALED TOOTH OR ANY INFECTED TOOTH IS A CHRONIC SOURCE OF INFECTION IRRITATING TO THE IMMUNE SYSTEM.

NO ONE WANTS TO LOSE THEIR TEETH, YOUNG OR OLD. IT IS UNDERSTANDABLE TO WANT TO HANG ON TO THEM FOR AS LONG AS WE CAN. BUT IF YOU PUT INTO PERSPECTIVE WHAT IT IS THAT YOU WANT TO HOLD ON TO AND HOW THAT WILL AFFECT YOUR HEALTH FOR THE LONG TERM... THE DECISION MAY BECOME MORE CLEAR AND A BIT EASIER TO DEAL WITH.

REGARDING THE DIFFERENT DENTAL IMPLANTS.... IT WOULD BE BEST TO GET YOUR BLOOD MARKERS UNDER CONTROL BEFORE HAVING ANY IMPLANT DONE AS THE IMPLANT IRRELEVANT OF THE TYPE CAN BECOME A CHRONIC SOURCE OF IMMUNE BURDEN IF YOUR IMMUNE SYSTEM IS NOT FUNCTIONING PROPERLY.

I HAVE A QUESTION ABOUT YOUR LOWER RIGHT DENTAL IMPLANT....
WHAT WAS THE HISTORY ON THAT TOOTH AND DO YOU TEND TO GET FOOD TRAPPED UNDERNEATH THAT CROWN?

Bryanna
Thank you so much for the information. Please check my replies under each quote.

Quote:
YES THE XRAYS INDICATE NEGATIVE PATHOLOGY GOING ON IN THE BONE WHICH IS POSSIBLY IN CLOSE PROXIMITY TO YOUR SINUS. IN YOUR ANATOMY IF THE PATHOLOGY HAS NOT INVADED THE SINUS MEMBRANE IT PROBABLY WILL EVENTUALLY. ANY INFECTION CAN BE RELATED TO ACQUIRING AN AUTO IMMUNE DISORDER. ORAL INFECTIONS ARE NOT EXCEPTION TO THAT FACT. HERE IS A BRIEF ARTICLE..
When I talked to the endodontist, he said that it's not always an infection but a scar? Does that sounds remotely logical or is this definitely 100% an infection in the bone?

Quote:
TO LEAVE TOOTH #11 ALONE OR TO HAVE IT RE TREATED WITH ANOTHER RC PROCEDURE OR TO HAVE AN APICOECTOMY MEANS TO KEEP THE INFECTION AS THE TOOTH WILL BE THE SOURCE OF THE CHRONIC INFECTION. IRRELEVANT OF HOW MANY TIMES THE RC PROCEDURE IS DONE, IRRELEVANT OF HOW MANY TIMES THE THE APICO IS DONE... IRRELEVANT OF HOW WELL EITHER OF THOSE PROCEDURES ARE DONE... THE TOOTH WILL REMAIN INFECTED BECAUSE THERE IS NO ACCESS TO THE HUNDREDS OF CURVY MICROSCOPIC CANALS CALLED DENTIN TUBULES THAT ARE IN THE TOOTH. THESE CANALS HARBOR NECROTIC AND OFTEN GANGRENOUS NERVE TISSUE. THIS BACTERIA IS NOT SELF LIMITING TO JUST THE TOOTH AS EVIDENCED IN THE PATHOLOGY INDICATED ON YOUR XRAYS.
My dentist did mention they can run a current that will zap all the bacteria dead in those 100's of tubes, if they open it up.


Quote:
I WOULD SUGGEST THAT YOU NOT HAVE AN IMMEDIATE IMPLANT AFTER THE EXTRACTION BECAUSE THE BONE IS OBVIOUSLY NOT HEALTHY WHICH MEANS THE IMPLANT WOULD NOT ONLY BE COMPROMISED BUT YOU COULD END UP WITH A SECONDARY INFECTION. IT WOULD BE BEST TO ALLOW THE AREA TO HEAL FOR SEVERAL MONTHS, HAVING IT MONITORED WITH ONE SINGLE PERIAPICAL XRAY AT MONTHLY INTERVALS TO BE SURE THAT THERE IS NO RESIDUAL INFECTION AND IT IS HEALING WELL.

IT IS IMPERATIVE THAT YOU HAVE AN ORAL SURGEON REMOVE THIS TOOTH AND NOT A GENERAL DENTIST... UNLESS THAT GD HAS HAD ADDITIONAL TRAINING IN ORAL SURGERY AND IS WELL EXPERIENCED IN IT. WHOMEVER YOU SEE FOR THE EXTRACTION BE SURE TO MAKE IT CLEAR THAT YOU WANT THE PERIODONTAL LIGAMENT AND ALL NECROTIC TISSUE AND BONE REMOVED AT THE TIME OF THE EXTRACTION. I KNOW IT SOUNDS STUPID TO HAVE TO BE THE ONE TO TELL THE DENTIST TO DO THIS BUT UNFORTUNATELY SOME ARE A BIT LAX ABOUT IT. LEAVING ANY OF THIS BEHIND WILL PREVENT THE BONE FROM HEALING AND CAN RESULT IN A CHRONIC INFECTION OFTEN REFERRED TO AS A CAVITATION. WHICH MOST DEFINITELY WILL COMPROMISE YOUR IMMUNE SYSTEM. YOU ALSO WANT TO KNOW HOW CLOSE THE ROOT AND THE INFECTION WAS IN PROXIMITY TO THE SINUS AND IF THERE WAS A SINUS COMMUNICATION. THOSE THINGS ARE IMPORTANT AS THEY WILL BE PART OF YOUR DECISION AS TO WHETHER OR NOT TO HAVE THE IMPLANT DONE LATER ON.
Hm, the dentist told me if I do not do an immediate implant I will lose bone and will need gum grafts? Is this correct, from you experience how much bone would be lost in a few months? Obviously I would like to keep the gum line relatively the same from a cosmetic point of view.

In terms of removing all infection, I see that the tooth is very deep rooted. Will the doctor be able to reach all the way in to clear the infection, since the root is so long?

Quote:
I HAVE A QUESTION ABOUT YOUR LOWER RIGHT DENTAL IMPLANT....
WHAT WAS THE HISTORY ON THAT TOOTH AND DO YOU TEND TO GET FOOD TRAPPED UNDERNEATH THAT CROWN?
That tooth was root canalled 10 years ago and developed a cyst / infection under it in the bone. I had the tooth extracted, waited 3 months and had a Zirconium implant put in 3 years ago. Yes, food traps there, but I make sure brush my teeth after each meal and clean all areas of food.
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Old 10-28-2014, 03:32 AM #4
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Posting an update.

Well I went to the oral surgeon to ask about #11. I did a cone beam ct scan of that tooth and it looks like the infection is 3x bigger on the front area and is quite large.

The oral surgeon insisted that I should try getting the root canal done again and get an Apicoectomy. He said there is plenty of tooth structure and healthy bone and that I can save the tooth.

So I'm ultra confused now, who to listen too. I still feel like I should extract and get rid of the chronic infection and then get an implant, but all the dentists tell me to do after all other options are exhausted.

Would an Apicoectomy compromise a future implant if it fails?
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Old 10-28-2014, 09:02 AM #5
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Hi chrisc,

I will re post your thread and answer you in bold type.

<<Well I went to the oral surgeon to ask about #11. I did a cone beam ct scan of that tooth and it looks like the infection is 3x bigger on the front area and is quite large.>>

SO THIS CONFIRMS WHAT I SAID ABOUT THE RADIO GRAPHIC PATHOLOGY IN THE BONE. KEEP IN MIND THAT YOUR JAW BONE IS RELATIVELY SMALL AND COMPACT COMPARED TO OTHER BONY AREAS OF THE BODY. SO A LARGE INFECTION IN THE JAW BONE MEANS THAT THERE IS A LOT OF AREA INVOLVED. THE FRONT PORTION OF THE BONE IS CALLED THE BUCCAL AND IT IS THIN AND FRAGILE COMPARED TO OTHER AREAS OF BONE. WHEN AN INFECTION HAS CONSUMED THE BUCCAL BONE, IT RESULTS IN SUBSTANTIAL BONE LOSS THAT IS NOT ABLE TO BE REBUILT WELL ENOUGH WITH A BONE GRAFT MATERIAL. EVEN BONE HARVESTED FROM YOUR MANDIBLE OR FEMUR MAY NOT BE ABLE TO REBUILD THIS AREA OF BONE AS IT HAS NOTHING TO HOLD ON TO OR GROW INTO. AT THIS POINT, DUE TO THE LONGEVITY OF THE INFECTION WHICH HAS BEEN BREWING AT LEAST 10 YEARS AGO WHEN YOU HAD THE ROOT CANAL, THERE IS LITTLE TO NO HEALTHY BONE IN THAT AREA AS IT HAS DETERIORATED FROM THE BACTERIA. THIS CONDITION IS COMMONLY SEEN WITH ANTERIOR ROOT CANALED TEETH.

<<The oral surgeon insisted that I should try getting the root canal done again and get an Apicoectomy. He said there is plenty of tooth structure and healthy bone and that I can save the tooth.>>

THE OS KNOWS THIS TOOTH IS HOPELESS AND THAT IT IS INEVITABLE THAT IT WILL NEED TO BE REMOVED. HE THINKS YOU WANT TO ATTEMPT TO BUY SOME MORE TIME AND THE APICO WOULD BE YOUR ONLY OPTION. HOWEVER, WHAT HE MEANS WHEN HE SAYS "SAVE" THE TOOTH, IS SIMPLY "RETAIN", NOT "CURE". THE LONGER THIS TOOTH IS PRESENT THE FURTHER THE INFECTION WILL SPREAD BECAUSE THE TOOTH IS CAUSING ALL OF THIS PROBLEM AND THERE IS NO DENTAL PROCEDURE OR MIRACLE ZAPPING MACHINE THAT CAN REMOVE THE NECROTIC TISSUE INSIDE OF THE MICROSCOPIC CANALS THAT IS HOLDING THIS TOOTH HOSTAGE TO INFECTION. THAT NERVE TISSUE IS SO SICK.... JUST LOOK AT WHAT IT HAS DONE TO YOUR JAW BONE ALREADY.

TO REPEAT THE RC PROCEDURE AND DO AN APICO IS 100% A WASTE OF TIME, MONEY AND PAIN. NEITHER OF THOSE PROCEDURES WILL ALTER THE SICK NERVE TISSUE INSIDE OF THOSE TINY CANALS. YOU WILL NOT ONLY BE LEFT WITH THE SAME PROBLEM THAT YOU HAVE NOW BUT ADDITIONAL INFLAMMATION AND PERMANENT BONE LOSS FROM THE APICO SURGERY.

<<So I'm ultra confused now, who to listen too. I still feel like I should extract and get rid of the chronic infection and then get an implant, but all the dentists tell me to do after all other options are exhausted.>>

THE DENTISTS ARE IN THE BUSINESS TO SELL DENTISTRY. THERE IS A LOT OF MONEY TO BE MADE WITH REPEATED ROOT CANALS AND APICOECTOMIES AS THEY ARE NOT INTENDED TO "CURE" THE PROBLEM. SO THE PATIENT INEVITABLY HAS TO REMOVE THE TOOTH AND THEN DEAL WITH THE COMPLICATIONS OF REPLACING IT DUE TO THE EXTENSIVE BONE LOSS.

ALSO, HAS ANY OF THESE DENTISTS GIVEN YOU ANY INCLINATION ABOUT HOW THIS INFECTION IS AFFECTING YOUR IMMUNE SYSTEM?

<<Would an Apicoectomy compromise a future implant if it fails?>>
YES, AN APICO WILL ALWAYS COMPROMISE THE SUCCESS OF A DENTAL IMPLANT BECAUSE THE APICO PROCEDURE CAUSES IRREPLACEABLE BONE LOSS. WHICH WOULD JUST FURTHER THE BONE LOSS THAT YOU ALREADY HAVE.
REGARDING A DENTAL IMPLANT.... ANY TIME THE BUCCAL PORTION OF THE BONE IS LOST TO DISEASE, IT IS VERY RISKY TO PLACE AN IMPLANT IN THAT AREA AS THERE MAY NOT BE ADEQUATE BONE TO COVER THE FRONT PORTION OF THE IMPLANT. IT IS NEVER IDEAL TO PLACE AN IMPLANT IN AN AREA LIKE THAT WHICH WOULD LEAVE ONE SIDE OF THE IMPLANT COVERED WITH GUM TISSUE AND NO BONE.

I know this is difficult to go through and I wish your dentists would be more informative with you... but so far they are not. You are experiencing a typical cluster mess because you are being sold tooth carpentry rather than healthy dental care.

Here are two links, from dental sites that I am unaffiliated with, that go into detail about root canaled teeth and the aftermath that they leave behind.

http://biologicaldentalhealth.com/co...ticle/106.html

http://toothbody.com/unexplained-den...ntal-ligament/

Also, re read through my posts to you. I think you know intuitively what you need to do. Listen to your intuition.

Bryanna
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 10-30-2014, 07:17 AM #6
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I'm attaching the CT scan images to give you an idea of how large or small the infection is. The bone does indeed look thin at the buccal side.

Yes I believe the dentist believes I can buy more time with it, he's not interested in selling unnecessary procedures, he genuinely believes why not give the tooth a chance to live for another 5-10 years or longer. I guess the question is what is the probability of reinfection in that situation. I would assume high in the 60% range?

Everytime I ask them about my immune system, they shrug and have no idea.. Yes I do believe logically removal of the tooth will give me a higher chance of getting rid of the infection permanently (at the cost of a lower cosmetic result) and possibly helping my immune system to heal.

Looking at the CT scans, how would you proceed with this situation, extract and wait for 1-2 months for the bone to heal then implant, making sure no infection is left? Do you think I have enough bone for an implant?
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Old 10-30-2014, 09:33 AM #7
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Hi chrisc,

I am going to re post and answer in bold type. I am going to be blunt with my reply simply because you have the right to be properly informed about the seriousness of this infection.

First I want to thank you for posting the ct scan images. They confirm the diagnosis without question.

<<I'm attaching the CT scan images to give you an idea of how large or small the infection is. The bone does indeed look thin at the buccal side.??

THE INFECTION IS LARGE. IF THIS TYPE OF INFECTION WERE ANYPLACE ELSE ON YOUR BODY, YOU WOULD BE SENT TO A SURGEON TO HAVE THE SOURCE OF THE INFECTION REMOVED. NOT TO SCARE YOU BUT TO INFORM YOU..... THIS INFECTION IS NOT SELF CONTAINED, IT IS IN YOUR HEAD ONLY 3-4 INCHES FROM YOUR BRAIN. THE BACTERIA IS PROGRESSIVE WITH A MULTITUDE OF PATHOGENS WHICH WILL END UP VERY DIFFICULT IF NOT IMPOSSIBLE TO ERADICATE COMPLETELY. THIS IS WHAT YOUR DENTIST SHOULD BE INFORMING YOU ABOUT.

<<Yes I believe the dentist believes I can buy more time with it, he's not interested in selling unnecessary procedures,>>

PLEASE DON'T BE FOOLED BY HIM NOT SELLING YOU SOMETHING UNNECESSARY. THERE IS NO BUYING TIME IF YOU UNDERSTAND THE HEALTH RISKS ASSOCIATED WITH RETAINING THIS TOOTH. YOUR DENTIST IS NOT INFORMING YOU OF THOSE RISKS BECAUSE HE IS LOOKING AT "YOUR TOOTH" AND NOTHING ELSE. MEANING, HE IS MORE CONCERNED ABOUT HOW TO REPLACE IT THAN THE PATHOLOGY ASSOCIATED WITH IT.

<< he genuinely believes why not give the tooth a chance to live for another 5-10 years or longer.>>

THIS TOOTH IS NOT ALIVE. IT IS NON VITAL, HAS NO BLOOD SUPPLYING IT NUTRITION, IT IS SURROUNDED BY A POOL OF PROGRESSIVE INFECTIOUS BACTERIA THAT IS CONTINUOUSLY FILTERING THROUGH YOUR BLOOD AND LYMPHATIC SYSTEM.
YOUR DENTIST GENUINELY KNOWS THAT THIS TOOTH IS VERY SICK BUT HE IS NOT GIVING THOUGHT TO THE SYSTEMIC HEALTH RISKS IN RETAINING IT. THE LONGER YOU WAIT TO REMOVE THIS TOOTH AND INFECTION, THE MORE DETERIORATION WILL OCCUR, THE MORE AREA WILL BECOME INFECTED AND YOU MAY END UP LOSING THE ADJACENT TEETH AS WELL. THOSE ARE THE THINGS HE SHOULD BE INFORMING YOU ABOUT.

<< I guess the question is what is the probability of reinfection in that situation. I would assume high in the 60% range?>>

WHEN IT COMES TO ROOT CANALED TEETH, THERE IS NO SUCH THING AS IT BECOMING RE INFECTED AS THE TOOTH REMAINS INFECTED IRRELEVANT OF WHAT IS DONE TO IT OR TO THE BONE AROUND IT. ONCE A TOOTH HAS BEEN ROOT CANALED, IT IS A SOURCE OF INFECTIOUS BACTERIA, NECROTIC NERVE TISSUE, AND GANGRENE. IS THIS SOMETHING YOU WANT TO KEEP IN YOUR HEAD?

<<Everytime I ask them about my immune system, they shrug and have no idea..>>

EXACTLY. DENTISTS HAVE BEEN EDUCATED ON THE CONNECTION BETWEEN ORAL AND SYSTEMIC HEALTH. THEY KNOW THE INTIMATE RELATIONSHIP BETWEEN THE MOUTH AND THE IMMUNE SYSTEM. HOWEVER, THE MAJORITY OF THEIR EDUCATION IS NOT ON ANY OF THAT... IT IS ON THE CARPENTRY ASPECT OF DENTISTRY INSTEAD.

<<Yes I do believe logically removal of the tooth will give me a higher chance of getting rid of the infection permanently (at the cost of a lower cosmetic result) and possibly helping my immune system to heal.>>

REMOVING THE TOOTH MEANS TO REMOVE THE SOURCE OF THE INFECTION. THE SURGEON WOULD NEED TO ALSO REMOVE ALL NECROTIC TISSUE AND BONE AS THIS IS THE ONLY MEANS OF ATTEMPTING TO CURE THE INFECTION. AGAIN YOU SHOULD BE INFORMED THAT THE INFECTION IS NO LONGER SELF LIMITING TO THE TOOTH, IT BECAME SYSTEMIC BY TRAVELING INTO YOUR JAW BONE AND IT WILL MOVE TO OTHER AREAS.

<<Looking at the CT scans, how would you proceed with this situation, extract and wait for 1-2 months for the bone to heal then implant, making sure no infection is left? Do you think I have enough bone for an implant?>>

IN MY PROFESSIONAL OPINION, IT WOULD BE WISE TO EXTRACT THE TOOTH AND EXPRESS TO THE SURGEON TO BE VERY THOROUGH WITH HIS DEBRIDEMENT OF THE SOCKET MEANING HE WOULD BE CAREFUL TO REMOVE ALL VISIBLE AREAS OF DISEASE. THAT DOES NOT MEAN THAT THERE WON'T BE RESIDUAL BACTERIA HIDING IN ANOTHER AREA. THIS IS WHY THIS AREA SHOULD THEN BE MONITORED FOR 6 MONTHS BY TAKING AN XRAY OF IT EVERY OTHER MONTH TO EVALUATE THE BONE FOR FURTHER INFECTION AND TO SEE HOW THE BONE IS GROWING. IF THE BUCCAL PLATE IS NOT HEALTHY AND/OR IT IS COMPLETELY GONE FROM THE INFECTION, THIS AREA WILL NOT BE ABLE TO PROPERLY HOLD A DENTAL IMPLANT. IN THOSE CASES, IF THE PATIENT HAS THE IMPLANT ANYWAY, IT WOULD BE HELD IN BY WHATEVER BONE IS THERE AND SOMETIMES THE IMPLANT IS ACTUALLY VISIBLE THROUGH THE GUM TISSUE ON THE BUCCAL SIDE. THEN THE IMPLANT WOULD BE COMPROMISED, UNSTABLE AND A CHRONIC SOURCE OF INFECTION. YOUR DENTIST WILL MOST LIKELY NOT WANT TO DISCUSS THAT AS HE AGAIN, IS ONLY INTERESTED IN THE $$$ FOR REPLACING THE TOOTH. WHEN IT FAILED HE WOULD BLAME IT ON THE LONGEVITY OF THE INFECTION AND TRY TO MAKE YOU THINK THAT HE DID ALL HE COULD TO HELP YOU. I KNOW THAT SOUNDS TERRIBLE AND IT IS TERRIBLE.... I HATE EVEN ACKNOWLEDGING THAT IT HAPPENS, BUT IT IS UNFORTUNATELY TRUE IN SO MANY CASES.

You need to be your own advocate. You need to become informed of the seriousness of this infection and not allow your dentist to distract you from that fact. I have known countless patients and many friends who have become seriously ill from their root canaled teeth. I choose not to get into their stories because quite frankly they will truly alarm you. So I choose to give as much information as I can to help empower you with enough knowledge so you can make an informed decision. Only you can decide what you feel is in your best interest. Go with your instinct on this.... listen to your body.

Bryanna
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 11-16-2014, 04:18 PM #8
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OK, I'm not a dentist...just learned a lot after going thru a malpractice case. It looks to me like the filling is not solid, that there are "voids".

Make sure that Sargenti Paste (aka RC2B, RC2W, N2, N2 Universal, Paste) was not used. The best approach is to get a copy of the records from the dentist that did the root canal, then see if you see any of the terms, then ask if formaldehyde in any form or amount was used. Don't ask what was used, specifically as if any formaldehyde was used. It can cause systemic and local problems....immediately or down the road.

If it was, start doing research into this material and find a lawyer. I can help you. Hopefully this is not your problem.

http://www.aae.org/uploadedfiles/aae...gmaterials.pdf
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Old 11-21-2014, 11:19 AM #9
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Hi Chrisc,

What have you done about your dental infection? How are you feeling?
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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