[KateJK]

Hi there. I posted previously about a root canal issue, but now I have a new terrible issue. Bryanna, or anyone who has experience, I would appreciate your advice greatly. I had an infection between my upper right wisdom tooth and molar next to it. I got my wisdom tooth taken out on November 14th. about 7 days after wisdom tooth extracted I had some pain in jaw, ear and figured I had a minor dry socket and did not return to have it seen right away. But when I did, the dentist said it looked fine (although he didn't have a good look because he was examining the molar next for the root canal issue). The jaw pain came and went. Then I had a root canal retreated on Dec 5th. A few days after, I started experiencing real tenderness above my wisdom tooth extraction site (something seemed to have flared up). Now, days later, the pain is so intense. There doesn't seem to be pain around the root canal - I just went back to see the specialist that did the root canal retreatment and he said aside from some inflammation behind the tooth and it bleeding easily, the pain and inflammation is moreso at the wisdom tooth extraction site. Extreme tenderness to touch and throbbing behind the site (not directly in the socket) and up into my upper gums behind the extraction site. Radiating horrible and intense pain in my jaw, TMJ, ear, and a little bit down my neck. Went to see GP today and she said it might be an infection back there. She put me on strong antibiotics intended for oral infections/bacteria and did bloodworm. And she also put in for me to have an urgent MRI on my jaw, which I should have scheduled within 2 weeks. I have no idea what this pain is from. Perhaps I had a dry socket that wasn't treated and an infection has developed? I am in SO much pain and painkillers don't see to be helping. This is not pain I had when I had the original infection way back in November. That was just a feeling of irritation. This is so much worse and different. I feel like I don't know what to do as the dentist, specialist, and doctor all seem to be at a loss. The specialist also checked for a root tip left and said there was none and that the sinus does not appear to be perforated. If antibiotics don't clear this up, I don't know what to do. I'm supposed to get my root canal retreatment finished next week but cannot bear the thought of having any more pain in that area until this clears up. Any advice is so appreciated. Thank you.

[Pamissotired]

Wow hang in there! Did they give you any painkillers? I have found they usually say take advil (which did nothing for me but maybe will help you). Throbbing pain is usually infection you should feel better if you are going to in 2-3 days on antibiotics. Though they say bacteria die off can cause a bit of flare up to. They give you a ten day course? Take the whole course of antibiotics. I sure hope you feel better soon. Oh couple questions is this pain constant? Does it occur only with pressure? In only one spot or several? Seems suspicious it happened after the root canal procedure.

Pam

I am not a doctor or a dentist just familiar with pain. So anything I say is just out if empathy don't listen to it if you don't want to.

[Bryanna]

CWMB,

Please re read my replies to your original posts. I answered all of these concerns that you currently have now in those posts. The reason you had an infection between your 2nd and 3rd molar was because your 2nd molar is root canaled and the bacteria from that tooth had proliferated beyond the tooth. Removing the wisdom tooth eliminated only one aspect of the problem as the original and continual source of infection is the second molar.

Just to reiterate, it is irrelevant how many times a tooth is root canaled, the tooth remains infected as there is no access to the hundreds of tiny canals inside of the tooth. Those canals harbor infected nerve tissue which renders the tooth very diseased. You may have had a dry socket in the wisdom tooth site which could have resulted in a cavitation which would cause you pain. However, your second molar is infected and will remain that way irrelevant of the re treatment.

All the re treatment did was cause additional trauma and inflammation. There is no antibiotic that is going to cure this infection so you are actually risking an intestinal infection by taking the antibiotic. Your medical doctor has no clue about anything that has to do with teeth. Your general dentist and root canal specialist are condoning the re treatment, not because they think it will make that second molar healthy again, but because they know that you want to retain your bridge.

If you choose to continue on this path, you will continue to have pain and infection. Eventually your dentists, both of them, will tell you.... the re treatment failed and the tooth is not salvageable. The truth of the matter is, they know the rc will not cure the infection but they want to make it look like they made heroic efforts to retain the tooth. Why? Because they know that you do not want to lose the bridge and be tooth less in that quadrant.

Long term infection and inflammation in a tooth as it proliferates beyond the tooth can result in temporary or permanent neurological problems.

Do a google search about root canals and systemic risks....
Dr Mercola and root canals
Dr Meinig and root canals.

Bryanna

Originally Posted by CWMB

Hi there. I posted previously about a root canal issue, but now I have a new terrible issue. Bryanna, or anyone who has experience, I would appreciate your advice greatly. I had an infection between my upper right wisdom tooth and molar next to it. I got my wisdom tooth taken out on November 14th. about 7 days after wisdom tooth extracted I had some pain in jaw, ear and figured I had a minor dry socket and did not return to have it seen right away. But when I did, the dentist said it looked fine (although he didn't have a good look because he was examining the molar next for the root canal issue). The jaw pain came and went. Then I had a root canal retreated on Dec 5th. A few days after, I started experiencing real tenderness above my wisdom tooth extraction site (something seemed to have flared up). Now, days later, the pain is so intense. There doesn't seem to be pain around the root canal - I just went back to see the specialist that did the root canal retreatment and he said aside from some inflammation behind the tooth and it bleeding easily, the pain and inflammation is moreso at the wisdom tooth extraction site. Extreme tenderness to touch and throbbing behind the site (not directly in the socket) and up into my upper gums behind the extraction site. Radiating horrible and intense pain in my jaw, TMJ, ear, and a little bit down my neck. Went to see GP today and she said it might be an infection back there. She put me on strong antibiotics intended for oral infections/bacteria and did bloodworm. And she also put in for me to have an urgent MRI on my jaw, which I should have scheduled within 2 weeks. I have no idea what this pain is from. Perhaps I had a dry socket that wasn't treated and an infection has developed? I am in SO much pain and painkillers don't see to be helping. This is not pain I had when I had the original infection way back in November. That was just a feeling of irritation. This is so much worse and different. I feel like I don't know what to do as the dentist, specialist, and doctor all seem to be at a loss. The specialist also checked for a root tip left and said there was none and that the sinus does not appear to be perforated. If antibiotics don't clear this up, I don't know what to do. I'm supposed to get my root canal retreatment finished next week but cannot bear the thought of having any more pain in that area until this clears up. Any advice is so appreciated. Thank you.

[KateJK]

Thank you both for your replies. I appreciate your empathy and advice. The pain seems to be subsiding somewhat. Yesterday it was unbearable but today it is less severe. The pain behind the root canaled tooth has also diminished. Slight irritation, but better. The pain up in my mouth is far away from the root candled tooth and an oral surgeon (friend of the family) said today, it appears to be a muscle issue. I have a very irritated muscle up in my mouth, perhaps from all the work done recently. I also have developed TMJ, as my bite is very much out of whack from the wisdom tooth removal, etc. I am going to try to wait it out before extracting the tooth. I figure i want to exhaust all options before losing this tooth (and the bridge) entirely - which seems to me, could be quite traumatic and lead to months upon months of surgery for implants to replace the molars, etc. Thank you again and I do hope my pain continues to subside. I appreciate your advice greatly.

[Bryanna]

CWMB,

The choice to keep your tooth is yours to make. Your "friend of the family" oral surgeon may be correct in that you have a muscular issue going on but he is remiss in leading you to believe that this tooth is healthy.

The decrease in pain can be misleading as it does not mean the infection from the tooth is going away. Remember those hundreds of inaccessible tiny canals that I mentioned earlier? They haven't disappeared and neither has the infected nerve tissue inside of them. The decrease in pain indicates that the antibiotic has temporarily subsided the inflammation and it also quite possibly indicates that the bacteria has migrated to a new place and is draining there.

It is understandable that you are concerned about not having any teeth in that upper quadrant and of course that is not ideal for many reasons. But please understand that what you are holding onto is a very diseased tooth that is going to cause further infection. Also, your dentists should be informing you about the permanent bone loss that will result due to this infection. Replacing root canaled teeth with dental implants is very risky and frequently unsuccessful due to the long term infection from the tooth that has resulted in irreplaceable bone loss.

It does not make me happy to be the one to inform you or others about these issues that your dentists have neglected to mention. However, in good conscience I know it's your right to be properly informed. What you do with the information and how you determine your decision is up to you.

I wish you all the best and I encourage you to do your own research on the subject of root canals and systemic health.

Bryanna

Originally Posted by CWMB

Thank you both for your replies. I appreciate your empathy and advice. The pain seems to be subsiding somewhat. Yesterday it was unbearable but today it is less severe. The pain behind the root canaled tooth has also diminished. Slight irritation, but better. The pain up in my mouth is far away from the root candled tooth and an oral surgeon (friend of the family) said today, it appears to be a muscle issue. I have a very irritated muscle up in my mouth, perhaps from all the work done recently. I also have developed TMJ, as my bite is very much out of whack from the wisdom tooth removal, etc. I am going to try to wait it out before extracting the tooth. I figure i want to exhaust all options before losing this tooth (and the bridge) entirely - which seems to me, could be quite traumatic and lead to months upon months of surgery for implants to replace the molars, etc. Thank you again and I do hope my pain continues to subside. I appreciate your advice greatly.

[KateJK]

So, does a retreat of a root canal absolutely never work? My pain is not near the retreated root canaled tooth. In fact, I am fairly certain that the inside pain behind the wisdom tooth is right where the pterygoid muscle is located and corresponds with my TMJ. I'm just confused as to why they would try to retreat a root canal if there is a zero percent success rate? I'm not trying to contradict your advice - I appreciate it so much. I'm just trying to determine how successful my retreat might be.

[Bryanna]

CWMB,

The anatomy of a tooth is the same for every single tooth. There are hundreds of microscopic canals within each tooth that contain nerve tissue. These canals are inaccessible to any instrument, disinfectant, laser, and oral or IV antibiotics. The nerve tissue that remains inside of these canals is not removed. The blood supplying these nerves inside of these canals is cut off as a result of the rc procedure which causes the nerve tissue to die and become decrepit. Bacteria takes over the dead nerve tissue rendering the tooth chronically inflamed and infected. Some but not all people will experience various degrees of pain at the onset or sometime later. Pain is most definitely not a good indicator of a tooth or oral infection because the bacteria can migrate very silently beyond the tooth or area of infection until a full blown abscess and bone loss occurs.

For example, periodontal disease which is a progressive infectious disease that not only affects the gums, bone and oral health but also causes or contributes to systemic health problems. Most often people are either unaware they have it or ignore the subtle but tell tale signs of it until it has progressed beyond the original area. Periodontal disease often occurs from a tooth infection, especially a long standing infection such as with a root canaled tooth. When the gum and bone near a root canaled tooth becomes diseased, it is referred to as a perio (gum)/endo (root canal) infection. In your case, as I explained earlier, this is most likely what happened to your upper wisdom tooth. To remove one aspect of the infection does not cure the other aspect of the infection as the bacteria continues to proliferate from the original and chronic source of infection.

A re treatment of a tooth with one, two, three or more root canals does not favorably alter the bacteria inside of those tiny canals for the reasons that I have given you. In fact, the instrumentation of the large canals causes further inflammation and injury to the entire tooth. There are also many other reasons why non vital teeth are a detriment to our oral and systemic health, but they are somewhat complicated to try and disclose here.

Dentists are taught to "retain" teeth... all teeth, good or bad. It is not done mean spiritedly, it is what they are taught. This does not mean they don't know all of the information that I have brought to you here, as they do. But in addition to being taught to "retain" teeth" they are also taught not to disclose this information to their patients unless they have no way around it because endodontics is the most lucrative form of dentistry. The literature that is written in dental publications like JADA or Dental Economics always contains instructive articles about promoting endodontics within the dental office as a way to rev up collection $$$. I am not faulting people for writing these articles, I am just giving you and others an insight into what is really going on. So that when you ask me how can this be??... how could my dentist(s) tell me to get the root canal .... or tell me to re treat the tooth for the 2nd, 3rd or 4th time .... how come I'm told to "save" the tooth only to end up with the same if not a worse problem? Now you have the reasons why.

I have been in the dental field for over 3 decades.... I am well aware of what goes on and I am only one of a handful that is not shy to share this knowledge here or elsewhere.

My purpose for bringing forth the information is to inform the public of the issues that they are not being informed about so an informed decision can be made, and that is all. I respect your personal choices as only you know what is best for you.

Be well,
Bryanna











QUOTE=CWMB;1112746]So, does a retreat of a root canal absolutely never work? My pain is not near the retreated root canaled tooth. In fact, I am fairly certain that the inside pain behind the wisdom tooth is right where the pterygoid muscle is located and corresponds with my TMJ. I'm just confused as to why they would try to retreat a root canal if there is a zero percent success rate? I'm not trying to contradict your advice - I appreciate it so much. I'm just trying to determine how successful my retreat might be.[/QUOTE]

[KateJK]

I just wanted to say thank you to Bryanna. I did end up needing to get the aforementioned molar (that had a root canal retreated) extracted about three weeks ago. The pain got simply ridiculous and my gums became very swollen. I really should have had it extracted earlier like you advised, but I honestly just hated the thought of having to lose that tooth (and the fake tooth connected by a bridge to it). It was quite traumatic actually. Since then, the extraction site seems to be healing well, but I do have quite horrible jaw pain. At first it was so bad in the jaw joint and radiating through the cheek, near the ear, and through the bottom jaw as well. Now, it appears to just be in the jaw joint, but still sometimes radiating through my cheek bone and into the extraction site. My jaw is sore on the other side too. I'm assuming having TMJ pain after so many dental procedures is normal, but I"m not sure what kind of treatment I should be seeking for this? Perhaps there is a different board I should be positing on re: TMJ, but any advice it appreciated. Thank you again for all the advice I have received here.

[Bryanna]

Hi CWMB,

You are welcome and thank you for posting an update. I'm sorry you are having pain but relieved to know that you had that infected tooth extracted.

I am not surprised about the jaw pain. You had a terrific infection in that quadrant of your mouth for quite some time. You also have had a lot of dental work done in that area of your mouth which required you to keep your mouth open wide for long periods of time putting a lot of stress on the jaw joints on both sides of your mouth. In addition to that, all of the dental work was traumatizing to the jaw joint and jaw bone.

It is common for tmj problems to cause pain in the joints which can often radiate to the cheek, the head, down the shoulder.... etc.

The first thing is to be sure that there is no more infection in that bone or in the sinus. Have both of those things been ruled out?

If the area is clear, then there are some things that you can do to help relieve the pain. The goal is to alleviate the pressure on the joint so the inflammation decreases. So that means less chewing. Try to eat a nutritious soft food diet. Avoid food that is chewy, sticky or requires you to open your mouth wide, like a sandwich. You may have to stick with this diet for several weeks or more because the benefits can only be achieved over a period of time. If you start to feel better and go back to over using your jaw, you will be right back to where you are now.

You will get relief from applying warm moist heat... not dry, moist. Dry heat brings the blood to the area and it just pools there. Moist heat encourages the flow of the blood. The best time to apply this is at night just before you go to sleep.

You can also try sleeping on two pillows. Just make sure you get into a comfortable position.

Chiropractic care, cranial sacral therapy, acupuncture and massage therapy are all very helpful. But again, it is going to take time to make this better so whatever therapy you choose, keep in mind that you will need to be committed to it for at least several weeks or more.

If you are clenching or grinding your teeth, then your dentist can have a night guard made for you which is worn when you sleep and this will also take the pressure off of your TMJ.

Hopefully you will find this information helpful. Keep me posted
Bryanna

Originally Posted by CWMB

I just wanted to say thank you to Bryanna. I did end up needing to get the aforementioned molar (that had a root canal retreated) extracted about three weeks ago. The pain got simply ridiculous and my gums became very swollen. I really should have had it extracted earlier like you advised, but I honestly just hated the thought of having to lose that tooth (and the fake tooth connected by a bridge to it). It was quite traumatic actually. Since then, the extraction site seems to be healing well, but I do have quite horrible jaw pain. At first it was so bad in the jaw joint and radiating through the cheek, near the ear, and through the bottom jaw as well. Now, it appears to just be in the jaw joint, but still sometimes radiating through my cheek bone and into the extraction site. My jaw is sore on the other side too. I'm assuming having TMJ pain after so many dental procedures is normal, but I"m not sure what kind of treatment I should be seeking for this? Perhaps there is a different board I should be positing on re: TMJ, but any advice it appreciated. Thank you again for all the advice I have received here.

[KateJK]

Thank you so much for your response Bryanna. In answer to your question, I was put on antibiotics for infection after the tooth extraction "just in case," but my dentist said that other than the small abscess that was removed with the tooth, there didn't appear to be any further infection. I have finished the course of antibiotics. The tissue/bone surrounding the extraction site is tender to touch, but it was a very difficult extraction (took a looong time, had to cut the tooth in three pieces, etc) so I'm thinking that's normal for the bone/tissue to take time to heal? My dentist said based on what that area had been through, it might hurt for "a while." It doesn't ache or anything… only a little tender if I touch it. As for a sinus infection…. I am quite prone to sinus issues and have had a feeling for some time now that I might have either chronic sinusitis or a deviated septum… but I don't presently feel like I have a sinus infection. Is there anything else I can do to rule out a possible infection somewhere that could be lurking and not detected by my dentist?