[Canmom]

Hello! I have learned so much from lurking on this board, I wish I had found you 2 years ago when I had my root canal done. I won't bore you with the details of my tooth saga, I am just so sick of being in pain and spending money trying to get this failed root canal to work so I am going to have it extracted on Monday.

I have read a lot on here about having the oral surgeon use a dental burr to debride the bone to make sure the infection site is gone. I called my surgeons office which is 3 hours away, just to make sure he will do this. The receptionist told me that the surgeon will use a "curette" to clean the area after extraction. I asked her if he could use a dental burr going down a millimeter and she put me on hold. She came back about 2 seconds later and told me that the surgeon does NOT do that and will use a curette only because that is sufficient. She then told me not to believe everything I read on the internet because there is a lot of misinformation out there.

I have spent so much money on this tooth and the facial numbness, migrains and jaw pain are honestly ruining my life. I just want to make sure that everything gets done properly so that the pain will stop. Can anyone let me know if the curette will work on its own?

Thank you so much.

[Bryanna]

Hi Canmom,

When an infected tooth is removed, a series of instruments are used to curette the socket clean. These instruments are very sharp and not only remove diseased tissue but they can also scrape away necrotic bone. The goal is to remove the tooth.... remove the periodontal ligament.... remove all surrounding granulation tissue..... remove all necrotic bone... and scrape down to achieve healthy solid bone.

In some cases a drill can be used prior the removal of the tooth to split the tooth in pieces allowing a less traumatic extraction. However a drill is seldom used inside the extraction site because the air from the drill can actually cause an air embolism amongst other things to occur.

Here is a little piece of information on that...
http://www.southernmaxillofacial.com...ll-surgery.pdf

Hope this info helps.
Bryanna

Originally Posted by Canmom

Hello! I have learned so much from lurking on this board, I wish I had found you 2 years ago when I had my root canal done. I won't bore you with the details of my tooth saga, I am just so sick of being in pain and spending money trying to get this failed root canal to work so I am going to have it extracted on Monday.

I have read a lot on here about having the oral surgeon use a dental burr to debride the bone to make sure the infection site is gone. I called my surgeons office which is 3 hours away, just to make sure he will do this. The receptionist told me that the surgeon will use a "curette" to clean the area after extraction. I asked her if he could use a dental burr going down a millimeter and she put me on hold. She came back about 2 seconds later and told me that the surgeon does NOT do that and will use a curette only because that is sufficient. She then told me not to believe everything I read on the internet because there is a lot of misinformation out there.

I have spent so much money on this tooth and the facial numbness, migrains and jaw pain are honestly ruining my life. I just want to make sure that everything gets done properly so that the pain will stop. Can anyone let me know if the curette will work on its own?

Thank you so much.

[Canmom]

Bryanna, thank you so much for replying to my question, you are a bit of a rock star around here I think!

I had read at "curezone" that a slow drill must be used as well as a curette and that is why I was so worried. I am so paranoid that he is not going to get everything out of my mouth and that is going to lead to more problems. I know I sounded dramatic in my post about the tooth ruining my life but that is truly what the pain and expense is doing! I will deal with this tooth first and then the other 2 root canals later, eventually getting a partial denture as well. I am not going to a biological dentist as there is not one anywhere near me. I am going to write down "periodontal ligament/remove all surrounding granulation tissue/remove all necrotic bone" just so he knows I have done a little research. My appointment is Monday at noon and I am scared!

I have one more quick question. A few years ago my dentist asked me if my wisdom teeth were bothering me at all. I told him "no." He said that I should get them removed anyways because they are way in the back and that is not an easy place to brush and they would probably end up with cavities anyways. I trusted him (why would a dentist misinform at patient? ) and got them removed even though they were perfectly healthy. It was just my regular old school dentist that did this and since reading about proper extraction protocol I have become concerned. Do you think I need to be worried about the space left vacant when the 4 teeth were pulled? I highly doubt he took the time to deal with cleaning the bone properly.

Thank you again for giving so much knowledge and support to so many people, not just the people who post here but those who are lurking.

[Bryanna]

Hi Canmom,

You are very welcome! Thank you for the kind words

Some dentists will use a slow speed drill after the removal of a tooth to mechanically "debride" the socket. However, the socket will still need to be curetted after the use of the drill because there will be all sorts of little pieces stuck to the bone that will need to be scraped away. If a dentist is very thorough during the manual debridement, then a drill is really not necessary unless the dentist thinks he cannot adequately scrape away all of the diseased tissue and bone, then he may go in with the slow speed drill and then manually scrape again after wards.

During a manual debridement of the socket the dentist can feel if he is against mushy tissue or bone compared to clear, solid healthy bone. Not only does it feel differently against the instrument but the color of the blood can be very dark or very scant when the socket is not clean enough as compared to a healthy very rich red color blood high in volume. Sorry to be so descriptive... you may be okay with this while others are hyperventilating while reading it!! :/

I understand how consuming this tooth problem has been for you. You deserve to have it taken care of properly so that it never bothers you again... I agree with that completely!!

Take the notes with you to the OS. Gently but assertively inform him that you expect XXX to be done because you do not want to have to deal with any residual infection or bone issues. Tell him your skepticism stems from your own personal past experiences as well as others who have shared their dental stories with you. Just let him know that you want to be taken care of as if you were a member of his own family... so no pressure... just don't leave any doubt behind.

Regarding your wisdom teeth... many times dentists will recommend their removal because they are in fact too difficult to keep clean. That may sound like an excuse to just make a quick buck but in reality..... some wisdom teeth can cause such infection in the jaw bone due to a build up of bacteria that sometimes it is best to take them out before that occurs. If you were to have a problem with those areas of your mouth due to an incomplete debridement of the sockets after the extractions.... you would most likely have known it by now. A panoramic xray can show those areas and it will tell if the bone has healed well or not.

Please try not to be scared. Be prepared.. feel empowered... and feel positive that you are going to be fine. It would also be good to have a healthy diet of soft foods on hand so that you are able to eat nutritiously without putting too much effort into it.

Bryanna

Originally Posted by Canmom

Bryanna, thank you so much for replying to my question, you are a bit of a rock star around here I think!

I had read at "curezone" that a slow drill must be used as well as a curette and that is why I was so worried. I am so paranoid that he is not going to get everything out of my mouth and that is going to lead to more problems. I know I sounded dramatic in my post about the tooth ruining my life but that is truly what the pain and expense is doing! I will deal with this tooth first and then the other 2 root canals later, eventually getting a partial denture as well. I am not going to a biological dentist as there is not one anywhere near me. I am going to write down "periodontal ligament/remove all surrounding granulation tissue/remove all necrotic bone" just so he knows I have done a little research. My appointment is Monday at noon and I am scared!

I have one more quick question. A few years ago my dentist asked me if my wisdom teeth were bothering me at all. I told him "no." He said that I should get them removed anyways because they are way in the back and that is not an easy place to brush and they would probably end up with cavities anyways. I trusted him (why would a dentist misinform at patient? ) and got them removed even though they were perfectly healthy. It was just my regular old school dentist that did this and since reading about proper extraction protocol I have become concerned. Do you think I need to be worried about the space left vacant when the 4 teeth were pulled? I highly doubt he took the time to deal with cleaning the bone properly.

Thank you again for giving so much knowledge and support to so many people, not just the people who post here but those who are lurking.

[Canmom]

Thanks again Bryanna!

I have the option of sedation (twilight sleep) but that costs more money - do you think I will be fine without it? It is a lower right molar.

[Bryanna]

Hi Canmom,

Only you know how anxious you are about having this done. If you want to be aware of what is going on and feel that need to be in control... then just do the local anesthetic. If you feel that you would prefer to not know what is going on and don't mind not being in control.... then by all means do the iv. You would have to let the dentist know ahead of time so they can prepare for that. Also, no eating or drinking for 9-12 hours prior to having that.

Bryanna

Originally Posted by Canmom

Thanks again Bryanna!

I have the option of sedation (twilight sleep) but that costs more money - do you think I will be fine without it? It is a lower right molar.

[Canmom]

Thanks Bryanna! I am going to just go with the local anesthetic I am pretty sure. I guess I will see how hungry I am in the morning!

[Canmom]

Well, I just got home from having my tooth pulled. I went over everything that you told me and the oral surgeon said he would "do his best to get everything looking good."

I went with local anesthetic and the tooth came out really fast. Three times while he was pulling the tooth a woman popped her head in the room to tell him he had to hurry. So he pulled out the tooth and then told me he was going to clean out the site with some water. He put in some gauze and then told me I was ready to leave. I asked him if he scraped everything away and got to healthy bone and he replied, "I made it look nice. That tooth was chronically infected but you are young and healthy I am sure things will turn out for the best." I asked him if he went in 1 millimeter to the healthy bone and he shook his head and said "it is fine, really fine, everything went well." Then he ran out of the room on to his next patient.

I asked the woman at the front desk if I needed a prescription for painkillers or antibiotics but she said no, just take something over the counter if I need it. So here I am hoping everything works out for the best.

[Bryanna]

Canmom,

OMG!!!!! You have got to be kidding! That woman had no right to interrupt him during your extraction and he was very negligent if he did not debride that socket thoroughly. He knew how concerned you were about being thorough....... I am floored at what happened to you today :/

Water does not clean out the site. That is a truly ridiculous statement! The socket and bone need to be scraped clean. I don't know what to tell you.

I hope you are really lucky and it heals okay.

Bryanna

Originally Posted by Canmom

Well, I just got home from having my tooth pulled. I went over everything that you told me and the oral surgeon said he would "do his best to get everything looking good."

I went with local anesthetic and the tooth came out really fast. Three times while he was pulling the tooth a woman popped her head in the room to tell him he had to hurry. So he pulled out the tooth and then told me he was going to clean out the site with some water. He put in some gauze and then told me I was ready to leave. I asked him if he scraped everything away and got to healthy bone and he replied, "I made it look nice. That tooth was chronically infected but you are young and healthy I am sure things will turn out for the best." I asked him if he went in 1 millimeter to the healthy bone and he shook his head and said "it is fine, really fine, everything went well." Then he ran out of the room on to his next patient.

I asked the woman at the front desk if I needed a prescription for painkillers or antibiotics but she said no, just take something over the counter if I need it. So here I am hoping everything works out for the best.

[Canmom]

Bryanna, this has pretty much been the attitude of the two dentists that I had through out this root canal saga, I had high hopes the oral surgeon would be different but nope! The good thing is I am going to Vancouver, Canada in a few months and am going to try my darnedest to get in a consultation with a biological/holistic dentist. Now, is the protocol which I requested something that I should have gotten in writing? I even brought my husband into the consultation with me and we both emphasized exactly what my expectations were. This whole experience has completely changed my view on dentists who strung me along all with the goal of saving an infected tooth that was impacting my health and life on a daily basis.

Now, he kept saying that everything looked good, does this mean there is a chance that the infected crap would have been flushed out? Is it possible that the tooth come out so well that there was a minimal amount of clean up? Is there anything you think I can do? I am thinking that I need another opinion on how my mouth looks but I want it done by a biological dentist. I feel there is nothing I can really do in the meantime.

I feel really feverish today and my husband bought me some collidal silver and oil of oregano I have read good things about both. Isn't antibiotics something that should have been prescribed?

I am not in too much pain, I took some advil last night and even though I didn't sleep much and am really tired, I am doing ok.

Thanks again you are so appreciated around here I really hope you know that!