So So that wasn't the last post. I just discovered that the tooth in front (20) definitely loose! I was playing with it with my tongue and felt it clicking kind of so i looked in magnifying mirror and pushed it with a q tip and it wiggles. I did that to the other teeth near it and they don't move. What do I do?

here is the xray from yesterday. It is a little off center but he said he can see enough that he is sure there is nothing awry in the socket. I asked if he needed to repeat it to try to get it centered more and he said no. I wish it had included the loose tooth in front rather than the one in back of the extraction, but that was not something I could control. It was painful enough holding that thing in my mouth with all the pain I was in. I hope it was good enough and worth it.

PS off topic but was this a digital or standard xray? Can you tell? It looks like a film, not like the digital xrays I have had in the past. Also that weird upside down A in the corner? I am concerned because I am very conscious of radiation exposure due to the extreme amount of xrays and even a 3d CBCT I have had over the last year since I have been trying to figure out my dental pain. I thought because it was a holistic dentist they would only have digital so I didn't think to ask...AND for the first time in my life they did not cover me with the lead apron while getting the xray. I asked and the assistant said they don't use them anymore unless someone is pregnant.

Hi nukuspot,

Congrats on all those babies!! And kudos for nursing all of them!! I'm a little scared to ask how many babies you have..... ;) SO how many??

I am floored that you are nursing while going through all of this! How old is this newest baby? I am not a pharmacist but in doing a quick google search if it were me I would definitely cut back on the amount of motrin to only 600 mgs a day. There is no definitive answer as to whether or not NSAIDS are safe during pregnancy or breastfeeding. The meds are certainly more readily absorbed by the placenta than they are via the breast. But please use great caution when taking it. It is also probably best to not feed your baby for at least an hour or more after you've taken an NSAID.

Okay so I looked at your xrays again, the pre op ones. Your upper left second pre molar, #13, was lined up to bite against #19 and 20. Now that 19 is gone it is hitting into #20 only. Which means 20 is now taking all the pressure of the bite from #13 whereas before it was shared between 19 and 20. If you are clenching, and I think you may be..... this could be why #20 feels so sensitive and surely why it has become loose. Look at the bitewing xray photo #2015 267 JPG. Notice where the cusp of #13 is hitting into #20. It's hitting on the distal (back) cusp of #20 where you have a good sized filling. This situation needs to be addressed or #20 is going to end up in trouble. The dentist may not be able to relieve this by adjusting your bite because it is tooth against tooth and there is really no where to alleviate it because these teeth need each other to bite against. So it is most likely the clenching that has to be brought under control in order to save #20. Can you visit the tmj dentist again for an adjustment on the appliance? I know the hard plastic ones are bulky and feel like a mouthful of plastic. I would talk to him about an alternative to what you have because something needs to be done. Did you read the info I gave about bruxism? Clenching is generally a stress habit.... not that you are under any stress.... !!!!! I know your day is wrapped around your children, as it should be,... but you're going to need to fit in mommy time to take care of this. There are relaxation exercises you can do, even meditation is helpful. Perhaps your dentist knows of a local massage therapist or other who can work with you on this.

nukospot,

I don't like this xray, sorry. But it is only part diagnostic and what good is that... really??

The way to tell if it is a digital or not.... when the xray was taken did the image come up on the computer screen? If so, then it is digital. The little @ in the corner is just the marking on the end of the sensor. Nothing to be concerned about. HOWEVER, never let any one take a dental xray without putting the lead shield including the lead thyroid collar on you. Yes, digital xrays are minimum radiation and much safer than most other forms of radiography. But they still give off radiation and because we are exposed to radiation in various ways throughout our day, we need all the protection we can get when deliberately radiating ourselves. The assistant is only thinking about the radiation from that one xray and not giving any thought to what we are all exposed to every single day. Radiation poisoning occurs from an accumulation of radiation. So with each exposure throughout our lives we get what is called a cumulative amount. Sounds like the assistant needs to become better informed as she is zapping people all day no doubt!

Thank you!!! That was so so helpful. The TMJ dentist is up in the big city so it's hard for me to go see him. Plus that guard he made me was about 1000 dollars and I know my insurance won't cover another one this soon. I wonder if all the issues I've been having were from clenching! And maybe I didn't even need the extraction????

I am going to try to wear that bulky hard plastic one again. I am just going to try to get used to it. I didn't give it much of a chance before, I was dismissive that I could not do it, but now I think I have to if that is what is going on.

I just drank a vegetable juice and with the straw I bit very lightly on all my teeth. #20 feels so weird. Other than being tender and slightly mobile it also feels almost like a pins and needles feeling when I bite on it.

I called my dentist and left a message, he just got the receptionist to call back and say that I need to give it a "few weeks" to see if it settles down and tightens up before he will see me about it. I think he is reluctant to adjust the bite but I might have to be persistent I think?

As far as the babies...Well...I just have two. I'm a VERY extended breastfeeder. Ha! I nurse until they want to stop. With my first it was around 3. My second might be going a bit longer :)

Good news is that I forced myself to not take any more Motrin. Today is day 3. I'm just working on the pain mentally.

Once I feel recovered enough I could try intra oral massage again. I tried that in the past and had a good experience and two bad ones.

You have made me cautiously hopeful that maybe it's not a surgical complication after all.
I have not work my appliance in weeks. How do you suggest I sterilize it before using it? Since my extraction site isn't closed yet I just want to be careful. Should I soak it in diluted hydrogen peroxide first?

I know I had a lot of other questions. No rush but hopefully if you had a chance you could get to them.

I wish I could pay you for your help. You have been more helpful to me than anyone I've ever "met" online. Thank you!!!

Oh we cross posted. When you said you didn't like the xray was it because it was off center or because you saw something weird in it?

It had a film which she took out and brought somewhere and then later it was on the computer screen next to me. What does that mean?

Holistic dentist for Nukospot's mom
 

Nukospot,

Okay so she lives in south jersey. There are a few down there, but no one I would personally recommend. Would she be willing to travel to King of Prussia, PA? It would be almost 2 hours from her. But the dentist I am thinking of has an office across the parking lot from the King of Prussia Mall which has like 350 stores!! People travel all over the country to see this dentist. Let me know.

You have been SO helpful. I can't thank you enough. I told my mom about this forum, she is on here right now across the country reading this.

I imagine that you cannot post specific dentist's names on here so could you PM it to me or could I just search on the IAOMT website to find one in King of Prussia and that would be who you were talking about?

If wearing this night guard would help the pain go away, make my tooth next to the extraction site feel normal and stop it from being loose, or even help one of these issues, it would be the most amazing thing ever. I am going to try my hardest to get used to wearing it.

I just made a massage appointment with the one therapist who did intra-oral massage in the past who I liked and didn't cause pain like the other ones did. I also am going do try acupuncture again. I am really hoping this is the answer.

My main question is below in bold:

My final question (for now) is do you think that I have messed up that tooth #20 permanently? I have been dealing with the pain for almost a year. Originally the pain was mainly in the gum between #19/20 (as well as my jaw and ear on that side, and above near #15 which I now think might have been my TMJ joint.) Being that #19 was a RCT tooth it took all the blame in my mind which was why I got it extracted. Now that it's out but the pain is worse and #20 feels so sensitive and not in the right position in my mouth, I can only imagine that if you are correct, the same forces that caused the pain before, which was my clenching at night, are still at play but now that #19 is gone, #20 is taking the whole force. If I could figure out how to post a photo from my phone, I can show you that #20 even looks different from my other teeth. My other teeth are all straight-ish but #20 is rotated with the cusps towards my tongue, almost like it is lying down. I have mentioned that all year to everyone I have seen and they never said that I could be moving it, they just said "teeth drift lingually over time as you age." But why it was JUST that one tooth seems really suspicious! If I take the pressure off the tooth now by all the things I read in that article you posted and start wearing my night guard faithfully and get massage, will that tooth every go back to normal, or will it just arrest any further damage? Will the tooth ever "stand back up" in my mouth and move back to a normal position and get less sensitive and stop being loose? Or will it just stop it from getting worse?

Hi nukuspot and mom ;)

First let me say I commend you on nursing your babies until "they" are done nursing. I did the same and personally think that's how nature intended it.

I will PM you the name of the dentist is KOP. He is well worth the trip! AND the mall is awesome!

I am going to re-post your questions and answer you in BOLD type.

<<My final question (for now) is do you think that I have messed up that tooth #20 permanently?>>

I HOPE NOT. THE XRAYS SHOW A BIT OF IRRITATION ALONG THE PERIODONTAL LIGAMENT AND SOME BONE LOSS. BOTH OF WHICH WILL OCCUR IF YOU ARE GNAWING INTO THIS TOOTH. BUT IT APPEARS TO BE VERY MUCH ALIVE AND I DON'T SEE ANY SIGNS OF A FRACTURE IN IT.

<< I have been dealing with the pain for almost a year. Originally the pain was mainly in the gum between #19/20 (as well as my jaw and ear on that side, and above near #15 which I now think might have been my TMJ joint.)>>

THE MESIAL ROOT OF #19, WHICH IS THE LEFT ROOT CLOSEST TO #20, WAS IN BAD SHAPE. THERE IS A LARGE VOID IN THE CENTER AREA OF THE CROWN PORTION OF THAT TOOTH WHICH MOST LIKELY WAS SURROUNDED BY DECAY. THE MESIAL ROOT APPEARS TO HAVE BEEN ONLY PARTIALLY INSTRUMENTED DURING THE RC PROCEDURE AND IT WAS NOT EVEN FILLED PROPERLY. THE GUTTA PERCHA IS SCATTERED ABOUT IN THE MID SECTION OF THAT ROOT WHICH CAN INDICATE A PERFORATION SOMEPLACE ALONG THE ROOT SURFACE. SO #19 WAS A BACTERIAL MESS. WHEN THE BACTERIA IN A ROOT CANALED TOOTH PROLIFERATES BEYOND THE TOOTH, IT ENTERS THE GUM TISSUE AND THE BONE. THE TYPICAL RESULT OF THIS PROLIFERATION IS OFTEN PAIN, TENDERNESS, SENSITIVITY IN THE GUM AND BONE LOSS ALL ON THE "ADJACENT TOOTH". SO THAT COULD BE PART OF WHAT HAS HAPPENED TO TOOTH #20. ESPECIALLY SINCE THE MESIAL ROOT ON 19 (CLOSEST TO #20) WAS THE MOST DISEASED OF THE TWO ROOTS. ADD TO THIS A CLENCHING HABIT AND I THINK ITS PRETTY REASONABLE TO SAY... POOR #20!

<< Being that #19 was a RCT tooth it took all the blame in my mind which was why I got it extracted.>>

TOOTH #19 WAS THE CULPRIT AND IF YOU HAD NOT HAD IT REMOVED, TOOTH #20 WOULD DEFINITELY BE IN DEEPER JEOPARDY DUE TO THE PROLIFERATION OF THE BACTERIA FROM THE MESIAL ROOT OF #19.

<< Now that it's out but the pain is worse and #20 feels so sensitive and not in the right position in my mouth, I can only imagine that if you are correct, the same forces that caused the pain before, which was my clenching at night, are still at play but now that #19 is gone, #20 is taking the whole force.>>

THE PAIN WAS MOST LIKELY CAUSED BY TWO THINGS. ONE, THE BACTERIAL INFECTION AND INFLAMMATION LIVING IN TOOTH #19. TWO, THE PROLIFERATION OF THE BACTERIA AND INFLAMMATION GOING FROM 19 TO 20. THIS CHRONIC CONDITION LEAVES 20 IN A VULNERABLE STATE.... ADD THE CLENCHING HABIT THAT YOU HAVE HAD FOR SOME TIME ALONG WITH THE CURRENT SITUATION OF HAVING NO NEIGHBOR TOOTH TO TAKE UP SOME OF THE FORCES OF YOUR CLENCHING, #20 IS NOT A HAPPY CAMPER.

<< If I could figure out how to post a photo from my phone, I can show you that #20 even looks different from my other teeth. My other teeth are all straight-ish but #20 is rotated with the cusps towards my tongue, almost like it is lying down. I have mentioned that all year to everyone I have seen and they never said that I could be moving it, they just said "teeth drift lingually over time as you age." But why it was JUST that one tooth seems really suspicious! >>

WAS TOOTH #20 ALWAYS A BIT ROTATED OR DID THIS JUST HAPPEN OR WORSEN SINCE YOU BEGAN TO HAVE SYMPTOMS IN THAT AREA A YEAR AGO?

<< If I take the pressure off the tooth now by all the things I read in that article you posted and start wearing my night guard faithfully and get massage, will that tooth every go back to normal, or will it just arrest any further damage?>>

THE SOONER YOU TAKE THE PRESSURE OFF, THE BETTER. THERE IS NO WAY TO KNOW IF #20 IS GOING TO COMPLETELY RECOVER OR NOT BECAUSE IT HAS BEEN THROUGH A LOT, UNBEKNOWN TO YOU UNTIL NOW. I THINK FINDING WAYS TO DE STRESS AND CLENCH LESS ARE KEY NOT ONLY FOR THIS TOOTH BUT FOR YOUR OVERALL HEALTH.

<<Will the tooth ever "stand back up" in my mouth and move back to a normal position and get less sensitive and stop being loose? Or will it just stop it from getting worse?>>

IF YOUR CLENCHING IS CAUSING THIS TOOTH TO ROTATE OUT OF ITS NORMAL POSITION AND YOU STOP CLENCHING, IT MAY MOVE BACK A LITTLE BIT BUT PROBABLY NOT BACK COMPLETELY AS THE BONE HAS ADJUSTED TO THE NEW POSITION OF THE TOOTH. THE GOAL IS TO RELIEVE THIS TOOTH FROM UNNECESSARY PRESSURE ASAP TO GIVE THE LIGAMENT AND NERVES A CHANCE TO RECOVER. HOPEFULLY THAT WILL OCCUR AND WHEN IT DOES, THE TOOTH WILL BECOME HEALTHIER AND WILL NO LONGER FEEL ODD TO YOU BECAUSE THE PAIN AND SENSATIONS WILL BE GONE. SO EVEN IF IT WERE TO STAY AT THAT ANGLE, IT WILL BE LESS NOTICEABLE BECAUSE NOTHING WILL BE DRAWING YOUR ATTENTION TO IT.

BTW....after reading your description of how the post op xray was taken, etc. it may or may not be a digital one. You should ask if it was or not when you make it clear that you expect to be covered with a lead shield for all future xrays!!

Yes the rotation of 20 was just in the last year. I first noticed it last winter which was right around the time the symptoms started. At first it was "just" a chronic earache with no known cause starting last fall. In January of this year I went to a dentist (just a local one, not my usual holistic one) for an eval on the suggestion of my ENT to see if a dental cause was part of the earache. Directly after that exam (which involved cold testing of all my teeth on my left side of my mouth and a vigorously done assessment of my TMJ--the dentist at the time said she didn't see any sign that anything oral could cause the ear pain but that was the pivotal "straw that broke the camel's" back, and I had pain between 19/20 in my gum and up behind 15 where my wisdom tooth had been ever since.

I first noticed that 20 was rotated but no other tooth was about a month later but I was told it was just in my head and it must have always been that way, and I was just focusing on my mouth now because of pain. Now puzzle pieces are coming together in my mystery, thanks to you. I still don't know what caused the earache and then all the other pain so suddenly after that exam, but now at least I do know that 20 rotating was not in my head. It was real. Thank you.

I am scared that I will not be able to manage the clenching and I'm going to cause more harm to 20. I am going to try my best with every tool I can think of. Even if removing 19 wasn't the magic answer to my pain that I had expected, I think it's opening the door to helping me further solve the mystery. And you are a big part of that help Bryanna! I am extremely grateful to you.

Ps I'm a bit disturbed if they don't use digital xray! I would imagine all holistic dentists would want to minimize radiation as much as they can. Since he is my children's new dentist (my usual dentist in the big city doesn't see pediatrics) I want to make sure they will get the least radiation. We will always request a shield from now on, regardless.