[jojo23]

Long story.....sorry.

In 2004 or 2005 I noticed tooth # 30 was painful when I pressed on it with my finger. This tooth had been root canalled in the early 1990’s and had a crown on it. I saw an endodontist who said the xrays were normal and sometimes teeth with crowns are painful on percussion. At that time I was also dealing with chronic osteomyelitis of my maxilla.

In March 2006 I received a Fibula Free-flap surgery to rebuild my right maxilla due to chronic osteomyelitis. I had multiple infections after the initial surgery. I was on multiple antibiotics for several years after surgery. I have pins/clips and screw remnants remaining in my body from my maxilla to my neck.

2007 through 2013 I had gradual worsening pain/stiffness in my lower jaw neck region, also heaviness in my lower jaw. It was thought to be due to remaining hardware.

January 2014 – Had severe pain and tenderness when I touched my face on the right lower side. (When I washed my face or slightly pressed on the area from the outside)

I looked at the cd of the ct scan from July 2013 and saw an abscessed tooth in my right mandible, tooth # 30. I did not have a tooth opposing tooth #30 in my maxilla since 2001 and have not chewed on my right side since 2002; therefore, I did not realize how painful the tooth was on percussion.

I saw my dentist the same day. He put me on antibiotics and told me to see an endodontist. I saw the endodontist. The pain in my lower face was worse and I had visible swelling. I had a golf ball size lump under my gums in my mandible. The endodontist opened the tooth and cleaned out the old root canal and put in medication, Calcium Hydroxide. He then put a temporary filling on the tooth. He made a cut into my lower gums below the tooth to drain the abscess. He got out a lot of pus and left it open to continue draining. He said the abscess was very large and the tooth might have to be extracted. He said it was very close to the nerve.

After a few days the pain from having the root canal cleaned out and the abscess lanced subsided and I felt GREAT!!! The best I have felt in years. No pain or heaviness in my lower jaw and neck. I could press on tooth #30 and I felt nothing.

On February 14, 2014 - I went back to the endodontist and he finished the root canal. He cleaned out the Calcium Hydroxide and filled the canals with Gutta Percha. I still felt great for a few days, but then had a gradual increase of pain and pressure. By February 24 the whole side of my face and under my jaw was swollen and VERY painful. All the teeth in my right mandible hurt when pressed on and the jaw would quiver at times.

I a ct scan of my jaw. The ct scan showed that the abscess/cyst had enlarged. There was a piece of root/bone that had broken off the tooth. There was now a break in the cortical bone. There was also a learge amount of sclerosis.

In April I had the tooth extracted by an Oral Surgeon. He put me on Clindamycin before the extraction. The oral surgeon pulled the tooth, irrigated the socket with saline and had me bite on gauze. There was no debriding of the socket done.

The pain decreased a bit after the extraction but I did not get relief of the heaviness in the lower jaw. It still felt like something was in there. Over the pass year the pain has increased. The gums around teeth # 28 and 29 are very sore to touch and look like they have lines of fluid in them.

Could I have a residual infection due to the long-standing infection and me being on multiple antibiotics? Also, the socket was not debrided.

I uploaded ct scan pics from 2007, 2013, 2014, and 2015. All the same view.

[Bryanna]

Hi JoJo,

First I have to say thank you for sharing your story here with us. For several years I have provided information on this forum about the chronic and progressive infection that resides and eventually proliferates from root canaled teeth. Anyone reading your thread and viewing your ct scan images, irrelevant of whether they have any knowledge of dentistry or not, will be able to appreciate the magnitude of your dental infection. It also describes how endodontists and some other dentists refer to the radio graphs of infected root canaled teeth as "normal".... unfortunately this reference does not mean healthy, just simply normal as in typical.

My first thought is.... what happen to cause the osteomyelitis in your upper maxilla? Did you have root canaled teeth in that area? Were you or are you on Bisphosphonate drugs for bone density?

I am not surprised, but still livid that someone performed such extensive surgery on your maxilla without removing root canaled and infected teeth prior to that surgery. If the endodontist did actually tell you that teeth with crowns on them are "normally" painful he was very mistaken. Crowned teeth should feel like your natural teeth, if they don't, then there is a problem. Tooth #30 should not have been allowed to progress to such a horrific state of infection. In addition to that, there was no excuse for the dentist to not debride the bone thoroughly when he finally extracted tooth #30. Just curious, are you comfortable being treated by these dentists or do you feel like they have perhaps not treated you properly?

The only reason you had relief after tooth #30 was re root canaled and the oral abscess was lanced and drained is simply because in doing those things, the pressure from the infection was released. Antibiotics simply subsided the inflammation temporary but by no means was the infection cured because the source of the infection which was the tooth was still present. So it didn't take long for the bacteria to build up again and cause further pain, swelling and damage. The broken area of the tooth was either due to decay that had eaten away that portion of your tooth... which would have been seen on an xray taken prior to the re treatment.... or the instrumentation during the re treatment perforated the tooth and literally broke off a piece. What this could mean is that every chemical that was used during the re treatment went directly into the jaw bone through that opening of the tooth.

I have a couple of questions.... the metal fragments in you neck are visible in all of the images but the final one. Were those fragments from the surgery in your maxilla and were they removed at some point? Did the oral surgeon who removed the tooth give you an explanation as to why he did not debride that area of bone when he removed the tooth?

To be completely truthful with you, I would be surprised if your jaw bone was not still infected. My professional suggestion is to seek an evaluation from an different oral surgeon, one who is not at all associated with any of the dentists you have been treated by. Gather all of your radio graphs and Ct scan images prior to that appointment and ask if the new surgeon wants to see them ahead of time. If he doesn't then bring them all with you with a complete history of this whole ordeal including the maxilla.

Just so you are aware..... Antibiotics cannot cure a bone infection unless the diseased tissue and bone is physically removed first. In some cases, the extent of the infection is so great that even after debridement, oral antibiotics are not adequate and the patient needs to have antibiotics intravenously. You need a competent oral surgeon to evaluate your case and offer you some surgical options.

I feel you have a very serious situation going on and should not wait to consult with someone about it. I'm sorry you have endured all of this.... please use your knowledge, of which you have a lot of, to seek the help that you need.

Check back with us when you can.
Bryanna

Originally Posted by jojo23

Long story.....sorry.

In 2004 or 2005 I noticed tooth # 30 was painful when I pressed on it with my finger. This tooth had been root canalled in the early 1990’s and had a crown on it. I saw an endodontist who said the xrays were normal and sometimes teeth with crowns are painful on percussion. At that time I was also dealing with chronic osteomyelitis of my maxilla.

In March 2006 I received a Fibula Free-flap surgery to rebuild my right maxilla due to chronic osteomyelitis. I had multiple infections after the initial surgery. I was on multiple antibiotics for several years after surgery. I have pins/clips and screw remnants remaining in my body from my maxilla to my neck.

2007 through 2013 I had gradual worsening pain/stiffness in my lower jaw neck region, also heaviness in my lower jaw. It was thought to be due to remaining hardware.

January 2014 – Had severe pain and tenderness when I touched my face on the right lower side. (When I washed my face or slightly pressed on the area from the outside)

I looked at the cd of the ct scan from July 2013 and saw an abscessed tooth in my right mandible, tooth # 30. I did not have a tooth opposing tooth #30 in my maxilla since 2001 and have not chewed on my right side since 2002; therefore, I did not realize how painful the tooth was on percussion.

I saw my dentist the same day. He put me on antibiotics and told me to see an endodontist. I saw the endodontist. The pain in my lower face was worse and I had visible swelling. I had a golf ball size lump under my gums in my mandible. The endodontist opened the tooth and cleaned out the old root canal and put in medication, Calcium Hydroxide. He then put a temporary filling on the tooth. He made a cut into my lower gums below the tooth to drain the abscess. He got out a lot of pus and left it open to continue draining. He said the abscess was very large and the tooth might have to be extracted. He said it was very close to the nerve.

After a few days the pain from having the root canal cleaned out and the abscess lanced subsided and I felt GREAT!!! The best I have felt in years. No pain or heaviness in my lower jaw and neck. I could press on tooth #30 and I felt nothing.

On February 14, 2014 - I went back to the endodontist and he finished the root canal. He cleaned out the Calcium Hydroxide and filled the canals with Gutta Percha. I still felt great for a few days, but then had a gradual increase of pain and pressure. By February 24 the whole side of my face and under my jaw was swollen and VERY painful. All the teeth in my right mandible hurt when pressed on and the jaw would quiver at times.

I a ct scan of my jaw. The ct scan showed that the abscess/cyst had enlarged. There was a piece of root/bone that had broken off the tooth. There was now a break in the cortical bone. There was also a learge amount of sclerosis.

In April I had the tooth extracted by an Oral Surgeon. He put me on Clindamycin before the extraction. The oral surgeon pulled the tooth, irrigated the socket with saline and had me bite on gauze. There was no debriding of the socket done.

The pain decreased a bit after the extraction but I did not get relief of the heaviness in the lower jaw. It still felt like something was in there. Over the pass year the pain has increased. The gums around teeth # 28 and 29 are very sore to touch and look like they have lines of fluid in them.

Could I have a residual infection due to the long-standing infection and me being on multiple antibiotics? Also, the socket was not debrided.

I uploaded ct scan pics from 2007, 2013, 2014, and 2015. All the same view.

[jojo23]

Hi Bryanna,

Thank you so much for responding.

To answer your questions about my upper jaw, the osteomyelitis was caused by two root canals in my right upper maxilla.

The hardware is still there, I guess the position of my head was a bit different when the scan was done.

All of the healthcare people that missed the infection in my mandible, from my dentists to the radiologist that read my ct scans have tried to minimize what is going on in my jaw and the extend of the infection. Not one of them has ever acknowledged that they failed to diagnose the infection for years.

My attitude has always been what do I need to do to fix this. Knowing that the infection was present in my mandible for a long time I was concerned about bacteria resistance and the condition of my jawbone.
All of them told me once the tooth was gone the infection would be gone as well, like it was no big deal. Now that I am still having problems they are not being helpful.

I did question the oral surgeon about the extend of the infection and asked him about debriding the socket. He told me that the infection would come out with the tooth.

I am in the process now of trying to find someone to help me. Sometimes I just don't know what to do. It is very hard to live with this pain.

[Bryanna]

Hi Jo Jo,

Thank you for answering my questions.

As I had expected and you confirmed, you did have root canaled teeth in your upper right resulting in osteomyelitis. Again, this is clear evidence of the chronic infection residing in root canaled teeth because osteomyelitis is an infection in the bone when the bacteria has traveled through the bloodstream or has spread from nearby tissue. Osteomyelitis can also be caused by an injury or trauma in which the bone becomes exposed to germs. For example, when a tooth is extracted there is always trauma to the bone. But combine that with incomplete debridement of the socket and the germs will multiply which can lead to osteomyelitis.

I am glad that you recognize that the infection should have been diagnosed much sooner. It's not like you didn't try to get help, you most certainly did. But here lies the problem..... it is no mystery amongst dentists that root canals are expected to cause problems. But until the infection is severe and/or the patient says remove this tooth, dentists tend to leave the problem undiagnosed. The medical profession for the most part is clueless about infected teeth. However, radiologist are well educated on diagnosing radio graphic pathology. So you are right, who are you suppose to turn to for help?

Also it can be unfortunately difficult to find a dentist who will eagerly take on a case that has been complicated by root canaled teeth... late or misdiagnosis of infections.... and/or incomplete surgeries. To be honest, anyone who gets involved with your case will know that to attempt to remedy it could cause further complications and/or they may not be able to meet your expectations of full healing. So they know they run the risk of getting caught up in a law suit in spite of trying to help you.

If it were me, I would seek an oral surgeon or oral surgery group in private practice. Not an insurance driven practice. Ideally, the oral surgeons should have a dual medical/dental degree... MD and DDS/DMD. When you call for an appointment do not go into too much detail about your case. Just request a comprehensive surgical consultation for an infected root canaled tooth. Then you obtain physical copies of ALL of your radio graphs from your dentists and bring them with you. This way there is no verbal interference between the offices as you do not know what conversation would occur without you present. I hope I explained that okay.

May I ask if you are in the US? If so, what state? Myself or someone else here might be able to give you a reference.

Bryanna

Originally Posted by jojo23

Hi Bryanna,

Thank you so much for responding.

To answer your questions about my upper jaw, the osteomyelitis was caused by two root canals in my right upper maxilla.

The hardware is still there, I guess the position of my head was a bit different when the scan was done.

All of the healthcare people that missed the infection in my mandible, from my dentists to the radiologist that read my ct scans have tried to minimize what is going on in my jaw and the extend of the infection. Not one of them has ever acknowledged that they failed to diagnose the infection for years.

My attitude has always been what do I need to do to fix this. Knowing that the infection was present in my mandible for a long time I was concerned about bacteria resistance and the condition of my jawbone.
All of them told me once the tooth was gone the infection would be gone as well, like it was no big deal. Now that I am still having problems they are not being helpful.

I did question the oral surgeon about the extend of the infection and asked him about debriding the socket. He told me that the infection would come out with the tooth.

I am in the process now of trying to find someone to help me. Sometimes I just don't know what to do. It is very hard to live with this pain.

[Bryanna]

Pained,

I agree with you that the use of Sargenti paste and others like it are toxic and capable of causing or contributing to severe health problems. However, these chemicals do not have to be literally pushed through the tooth into the bone (as in an overfill) for them to be toxic to the patient. Irrelevant of what is done to the tooth, the tooth remains in intimate contact with the surrounding ligaments, blood vessels and bone. What occurs within the tooth eventually affects all that it is connected to it and because the toxins filter through the blood stream, the potential for systemic consequences is likely. The intention of using toxic chemicals that never dissipate is to continuously kill off live nerve tissue and embalm the tooth. However in doing so, common sense should tell us that these chemicals are not capable of differentiating between what is live in the tooth and what is live around the tooth. Thus, when the material moves into the jaw bone, the jaw bone dies.

You are truly misinformed about the root canal procedure being something that if done "correctly", the outcome is systemically benign. Just because there are millions of them being done, does not make them harmless. There are millions of people smoking cigarettes, does that make smoking a healthy habit?

Aside from the toxic chemicals that are used during a root canal, the procedure itself warrants the tooth NON VITAL which in of itself causes and contributes to a host of other complications.... osteomyelitis is just one of them. All living organisms of the body require vitality to function properly and remain healthy. The systemic consequences of dead organisms is eventual death of other live organisms.

The dental industry wants to continue to market root canal therapy for 2 main reasons. One is financial gain and two is for those people who <<unknowingly>> choose to retain their infected teeth. The written literature about the physical health risks associated with root canaled teeth are for the most part only available to dental professionals. When you hear from a friend or are advised by a dentist about a failed root canal or you hear the term osteomyeltitis of the jaw bone associated with the use of sargenti paste, you are only being informed of a smidgeon of the real problem.

I hope you continue your research on this topic so you can become informed more clearly about the anatomical reasons why root canal therapy and retainment of non vital teeth are equally risky to your health.

Bryanna

Originally Posted by pained

This post is about a friend of mine who I met while we were both on line trying to diagnose our dental problems. She and I both had sargenti paste used on us. She had 2 root canals with that material used on her and that was/is the source of her problems that continue today. It is not simply a root canal that caused her problem....thousands of root canals are done daily in the world that few people have problems with....many never need to be repeated. This lady's problem was that the sargenti paste (formaldehyde) was overfilled and the formaldehyde set up the infection that continued to spread and worsen because her dentist never told her what he used on her. To this day, she continues to have chronic osteomyelitis that is wreaking havoc on her jaw. Minus the sargenti (and to a lesser extent, the overfill), she would not be having this problem today. I suspect that many root canals that continue to cause long term problems are done using materials such as Sargenti, Russian Red, and God knows what else is out there. These dentists don't tell their patients and if the patient finds out, they hush them up with a malpractice settlement. It is these types of issues that give root canals a bad reputation. Granted there are many that fail but the vast majority done correctly and with state of the art/non-toxic materials don't fail and last for decades with out further problems. There is an NBC report on this case at www.sargentipaste.org. She did not find out that this was sargenti until long after this post was written. In order to view the video, you have to use a windows computer. for some reason it does not run on smart devices or the Apple OS...don't know why.

[pained]

I only perused this original post and didn't pay attention to the details and thought it was about an old story...by looking at the poster's name. I should have read it the post. Had I known read beyond the poster's name and the fact that osteomyelitis was the problem, I NEVER would have replied. I no longer communicate with this person and I feel that I was out of line to even comment.

[pained]

JoJo23,

Since you are in the US and looking for someone to help, I had an Oral surgeon who helped me knowing exactly what caused my problem and was not in the least intimidated by malpractice suits against the dentists that harm their patients the way that we were...if you remember, he was the one telling me to find a lawyer. This doctor is an Oral and Maxillofacial micro surgeon who specializes in jaw cancer surgeries. He knows his stuff....he is compassionate...as you know from hearing my story and if you get a referral to him from the doctor who has been ordering your CT scans, I suspect he will help you. He graduated top of his class and is extremely well respected in this state and beyond. I can't imagine that he would not be willing to do what he can for you.

*admin edit*

[Cleo]

DDS/DMD has a consent form a mile long to cover all aspects of being sued over attempted oral nerve surgery. It doesn't come with any guarantee of success. I know this because I had nerve surgery in 2002.

I really hope you don't get caught up on other forums where people are being lead to believe that brain surgery will help damage going on in the jaw like this.

[Bryanna]

Cleo,

Not all dentists utilize the consent form you are speaking about and you are right, there is unfortunately no guarantee of the outcome either good or bad.

I also agree that brain surgery should be a last resort under most circumstances.

Bryanna

Originally Posted by Cleo

DDS/DMD has a consent form a mile long to cover all aspects of being sued over attempted oral nerve surgery. It doesn't come with any guarantee of success. I know this because I had nerve surgery in 2002.

I really hope you don't get caught up on other forums where people are being lead to believe that brain surgery will help damage going on in the jaw like this.

[Cleo]

Bryanna, I was admitted to a hospital for the surgery. It wasn't done as a standard in office treatment with the standard consent form. Lack of informed consent is what may cause problems with lawsuits as you may well know.