[nukuspot]

Hi Bryanna and all--

I'm on my phone so I need to be brief but I can give lots more info later.

As you know I had major dental issues this year. First #19 RCT which I had extracted with great pain and long healing time.

Then unexplained pain and facial numbness around apicoectomy tooth #11--cause still unknown. Numbness/tingling spread to nose and upper lip and even right side a bit so it might not even be related to #11 but it's the best idea I have.

Now in these past 2 weeks--pain on #7 (not a RCT, a virgin tooth!)
#7 started to become painful to heat. It lasted awhile but would go away. Then it stopped going away and started hurting all the time. No cold issue. As a matter of fact if I touched the tooth with ice I did not feel anything. So back I went to the holistic dentist. They saw nothing on the CBCT scan. He thought (even though both him and I know I don't want RCTs) that I should see an Endo for eval. Saw endo today. He did periapical xray. Said no infection but tooth almost completely calcified with a very very blunted root (all my front teeth have short roots from earky and aggressive braces.). He did cold test with endo ice. I felt cold on all my other teeth but nothing on #7. He had a syringe of hot water, sprayed it on #7. Sharp pain! But resolved back to baseline (which is still pretty painful.)

He recommended RCT based on the results of the testing plus the calcification. He said nerve is irritated to the point of dying.

At this point even though I know RCTs are not ideal, I can't keep pulling teeth. With 19 gone, 11 maybe going, I can't lose another front tooth. I'm only 35. I'm worried about becoming a "dental cripple."

I don't understand why my teeth are having all these unrelated issues in unrelated quadrants. I don't know why a Virgin tooth would just start dying.

My options are now: 1.). Do the RCT using ozone supplied by my holistic dentist (they offer this service that my dentist brings over the ozone to endodontist. They said they do this a lot because many people choose RCT over extraction. I understand why, I'm in that boat.)
2.). Leave the tooth and live with the pain, see if it heals by itself? Is that possible? Endo says no, dentist said rare but maybe. Endo said no rush to do RCT because not infected but I will have to live in pain until then. I made an appointment for RCT with ozone in 5 days. I can always reschedule or cancel....

I'm lost. Just lost. Any advice would be helpful.

I don't have the copy of the xray as they said they would send it to me but I imagine forgot. I can get it and post it on Monday. But if you had advice before then I would be SO grateful.

I leave town to fly across the country in 2 weeks to further complicate things and I stay for 2 weeks in NJ. I do not want to have complications when I am over there from the flight if I choose to wait. I'm scared. And I would greatly appreciate help.

I am very informed about RCTs I have read every link and book you suggest. But I feel like I have to take in my own circumstances to account too and make hard decisions. I don't want to have missing front teeth, especially multiple ones!!!

Also pain on 7 is quite bad. It eclipses the pain on 11. It's hard to live with it like I'm living with the pain on the other side. I wondered if it was referred but they tell me "pain can't cross the midline."

And to make matters worse, my dentist is on vacation starting today! But his assistant is still in the office. She's very nice. She would be bringing the ozone if I chose to do the RCT.

[Bryanna]

Hi nukuspot,

I am sorry you are having all of these dental problems. Obviously your immune system is dealing with more than it can handle and my guess is that things that were laying dormant are now no longer in the dormant stage. The reason I say that is because every dental problem that you have had in the last several months were with teeth that have had some degree of trauma, infection, or abnormality. Meaning something happened to them in the past and were asymptomatic for a long time.

The orthodontia that you had caused blunting of the roots of your 4 upper anterior teeth. That means that those teeth were permanently and unfavorably affected by the orthodontia. Teeth with blunted roots from ortho trauma frequently end up slowly dying over time and the large canal(s) becomes closed or partially closed due to calcification. There may or may not be symptoms of this occurrence as it is happening. However, calcified canals often show up on dental radiographs because the teeth look different compared to healthy teeth. I would be curious to see past and present single periapical radiographs of your teeth to see if the calcification is apparent on them. This panorex shows the root blunted and there is some indication of the calcification's going on but the film is too blurry to be sure. The periapical films show a 2 dimensional view of the anatomy of the teeth more closely than the panorex.

I am going to re post some of your thread and answer in bold type. Hopefully I will be able to clarify some things for you.

<<Then unexplained pain and facial numbness around apicoectomy tooth #11--cause still unknown. Numbness/tingling spread to nose and upper lip and even right side a bit so it might not even be related to #11 but it's the best idea I have.>>

THE SYMPTOMS IN THE AREA OF TOOTH #11 ARE NOT UNUSUAL FOR A ROOT CANALED TOOTH, ONE THAT WAS PERFORATED DURING THE RC AND THEN APICOED. THE RC, THE PERFORATION AND THE APICO ARE ALL INVASIVE AND TRAUMATIC TO THE TOOTH AND THE BONE. AS LONG AS THE TOOTH IS PRESENT THERE WILL BE A INFLAMMATION AND IRRITATION TO THE FACIAL NERVES THAT CORRELATE WITH THAT TOOTH. IT IS NOT A PHANTOM PAIN OR SOMETHING THAT OCCURRED FOR NO REASON. IT'S BEEN ONGOING FROM THE BEGINNING, JUST ASYMPTOMATIC UNTIL NOW.

WHEN YOU THINK ABOUT IT, TOOTH #7 IS IN THE SAME BOAT AS #11. BOTH HAVE BEEN TRAUMATIZED BY THE FORCE OF ORTHODONTIA. BOTH HAVE CALCIFIED CANALS. TOOTH #11 WAS PERFORATED DURING THE RC BECAUSE CALCIFIED MEANS CLOSED, NOT OPEN. SO DURING THAT RC THE INSTRUMENT USED TO DEBRIDE "OPEN" CANALS, WAS PUSHED THROUGH THE TOOTH FURTHER INJURING IT WHICH ALSO MEANS THE DEBRIS ON THAT INSTRUMENT WAS PUSHED INTO THE BONE. FURTHER SURGERY, THE APICO, WAS DONE TO TRY TO PATCH THE PERFORATION CLOSED AND SEAL OFF THE TIP OF THE ROOT. ALL OF WHICH CREATES CHRONIC INFLAMMATION AND VARIOUS SPECIES OF BACTERIA TO GROW BECAUSE THE BONE THAT THIS DEAD TOOTH SITS IN IS ALIVE WITH COUNTLESS NERVES AND BLOOD VESSELS SURROUNDING IT. THE TOOTH IS NOT SEPARATE FROM THE BONE, THE NERVES THE VESSELS. IT IS INTIMATELY CONNECTED TO ALL OF THEM.

<<Now in these past 2 weeks--pain on #7 (not a RCT, a virgin tooth!)
#7 started to become painful to heat.>>

THIS IS A VIRGIN TOOTH ONLY BECAUSE IT DOES NOT HAVE A RESTORATION IN IT. HOWEVER, IT IS A TOOTH THAT HAD BEEN TRAUMATIZED DURING THE TIME YOU WORE BRACES TO THE POINT THAT THE ROOT BECAME BLUNTED AND THE CANAL CALCIFIED. SO IT'S NOT A VIRGIN TOOTH IN THE SENSE THAT IT WAS PERFECTLY HEALTHY AND ALL INTACT. HEAT SENSITIVITY INDICATES THAT THERE IS SOME VITALITY AND ALSO SOME INFLAMMATION TO NERVES INSIDE OF THE TOOTH. THERE COULD BE A SMALL PORTION OF THE LARGE CANAL THAT HAS NOT YET CALCIFIED AND/OR THE NERVES IN THE DENTIN TUBULES ARE STILL ALIVE. EITHER WAY, WHAT IS HAPPENING TO THIS TOOTH IS VERY SIMILAR TO WHAT TOOK PLACE WITH TOOTH #11.

<<Saw endo today. He did periapical xray. Said no infection but tooth almost completely calcified with a very very blunted root (all my front teeth have short roots from earky and aggressive braces.). He did cold test with endo ice. I felt cold on all my other teeth but nothing on #7. He had a syringe of hot water, sprayed it on #7. Sharp pain! But resolved back to baseline (which is still pretty painful.)>>

EXACTLY. THE CALCIFICATION WAS PICKED UP ON THE PERIAPICAL XRAY. THAT CALCIFICATION DID NOT HAPPEN OVER NIGHT. SO I'M CURIOUS WHAT PREVIOUS PERIAPICAL XRAYS SHOW OF THAT TOOTH AND THE OTHERS. KEEP IN MIND THAT THE BACTERIA INSIDE OF THE TOOTH OR INSIDE OF THOSE MICROSCOPIC DENTIN TUBULES WILL NOT SHOW ON DENTAL XRAYS UNTIL IT BECOMES LARGE ENOUGH TO BE PICKED UP BY THE RADIATION.

<<He recommended RCT based on the results of the testing plus the calcification. He said nerve is irritated to the point of dying>>

HE'S RIGHT ABOUT THE IRRITATION AND VITALITY. BUT HE SHOULD BE INFORMING YOU THAT YOU CANNOT ROOT CANAL A CALCIFIED CANAL AS THERE IS NO OPENING TO GET INTO THE CANAL. EVEN IF THERE IS SOME TINY PORTION OF THE CANAL STILL OPEN, BY NOW IT IS NOT ACCESSIBLE TO HIS INSTRUMENTS, THAT'S HOW TINY IT WOULD BE. IN ADDITION, THE DENTIN TUBULES WILL REMAINED UNTOUCHED BY THE RC PROCEDURE. SO THIS TOOTH WILL BE THE SAME AS TOOTH #11.

<<At this point even though I know RCTs are not ideal, I can't keep pulling teeth. With 19 gone, 11 maybe going, I can't lose another front tooth. I'm only 35. I'm worried about becoming a "dental cripple.">>

YOU ARE FAR FROM A DENTAL CRIPPLE. THAT IS WHEN SOMEONE LOSES MOST OR ALL OF THEIR TEETH "DUE TO CHRONIC INFLAMMATION AND INFECTION" THAT HAS CAUSED THEM TO HAVE SEVERE BONE LOSS. YOU ARE NOT ANYWHERE NEAR THAT STAGE AND DO NOT HAVE TO END UP THERE.

I don't understand why my teeth are having all these unrelated issues in unrelated quadrants. I don't know why a Virgin tooth would just start dying.

<<THE VIRGIN TOOTH HAS BEEN DYING FOR A LONG TIME DUE TO THE ORTHO. NOT ALL PEOPLE WHO HAVE ORTHO WILL EXPERIENCE BLUNTING OF THE ROOT STRUCTURE OF THEIR TEETH. BUT THOSE THAT DO, TEND TO LOSE MORE "UNRESTORED" TEETH THAN ANYONE ELSE BECAUSE OF THE EXCESSIVE TRAUMA CAUSED BY THE MOVEMENT OF THE TEETH DURING ORTHO.

<<My options are now: 1.). Do the RCT using ozone supplied by my holistic dentist (they offer this service that my dentist brings over the ozone to endodontist. They said they do this a lot because many people choose RCT over extraction. I understand why, I'm in that boat.)>>

OZONE IS AWESOME AND VERY THERAPEUTIC IN MANY APPLICATIONS AS IT ENCOURAGES POSITIVE CELLS TO FORM IN AREAS WHERE THEY MAY BE LACKING. HOWEVER, IT CANNOT ALTER THE ANATOMY OF YOUR TOOTH IN ANY WAY. SO WHATEVER IS PRESENT IN THE DENTIN TUBULES WILL REMAIN THERE. IT'S IMPORTANT THAT YOU UNDERSTAND THAT WHATEVER YOU DO TO THIS TOOTH AND #11 IS TEMPORARY AND WILL NOT PREVENT FUTURE ISSUES TO OCCUR.

<<2.). Leave the tooth and live with the pain, see if it heals by itself? Is that possible? Endo says no, dentist said rare but maybe. Endo said no rush to do RCT because not infected but I will have to live in pain until then. I made an appointment for RCT with ozone in 5 days. I can always reschedule or cancel....>>

THE TOOTH HAS BEEN DYING FOR YEARS AND HAS NOT BECOME SYMPTOMATIC TIL NOW. iF YOU DO NOTHING, IT MAY CALCIFY FURTHER AND IN TIME SLOWLY EVULSE ITSELF FROM THE BONE. THIS MEANS IT MAY CONTINUE TO HURT OR NOT AND EVENTUALLY IT WOULD BECOME LOSE. IT MAY CALCIFY FURTHER AND BECOME INFECTED WHICH MEANS AN ABSCESS CAN DEVELOP. TO RC THE TOOTH MEANS TO CAUSE FURTHER TRAUMA RESULTING IN MORE INFLAMMATION, POSSIBLE PERFORATION AND APICO WITH NO FAVORABLE ALTERATION OF THE HEALTH OF THE TOOTH.

<<I leave town to fly across the country in 2 weeks to further complicate things and I stay for 2 weeks in NJ. I do not want to have complications when I am over there from the flight if I choose to wait. I'm scared. And I would greatly appreciate help.>>

THERE IS NO WAY TO TELL YOU WHAT MIGHT HAPPEN FROM THE PRESSURE OF FLYING. THE TIMING OF TOOTH PROBLEMS IS NEVER REALLY GOOD :/

<<I am very informed about RCTs I have read every link and book you suggest. But I feel like I have to take in my own circumstances to account too and make hard decisions. I don't want to have missing front teeth, especially multiple ones!!!>>

YOUR PERSONAL UNDERSTANDING OF WHAT YOU HAVE READ IS WHATEVER YOU INTERPRET IT TO BE. THE ANATOMY OF A TOOTH IS WHAT IT IS AND THERE IS NO GETTING AROUND THAT IRRELEVANT OF THE CIRCUMSTANCES. THE CHOICE YOU MAKE IS WHAT YOU FEEL IS IN YOUR BEST INTEREST.

<<Also pain on 7 is quite bad. It eclipses the pain on 11. It's hard to live with it like I'm living with the pain on the other side. I wondered if it was referred but they tell me "pain can't cross the midline.">>

IT IS NOT REFERRED PAIN FROM #11. IT IS THE IMMUNE SYSTEM REBELLING JUST LIKE IT WOULD IF YOU HAD A WEAK AREA ELSEWHERE IN OR ON YOUR BODY. THE WEAK AREAS SEEM TO ACT UP WHEN THE IMMUNE SYSTEM IS TIRED FROM SOMETHING CHRONICALLY IRRITATING IT.

I feel terrible that you are in this situation. Only you can make an informed decision based on what you feel is in your best interest. I know what I would do if it were me, but no one can guide you to do what you feel is right for you.

Please keep us posted...
Bryanna

[nukuspot]

Hi Bryanna!

I have been checking neurotalk every few hours hoping you would write back. A big THANK YOU!

I don't have any other PAs of my front teeth to compare the calcification to, unfortunately. I have all the xrays my current holistic dentist has ever taken saved in an email folder, and they are all bitewings or PAs of back teeth. I have no PAs of front teeth. I saw a ADA dentist before him and I have some of her xrays but I just looked and again, no PAs of front teeth. Everything is just always the back molars or the canine teeth.

As soon as the endo office opens on Monday I will ask them to resend the xrays and I will post them on this thread.

What I was really wanting and hoping for from you was a good explanation of what would happen if I do nothing. My dentist tells me to follow my intuition. All my intuition says right now is that I do not want to extract #7. I have already extracted #19 and have to go through a long implant process. I might be looking at that for #11 as well. I can't face doing #7 right now. So I guess my choices are 1.) Do nothing 2.) Do the RCT with ozone and use it as a stopgap for a few years until the implant on #19 is successful and I figure out and implement what to do on #11 and have that be successful.

So I already know what the outcome of RCT will be (most likely a tooth without pain but with anaerobic bacteria trapped in the tubules that may or may not cause issues down the road) but I am not totally sure about what the future would look like if I did nothing on #7. I can't really accurately compare it to my experience with #11 because that one never had pain. It just one day BOOM a painful abscess which there was no living with. Right now, #7 has pain but no abscess or sign of infection. I have read that calcified canals can sometimes be the body's own way of doing a "natural" root canal. If I live with the pain for awhile, I guess I wonder if that is better in the long run than doing the RCT. Would the pain get worse? If it got worse I couldn't choose the do nothing option. If it stayed exactly like it is now, I could live with it, I just would put ice cubes in my hot drinks or broth to cool it down. I have no pain with room temp or cold. Just a general dull ache from that tooth which gets worse for a moment with heat and then stays a bit more painful for a few hours afterwards. But in the long run, is that OK? Is it safe to live that way? That is what I am trying to figure out. The endo was confused as to why I would want to live with pain when I asked him these questions, but he said that right now it's not dangerous to live with a dying nerve. Lots of people do it without having pain so they don't know. That was my experience with #11.

But...Is that tooth still protected from infection by it's natural defenses at this point? That is what I need to know to make this decision.

Also, I guess I should call the endo office and leave a message for the endo who said I can ask him any questions. He said at the time he would just do a RCT with ozone. But you seem to be implying (and it makes sense) that he would not be able to do that with the calcification and I would have to get another primary apico just like #11. I need to know if this would be the case before I go in IF I go in. My canal on that tooth is calcified but also very wide as all my 4 front teeth basically stopped growing at age 9 with the braces, they say. They said my tooth is the size and shape and has canals like a child's tooth. I am very upset that braces did this to my teeth.

Finally I wanted to clarify the remark I made about being a dental cripple. I know that term well because of my mother. She has almost all of her teeth either RCTed or implanted with bridges. She struggles daily. Hers were not due to decay, they were due to bad dental work through her life. I wonder how genetic my teeth issues are. When I mentioned it I meant that if I default to extraction every time one of my teeth needs a RCT, I may eventually be one. Because the braces blunted my 4 front teeth AND I had the impaction surgery on both canines (with #11 deemed already dead 20 years later) and now my #7 doing a similar fate---I imagine that over my life the remaining 3 fronts and 1 canine will get that way. It's a horrible prospect to think of, but I don't know when or if it will happen. And I don't know how I will respond to implants. Plus my dentist strongly suggests that if I do implants I only do zirconia ones. He said that with my history of hypersensitivity and autoimmune disease, we would not recommend titanium, even though most of the population would probably be OK with them. The zirconia ones are pretty intense of a process--Being that they are one piece and cannot be covered by gums then uncovered after integration, every time I get one I would have to wear an Essix and not chew on that side for 6 months while they are osseointegrating. So....Being that I am going to start that process with #19 in December and wear a lower essix and not be able to chew on my lower left---I cannot also be dealing simultaneously with an upper essix and not being able to chew on my upper right. Does that make sense? I need to do these one at a time I feel. So that is why I am not considering extraction of #7 at the moment.

I hope this all made sense and was no too rambly. If this was an issue of lower molars on the same side it would be such an easy decision to make! I would extract and do implants in the same quadrant. But my case and situation feels a bit bleak. I get very sad when I think about what is going on. This has been one of the worst years of my life. And it's all teeth related!

So if you wouldn't mind, could you please give me a general idea of what I might be facing if I decide to just do nothing on #7 for the moment? How might it progress? Would it ever favorably turn around or would it always get worse? What might be the time frame? It will help me with my decision SO much.

[Bryanna]

nukuspot,

It is odd that you don't have xrays of your front teeth. The blunting or resorption of the roots began "during" orthodontia as the teeth were moved faster than the body could tolerate. If it wasn't diagnosed at that time, it should have been so the orthodontist could have backed off of the adjustments until the bone could catch up. The resorption of the roots can continue to progress especially if the teeth become traumatized and/or infected.

So as I said earlier, those upper anterior teeth, although asymptomatic, have been in a compromised state for many years. There is no way for anyone to predict what will occur at what time with any of those teeth. This is why many dentists will wait until they become symptomatic before they even mention the root resorption or discuss the problems that can occur due to the condition.

Is it safe to just leave them, even if they hurt? They have been asymptomatic but in a compromised state for years. The symptoms indicate a change is occurring and no one can predict where that will lead to or when/if something else will occur. Your "natural defenses" are dependent on your immune system and how healthy it is and how well it deals with the problems. Anything else that taxes the immune system, like becoming ill, chronic stress, lack of nutrition, allergies or even getting pregnant can cause further symptoms to develop as the immune system becomes busy dealing with other issues.

Things that can occur as a result of traumatic root resorption/blunting are:

**Nothing. In people who have a truly healthy immune system, these teeth will rarely have problems in spite of becoming calcified.

**The nerves inside the tooth can die. If this occurs very slowly and infectious bacteria does not take over, there may be vague or no symptoms. The teeth may just eventually loosen and separate from the periodontal ligament, become very mobile to the point of needing to be extracted or they can literally just fall out. The mobility and loosening of the teeth would become quite evident before they evulse.

**The large canals become calcified, closed. The nerve tissue dies inside and the teeth eventually loosen, etc.

**Any remnants of dead nerve tissue can become infected leading to loosening of the tooth and the ligament or even an abscess.

Root canaling a calcified tooth is like trying to put your fingers into a glove where the fingers of the glove are either sewn shut or only partially open. It doesn't work. Apicos are done on calcified teeth to amputate the blunted root tip and seal it off from the blood vessels in the bone. The "logic" (sarcastically) behind doing the apico .............. there really is none other than it can give the patient false hope that the tooth is miraculously healthy again and the tooth can be retained for an undetermined amount of time. The systemic and neurological consequences of retaining non vital teeth that have been traumatized by an rc or apico procedure are not measurable.

People who have a compromised immune system and/or who have other dental problems, tend to have more severe complications with these teeth than people who are in a healthier state. People who have been healthy and then develop chronic health problems or chronic physical/mental or emotional stress will then tend to develop symptoms in these teeth as their immune system becomes less able to function at an optimal level.

Tooth #7 and tooth #11 are very similar. The only difference is #7 became symptomatic sooner whereas #11 was quiet until it abscessed. Both had suffered the same trauma and both were in the same condition for many years.

I agree with you that dental implants are not without systemic concerns, especially in someone with a compromised immune system. However, zirconia implants are covered by the gum tissue and because they are white they have a tendency not to show through the gum like titanium, unless the gum tissue is very thin. Any dental implant that is placed in healthy bone is not going to show through the gum as it will be embedded in thick, healthy bone. It is when the gum tissue is thin and the bone is compromised due to infection and bone loss that the bone becomes weak and shallow. This is when an implant would show through the gum. I am referring to the buccal or facial side of the gum.

Now if you are talking about the occlusal surface, biting surface, of the dental implant when it is first placed in the bone... that again is dependent on how deeply the implant is placed. On titanium implants a small metal healing cap is put on top of the implant head and this little cap may or may not be visible through the top of the gum as it depends on the individual case. If tissue grows over the healing cap, it is laser ed off before the final restoration is put on. Zirconia implants are one piece, they do not have a healing cap so a small piece of implant is usually seen above the gum line. However, gum tissue may grow over that during the healing phase which is not a bid deal because it is removed with a laser before the final restoration is done. Here is a link about implants.........
http://www.ceraroot.com/patients/zirconia-vs-titanium/

To answer your deeply concerning question about a time frame with #7....
I wish I could give you a time frame as to what will occur if you do nothing with #7 but there is no way for me or anyone else to know that. To get you through the next few weeks, discuss ozone options with your dentist, although anything he does will only be temporary and no one can forecast the longevity of temporary.

I personally believe our immune system is the link to how well our body deals with trauma and chronic inflammation. I know you are concerned and I agree with your concern about the future of all of those front teeth. I think it would behoove you to consider exploring this topic with professional help from an Integrative, Naturopathic or Functional Medical Professional to find out what is going on with your immune system and take measures to improve its function so as to prevent or minimize complications in the future.

Even though we have DNA predispositions, we all have the ability to prevent or minimize those events from happening to us. It all comes down to the health of our individual immune system which is determined by our nutrition, our environment, toxicities, lifestyle choices and our spirituality.

Bryanna

Originally Posted by nukuspot

Hi Bryanna!

I have been checking neurotalk every few hours hoping you would write back. A big THANK YOU!

I don't have any other PAs of my front teeth to compare the calcification to, unfortunately. I have all the xrays my current holistic dentist has ever taken saved in an email folder, and they are all bitewings or PAs of back teeth. I have no PAs of front teeth. I saw a ADA dentist before him and I have some of her xrays but I just looked and again, no PAs of front teeth. Everything is just always the back molars or the canine teeth.

As soon as the endo office opens on Monday I will ask them to resend the xrays and I will post them on this thread.

What I was really wanting and hoping for from you was a good explanation of what would happen if I do nothing. My dentist tells me to follow my intuition. All my intuition says right now is that I do not want to extract #7. I have already extracted #19 and have to go through a long implant process. I might be looking at that for #11 as well. I can't face doing #7 right now. So I guess my choices are 1.) Do nothing 2.) Do the RCT with ozone and use it as a stopgap for a few years until the implant on #19 is successful and I figure out and implement what to do on #11 and have that be successful.

So I already know what the outcome of RCT will be (most likely a tooth without pain but with anaerobic bacteria trapped in the tubules that may or may not cause issues down the road) but I am not totally sure about what the future would look like if I did nothing on #7. I can't really accurately compare it to my experience with #11 because that one never had pain. It just one day BOOM a painful abscess which there was no living with. Right now, #7 has pain but no abscess or sign of infection. I have read that calcified canals can sometimes be the body's own way of doing a "natural" root canal. If I live with the pain for awhile, I guess I wonder if that is better in the long run than doing the RCT. Would the pain get worse? If it got worse I couldn't choose the do nothing option. If it stayed exactly like it is now, I could live with it, I just would put ice cubes in my hot drinks or broth to cool it down. I have no pain with room temp or cold. Just a general dull ache from that tooth which gets worse for a moment with heat and then stays a bit more painful for a few hours afterwards. But in the long run, is that OK? Is it safe to live that way? That is what I am trying to figure out. The endo was confused as to why I would want to live with pain when I asked him these questions, but he said that right now it's not dangerous to live with a dying nerve. Lots of people do it without having pain so they don't know. That was my experience with #11.

But...Is that tooth still protected from infection by it's natural defenses at this point? That is what I need to know to make this decision.

Also, I guess I should call the endo office and leave a message for the endo who said I can ask him any questions. He said at the time he would just do a RCT with ozone. But you seem to be implying (and it makes sense) that he would not be able to do that with the calcification and I would have to get another primary apico just like #11. I need to know if this would be the case before I go in IF I go in. My canal on that tooth is calcified but also very wide as all my 4 front teeth basically stopped growing at age 9 with the braces, they say. They said my tooth is the size and shape and has canals like a child's tooth. I am very upset that braces did this to my teeth.

Finally I wanted to clarify the remark I made about being a dental cripple. I know that term well because of my mother. She has almost all of her teeth either RCTed or implanted with bridges. She struggles daily. Hers were not due to decay, they were due to bad dental work through her life. I wonder how genetic my teeth issues are. When I mentioned it I meant that if I default to extraction every time one of my teeth needs a RCT, I may eventually be one. Because the braces blunted my 4 front teeth AND I had the impaction surgery on both canines (with #11 deemed already dead 20 years later) and now my #7 doing a similar fate---I imagine that over my life the remaining 3 fronts and 1 canine will get that way. It's a horrible prospect to think of, but I don't know when or if it will happen. And I don't know how I will respond to implants. Plus my dentist strongly suggests that if I do implants I only do zirconia ones. He said that with my history of hypersensitivity and autoimmune disease, we would not recommend titanium, even though most of the population would probably be OK with them. The zirconia ones are pretty intense of a process--Being that they are one piece and cannot be covered by gums then uncovered after integration, every time I get one I would have to wear an Essix and not chew on that side for 6 months while they are osseointegrating. So....Being that I am going to start that process with #19 in December and wear a lower essix and not be able to chew on my lower left---I cannot also be dealing simultaneously with an upper essix and not being able to chew on my upper right. Does that make sense? I need to do these one at a time I feel. So that is why I am not considering extraction of #7 at the moment.

I hope this all made sense and was no too rambly. If this was an issue of lower molars on the same side it would be such an easy decision to make! I would extract and do implants in the same quadrant. But my case and situation feels a bit bleak. I get very sad when I think about what is going on. This has been one of the worst years of my life. And it's all teeth related!

So if you wouldn't mind, could you please give me a general idea of what I might be facing if I decide to just do nothing on #7 for the moment? How might it progress? Would it ever favorably turn around or would it always get worse? What might be the time frame? It will help me with my decision SO much.

[nukuspot]

Thank you again for your response. I understand what you say about immunity and lifestyle as how it impacts dental and general health. I am and have been an obsessively "holistic" person. I make sure my family eats 100% organic. We only eat whole, unprocessed foods. I grow much of our own produce in my organic garden, the rest we buy from local organic farms, including our meat and eggs. I bake everything from scratch and am gluten, refined sugar, and mostly grain free. I see a myriad of holistic health practitioners, an integrative MD, ND, acupuncture, chiropractor, (as well as holistic dentists). I take supplements each day which have been tailored to my needs by my holistic physician. I do not use chemicals at all in my life in cleaning or body care. We sleep on organic mattresses, we are in the process of getting rid of all our couches so make our home flame retardant free...It goes on. What I am trying to say by all of this is that I don't know what else I can do to help my immune system not attack my teeth. My doctor also does not know. I am trying unusual things like EFT recently and other energy work. But my teeth keep causing issues.

I have no known allergies (except to certain antibiotics and gluten) and the only stress I have is regarding my teeth! For this last year I sometimes cannot eat or sleep I worry about my teeth so much. Before this I was pretty happy. Other than being pregnant/breastfeeding for the last 6 years, I can't think of anything specific that would cause all my dental issues. I have an autoimmune disease called interstitial cystitis but it has been in remission for the last 6 years. And to my knowledge it should not affect teeth. So I am sure you can understand I am feeling hopeless because it seems like no matter how well I take care of myself, it's not enough. And my teeth are just causing so many issues all at once.

I am going to ask every dentist I know if they could do anything with ozone to help give me more time until I can make a decision. I truly do not want to get this tooth extracted at the moment. It is not the zirconia implant itself that I worry about, it is the essix device that goes over the teeth. Because the zirconia implant cannot get a healing cap like a titanium, gum cannot grow over it and there can be NO pressure on it from occlusal force or eating, etc, during the time it is osseointegrating. So I will have to wear a plastic appliance on all my bottom teeth starting in December for 6 months to protect the implant at #19. It will affect speech. That is why I also know that I cannot have the same process going on in the upper. I want to do one implant at a time per arch.

So my choices remain to either do the RCT and see it as temporary until I can extract it later or leave the tooth the way it is. As everyone who has dental pain knows, there is a very fine line between bearable and unbearable dental pain. Right now this #7 is straddling that line. I can live with it now. But if it even got a tiny bit worse, it would be not able to be functional with. And that is what I am so scared of, if I leave it alone. I go back and forth on my mind about 20 times a day between what my choice would be. I need to call the endodontist on Monday and get a message to him and ask if he thinks he would be doing an RCT or an apico. The quote given to me was for an RCT and the discussion was about RCT. But with the calcification, you are bringing up a good point. How could he RCT through a calcification? Maybe it is not as calcified as I think it is? The teeth are not mobile at all.

I will get them to send me the PA xray tomorrow and I will post it here, if you don't mind. I trust your expert eye so much, and I am sure you can tell me what you see as far as the extent of calcification. Right now I guess I am in an information gathering mode, and your information you give me is very important to me.

[nukuspot]

I wonder why I don't have any xrays of my front teeth before this? I never knew it was odd. I switched to my holistic dentist about 7 years ago. They take xrays every 2 years but they are just a set of 4 bitewings. All the xrays I have from my dentist before that have been bitewings or PAs too, none of the front teeth. Is it "normal" to take xrays of front teeth? Do they usually do it every 2 years as well? I need to ask my general dentist about that but not sure when I will next see him unless he is willing to do ozone on #7.

[Bryanna]

nukuspot,

It sounds like you are very wise and well informed on many levels from a holistic aspect. My family has also adapted to an organic and holistic lifestyle that many others would consider to be extreme. We've lived this way for several years and continue to make changes and improvements along the way as we become better informed. It's always good to surround yourself with people who gravitate towards similar healthy goals as that makes the journey so much more interesting.

Are you familiar with the tooth and organ chart? Here is a link to one of them. As you will see, each tooth correlates with different meridians throughout the body that link to different parts of the body. The upper and lower 4 anterior teeth are on the same meridian as the kidney and bladder. All acupuncture meridians are in close connection with their neighboring meridians. The meridians that correlate to our teeth tend to include the adjacent teeth. For example, teeth #7-10 connect to the bladder and kidney which generally means to some degree so does the neighboring teeth #'s 6 and 11.

http://www.naturalworldhealing.com/D...organchart.htm

You had a traumatic and progressive root resorption problem going on with your upper anterior teeth starting sometime around 9 years old or so. At some point the trauma caused portions of the large interior canals to became calcified. Your immune system may not have offered you too many dental symptoms as that was going on, other than with tooth #11. Instead it may have taken a different direction and followed the meridian to your bladder. How long ago did you first experience IC? The immune can change direction when something or somewhere else becomes more irritating to it. Do you understand what I mean?

A Zirconia implant like a titanium implant is not suppose to be disturbed by chewing on it for the first few months. Implants are not fully integrated with the bone until a year has passed since their placement... and that's considering the bone is healthy to start with. Gum tissue can overgrow the end of the implant in some people. It depends on how deeply seated the implant is placed in the bone, how thick/thin or fibrous the gum tissue is and how well the individual's home care is. If tissue grows over it, it is removed by a laser before the final restoration is fitted. The essix retainer is similar to an invisalign retainer and is not cumbersome. Should not interfere with your speaking and may not have to include your entire lower arch. Talk to the dentist who is making that for you to be clear on how large it is going to be.

Allergies..... are you non celiac gluten sensitive or do you have celiac? There are so many levels of immune and auto immune issues associated with allergies and sensitivities. That is a very complicated subject and the only test that I am familiar with that covers all three reactive antibodies to check for delayed hypersensitivity reactions is called the ELISA ACT LRA blood test. Here is the link if you are interested in it: http://www.elisaact.com/

Are you currently working with a holistic practitioner or have you worked with them in the past?

Bryanna

Originally Posted by nukuspot

Thank you again for your response. I understand what you say about immunity and lifestyle as how it impacts dental and general health. I am and have been an obsessively "holistic" person. I make sure my family eats 100% organic. We only eat whole, unprocessed foods. I grow much of our own produce in my organic garden, the rest we buy from local organic farms, including our meat and eggs. I bake everything from scratch and am gluten, refined sugar, and mostly grain free. I see a myriad of holistic health practitioners, an integrative MD, ND, acupuncture, chiropractor, (as well as holistic dentists). I take supplements each day which have been tailored to my needs by my holistic physician. I do not use chemicals at all in my life in cleaning or body care. We sleep on organic mattresses, we are in the process of getting rid of all our couches so make our home flame retardant free...It goes on. What I am trying to say by all of this is that I don't know what else I can do to help my immune system not attack my teeth. My doctor also does not know. I am trying unusual things like EFT recently and other energy work. But my teeth keep causing issues.

I have no known allergies (except to certain antibiotics and gluten) and the only stress I have is regarding my teeth! For this last year I sometimes cannot eat or sleep I worry about my teeth so much. Before this I was pretty happy. Other than being pregnant/breastfeeding for the last 6 years, I can't think of anything specific that would cause all my dental issues. I have an autoimmune disease called interstitial cystitis but it has been in remission for the last 6 years. And to my knowledge it should not affect teeth. So I am sure you can understand I am feeling hopeless because it seems like no matter how well I take care of myself, it's not enough. And my teeth are just causing so many issues all at once.

I am going to ask every dentist I know if they could do anything with ozone to help give me more time until I can make a decision. I truly do not want to get this tooth extracted at the moment. It is not the zirconia implant itself that I worry about, it is the essix device that goes over the teeth. Because the zirconia implant cannot get a healing cap like a titanium, gum cannot grow over it and there can be NO pressure on it from occlusal force or eating, etc, during the time it is osseointegrating. So I will have to wear a plastic appliance on all my bottom teeth starting in December for 6 months to protect the implant at #19. It will affect speech. That is why I also know that I cannot have the same process going on in the upper. I want to do one implant at a time per arch.

So my choices remain to either do the RCT and see it as temporary until I can extract it later or leave the tooth the way it is. As everyone who has dental pain knows, there is a very fine line between bearable and unbearable dental pain. Right now this #7 is straddling that line. I can live with it now. But if it even got a tiny bit worse, it would be not able to be functional with. And that is what I am so scared of, if I leave it alone. I go back and forth on my mind about 20 times a day between what my choice would be. I need to call the endodontist on Monday and get a message to him and ask if he thinks he would be doing an RCT or an apico. The quote given to me was for an RCT and the discussion was about RCT. But with the calcification, you are bringing up a good point. How could he RCT through a calcification? Maybe it is not as calcified as I think it is? The teeth are not mobile at all.

I will get them to send me the PA xray tomorrow and I will post it here, if you don't mind. I trust your expert eye so much, and I am sure you can tell me what you see as far as the extent of calcification. Right now I guess I am in an information gathering mode, and your information you give me is very important to me.