[Angels31]

I had #14, upper molar removed two weeks ago. It had given me problems back in 2010 and I had a root canal on it. After 8 months of a sinus infection, it had an infection in the root that apparently was in my sinus. After removal, the oral surgeon gave me Augmentin to take for 10 days. Thursday was my last day of the antibiotics and my sinus infection feels like it is getting worse daily. The left side of my neck is very swollen, my left ear is ringing and I am swollen around my eyes. It feels like there is fluid all around. Also, my jaw feels weird on the left side. I went to the oral surgeon today and he did a panoramic and 3D xray. He could see the sinus infection but said it is small. He said he might see a little infection in #15 but wasn't sure. He was baffled by the neck swelling. In 2010 when I had the problem with #14 I also had neck swelling in the same place. He put me on a different antibiotic and said if it doesn't get better than I will need to remove #15, which I guess will be ok because I don't have an opposing tooth there anyways. I feel like I have a giant infection in my body, also I am losing my hair as well. I have noticed that most of the hair loss is on the side of the infection. It is very strange! Has anyone had a similar experience? I am so frustrated and I feel sick all the time.

[Angels31]

Also, could #15 be causing this?

[Bryanna]

Angels31,

Your question was answered in your original post.

Bryanna

Originally Posted by Angels31

I had #14, upper molar removed two weeks ago. It had given me problems back in 2010 and I had a root canal on it. After 8 months of a sinus infection, it had an infection in the root that apparently was in my sinus. After removal, the oral surgeon gave me Augmentin to take for 10 days. Thursday was my last day of the antibiotics and my sinus infection feels like it is getting worse daily. The left side of my neck is very swollen, my left ear is ringing and I am swollen around my eyes. It feels like there is fluid all around. Also, my jaw feels weird on the left side. I went to the oral surgeon today and he did a panoramic and 3D xray. He could see the sinus infection but said it is small. He said he might see a little infection in #15 but wasn't sure. He was baffled by the neck swelling. In 2010 when I had the problem with #14 I also had neck swelling in the same place. He put me on a different antibiotic and said if it doesn't get better than I will need to remove #15, which I guess will be ok because I don't have an opposing tooth there anyways. I feel like I have a giant infection in my body, also I am losing my hair as well. I have noticed that most of the hair loss is on the side of the infection. It is very strange! Has anyone had a similar experience? I am so frustrated and I feel sick all the time.

[Angels31]

Originally Posted by Bryanna

Angels31,

Your question was answered in your original post.

Bryanna

Bryanna,
Are you talking about my post a week and a half ago? I read your answer to that one again and I had my follow up. He said everything with the bone graft is healing nicely. Something is not right though and now I am wondering if it is #15? Or should I take these antibiotics and see if I get better in the next 10 days? On Wednesday I have an MRI scheduled and it is ocular/facial ordered by the ENT. I had an appointment with my regular doctor today and he was going to have them include the neck and teeth if they could. This is the most frustrating thing. Also, I have significant hair loss on top of it all. Could this be caused by a dental infection? I am a normally healthy person but right now I am a mess. I am not sure where to turn. Also, how do you know of the infection is in the bone? Would that have shown up on the X-ray?

[Bryanna]

Angels31,

I have copied and pasted just a snippet of my reply. Please read it again so you can become informed about the consequences between the longevity and severity of the infection.

<<It's important to know that the root canaled tooth that you had was infected for several years (SINCE 2010 OR SOONER) as all infected teeth as well as root canaled teeth contain infectious bacteria inside the microscopic canals. The rc procedure does not cure the infection in the tooth as it cannot reach into those tiny canals. The rc procedure is done to attempt to keep the infected tooth for an uncertain amount of time. The proliferation of the bacteria entered your sinus long before you developed symptoms as symptoms are usually delayed when an infection is able to drain, as it is when it is in the sinus. It is when the sinus becomes overwhelmed with bacteria and either it stops draining or the immune system says I've had enough of this and symptoms become more obvious. So in addition to the tooth being infected, the surrounding area of bone/tissue and the sinus were also infected. This is a typical occurrence for root canaled teeth and the upper teeth frequently infect the sinus. >>

The swelling that you had in your neck in 2010 and now again 5 years later is most likely associated with the same infection. The species of bacteria may or may not be the same this time or there could be a combination of different species, but the correlation is highly probable. The only way to know what proper antibiotic to prescribe is to culture the bacteria. This should have been done when the tooth was removed. There is also a chance that the bone graft is exacerbating the infection because the area may be too infected to receive the graft. Grafts should ideally be placed in healthy bone with no indication that there is any indication of infection brewing anywhere near the placement. The swelling of your face, eyes, ear pain often indicate significant inflammation within the jaw bone and/or the sinus. The swelling in your neck can also be indicative of the same thing and your lymphatic system may be reacting to the infection and inflammation. Your body is trying to deal with this infection but something (perhaps the graft and/or residual bacteria still in the bone of the extraction site and/or the chronic sinus infection) is preventing the healing from taking place.

Regarding the infection in the jaw bone.... the infection traveled a path through your tooth, into your bone to end up in your sinus. This occurred over a 5 year period or longer.

What did the oral surgeon say about the size or severity of the sinus perforation when he removed the tooth? Did he close the sinus before he placed the bone graft?

The MRI should most definitely include the entire sinus, the ear, the eye, the neck (lymph glands), jaw bone and teeth. There is no real purpose for that MRI if those things are not included.

The hair loss can be due to stress, medication, etc. Your body has been dealing with a lot and it is stressed to the max! Please keep in mind that you had a chronic infection brewing in your tooth, jaw bone and sinus for several years. The symptoms of the sinus began 8 months ago but the bacteria was present there long before then. Your immune system was doing it's job but the inflammation became too great to handle... thus the symptoms.

Regarding tooth #15... it is typical for a root canaled tooth to infect the adjacent teeth as they all share the same blood vessels, etc. So #15 could be infected and is just now showing up on the xray. A small periapical xray of #15 would focus in on the details of that tooth and it's surrounding bone more so than a panorex xray. If this tooth is infected, it too can be a contributing factor to the infection in general.

I cannot tell you whether to take the new rx of antibiotics or not. That decision has to come from your doctor/dentist. I can recommend that you take a probiotic supplement starting asap to help restore some healthy intestinal bacteria in your gut. Antibiotics and infection destroy the healthy flora in the gut and that alone can make you ill. Yogurt is not adequate in live bacterial cultures to make any difference. You would need a powerful supplement like Saccharomyces Boulardii. It should be taken an hour prior to the antibiotic or 2 hours after the antibiotic to avoid cross contamination. Generally, unless prescribed otherwise by a physician, the supplement is taken 2 times per day, 500 mgs each time during the course of the antibiotic and then for 2-4 weeks after.

Here's info on that...
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296087/

An example of one quality brand...
http://www.swansonvitamins.com/aller...ii-50-veg-caps

Bryanna

Originally Posted by Angels31

Bryanna,
Are you talking about my post a week and a half ago? I read your answer to that one again and I had my follow up. He said everything with the bone graft is healing nicely. Something is not right though and now I am wondering if it is #15? Or should I take these antibiotics and see if I get better in the next 10 days? On Wednesday I have an MRI scheduled and it is ocular/facial ordered by the ENT. I had an appointment with my regular doctor today and he was going to have them include the neck and teeth if they could. This is the most frustrating thing. Also, I have significant hair loss on top of it all. Could this be caused by a dental infection? I am a normally healthy person but right now I am a mess. I am not sure where to turn. Also, how do you know of the infection is in the bone? Would that have shown up on the X-ray?

[Angels31]

Thank you Bryanna! You are so knowledgable and I appreciate you taking so much time out of your busy day to help me. One thing I did not tell you is that number 15 also had a root canal. I am thinking I should just take it out also. Then I will have no molars on the top left until I get the implant.

[Bryanna]

Angels31,

You are welcome.

If tooth #15 is root canaled, then irrelevant of what shows on an xray, the tooth is infected. When the bacteria in the dentin tubules proliferate beyond the tooth and seeps into the bone, that is when the infection shows up radio graphically. Until that proliferation, the tooth can appear "normal" on an xray.

With that said, in all probability tooth #15 is contributing to the on going infection and may have even infected the graft material. It may behoove you to have the graft removed from the #14 site when 15 is extracted to be certain of eliminating the major sources of the infection. Please discuss that with the oral surgeon in detail. Let him know you are concerned about dealing with further infection and how that would affect your over all health.

FYI... the oral surgeon knows that root canaled teeth are unhealthy but he has to be careful how he discusses this subject and cautious of what he recommends to patients as he does not want to stand in opposition of his colleagues who make a very good living at doing root canals. So it's best for the patient to bring up the subject and voice their health concerns pertaining to infected teeth as in that way he can speak more informatively about the systemic consequences.

Keep us posted.
Bryanna

Originally Posted by Angels31

Thank you Bryanna! You are so knowledgable and I appreciate you taking so much time out of your busy day to help me. One thing I did not tell you is that number 15 also had a root canal. I am thinking I should just take it out also. Then I will have no molars on the top left until I get the implant.

[Angels31]

Originally Posted by Bryanna

Angels31,

You are welcome.

If tooth #15 is root canaled, then irrelevant of what shows on an xray, the tooth is infected. When the bacteria in the dentin tubules proliferate beyond the tooth and seeps into the bone, that is when the infection shows up radio graphically. Until that proliferation, the tooth can appear "normal" on an xray.

With that said, in all probability tooth #15 is contributing to the on going infection and may have even infected the graft material. It may behoove you to have the graft removed from the #14 site when 15 is extracted to be certain of eliminating the major sources of the infection. Please discuss that with the oral surgeon in detail. Let him know you are concerned about dealing with further infection and how that would affect your over all health.

FYI... the oral surgeon knows that root canaled teeth are unhealthy but he has to be careful how he discusses this subject and cautious of what he recommends to patients as he does not want to stand in opposition of his colleagues who make a very good living at doing root canals. So it's best for the patient to bring up the subject and voice their health concerns pertaining to infected teeth as in that way he can speak more informatively about the systemic consequences.

Keep us posted.
Bryanna

Bryanna,
How long do I have to wait after extracting #14 to get #15 extracted? It was two weeks yesterday and the area is quite sore still. Is this normal? Also, I have a little pain in my cheek and jaw. Is this normal also? It definitely still feels like there is an infection and it is affecting the whole left side of my face. I am taking Biaxin.

[Bryanna]

Angels31,

Tooth #14 was infected since 2010 which had proliferated into the bone and into the sinus ... and #15 has been infected since on or before the day it was root canaled. Your ongoing symptoms indicate that antibiotics are not able to cure the problem.

As long as there is a physical reason for the infection to remain active, for instance infected tooth #15 and possibly the graft and sinus, the bacteria will continue to be infectious irrelevant of what antibiotics you take. Also with each additional antibiotic prescription you take you run the risk of acquiring an intestinal infection called Clostridium Difficile. This is a very debilitating infection that can take months to treat. Antibiotics are intended to be prescribed for very specific reasons and they cannot cure an infection when there is a physical reason for the infection to remain active.

It is normal to have soreness and minor swelling and discomfort 2 weeks post op oral surgery. However, your ongoing symptoms as you have stated them here are not normal healing post operative complaints. They are indicative of an ongoing infection. I'm sorry if I am repeating myself. I really don't know how else to explain it to you. If the oral surgeon seems uninterested in dealing with this infection, perhaps you should consult with someone else.

Bryanna

Originally Posted by Angels31

Bryanna,
How long do I have to wait after extracting #14 to get #15 extracted? It was two weeks yesterday and the area is quite sore still. Is this normal? Also, I have a little pain in my cheek and jaw. Is this normal also? It definitely still feels like there is an infection and it is affecting the whole left side of my face. I am taking Biaxin.

[Angels31]

Originally Posted by Bryanna

Angels31,

Tooth #14 was infected since 2010 which had proliferated into the bone and into the sinus ... and #15 has been infected since on or before the day it was root canaled. Your ongoing symptoms indicate that antibiotics are not able to cure the problem.

As long as there is a physical reason for the infection to remain active, for instance infected tooth #15 and possibly the graft and sinus, the bacteria will continue to be infectious irrelevant of what antibiotics you take. Also with each additional antibiotic prescription you take you run the risk of acquiring an intestinal infection called Clostridium Difficile. This is a very debilitating infection that can take months to treat. Antibiotics are intended to be prescribed for very specific reasons and they cannot cure an infection when there is a physical reason for the infection to remain active.

It is normal to have soreness and minor swelling and discomfort 2 weeks post op oral surgery. However, your ongoing symptoms as you have stated them here are not normal healing post operative complaints. They are indicative of an ongoing infection. I'm sorry if I am repeating myself. I really don't know how else to explain it to you. If the oral surgeon seems uninterested in dealing with this infection, perhaps you should consult with someone else.

Bryanna

I definitely have an infection! Sorry if I seem dense, but all this dental stuff is new to me. You are right, the antibiotics make it feel a little better, but do not cure it. My oral surgeon did a panoramic X-ray and also a 3D x-ray and did not see any infection in #14. Wouldn't he be able to see it if there was an infection? He did think he saw infection in 15 but was not sure. I just put myself through a very bad experience this afternoon! After calling yesterday to make sure all the areas that you said should be included were in today's MRI, they told me they were. I found out that my neck was not included and it was just frontal face. They told me he was looking for trigeminal neuralgia. I know for a fact that this is not it! The guy doing the MRI was a complete jerk to me. I think I just wasted 270 dollars and my time on that! It is so frustrating. Meanwhile, I feel horrible. I have a follow up appointment on Monday with oral surgeon and I think I should just have him take #15 out! The whole left side of my face is hurting! I think it is originating in my tooth cause it feels weird. Even my neck is still swollen under my ear on the left side.