[woodyfly]

I was referred to an endo for "#19 has an existing RCT". If I'm correct, that means I have an infected root canal. Now that tooth has been infected for maybe 7 years...

I don't feel any pain there so I never took care of it but I wonder if it's possible that it's causing me physical illnesses in other parts of my body? I've had years of unexplained headaches, depression, anxiety, fatigue, insomnia. Is it really possible?

Also, what is my best course of action here? Do I re-do the root canal or is pulling the tooth better?

Thank you

[woodyfly]

I attached an xray below.

I think I have another infected tooth in my upper right, I don't remember. Can someone read this xray and tell me what they see? My short term memory is reallly bad, I don't remember most of the stuff my dentist told me

[woodyfly]

Also I forgot to mention that I have amalgam fillings that fell out on my upper right

[Bryanna]

Hi Woodfly,

Thanks for posting the panoramic xray.

To help your dentist confirm what appears to be on this xray it would really behoove you to have a full series of individual x-rays (18-20) called periapicals and bite wings because there are areas that need to be viewed in more detail. A panoramic xray like this one shows the upper and lower dentition in it's entirely as well as some other anatomical areas. So it is a good diagnostic xray for certain things but in your case the smaller xrays would be very helpful with a more definitive diagnosis.

Here is what I see on the panoramic film:

An infection in the bone on the UR that goes from your second pre molar to the last molar which most likely originated from your root canaled pre molar. It is a good possibility that the sinus is involved too. Both the pre molar and the molar have decay and mercury fillings.

There may also be something brewing in your UL from the first pre molar to the first molar. Possible decay on the first molar and maybe the last molar too.

The root canaled first molar tooth on your lower left has a large area of infection around the mesial (front) root. Also possible decay in between the second pre molar and this molar. This mesial root may also be fractured at the furcation which is the area in the upper middle portion of the tooth where the two roots split.

You also have some hard tartar below the gum line. Perhaps you have not had a cleaning in a awhile and/or you don't floss regularly?

Do you grind your teeth? It looks like you have some excessive wear on the enamel of your teeth.

Your best bet is to have that full series of xrays taken so that your dentist can have a closer and more detailed look at all of your teeth individually so as to get a more definitive diagnosis than what can be given from this film.

Regarding your concern about systemic health problems associated with your teeth and gum health..... very often there is no mouth pain with tooth infections when the bacteria has managed to find a path to drain to. When that drain area inflames then pain and swelling sets in. It is very possible and highly likely to end up with systemic problems from infection in your teeth and jaw bone simply because the bacterias, both good and bad, that live in our mouths travel throughout our blood stream and filter through our major organs. When the immune system becomes unwell due to chronic infection and inflammation, not only can we end up with physical ailments but mental and emotional ones as well. The immune system and the nervous system works syergistically so when one is off kilter the other one can be too.

Regarding tooth #19 in particular, it is not the root canal that is bad or infected on the tooth, it is the tooth itself and the mesial root is in very poor health. So to re treat this tooth with another rc procedure will not favorably alter the status of the infection and it will not offer you a favorable benefit from a systemic health standpoint.

If you choose to have #19 extracted, it would behoove you to see an oral surgeon, rather than a general dentist, for the removal as this tooth and surrounding bone is very unhealthy and fragile. The jaw bone also needs to be thoroughly debrided of infection and diseased tissue to encourage complete and healthy healing, which most GD's don't usually do. As a side note, according to this xray, #19 is not located near the mandibular canal, which is a good thing!

[woodyfly]

Originally Posted by Bryanna

An infection in the bone on the UR that goes from your second pre molar to the last molar which most likely originated from your root canaled pre molar. It is a good possibility that the sinus is involved too. Both the pre molar and the molar have decay and mercury fillings.

Thanks so much for taking your time to reply to me.

By UR it means upper right, correct? What do you mean an infection in the bone? Is it very serious? Will getting rid of the infection in the teeth, get rid of the infection in the bones and sinuses (if they are also affected?)

I have a pressure-like pain near my right nostril and goes up to my inner eyes. Could that be caused by whatever infection you're seeing? I do have unexplained issues with my sinuses as well.

[woodyfly]

Originally Posted by Bryanna

Hi Woodfly,

Your best bet is to have that full series of xrays taken so that your dentist can have a closer and more detailed look at all of your teeth individually so as to get a more definitive diagnosis than what can be given from this film.

I believe my dentist did do all the xrays, I just don't have copies of them except for the only one I showed.

Why did she send me to an endo if retreating the root canal isn't gonna do much?

Should I see another dentist perhaps?

In order of importance and severity, what do I need to take care of in order?

[Bryanna]

Hi woodfly,

Yes, UR means upper right. The infection in that posterior quadrant of jaw bone appears quite large and extensive. Given your description of your sinus and nasal symptoms in the UR are indicative that the bacteria has spread to the sinus. The only way to attempt the eradication of the infection is to remove the infected teeth. In that quadrant the premolar is root canaled and it is possible that the infection from that tooth spread to the adjacent teeth. So you would need vitality testing on those other teeth to determine the vitality and then proceed accordingly. An oral surgeon is the only type of dentist to see for this type of infection as a general dentist is not knowledgeable or experienced in dealing with it.

[Bryanna]

Woodfly,

If your general dentist has done the 18-20 single xrays and has not informed you of the infections present, then it would be a good idea to see a different dentist.

Conventional dentists are taught to retain (not cure) teeth, even sick teeth. So that is what she knows. Rarely does a conventional dentist connect oral health with systemic health because they have not been taught to do that. But as you are questioning.... perhaps your systemic sinus and health problems are in fact correlated with your teeth.

It would be wise to get ALL of your xrays and consult with an oral surgeon.

The UR is pretty urgent and the lower left is a close second.

[Gizzy]

I am here to attest to the dangers and repercussions due to an improperly performed root canal therapy. Maybe this will help others who make the decision to allow a general dentist to perform RCT on molars in particular.

My ill health was progressively getting worse. Stomach and intestinal problems, dehydration, skin problems, sinus problems and swelling.....the list goes on. My Physician was at a loss, I had been thru every test under the sun. But he did say my symptoms reeked of bacterial infection maybe from my teeth but my dentist at the time told me to get another Dr as my teeth were healthy. He was a bad dentist!

About a year ago my new valued dentist informed me that my last RCT looked horrible and performed very badly and I should have it looked at by Endo but it was not bothering me - no pain - no signs of infection - other than the taste in my mouth which was beyond disgusting. The cost alone kept me from seeing an Endo but recently I developed a small hard bump on my jaw that caused some concern. My new dentist said I didn't have a choice now.

Within the 2 hours in the Endo's chair the hideous taste had gone! It's been a week and all my other symptoms are subsiding. I am finally starting to feel better. The RCT was creating a toxic soup in my mouth then headed straight to my belly every time I swallowed food or even saliva.

The poorly performed RCT was causing these symptoms, nobody will be able to convince me otherwise. My new valued dentist says "Don't ever EVER EVER let a general dentist perform RCT on a molar, there are too many things that can go wrong". I will NEVER NEVER let a general dentist touch a molar ever again!!!!!

I wonder how many people are out there who are being treated for IBS and other serious intestinal ailments that are only suffering from bad dental practices.