Originally Posted by Bryanna

Angels,

Ironically, the endodontist is a strong promoter of root canal therapy which is the very thing that has contributed to the severity of your infection. Is this the same endodontist that did both root canals on 14 and 15? Did he also do the root canals on the other two upper teeth that resulted in a sinus infection? How long ago was the problem with the other side and what transpired during that situation? Was that sinus infection ever completely resolved?

By any chance has this endodontist and the oral surgeon that he referred you to communicated with each other about your case?

I think it would be wise to insist and expect the oral surgeon, the endodontist and the ENT doctor to confer on your case. If they are reluctant to do that, then something is weird because these discussions are done routinely especially in cases such as yours. It would be difficult to try and find another oral surgeon, etc to take on your case at this stage because it's complicated and no one really wants to end up being wrongly blamed for what someone else did or didn't do. So you have to try to get these guys to collaborate with each other.

I know you are suffering with this infection and I know the stress of all of this is becoming unbearable. However, before you jump out the window, you have to be truthfully informed of the status of the situation. Are there retained roots of #14 and/or #15, is so why and where are they?.... Is there still an apical lesion in the sinus from prior to the extraction of #14, if so why wasn't it removed?.... Is the bone graft causing further problems, if so should it be removed immediately and how involved will that be? These are the pertinent things you need to be informed about so that you know what is worrisome and what isn't. Those 3 doctors need to collaborate on your case, figure out what is going on and then truthfully inform you of whatever that is. Otherwise, you will keep stressing about possibilities and making assumptions that may or may not have any relevance.

I really cannot stress enough that before you try to get other dentists involved, those 3 practitioners need to collaborate. In most cases, it is the oral surgeon who ends up being the one who presents the outcome of that collaboration and treatment options to you.

Bryanna

Originally Posted by Angels31

Hi Bryanna,
I had similar problems in 2010 and this endodontist did that root canal on #14. I had 5 good years until I had another bout with bronchitis and a sinus infection. That is just how it started in 2010. I am guessing that all of this started in #15 because when the oral surgeon took that one out he said that it was a very bad and old infection that apparently had gone way up. He said that was from a bad root canal where the roots were severed, infected and in my sinus. This endodontist did not do that root canal. In fact, it was a fancy dentist in the wealthy part of town who did it. He was all about the money. I also remember being in a lot of pain after that procedure. It was in the early 2000's. So tomorrow I will talk to the endodontist and hopefully the ENT will call me back. The oral surgeon is out of town. I do feel like nobody cares and they just write me off. This is my life and it has been ruined. I can't go to work until this is better, I am a flight attendant and can't fly like this. I very much feel like I still have infection in that area. I am normally a healthy person and there is no other reason why I can't get rid of this.
Thank you for helping me, I so appreciate it.

Originally Posted by Bryanna

Angels,

The infection is the result of both root canaled teeth. One tooth could easily have infected the other and the infection continued to spread from there.

Endodontists are the highest earning dentists on the planet. In the dental profession, they are regarded as the money makers for not just themselves but for the profession as their endodontic treatments provide additional and expensive work for the referring dentists. Especially when you consider that a tooth can be root canaled and re crowned numerous times before it is finally extracted. For this reason, many dentists are reluctant about speaking up about the systemic health risks associated with dead infected teeth. It would be like shooting themselves in the foot.

I hope you can get these doctors on board to figure out exactly what is keeping the infection active and be given options how to take care of it once and for all.

Bryanna

Originally Posted by Angels31

Me too! Just one more question. I have had these bone grafts in since October and November. How hard would it be to take them out?

Originally Posted by Bryanna

Angels,

Generally in that time frame, 3-4 months, some integration has taken place but it really depends on the infection. If the grafts are just swimming in mushy infection, then they can be scraped out along with the infection. If the grafts have moved or migrated due to the infection, then a more exploratory surgery is needed to remove as much as possible.

Any oral surgery that you have from this point on in that quadrant of your mouth has got to be done under very sterile conditions and by a highly skilled oral surgeon. However, before any surgery takes place, the sinus involvement needs to be determined first.

Bryanna

Originally Posted by Bryanna

Angels,

Ironically, the endodontist is a strong promoter of root canal therapy which is the very thing that has contributed to the severity of your infection. Is this the same endodontist that did both root canals on 14 and 15? Did he also do the root canals on the other two upper teeth that resulted in a sinus infection? How long ago was the problem with the other side and what transpired during that situation? Was that sinus infection ever completely resolved?

By any chance has this endodontist and the oral surgeon that he referred you to communicated with each other about your case?

I think it would be wise to insist and expect the oral surgeon, the endodontist and the ENT doctor to confer on your case. If they are reluctant to do that, then something is weird because these discussions are done routinely especially in cases such as yours. It would be difficult to try and find another oral surgeon, etc to take on your case at this stage because it's complicated and no one really wants to end up being wrongly blamed for what someone else did or didn't do. So you have to try to get these guys to collaborate with each other.

I know you are suffering with this infection and I know the stress of all of this is becoming unbearable. However, before you jump out the window, you have to be truthfully informed of the status of the situation. Are there retained roots of #14 and/or #15, is so why and where are they?.... Is there still an apical lesion in the sinus from prior to the extraction of #14, if so why wasn't it removed?.... Is the bone graft causing further problems, if so should it be removed immediately and how involved will that be? These are the pertinent things you need to be informed about so that you know what is worrisome and what isn't. Those 3 doctors need to collaborate on your case, figure out what is going on and then truthfully inform you of whatever that is. Otherwise, you will keep stressing about possibilities and making assumptions that may or may not have any relevance.

I really cannot stress enough that before you try to get other dentists involved, those 3 practitioners need to collaborate. In most cases, it is the oral surgeon who ends up being the one who presents the outcome of that collaboration and treatment options to you.

Bryanna

Originally Posted by Angels31

I took the CD to the Endodontist and he told me that sometimes a new bone graft can look like roots. The ENT still won't call me back. Something is very wrong and nobody cares. I really don't know where to turn next. This is devastating me both emotionally and financially. It has ruined my life and I am ready to just give up.

Originally Posted by Bryanna

Angels,

I am not surprised by what you were told by the Endodontist. He may be "nice" to you and compassionate towards you, but he is very mindful not to risk throwing any of his colleagues under the bus. I know that sounds really terrible but unfortunately it is how things are done.

The endodontist should be able to distinguish the radio graphic difference between retained roots of the tooth and bone graft material. What was his interpretation of the written radiology report? Does he acknowledge the severity of your infection? What did he suggest that you do?

Your ENT doctor is not going to be comfortable dealing with the problem (solely) if he feels it is related to the oral surgery. Again, he is also going to be mindful not to throw anyone under the bus.

This is why they all need to collaborate so that no one is apt to (accidentally) step on anyone elses toes. Have you asked them to collaborate?

Bryanna

Originally Posted by Angels31

The Endodontist told me that I can come in for an X-ray and he will be able to tell from that. He said the pictures are not real clear. I have a copy of them if you want to see them. I am thinking that maybe I should go back to the lab and get a new 3d x ray of those two teeth and then I will have a copy on my own and can bring it to another oral surgeon who isn't worried about throwing anyone under the bus. I don't think anyone realizes how bad the infection really is. At least what I am feeling in my head. I just spent 28 days on Levaquin and today was the last day, I don't feel like the infection is completely gone and I really hope it doesn't get bad again. The ENT still won't call me back so I can't even discuss this with him. I am feeling very lost and unimportant right now. I am in a severe depression which is not my personality at all.

UPDATE since I wrote this earlier
The Endodontist called me and told me that he called the oral surgeons office this morning and got the X-ray that he took on Christmas Eve and also the 3D panoramic image from right after he removed the last tooth. He said there is absolutely not a root there and everything looks great. He could see no infection. I am baffled. I really don't know where to turn next. I think it would be better if they just found something. The not knowing is what is killing me. Do you think it is just healing and going to take a very long time?

Originally Posted by Bryanna

Angels,

What is their, endodontist and os, interpretation of the written radiology report?

A 2 dimensional dental xray taken by the endodontist will only show a 2 dimensional view. That is why you had the 3 D done in the first place. Who did the 3D scan.... the oral surgeon? If it is blurry, as the endodontist told you it was, then they need to do it again and do it right this time.

In order for you to proceed with a new oral surgeon you will need to have all of your radiographs and scans both pre and post op the removal of these teeth. You will also need to have copies of all of the chart and surgical notes. Anyone taking on your case will need to see that history of this quadrant of your mouth in order to proceed properly. I think you may have to that if you feel that you are not getting better. You cannot keep going on antibiotics as that puts your systemic health in jeopardy.

Bryanna