[Pravs]

Hi,
Last month I had severe pain on my upper left molar and I suspected that my tooth with a 1 year old RCT was the culprit. I went to a dentist and my fears were true. The infections was there in XRays, below the roots. He recommended doing a root canal again and sent me to an endodontist. The endodontist recommended the same thing and fixed an appointment. But then, I stumbled on this website and read Bryanna's views about RCT. I was thinking that how the re-RCT will correct an infection which is not even on the roots. I looked for a holistic dentist. She got a 3D xray and showed that there was no bone left around the roots. So a extraction was preferred. My tooth was sensitive to cold and hot fluids(strange that one is not supposed to feel anything on the tooth after RCT).

Anyways, 3 days back I got the extraction and bone graft done. She didn't prescribe any antibiotics as she said that infection was scraped out. She prescribed painkiller, only if needed, and a gel(sockit). I am using the gel regularly but I am still feeling the heat and cold the same way I used to feel earlier. Apart from that, I don't feel much pain throughout the day. Couple of advils work fine along with Vicodine at night.
Only issue for me is the sensitivity and occasional headache on same side as the molar. Is this normal after a extraction/bone graft? I am seeing the dentist again on Wednesday for removing the sutures from membrane she used. Shall I ask her something else?

Thanks
Pravs

[Bryanna]

Hi Pravs,

I am going to re post some of your post and reply in bold type. This makes it easier to follow.

<<The infections was there in XRays, below the roots. He recommended doing a root canal again and sent me to an endodontist. The endodontist recommended the same thing and fixed an appointment. But then, I stumbled on this website and read Bryanna's views about RCT. I was thinking that how the re-RCT will correct an infection which is not even on the roots.>>

THE PATHOLOGY (INFECTION) THAT WAS SEEN ON THE DENTAL XRAYS GIVES THE IMPRESSION THAT THE INFECTION IS "ON THE ROOTS" BECAUSE:

#1) THOSE XRAYS ARE ONLY A 2 DIMENSIONAL PICTURE WHICH GIVES A LIMITED VIEW OF THE EXTENT AND AREA OF THE INFECTION.

#2) THE INFECTION BEING NOTED AS "ON THE ROOTS" ARE ACTUAL PERIAPICAL CYSTS. THESE ARE FLUID FILLED BALLOON LIKE SACS OF INFECTION THAT ARE ATTACHED TO THE TOOTH AND TO THE JAW BONE. THEY COMMONLY OCCUR WITH ROOT CANALED TEETH AS THE INFECTIOUS BACTERIA FROM INSIDE THE TOOTH SPREADS BEYOND THE TOOTH.

AS YOU STATED, THE 3D SCAN SHOWED THAT THE INFECTION WAS NOT JUST "ON THE ROOTS", AS THE FIRST DENTIST AND ENDODONTIST HAD TOLD YOU. BUT RATHER THAT THE INFECTION HAD CAUSED THE BONE TO DETERIORATE AROUND THE ROOT STRUCTURE OF THE TOOTH. THIS FINDING INDICATES THAT THE TOOTH HAS BEEN INFECTED FOR QUITE SOME TIME. NOT EVERYONE HAS OBVIOUS SYMPTOMS AS THIS IS OCCURRING. DID YOU HAVE SYMPTOMS OF THIS INFECTION PRIOR TO JUST RECENTLY?

<<My tooth was sensitive to cold and hot fluids(strange that one is not supposed to feel anything on the tooth after RCT).>>

IT IS NOT UNCOMMON FOR ROOT CANALED TEETH (OR AREAS AROUND RC TEETH) TO BE TEMPERATURE SENSITIVE, FEEL ACHY, POSSIBLY A BIT LOOSE, HAVE GUM INFLAMMATION, PRODUCE PUS, CAUSE A BAD ODOR OR GUM SORENESS. THESE SYMPTOMS CAN BE CHRONIC OR OCCUR INTERMITTENTLY. CONVENTIONAL DENTISTRY CONSIDERS THESE SYMPTOMS WITH RC TEETH TO BE "NORMAL" SIMPLY BECAUSE THEY ARE "TYPICAL" AND "EXPECTED" TO OCCUR DUE TO THE CHRONIC INFECTION INSIDE OF THE TOOTH.

<<Anyways, 3 days back I got the extraction and bone graft done. She didn't prescribe any antibiotics as she said that infection was scraped out.>>

ANTIBIOTICS ARE NOT ALWAYS NEEDED AFTER A TOOTH EXTRACTION. GLAD TO HEAR THAT SHE SCRAPED THE SURGICAL SITE CLEAN OF VISIBLE INFECTION.

<<She prescribed painkiller, only if needed, and a gel(sockit). I am using the gel regularly but I am still feeling the heat and cold the same way I used to feel earlier. Apart from that, I don't feel much pain throughout the day. Couple of advils work fine along with Vicodine at night.>>

OKAY. HOW OFTEN ARE YOU USING THE SOCKIT? IT IS MEANT TO BE USED TO RELIEVE PAIN, UP TO 4-6 TIMES A DAY FOR ABOUT THE FIRST 2-3 DAYS. YOU CAN APPLY IT LONGER THAN THAT BUT GENERALLY IT'S NOT NECESSARY. HOWEVER, YOU DETERMINE IF YOU NEED TO CONTINUE WITH IT BASED ON WHETHER OR NOT YOU STILL HAVE PAIN.

THE TEMPERATURE SENSITIVITY CAN BE DUE TO THE RECENT SURGERY.. IT CAN ALSO BE DUE TO GUM RECESSION ON ONE OR BOTH ADJACENT TEETH. WHAT IS THE HEALTH OF THE ADJACENT TEETH? DO THEY HAVE CAVITIES? DO YOU HAVE OTHER RC TEETH IN THAT QUADRANT? DO YOU HAVE GINGIVITIS (BLEEDING AND/OR PUFFY GUMS) OR PERIODONTAL DISEASE? ARE YOU ABLE TO BRUSH AND FLOSS ALL OF YOUR TEETH EVERY DAY?

<<Only issue for me is the sensitivity and occasional headache on same side as the molar. Is this normal after a extraction/bone graft?>>

SENSITIVITY AS I MENTIONED ABOVE CAN OCCUR FOR THOSE REASONS. SO YES, IT CAN BE NORMAL IF IN THAT QUADRANT YOU DO NOT HAVE GUM RECESSION, CAVITIES. OTHER RC OR INFECTED TEETH, OR GUM DISEASE.

<<I am seeing the dentist again on Wednesday for removing the sutures from membrane she used. Shall I ask her something else?>>

OKAY. TELL HER ABOUT THE TEMPERATURE SENSITIVITY AND TRY TO BE SPECIFIC AS TO WHEN AND WHERE YOU FEEL IT. ASK HER TO EVALUATE THE HEALTH OF YOUR OTHER TEETH AND GUMS AND GIVE YOU HER FINDINGS IF ANY. ALSO ASK HER TO CHECK FOR GUM RECESSION ON THE ADJACENT TEETH TO THIS EXTRACTION SITE.

Thank you for reading the information on this forum, glad it was so helpful to you. Also, thank you for sharing your dental experience with us as it may be of help to other reading here. Please check back and let us know how you are doing.

Bryanna

[Pravs]

Hi Bryanna,
Thanks for your advice and apologies for being late on posting this.
My appointment needed to be postponed multiple times due to the holiday season.
I had been to my dentist last week for regular checkup as well as full dental checkup.
Regular checkup turned up fine with the bone graft holding up well but it was the full dental checkup which had some bad revealations in store.
Overall there were following issues:
1. Some of my gum area has receded in lower jaw indicating Periodontal issues. Dentist has suggested Periodontal scaling and root planing(scheduled next Thursday). She also recommended laser bacterial decontamination after that. I am not sure if the laser part is helpful. Will you be able to advise?

2. I have 3 wisdom teeth which the dentist has asked to remove. Due to the cases I hear about sinus or eyesight issues after teeth removal, I am trying to avoid it. One of the wisdom tooth has some calcium deposit and other issues. So probably that will need to go.

3. I mentioned in the last post about the sensitivity. As you suggested, it was due to the neighboring teeth roots getting exposed. But the dentist also found some big cavities there and she is suggesting onlay's on the affected tooth(3 surface onlay with resin based restoration). As it is costly(around 800 bucks) and my insurance is not so keen on compensating it, I may decide to go for crown.

Thanks
Pravs

[Bryanna]

Hi Pravs,

Thank you for sharing the additional information. I will re post your questions and reply to them in bold type

<<1. Some of my gum area has receded in lower jaw indicating Periodontal issues. Dentist has suggested Periodontal scaling and root planing(scheduled next Thursday). She also recommended laser bacterial decontamination after that. I am not sure if the laser part is helpful. Will you be able to advise?>>

PERIODONTAL DISEASE IS AN INCURABLE INFLAMMATORY AND BACTERIAL INFECTION THAT IS USUALLY FOUND BELOW THE GUM LINE OF THE TEETH. IT AFFECTS THE TEETH, THE BONE AND THE GUM TISSUE. IT IS ALSO A SYSTEMIC INFECTION, MEANING THE BACTERIA AND INFLAMMATORY CELLS TRAVEL THROUGH THE BLOOD STREAM.

REGARDING THE ORAL INFECTION, SCRAPING AND ROOT PLANING THE TEETH BELOW THE GUM LINE IS HELPFUL IN REMOVING THE HARD CALCIUM DEPOSITS THAT FORM ON THE ROOTS OF THE TEETH CONTRIBUTING TO THE DISEASE. THE LASER USED AFTER THE ROOT PLANING IS EFFECTIVE AT KILLING INFECTIOUS BACTERIA WITHOUT HARMING THE BENEFICIAL BACTERIA. IT ACTUALLY STIMULATES YOUR IMMUNE SYSTEM TO SEND HEALTHY HEALING CELLS TO THE AFFECTED AREAS.

PERIODONTAL DISEASE IS NOT CURABLE BUT IT IS MANAGEABLE AND CAN BE BROUGHT UNDER CONTROL.

IT IS IMPORTANT TO KNOW THAT NONE OF THAT DENTAL TREATMENT WILL HAVE A POSITIVE LONG TERM AFFECT UNLESS YOU DO YOUR PART TO KEEP THE BACTERIA LEVEL UNDER CONTROL. THAT IS SIMPLY DONE BY THOROUGH TOOTH BRUSHING (AN ELECTRIC TOOTH BRUSH IS IDEAL), THOROUGH FLOSSING AND GENTLY SCRAPING THE TONGUE OF DEBRIS EVERY SINGLE DAY WITHOUT FAIL. YOU MAY ALSO HAVE TO USE SOME DENTAL PROXI BRUSHES TO CLEAN IN BETWEEN THE TEETH IN ADDITION TO THE OTHER ORAL CARE. IF YOU DO NOT ADHERE TO A STRICT ORAL CARE REGIMEN, THE INFECTIOUS BACTERIA WILL BUILD UP AGAIN VERY QUICKLY AND THE PROBLEM USUALLY COMES BACK MORE SEVERE AND TENACIOUS.

THERE ARE SOME HERBAL HOME REMEDIES THAT ARE HELPFUL AT LOWERING THE INFECTIOUS BACTERIA AFTER THE SCALING AND ROOT PLANING THAT CAN BE INCORPORATED WITH YOUR DAILY ORAL CARE. I CAN GIVE YOU SOME SUGGESTIONS ABOUT THAT IF YOU ARE INTERESTED.

<<2. I have 3 wisdom teeth which the dentist has asked to remove. Due to the cases I hear about sinus or eyesight issues after teeth removal, I am trying to avoid it. One of the wisdom tooth has some calcium deposit and other issues. So probably that will need to go.>>

MOST WISDOM TEETH EXTRACTIONS HAVE NO LONG TERM POST OP COMPLICATIONS. EVERY CASE IS A BIT DIFFERENT AND EVERY SURGEON IS DIFFERENT. SO YOUR PARTICULAR CASE, YOUR OVERALL HEALTH, YOUR PERSONAL POST OP CARE AND THE SKILL OF THE ORAL SURGEON WILL DETERMINE THE POST OP OUTCOME. I WOULD RECOMMEND THAT YOU ONLY SEE AN ORAL SURGEON FOR THE REMOVAL OF THE WISDOM TEETH UNLESS YOUR DENTIST HAS EXTENSIVE AND DAILY EXPERIENCE IN EXTRACTING THEM.

THE CALCIUM DEPOSIT IS WHAT I REFERRED TO ABOUT THE PERIODONTAL DISEASE. YOU MOST LIKELY ALSO HAVE THIS IN OTHER AREAS AS WELL.

WISDOM TEETH THAT ARE DISEASED FROM INFECTION OR DECAY... HAVE CYSTIC ACTIVITY ..... ARE CAUSING PROBLEMS WITH THE ADJACENT TEETH ... OR ARE IMPOSSIBLE TO CLEAN ..... ARE THE ONES THAT MOST OFTEN NEED TO BE REMOVED.

IT IS IMPORTANT TO DISCUSS THE LOCATION OF THE WISDOM TEETH WITH THE ORAL SURGEON REGARDING THEIR PROXIMITY TO THE SINUS (UPPER ONES) AND THE PROXIMITY OF THE LOWER ONE TO THE MANDIBULAR CANAL. THIS WAY YOU WILL BE WELL INFORMED OF POSSIBLE POST OP COMPLICATIONS WITH THE SINUS OR THE MANDIBULAR CANAL. NEITHER OF WHICH DEFINITIVELY MEANS THE COMPLICATIONS WILL BE PERMANENT.

<<3. I mentioned in the last post about the sensitivity. As you suggested, it was due to the neighboring teeth roots getting exposed. But the dentist also found some big cavities there and she is suggesting onlay's on the affected tooth(3 surface onlay with resin based restoration). As it is costly(around 800 bucks) and my insurance is not so keen on compensating it, I may decide to go for crown.>>

IT SOUNDS LIKE SHE IS TRYING TO BE CONSERVATIVE WITH HER RESTORATIONS ON THOSE TEETH. THERE COULD BE A FEW REASONS FOR THIS. SHE MAY NOT FEEL THE TEETH WARRANT A FULL COVERAGE CROWN... THE TEETH MAY BE IN A GUARDED CONDITION WITH A LIMITED LONGEVITY EVEN POST OP THE PERIO TREATMENT ..... PREPARING THE TEETH FOR FULL COVERAGE CROWNS MEANS REDUCING THE TOOTH STRUCTURE SIGNIFICANTLY WHICH COULD RESULT IN NERVE DAMAGE OF THE TOOTH ESPECIALLY ON TEETH THAT ARE ALREADY COMPROMISED ..... ETC. SO ASK HER WHY SHE TREATMENT PLANNED THE WAY SHE DID.

YOUR INSURANCE WILL ALLOW A PERCENTAGE TOWARDS THE RESTORATIONS. BE MINDFUL OF THE FACT THAT IT MAY NOT BEHOOVE YOU TO HAVE MORE AGGRESSIVE DENTISTRY JUST BECAUSE THE INSURANCE MAY PAY A BIT MORE FOR IT. ALSO, YOU MOST LIKELY HAVE A MANDATED YEARLY MAXIMUM OF INSURANCE BENEFITS WHICH YOU WILL UTILIZE VERY QUICKLY WITH YOUR DENTAL TREATMENT.

Hope this info is helpful...
Bryanna

[Pravs]

Thanks Bryanna,
The information shared by you was really helpful. I am done with my root scaling and my gums feel better now. Sensitivity on teeth has also decreased. To improve my overall oral hygiene, I have also started with oil pulling after reading some articles about it.

From last couple of days I am facing another issue. On the side where bone grafting was done, I am feeling some pain. There is also some swelling on that side today. At first I was thinking that it is some sinus issue and was planning to visit ENT specialist but I thought to check with you if it can be related with the bone graft. My bone graft is around 6 weeks old now and a checkup 2 weeks back didn't show any issues.
Please advise.

Pravs

[Pravs]

Hi Bryanna,

I missed to ask about the herbal medicines you mentioned.
I will definitely like to have some suggestions about it. About the pain and swelling issue, I just spoke to my doctor. She asked if I had fever or allergy issue. I don't have any, apart from the pain and swelling. She will take a look in couple of days.

Pravs

[Pravs]

Further updates:
I went to the dentist yesterday about the swelling and pain on the same side as bone graft. Nothing came up on normal X-rays. Cone beam scan showed little infection on the tooth next to the area with bone graft. But the Cone beam scan also showed unhealthy sinus. So now, she has referred me to an ENT and another dentist for root canal on the tooth.
Please advise if root canal is the right way as the infection is very little or I can ignore it and later get it extracted.(By the way, this tooth with minor infection is the same one where dentist had earlier suggested onlay).

Thanks
Pravs

[Bryanna]

Pravs,

The adjacent tooth with "the little infection" is just as much a part of the infection issue as the tooth you just had extracted. One tooth infected the other and so on. The infection in this tooth can be infecting the graft. So it was not real wise for the dentist to put the bone graft in the bone next to an infected tooth. The findings on the CT pertaining to the sinus are more than likely directly correlated with the infected teeth.

It makes no sense to extract one infected tooth and leave the other infected one in there .... place a bone graft in infected bone... and then send you to the ENT due to the sinus infection from the dental infection. Can you see the pattern and history of the infection and the reason why it is still brewing?

The ENT cannot do anything for you and antibiotics will be useless as long as the infected tooth is present as that is a major contributing factor to the sinus problems. Extracting this other infected tooth will most likely result in removal of the graft placed in the adjacent area. Please consult with a new oral surgeon as the dentist who has treated you may not be ideal for your situation. You would need all of your xrays and scans to consult with a new oral surgeon.

Bryanna

Originally Posted by Pravs

Further updates:
I went to the dentist yesterday about the swelling and pain on the same side as bone graft. Nothing came up on normal X-rays. Cone beam scan showed little infection on the tooth next to the area with bone graft. But the Cone beam scan also showed unhealthy sinus. So now, she has referred me to an ENT and another dentist for root canal on the tooth.
Please advise if root canal is the right way as the infection is very little or I can ignore it and later get it extracted.(By the way, this tooth with minor infection is the same one where dentist had earlier suggested onlay).

Thanks
Pravs