Angels,

Then perhaps you should have asked the ENT for a different referral? Which you still can do. You need to understand the reluctance of a doctor who is not real thrilled about running repetitive scans on you especially if he knows the problem is evident on what he has already taken.

So another antibiotic with no diagnosis. This is unfortunately mainstream medicine, irrelevant of the reputation of the hospital, which is about as helpful as a brick when it comes to dental problems.

The CT scans that you have had done, were they 2D or 3D scans? It is imperative to have a 3D scan because it much more diagnostic than a 2D. Before you go and have another one or another MRI, check to see specifically which type of scan they were. If they were 3D scans, then you have had enough scans to diagnose the problem and I would urge you to NOT keep getting them. Radiation exposure to your head, especially in a short amount of time, is a very serious and can be an irreversible health hazard.

An oral surgeon can remove the implant and remove as much bone grafting as possible. This surgery may involve the sinus. Sometimes the oral surgeon performs the implant and graft removal and the ENT performs the sinus surgery. This is often done simultaneously. It is important to NOT assume that the oral problem is not connected to a sinus issue. The connection needs to be ruled out with positivity prior to removing the implant if at all possible. This is where the 3D scan comes into play at it will show all of those anatomical areas in multi dimensions.

If you contact the attorney that Cleo provided, do not assume you are filing a law suit. I think it would be worth the consult to see how this guy could help you get beyond where you are at now.

Bryanna

Hi Bryanna,
Is the panoramic xray a 3D xray? They have done so many scans and can't find anything. This is definitely tied to the left side of my face and I KNOW it is from my teeth, I can feel it. The whole time I have had a bitter taste coming from that area and they are saying there is no way it is coming from there because it is all healed. I do feel a little better today as I don't have the fever anymore. I do think that shot helped a little. But I have drainage and sticky mucus all on the left side. It is making me cough. My left ear is ringing constantly. The ct scan is what the ENT was looking at and he said that it looked like there are roots in my sinus but when I told him that I had a bone graft he said it was the grafting material then. The oral surgeon is adamate that nothing looks wrong. I do need to call and let him know what is going on. I felt like I had an infection since I had the implant put in. When I had the Last MRI it caught the infection in tooth number 15 when the CT scans were not. The last maxofacial MRI scan I had was before #15 was removed. That is where I feel the problem is. The MRI is safe, or at least safer than a ct. I hate doing them but it will be worth it if something shows up.
I feel like people are probably reading this and saying maybe this lady is a nut! But this is real and I think I am a normal person! (I guess ask my husband! Lol) I can take a lot of pain. But this is ridiculous after a year and 7 months. Someone needs to figure it out. Nobody should have to live like this. One of the best days of my life will be when someone figures it out. I keep hoping.

Angels,

The panoramic is 2D, 2 dimensional radio-graph. It does not show the detail like a 3D, 3-dimensional CT image. The alveolar ridge (bone that contains the root sockets) and the sinus area can be a bit skewed depending on the density of the patients bone and the position of the patients head when the xray was taken. Was your oral surgeon relying on panoramic xrays for the diagnosis?

How many actual THREE D CAT SCANS have you had? How many PANORAMIC xrays have you had and how many MRI's have you had?

Your ongoing symptoms indicate something is wrong ... and there is no reason for anyone to think you are making it up. Also, let me reiterate that your complications are NOT unusual for someone who had upper root canaled teeth removed and had a history of infection and sinus problems. Those teeth were causing havoc to occur in that bone and in the sinus for God knows how long before you actually had developed obvious symptoms or before the problems were diagnosed.

The findings on the CT by the ENT dr need to be further evaluated. Bone graft material should not resemble root tips unless the periodontal ligaments were not removed when the teeth were extracted. If the ligaments were not removed, then the ligaments would hold the graft material as if it was sitting in a cup and the cup would be in the shape of the root tips. This is not ideal because the ligaments are now dead tissue which could easily be harboring infectious bacteria. It is imperative to remove the periodontal ligaments in their entirety after the teeth are extracted to minimize post operative complications such as chronic infection and spread of infection.

Periodontal ligaments are live fibrous tissue that serve a few purposes but they are mainly there to protect each tooth and act like a rubber band around the circumference of the roots of each tooth to give it some flexibility. These ligaments also help supply the tooth with nutrition via the blood vessels. Once a tooth is extracted, the ligament looses all vitality and is nothing more than necrotic tissue that no longer serves any beneficial purpose.

The periodontal ligament can be compared to the after birth (placenta) in a pregnant woman. The placenta serves to protect and nourish the baby. Once the baby is born, the placenta serves no beneficial purpose and needs to come out or complications will occur.

All dentists are taught the importance of removing the periodontal ligaments at the time of a tooth extraction. They all know what can happen if the ligament is not removed. However, some dentists are either sloppy in the removal or they just don't bother removing it. Some dentists think the body will just miraculously absorb the ligament, which does not happen. Imagine an obstetrician being sloppy about removing a placenta or just leaving it in the women's uterus?!! As a noteworthy side ... when complications occur due to not removing the periodontal ligaments, those dentists who leave the ligament usually don't like to admit that they did that because it's a red flag that the job was incomplete. To make matters worse, their peers are reluctant to mention the ligament issue to the patient because they don't want to step on anyone's toes, they don't want the patient to go back to the dentist and be told something to the contrary or they just believe that that information should come from the dentist who did the surgery. When an ENT and an oral surgeon or 2 oral surgeons collaborate on a case, this is one of the issues they discuss without the patient being present.

The antibiotic injection that you had has likely reduced the inflammation and brought down the fever. This is not a cure, but it is a temporary relief... thank goodness for that!

Please consider what your next moves should be before you start making phone calls. Yes, you need to inform the oral surgeon who did the implants of the problems you are having so he notes them in your chart. If you don't inform him, he can say (at a later date) that you were content with the implant surgery because you didn't report having any further problems. However, I would hesitate to let him do anything further. I would not make light of what has been transpiring. When we feel relief, we tend to minimize what we've been through. Also let him know that you are deeply concerned about the ongoing symptoms and upset that you had to have more antibiotics. Let him know how you feel about this medication being a band ade and the actual cure for whatever is causing the symptoms.

You have to be careful how you present your words and emotions when you speak to any professional involved in this case. The last thing you want to be accused of is being overly dramatic or needy yet you seem content with the treatment that has been rendered to you. Do you understand what I mean by that?

Bryanna




Bryanna

Bryanna, Stop with the constant BS every time i post something here... which isn't often. You are not the one that feels like they are dying here with very little time left before the statue of limitations runs out.... Not that i have a crystal ball predicting negligence. FYI- I didn't show up at the OS with any of my prior records. You may or may not recall, I had my lingual nerve disected out of scar tissue.

Angel, Yes he can refer you to places where you might get this figured out and it may be nothing more than time will tell. I wish you better luck than you've encountered so far!

Cleo,

I do not give you BS when you post here. I will frequently ask you to clarify your short blanket statements. I truly believe you have the best of intentions but some clarification of your knowledge can really go a long way.

I also ask that you please think twice before you lash out at me again. I really feel it was not warranted at all.

Bryanna

Oh no! I don't want this to turn into a negative thing. I so appreciate everyone trying to help me.
Bryanna, the last statement of being overly dramatic or needy, what do you mean by that?

Angels,

I know you are very appreciative of the help that you get here. Asking to clarify something should be a part of the communication that is shared here .... just as you are asking me to do now.

To answer your question Angels ...

Patients, both medical and dental, are typically profiled (for lack of a better word). It's not done to discriminate against anyone. It's done because patients are often anxious (maybe even petrified or in pain) and sometimes not very forth coming or accurate with information or they are not acting rationally like they would under different circumstances. Some people are naturally combative or thrive on the negative which means anything you say or do to them, is going to come back to you conflicted in some way. Also, most lay people have little knowledge of what exactly has taken place in their mouth or they have been told only bits and pieces of what was done. It can get pretty sticky ...

As a professional we need to be able to keep the important stuff at the forefront and not get too caught up in the other. When a patient is unhappy with their dentist or they are unsure of the work their dentist has provided, but they keep going back to that dentist... it makes the other dentists/doctors who were consulted wonder... why does that person keep going back there? That patient may be doing that because they feel loyal to that dentist, they may be concerned about the $$$ they laid out, they could feel confused or may feel lost as to where else to go since at least some or maybe all of the work has been done. It makes it sticky for anyone else to get involved because they do not want to make matters worse for that patient, their peers or themselves. Also, not all practitioners are going to take the time to take all of those possibilities into consideration. Instead they might interpret their initial impression of the person as overly dramatic, unsure, very needy .... etc. Did I explain that okay??

A basic example for you would be a passenger on one of your fights who is acting overly needy, dramatic or aggressive. Who knows why they are acting that way but instinctively you will know to handle that person differently because you can't get caught up in their issues, you have to get through the flight and there are also others that you have to think about.

When you speak to your ENT or others you have already consulted as well as any new practitioners you consult (including an attorney), it would always behoove you to be well prepared with your history of what has taken place and why you have concerns that something is not healing well. If your demeanor or words come across as being overly sensitive/needy, aggressive, vengeful, angry, neglected or anything other than deeply concerned about your ongoing symptoms of which you are very unsure of where to go from here for help ... you will be perceived very differently and in a more positive light. Did I explain that okay?

Bryanna