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Old 08-12-2017, 11:43 PM #11
Cleo Cleo is offline
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I don't believe that's amaglam. You need records including xray from endo 2 years ago to confirm that one. I would ask OS for more than just what you paid out of pocket! I would also consider getting reimbursed for money spent on neurolgist and drugs. Including any future expense as this may be for life type pain condition!
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Old 08-13-2017, 08:44 AM #12
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Bryanna,

I cannot thank you enough for your thorough explanation regarding my issues with the upper left quadrant of my mouth I don't know anywhere else I would have been provided with such an honest and expert explanation with the issues I am facing.
It is depressing for me to hear what you have to say, but I also believe it to be totally accurate and straight to the point which is what I want.

Thank you again, and I will keep you updated on the outcome.

Jamm
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Old 08-13-2017, 10:16 PM #13
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Cleo,

The shiny irregularly shaped blob on Jamm's that is clearly visible in the extraction site on the radio graph is without question mercury from a retograde amalgam filling that was placed in the jaw bone at the apex of the (now extracted) molar at the time of the apicoectomy. The other shiny "fragments" are pieces of mercury that have broken off and traveled to other areas and become embedded in the soft tissue.

I do not believe it would behoove Jamm to seek a monetary reward or reimbursement for neuro consults or meds from OS #1 at this time. Her first priority should be to get in to see another oral surgeon to perform a proper and thorough debridement of the extraction site and clean out the sinus if needed. She needs to keep impeccable records of everything, only seek reimbursement from OS #1 for the second surgery done by OS #2 and keep it strictly to that without mention anything to OS #1 about further action OR closing this case, and then see how things heal over the next few months.

Here's the problem with accusing OS #1 of wrong doing, other than his less than optimal oral surgery to extract the molar. Because the tooth was root canaled and had an apicoectomy, the tooth, jaw bone and sinus were already in trouble long before Jamm ever saw OS #1 for the extraction. So any temporary or permanent nerve or pain problems in that area could be directly due to the longevity of the ongoing infection of 20+ years in that molar AND from the root canaled pre molar.

Completely eradicating an infection of this type will be a difficult task even for an outstanding surgeon. Simply because bacteria hides in the nooks and crannies of the jaw bone and you cannot remove what you cannot see.

Also, if nerve damage did happen to occur after any of these follow up surgeries, it is not necessarily the fault of the oral surgeon performing those surgeries. Doing surgery in an area of the jaw bone that is already in a compromised state is risky due to the long term infection. What needs to be taken into account is that the various bundles of nerves associated with that quadrant of the mouth have been inflamed for 20 years making it basically impossible to determine the exact culprit(s) of nerve damage, if any should occur.

Bryanna




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I don't believe that's amaglam. You need records including xray from endo 2 years ago to confirm that one. I would ask OS for more than just what you paid out of pocket! I would also consider getting reimbursed for money spent on neurolgist and drugs. Including any future expense as this may be for life type pain condition!
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 08-13-2017, 10:17 PM #14
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Jamm,

Please consider getting Dr Kulacz book. It will help you to become better informed and help you to communicate better with oral surgeons.

Bryann


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Bryanna,

I cannot thank you enough for your thorough explanation regarding my issues with the upper left quadrant of my mouth I don't know anywhere else I would have been provided with such an honest and expert explanation with the issues I am facing.
It is depressing for me to hear what you have to say, but I also believe it to be totally accurate and straight to the point which is what I want.

Thank you again, and I will keep you updated on the outcome.

Jamm
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***I have been in the dental profession for 4 decades. I am an educator and Certified Dental Assistant extensively experienced in chair side assisting and dental radiography. The information that I provide here is my opinion based on my education and professional experience. It is not meant to be taken as medical advice.***
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Old 09-13-2021, 03:36 AM #15
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Hi Bryanna,

I was doing a search on healing after amalgam removal & this thread came up. Not sure if replies are monitored as this thread is from some years back tho I thought I would write.

I had a root canals in 1 molar, lower right. It got reinfected a few yrs later & infection appeared in molar next to it, which had a previous silver filling. I decided to have both teeth pulled in 2012 & 2014. First surgeon found infection in gum & bone & debrided with ozone. Iím not sure the 2nd surgeon in 2014 checked for osteomyelitis. I felt extremely ill on an off from 2015-2020. Finally, I found a naturopath who directed me to a holistic oral surgeon. He did a 3D cat scan saw 2 big pieces of silver amalgam in the gum above infected jaw bone, left by a previous surgeon for over 5 yrs! Gum had turned gray. He removed, debrided the bone & flushed the area & my body with ozone & vit c & packed the area with my prp. I also had all old amalgam fillings removed expertly & cleansed the body of heavy metals with colonics etc. 3 months later, April 2021, right side of my face swole up & I took clindamycin which worked. Repeat scan in May showed no infection in jaw bone & my health has been improving dramatically. Tho, I still have swelling in the debrided jaw area. Iíve been having acupuncture done regularly to lower the swelling. Ever since 2015, I sometimes feel a nerve pain up side of face like a towel is being wrung. It has lessened since the debridement in Jan 2021, but still present. Iím wondering if the body is still healing & it just takes more time, or do I need to re-address the swelling & nerve pain. Thank you very much for possibly reading & replying to my (long) post.


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Hi Jamm,

Thanks for the xray.

Here's what I see on the xray..

1) A root canaled pre molar with radio graphic pathology. Did that tooth have an apicoectomy? It looks like it may have due to the blunting of the root tip..... OR the gutta percha perforated the apex. Either way, there is a cyst at the apex.

2) There is a moderate size piece of mercury lodged in the extraction site. This was likely the mercury blob that was placed at the apex of that extracted molar when the apico was done. Ideally the oral surgeon should have removed that mercury when he extracted the tooth. Really there is no excuse for leaving it there.

3) There are other small fragments of mercury scattered about which would be difficult to remove as they become embedded in the tissue.

4) There is a moderate area above the mercury blob that is suspicious. May be an infection and that may be where the sinus is involved.

5) Not sure of the health of the last molar. That tooth needs another xray taken at a bisecting angle.

6) All of these problems are likely apparent on the 3D scan.

You have a long history of dental infection in that quadrant of your mouth because root canal therapy and apicoectomies do not cure an infected tooth. The dentin tubules will remain infected with trapped nerve tissue irrelevant of how perfect either of those procedures are done.

This is not going to settle down on it's own because .....

1) There is a blob of toxic mercury stuck in the surgical site that will prevent healing.
2) There is pathology and infection with the pre molar as well as in the surgical site of the extracted molar.

The oral surgeon should have informed you of the problems with the pre molar and he should have been MUCH more thorough with the extraction and debridement of the molar. The problems you have are not going to heal in time. They require intervention.

Medicating you to kill the pain, is only a band aid at the very least.
I am really sorry your dentist has not informed you of these things. Your choices are to go back to the oral surgeon that botched up the molar extraction or see a different one and explain you want a thorough debridement of the surgical socket.

I know this is depressing news...... but I hope it is helpful to you.

Bryanna
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Hi Jamm,

I understand that you paid privately.... I often suggest that people take that route because the care is often higher quality and more individualized. I still feel that is usually the best way to go over a dental school or insurance based practitioner.

However, in the case of your first oral surgeon..... to extract a tooth without an xray is a huge NO NO as you cannot possibly know what you are getting into without that xray. That is why the surgery was so quick because he did not debride the area... because he didn't know the full extent of what was there. Secondly, ALL tooth extractions REQUIRE a thorough surgical debridement, there are no exceptions to that rule. Unfortunately, this step is not routinely done as it is suppose to be. The granuloma he referred to was a clear indication that there was more happening in that site which needed further investigation (an xray) and debridement.

What the second oral surgeon is referring to as scar tissue is most likely infection and granulation tissue. Scar tissue does not have the exact appearance as infection, which is pretty obvious on your xray. He may be making that reference to avoid further questions from you about why the first OS didn't do a more thorough debridement.

The concern about having permanent damage is two fold:

1) Without question it is never healthy to have an infection in your jawbone and especially one that has traveled to the sinus cavity. In your case you have at least 4 issues that are contributing to the bacterial problem. One is the root canaled pre molar, the second is the dirty extraction site, the third is the toxic mercury sitting in the surgical site and the fourth is the sinus perforation which is not likely to heal unless the other issues are taken care of.

2) Permanent damage can occur from long term infection (ie root canaled teeth, non debrided extraction sites and chronic sinus involvement). It can also occur from deterioration of the jaw bone due to the proliferation of infectious bacteria. All of which can make the person very ill beyond the original source of the infection.

3) At some point this quadrant of your mouth.... the rc tooth/the infected extraction site/the blob of mercury/ the sinuses.... will have to be addressed. The more deterioration that occurs, the more prolific the infection will become and the more likely it will become a systemic health concern.

Based on all of those things going on and in addition to the length of time that there has been infection in that quadrant (20 years), if the surgery is done now there is a possibility of some damage occurring with the surgical intervention, but no one can tell you if it would be temporary or permanent.
There are also no guarantees that the surgical intervention would be able to cure the infection in it's entirety because the bacteria may be hidden and not yet visible clinically or radio graphically.

The options are....

1) Wait and let it proliferate and be medicated for the pain.
2) Do not wait. Debride and remove the visible sources of the infection and the mercury giving you a better chance of a healthier, more complete recovery.

I know people think they have to just trust their dentist to always do the right or best thing. However, as much as you have no choice but to trust the skills and knowledge of the dentist, it is imperative to remain your own advocate and use your voice to make your concerns and expectations clear.

Again, I hope this info is helpful to you.
Bryanna
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Old 09-13-2021, 09:19 AM #16
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Welcome Bhav.
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Old 09-13-2021, 10:55 AM #17
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Welcome, Bhav!

Dental procedures often do take a surprisingly long time to heal up completely. Gum tissue is tender, and sometimes it has had quite an assault on it from the procedure whether it's a root canal or an extraction or some other procedure, particularly involving anesthesia.

It's not usually the anesthesia that is the problem. But any procedure that requires anesthesia is going to be invasive, and that means a trauma to your mouth.

We have to respect that and treat our teeth and gums appropriately--and sometimes just allow time and more time to pass. If the trend is a very slow and gradual improvement, we're doing well. If signs of trouble appear--new swelling and pain or a discharge, for instance--we should get to the dentist soon. Preferably the same dentist who did the procedure unless you have reason to think that that dentist didn't do a competent job.
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