Bryanna how can i be sure dentist has removed perio ligament properly
 

Dear Bryanna

Hello again and hope you are well.

I just had a central upper incisor removed two days ago by a holistic dentist that I explained to remove all the perio ligament with the tooth. The dentist extracted the tooth slowly and with care to not damage the surrounding area and regarding the ligament gently touched the inside of the socket to feel for and remove any dead ligament attached hence it was not scraping at all and i could barely feel anything or scraping etc. My point is that I hope all the ligament has been removed in this way as i certainly don't want cavitations starting there, can you give me your feedback if this sounds like the perio has been removed OK or whats your thoughts?

Sincerely
Chris

Hi Chris,

Nice to see you.... hope you are well!

Based on your description the dentist performed what is referred to as Atraumatic or Nontraumatic oral surgery. This is when the dentist purposely uses a very gentle approach to remove the tooth so as to cause the least amount of trauma to the bone with the intention of preserving as much healthy bone as possible. In this type of surgery the debridement of the socket is usually gentle unless he finds diseased bone which would require a bit more scraping to remove.

Dentists usually have to seek education outside of their usual dental curriculum to learn this technique. Those who are taught and practice this form of oral surgery... are usually so gentle that their patient does not even realize how thorough the procedure really is. I worked with a Biological Dentist who performed Atraumatic oral surgery .... his work was remarkable!

With all of that said... I cannot completely assure you that the socket was thoroughly debrided. But my guess is that this is the type of surgery that he does and you will be fine. You can always ask him if this is what is does :)

Chris, was this dentist an oral surgeon or a general dentist? I have a few people who need a holistic minded gentle dentist.... could you tell us what state or country you live in??

Bryanna

Hi Bryanna,

I hope this is the case as to to how my dentist removed the tooth hence it was a dead tooth that was causing some trouble. From speaking with you before Byranna if you recall I had the other upper incisor tooth removed due to a bad dentist drilling my teeth away for the purpose of crowns hence it killed both teeth at the time hence the reason for this situation now. However as I was aware of your input previously advising that the perio ligament be removed I told my previous dentist to make sure and remove it and it felt like a much more through clean and scraping so I was questioning this as I was relating the two. The dentist I went to is in Ireland in a town called Bray and he seems like a dentist that thinks outside the box of which he does not do root canals etc which all dentists should not of course. The tooth was removed on Tuesday and its still sore with a bruised feeling around the socket and I sincerely hope the site heals properly with new bone regeneration as the whole ordeal has been quite troubling for me. I now have a TCS partial denture that is completely bio compatible to my knowledge and another point is that the dentist did say I have severe abnormal wear on my teeth which he has rarely saw so bad and he describes it as corrosion of the enamel hence there is none left, it could be acid reflux or whats your thoughts?

Hi Chris,

I do recall your dental situation but would have to look back and refresh my memory of it's entirety. Each dentist will have their own set of skills and some will be more gentle than others. Hopefully this is the case with the dentist who extracted this tooth.

I would expect the surgical area to be sore for several days. That is a very tender spot and you may have had more bone deterioration in that area than the other side. So that could account for the lengthy healing time.

Also be sure that the removable partial is not rubbing against that area. If it is, then go back and have it adjusted. Are you able to eat with the partial or do you take it out to eat? Are you wearing the partial at night when you sleep? Usually the patient is instructed to not wear it while sleeping after the first few days post op. What did your dentist recommend?

Regarding the enamel erosion on your teeth.... this is not good. This can be caused by digestive issues, medications, diet or a lifestyle habit. Do you have digestive issues? Do you take medications that dissolve in your mouth rather than swallow them? Do you suck on sugar candies or cough drops or mints? Do you drink things like gatorade, soda, lemonade...?

Bryanna

Thanks Bryanna for reply.

Regarding partial denture I am not wearing at all now as I want to allow for some healing time. Dentist said to try and wear it however its just more sensible to me for now to leave it out. Regarding erosion on teeth I have had digestive issues in the past including acid relux ie bad tastes in my mouth in morning and easy bleeding of gums with slightest suction. I did drink a lot of ornage juices and other drinks that had high sugar content though I have cut back on all that now hence my feeling is that it has to do with stomach/digestion etc which is concerning. Is there anything you could advise to help this possible reason s? And dentist actually used the term "abnormal" relating to the amount of wear on my teeth.

Hi Bryanna

I have just visited my dentist today as he completed some fillings. I had the upper right incisor tooth extracted 1 week ago today and there is now an infection around the gum and extraction area hence the dentist gave me details of another person to contact to make sure there is no cavitation hence I am scared now that there might be a cavitation infection but it is still early days in the healing process also, please advise?

Hi Chris,

Is the infection in the gum and/or in the bone? Did he take an x-ray of the area? Did he place a bone graft at the time of the extraction? Has he referred you to an oral surgeon?

Bryanna

The infection seems to be in the gum area right at the tip of my tooth socket which I have pain still from the injection needles hence he said yesterday that it appeared like it was only two days into healing when it was 6 and he said that he felt that it would clear up but may take up to 4-6 weeks just a bit longer. He didn't do an Xray or bone graft nor has he referred me to an oral surgeon but said I feel its still at a very early healing stage and I'm hoping it will get better itself what you think?

Hi Chris,

The tip of the tooth socket.... do you mean at the gum line edge or above the gum line where the roots were?

Did you have a fistula (pimple like bump on the gum) prior to the extraction? How many times was this tooth root canaled and did it ever have a surgical procedure called an apicoectomy?

Bryanna

Hello Bryanna,

I mean at the gum line edge and not in deep where the root was etc. I didn't have a fistula prior to extraction and the tooth was only opened 2 weeks before it was removed hence no full root canal was ever done nor a apicoectomy. Am wondering as to why this infection is there and am hoping its just slow healing of wound and something irritated it but I don't know for sure and am worried about a cavitation. It does seem slightly better today but its to early for me to judge as to how it is properly etc.

Thank you Bryanna for your words and great help which is truly a blessing..

Hi Chris,

It is unusual to have an "infection" at the edge of the gum after an extraction. I'm thinking it's more of an irritation or perhaps a bone spur that is caught in the tissue.

Keep a close eye on this... a good sign is it will continue to improve each day. IF it gets worse, larger, more painful, then go see an oral surgeon.

Be diligent with warm salt water rinses and avoid mouthwash as that is too harsh and irritating to the gum tissue.

Thanks for the kind words.... I am always happy when I can be of help to someone here :)

Keep us posted.

Bryanna

Cavitation?
 

Hello Bryanna,

I had normal xrays taken of two extracted teeth hence the left side was extracted 1 3/4 years ago and the right 6 months ago. As different dentists removed each tooth for example on the right one I can still feel the area of where the tooth was not be fully closed over if you take my meaning scaring me that the perio ligament or necrotic tissue is remaining forming a cavitation? I get sometimes red mouth spots on my inner cheeks and on my tongue. I attached the two images of the recent xrays hence can you give me your best diagnosis on all this?

Chris

Hi Chris,

Thanks for posting the xrays.

Both sites look similar in their healing. I cannot tell from these xrays which one was done recently or which one was done over a year ago. I am not able to tell which one is your left or which is your right front area because I don't know if you posted this xray face up or face down.

So looking at these xrays as you have them posted here, which is YOUR left side and which is YOUR right side? Which one was done recently?

Bryanna

Hi Bryanna,

The X-ray was given to me on cd and I think the image that has more whitness is 1 3/4 years ago and the other 6 months. Think they are face down from left to right.

Chris




QUOTE=Bryanna;1131752]Hi Chris,

Thanks for posting the xrays.

Both sites look similar in their healing. I cannot tell from these xrays which one was done recently or which one was done over a year ago. I am not able to tell which one is your left or which is your right front area because I don't know if you posted this xray face up or face down.

So looking at these xrays as you have them posted here, which is YOUR left side and which is YOUR right side? Which one was done recently?

Bryanna[/QUOTE]

Hi Bryanna,

Concentrate on this image as it shows both upper incisor sites from left to right as you see it ie the one with fuller white is 1 3/4 years ago and the other 6 months extracted.

Hi Chris,

The area on the left of the posted xray is more filled in with bone as compared to the image on the right. That would make sense if the site on the right was done 6 months ago. There doesn't appear to be residual remnants of the periodontal ligament in either site. Keep in mind that this xray is 2 dimensional so it is only giving you that limited image.

Bryanna

Hi bryanna,

Thanks again for replying and giving me your valued thoughts hence I understand it is a basic X-ray and it's hard to see much detail. It feels like it's taking a long time to heal given it's six months now.

Chris