Help with previous root canals; now dental implants
 

I have just found this forum; thank you.

I have a long story. (Of course, everyone has a story, lol! :) )

I am not looking for a diagnosis, but maybe a confirmation of what might be causing my current situation, and also some possible options.

I won't post the entire story initially; I don't want to presume on Bryanna or others and their helpful advice. But if this sounds like something that anyone can help with, I would be glad to post more info and answer any questions.

I had 2 old root canals, in both front top teeth. (#8 and 9, I believe.) #9 was when I was 10 years old and developed a painful abscess on the tooth, that had been chipped and not repaired three years earlier. #8 root canal was a few years later, no abscess, another chipped tooth.

Had flare ups and abscesses on #9 (if that is the tooth on my left side) when I was 40, then again at 42, then again at 45. The first time I had a dental procedure to drain the abscess - I don't think this was an apicoectomy, but it was a re-treatment. Second time was the apico.

Third flare up was now 3 years ago - I had started to feel the same symptoms as I had the two previous times: tenderness, swelling, sensitive to heat and cold, low grade fever and constant headache. I researched my options and did not want another apico or re-treatment. Decided to have both root canal teeth removed and dental implants.

There was a bacteria-filled "sac" at the root of #9 when they removed the tooth. Implants were placed at the time of the extraction. All seemed to heal properly over the next several months and I got the crowns at about 6 months.

I have now been experiencing the SAME symptoms as the other three times of the infections at tooth #9. I didn't recognize the symptoms at first, (too many details to list at the moment, but I can elaborate further if necessary). The initial symptoms I focused on were (I believe) secondary to what may actually be going on. I now have the constant headache and sinus pain, low grade fever and general feeling of unwell. I don't have much tenderness when pressing or tapping the crowns, however. But the left side of my face, nose, temples, and jaw are constantly aching now. I had swollen lymph glands along my jaw a few weeks ago that were very painful. I also have had multiple cold sores on my face in just a few weeks, and in odd places that I have never had them before.

I usually get 4-6 cold sores a year, and now I have had severe outbreaks, at least 6-8, in just the last month. That was what I was focused on, initially, until I realized that the virus might be secondary to a deeper infection.

I have an appointment with general physician next week, (to deal with the secondary issues, of the cold sore outbreaks and general fatigue, etc.) and then an appointment with the oral surgeon who performed the extractions and implants 3 years ago.

My implants do not feel loose at all, and last year when I asked my regular dentist about some mild symptoms, the x-rays showed that the implants were setting well in the bone, etc.

So what could this be? And what might happen? I don't necessarily want the implants removed unless that is causing the infection? Could the infection be in the bone/jaw from the old root canaled tooth, all these years later? How can it be treated, if that is the case?

Thank you for any replies and advice. Please ask questions if needed for clarification.

Do you know if when they removed the teeth, did the dentist or oral surgeon also remove the periodontal ligament and scrape out any infected tissue from the socket? If they did not, there might have been some bacteria left over which is now still in those areas. Do you have a biological or holistic dentist near you? If so, they might be able to do ozone injections in the area. I would hate to see you have to remove implants of the front teeth for a re-opening and re-debridment of the socket.

I am sure Bryanna will have much more information for you. I am just a patient going through dental/root canal/extraction issues much like yourself.

Thanks for your reply, nukuspot.

I didn't know to ask about the periodontal ligament at the time. :(

So I assume they did not remove that. Same with any infected tissue. They did mention the infection "sac" attached to the the root of #9.

I don't know about holistic dentists, but I will be looking into that. I'm in a fairly rural area.

My frustration comes with my (misguided) assumption that I was DONE with all of this after getting the implants.

The re-treatment and apico surgeries were dreadful, as well as the infections leading up to that. I have now been feeling sick for weeks without knowing why, and to even entertain the idea that it might be these teeth, again, is disheartening.

Not to mention possibly expensive!

Hi ctfromnh,

Welcome to Neurotalk and our dental forum ...and thank you for visiting :)

I am going to re post some of your thread and reply to you in bold type as it just makes it easier to follow. Your dental case is extensive due to the lengthy time frame (number of years since first rc procedure) and due to the events that took place at the same time as the extraction of #8 and 9. It's important for you to know that your case is not unusual and is actually a typical occurrence given the dental history. That does not mean it's not problematic or systemically healthy to remain status quo. It just means it's typical. Therefore additional information is really not necessary unless you want to disclose and specifically discuss more about the systemic issues that you have been dealing with as they may relate to your dental issues. The information that I will provide is not a diagnosis. It is actual information that will confirm why this is all happening.


<<I had 2 old root canals, in both front top teeth. (#8 and 9, I believe.) #9 was when I was 10 years old and developed a painful abscess on the tooth, that had been chipped and not repaired three years earlier. #8 root canal was a few years later, no abscess, another chipped tooth.>>

THAT STATEMENT INDICATES THE ONSET TO THE LENGTHY HISTORY OF THE PATHOLOGY OF BACTERIA IN AND AROUND TEETH 8 AND 9. THE INFORMATION I PROVIDE HERE WILL HELP YOU UNDERSTAND WHAT THAT MEANS AND WHY IT IS SIGNIFICANT.
CHANCES ARE THE CHIPPED AREA OF THE TOOTH DECAYED, BACTERIA SPREAD TO THE PULP AND THINGS PROGRESSED FROM THERE. THE ABSCESS IS CAUSED BY BACTERIA WHICH BECOMES INFECTIOUS CAUSING AN ACCUMULATION OF PUS TO BUILD UP RESULTING IN INFLAMMATION. OVER TIME THE INFLAMMATION AND BACTERIA SPREADS TO OTHER AREAS THAT ARE DIRECTLY OR INDIRECTLY CONNECTED TO THE ORIGINAL PROBLEM VIA BLOOD, NERVES OR OTHER FLUID.

<<Had flare ups and abscesses on #9 (if that is the tooth on my left side) when I was 40, then again at 42, then again at 45. The first time I had a dental procedure to drain the abscess - I don't think this was an apicoectomy, but it was a re-treatment. Second time was the apico.>>

IT IS IMPORTANT TO NOTE THAT INFECTED TEETH CAN GO FOR YEARS WITHOUT BEING PAINFUL.. THIS DOES NOT MEAN THAT THE TOOTH WAS HEALTHY OR THAT THE INFECTION WAS NOT SPREADING.
ALL ROOT CANALED TEETH TYPICALLY AND THEREFORE ARE BASICALLY EXPECTED TO HAVE FLARE UPS AND MORE ABSCESSES FOR SEVERAL REASONS.
ONE IS BECAUSE THE HUNDREDS OF TINY CANALS, CALLED DENTIN TUBULES, ARE NOT ACCESSIBLE LIKE THE LARGE CANAL AND WILL THEREFORE ALWAYS CONTAIN INFECTED NERVE TISSUE. SECONDLY A ROOT CANAL TREATMENT SEVERS THE BLOOD SUPPLY TO THE VESSEL THAT WAS FEEDING THE TOOTH NUTRITION CAUSING THE TOOTH TO BECOME MUMMIFIED/NON VITAL. THIS MUMMIFICATION SETS OFF A SERIES OF PATHOGENIC BIOLOGY TO TAKE PLACE IN THE DENTIN TUBULES AND ALSO IN THE SURROUNDING AREAS THAT ARE STILL VERY MUCH ALIVE. FOR EXAMPLE THE PERIODONTAL LIGAMENT, THE JAW BONE, THE SINUS CAVITY, ETC.
AN APICO IS A SURGICAL ROOT CANAL. IT IS DONE VIA THE END OF THE APEX (ROOT) WHEREAS AN RCT IS DONE VIA THE OCCLUSAL (BITING) SURFACE OF THE TOOTH. THE ONLY DIFFERENCES BETWEEN THE TWO PROCEDURES IS THEIR ENTRY WAY AND THE APICO INVOLVES AMPUTATING THE END OF THE ROOT AND THEN PLUGGING IT UP WITH A MERCURY OR SIMILAR TYPE FILLING MATERIAL. AS FAR AS THE ABILITY TO CURE AN INFECTED TOOTH, NEITHER PROCEDURE IS CAPABLE OF DOING THAT BECAUSE OF TWO REASONS. ONE IS THE INACCESSIBLE DENTIN TUBULES AND THE OTHER IS THE PATHOGENIC BIOLOGY ASSOCIATED WITH THE MUMMIFICATION OF THE TOOTH.

<<Third flare up was now 3 years ago - I had started to feel the same symptoms as I had the two previous times: tenderness, swelling, sensitive to heat and cold, low grade fever and constant headache. I researched my options and did not want another apico or re-treatment. Decided to have both root canal teeth removed and dental implants.>>

SO AFTER BEING GIVEN THE PATHOGENIC BIOLOGICAL INFORMATION, YOU CAN SEE HOW THIS 3RD FLARE UP WAS JUST A CONTINUANCE OF THE CHRONIC NATURE OF THE INFECTION. THE DIFFERENCE NOW IS THAT YOU ARE HAVING SYSTEMIC RELATED AILMENTS ASSOCIATED WITH IT.

<<There was a bacteria-filled "sac" at the root of #9 when they removed the tooth. Implants were placed at the time of the extraction. All seemed to heal properly over the next several months and I got the crowns at about 6 months.>>

THE PUS FILLED SAC WAS A CYST THAT TYPICALLY FORMS AT OR NEAR THE APEX OF A ROOT CANALED OR APICOED TOOTH. THESE CAN BECOME QUITE LARGE AND QUITE EXTENSIVE INTO THE BONE,THE SINUS, THE VARIOUS BUNDLES OF NERVES, ETC.
THE CYSTS INDICATE DEFINITIVE PROLIFERATION OF THE BACTERIA BEYOND THE TOOTH. WHICH MEANS THAT THE BONE WAS NOT HEALTHY AND DUE TO THE LONGEVITY OF THE INFECTION, THERE MAY HAVE BEEN SIGNIFICANT BONE LOSS.
IDEALLY, DENTAL IMPLANTS SHOULD BE PLACED IN HEALTHY, VIABLE BONE ONLY. IF THERE IS LONG TERM INFECTION AND/OR DETERIORATION OF THE BONE DUE TO INFECTION, THEN THE RISK OF FURTHER INFECTION AND FAILURE OF THOSE DENTAL IMPLANTS IS ELEVATED. AGAIN, SYMPTOMS ARE NOT ALWAYS APPARENT RIGHT AWAY. THEY OFTEN DO NOT SHOW UP UNTIL THE CROWNS ARE PUT ON WHICH MAKES IT SEEM LIKE THE CROWNS WERE AT FAULT. NOT SO.

<<I have now been experiencing the SAME symptoms as the other three times of the infections at tooth #9. I didn't recognize the symptoms at first, (too many details to list at the moment, but I can elaborate further if necessary). The initial symptoms I focused on were (I believe) secondary to what may actually be going on. I now have the constant headache and sinus pain, low grade fever and general feeling of unwell. I don't have much tenderness when pressing or tapping the crowns, however. But the left side of my face, nose, temples, and jaw are constantly aching now. I had swollen lymph glands along my jaw a few weeks ago that were very painful. I also have had multiple cold sores on my face in just a few weeks, and in odd places that I have never had them before. >>

RE READ MY REPLY ABOVE.
DENTAL INFECTIONS CONCERNING TEETH, IMPLANTS OR CROWNS DO NOT HAVE TO SHOW SYMPTOMS IN THE MOUTH WHEN SOMETHING WRONG. THE SYMPTOMS CAN BE "SYSTEMIC" JUST AS YOU HAVE DESCRIBED WHICH MAKES IT SEEM LIKE THEY ARE NOT DENTAL RELATED.

<<I usually get 4-6 cold sores a year, and now I have had severe outbreaks, at least 6-8, in just the last month. That was what I was focused on, initially, until I realized that the virus might be secondary to a deeper infection.>>

FREQUENT COLD SORES, MORE THAN ONCE A YEAR MAX, INDICATE AN IMBALANCE WITH THE IMMUNE SYSTEM AND POSSIBLY THE ENDOCRINE SYSTEM AS WELL. CHRONIC INFECTION AND INFLAMMATION WILL CAUSE THE IMMUNE AND ENDOCRINE SYSTEM TO FUNCTION LESS THAN OPTIMALLY. THE MORE CHRONIC THE PROBLEM, THE MORE DEPLETED AND EXHAUSTED THE SYSTEMS BECOME.

<<I have an appointment with general physician next week, (to deal with the secondary issues, of the cold sore outbreaks and general fatigue, etc.) and then an appointment with the oral surgeon who performed the extractions and implants 3 years ago.>>

THESE PHYSICAL ISSUES ARE NOT REALLY SECONDARY ISSUES. THEY CAN BE DIRECTLY RELATED TO THE CHRONIC INFECTION AND INFLAMMATION THAT YOU HAVE ENDURED SINCE YOU WERE 10 YEARS OLD. YOUR PHYSICIAN IS NOT GOING TO BE ABLE TO KNOWLEDGEABLY DISCUSS YOUR DENTAL SAGA AS HE HAS NO EDUCATION IS DENTAL HEALTH WHATSOEVER. IF YOU TELL HIM THAT YOU HAVE HAD AN ONGOING DENTAL INFECTION SINCE YOU WERE 10 AND IT HAS RESULTED IN NUMEROUS DENTAL PROCEDURES, SURGERIES, MEDICATIONS, NOW DENTAL IMPLANTS.... HE MAY BE ABLE TO CONNECT THE DOTS BETWEEN THE ORAL AND SYSTEMIC CONNECTION.

<<My implants do not feel loose at all, and last year when I asked my regular dentist about some mild symptoms, the x-rays showed that the implants were setting well in the bone, etc. >>

THE IMPLANTS MAY NOT BE LOSE. BUT THAT DOES NOT NEGATE THE POSSIBILITY OF PATHOGENIC BACTERIA PROLIFERATING THAT AREA OF YOUR MOUTH, BONE, SINUS, ETC. ARE THE CROWNS INDIVIDUAL UNITS OR ARE THEY SOLDERED TOGETHER?

<<So what could this be? And what might happen? I don't necessarily want the implants removed unless that is causing the infection? Could the infection be in the bone/jaw from the old root canaled tooth, all these years later? How can it be treated, if that is the case?>>

THE CHOICES ARE TO KEEP THINGS THE WAY THEY ARE AND SEE WHAT HAPPENS OR REMOVE THE IMPLANTS. YES, THE INFECTION COULD STILL BE IN THE BONE FROM THE OLD ROOT CANALED TEETH. YOU ARE EITHER READING A LOT ABOUT THIS OR YOUR INTUITIVENESS IS KICKING IN!

You may find that you have to gather your dental records and radiographs from all of the dentists who have treated you to seek a consult with a new oral surgeon. This would include the surgical report of the extractions and implant placements. Was bone graft material put in when the teeth were removed? Are the implants titanium or zirconia? Are the laterals, adjacent teeth to 8 and 9, root canaled?

Bryanna

Hi. Did you have several cold sores appearing in a group? For cold sores research l-lysine it helps a great deal in healing and preventing, for a lot of people (and also with shingles). Hope you'll get well very soon!

Thank you so much, Bryanna, for your thorough replies and helpful information. I wish I had known this information 8 years ago when the first flare-up occurred! I couldn't help or prevent that first root canal, so long ago, and apparently, many of my lifelong issues might be connected with that first surgery.

I made the appointment with my general physician a few weeks ago, before I recognized that the implants/teeth/infection might be the source of the problems. So I might not get much help in that area. I had a serious outbreak of (what I thought was) the cold sores last year, on the inside of my nose, with ongoing sores for over 8 months. They tested the sores and discovered some other bacteria, possibly MRSA, and a strong dose of antibiotics finally cleared that up.

So when I thought the recent problem was merely all of these cold sores, I thought that maybe another similar skin infection was happening again, and we might be able to deal with that.

I have had NO success from any conventional or alternative medicine with the cold sores, in the last 23 years, since my first outbreak. (I have both strains of the herpes simplex virus, and suffer from genital and oral outbreaks.) Nothing topical helps, no prescriptions, l-lysine, etc. Obviously when I am in good health, the outbreaks are less frequent, maybe 4-6 times a year. Every time I experience an outbreak, I get flu-like symptoms for about 24 hours - general achiness, swollen lymph nodes, low fever, etc.

So when these symptoms started to recur every few days, I was concerned! And I spent day after day, not feeling well. This started in earnest about a month ago. In the last 4 weeks I have had at least 8 separate outbreaks of cold sores, in odd places on my face. (They usually recur in the same area as the initial outbreak, which is inside my nose, or directly below my nose, above my lips.) I have recently had them on my neck, below my lips, my earlobe, and now my eyebrow.

The last several days, I have started to write things down and do some research, and that is why I am beginning to see that all of this might be connected to the old root canals and the infection that is likely still in the bones, jaw, sinus, or wherever.

I don't remember if the implants are titanium or zirconium. I think the oral surgeon said that the bone looked healthy when he put in the implants, immediately after the extractions. So I think now, that I should have had more extensive surgery to clear out the infection, before placing the implants?

Is it at all possible to deal with the infection, likely in the bone and maybe sinus cavity, by some sort of surgery or other treatment, while still leaving the implants intact?

The total cost was about $10,000 for these implants - it took us most of the last 3 years to pay that off! I know we can't put a price on good health, but it is discouraging and scary to think of having to take these implants out.

None of my other teeth have implants or root canals.

I believe the crowns are separate crowns, not soldered together.

I have suffered from numerous sinus infections in the last 10 years or so.

I also was a normal weight kid until the first root canal at age 10. That was the year my parents separated and we moved several times, and I started gaining weight. I always figured that the weight gain began due to stress and hormones and puberty. I wonder if that tendency (I have struggled with weight issues ever since then) is connected to the infected teeth, all that time?

I know this is kind of a rambling answer, and I appreciate all the help you have already offered. Might be helpful for others to read my story?!

I will keep my appointments next week, with the regular physician and the oral surgeon, but I will do some additional research and strongly consider finding a holistic dentist and getting another opinion. (The closest one may be about 90 minutes away.)

The way I have felt the last few weeks and especially the last few days, I guess I would choose to gladly have these implants removed, even if it means no front teeth! I stayed home this weekend instead of traveling to family wedding because I just don't feel well enough to attend. I have a low fever, constant pain and a severe headache. :( I certainly can't live like this every day for much longer.

So really, after all this, I guess my only question is whether any kind of treatment is possible while still keeping the implants, if the infection from the old root canaled tooth is indeed in the bone and surrounding tissues, etc?

Thank you, ELna!

L-lysine has not seemed to help me with the severity, frequency, or duration of the outbreaks. Nothing has. :(

Your implants are almost definitely titanium. Zirconia are very very new (only FDA approved for 5 years in the US) and very few place them yet. Also they are much more expensive, you would know if you had them! The quote I got was 5k per implant. And I have to travel 2-3 hours to find the closest person who does them vs titanium I could get from multiple places right in my town and they are more like 2-3k each. I hope that is helpful info.

ctfromnh,

Regarding the frequency and severity of the sores...... although you are accustomed to dealing with this problem, it's important to know that it is not a normal occurrence in someone who is healthy. In addition to herpes, do you have auto immune disorders? Thyroid or Graves Disease? Shingles? Epstein Barr Virus (EBV) or Cytomegalovirus (CMV)?

Unfortunately, conventional medicine does not look for the root cause of the problem. Instead they just medicate the symptoms. Integrative medicine offered by Naturopathic Doctors, Functional Medicine Physicians and so forth is the branch of medicine that will look for the cause of the problem and treat the entire patient, not just the symptoms. Have you ever consulted with an Integrative Practitioner?

Quite possible the reason L lysine and most other things like that have not been helpful to you for the long term is because the virus or viruses that you are carrying are virulent and out of control. Certain drugs in large doses may reduce your symptoms but they are not effective at curing the root cause so you will continue to have repeated outbreaks.

Were your dentists and oral surgeon aware of your frequent sinus infections and your lengthy history of these outbreaks? Do you the outbreaks have become worse or more often since you had the dental implants placed?

FYI....... Repeated sinus infections are often associated with infected teeth as the sinus sits in very close proximity to the roots of the upper teeth. So that would be a significant indicator that your upper front teeth, at minimum, could have been causing your sinus problems. Another reason why it is imperative for dentists not to rush into placing dental implants when infected teeth are extracted.

Unfortunately, there is no proper way to eradicate infection and diseased jaw bone from around dental implants. So if infection and disease are present in that area of your bone, then the implants would have to be removed :/

Please consider consulting with an oral surgeon, preferably one with a dual degree meaning DDS or DMD (dentist) and MD (physician), who is not associated with any of your dentists. Make sure he has your complete medical and dental history.

Bryanna

Bryanna,

What do you think about ozone injections in this case? When I was researching them recently for myself, peri-implantitis or other infection around an implant was one of the indications for them.

Thank you, again, Bryanna!

I have consulted with several naturopathic physicians/practioners in the past. The frequency of the herpes outbreaks was reduced, slightly, but never helped very much. One practioner in particular, was very focused on helping with the herpes outbreaks, but nothing we tried seemed to help in the long term. She had correctly diagnosed me with other significant issues and her treatments were very successful in those other areas. She helped my sister get rid of Lyme disease with no antibiotics or conventional treatments. I may return to her and have her help me sort some of this out.

I have never been diagnosed with any of the auto-immune disorders you mentioned. That was one thing that I was recently starting to be concerned about, however, and I will pursue this, in case there is now a co-existing virus or disease occurring.

I have had some arthritis in my knees and now one shoulder, but as far as I know, this is only osteoarthritis, and not related to rheumatoid arthritis. Diet, gentle exercise like Tai Chi, and surgery to repair the torn meniscus in each knee has helped tremendously in the last 2 years and I barely have a twinge, when 2 years ago I could not walk or stand without great pain.

I DO recognize that the number of outbreaks, especially recently, is not normal for a healthy person. :( I am very concerned about it, as it is now affecting my day to day activities. And I thought I WAS a healthy person, lol, until I started to make the connections with these teeth!

Most conventional doctors, dentists, etc., do not know what to do about herpes and do not appear to be concerned about it. Same goes for the sinus infections - they have never seemed to be concerned that there is a connection to the root canaled teeth and these infections. As you said, they treat the symptoms, not the cause.


The above quote makes me very sad and discouraged, but I appreciate your honesty. This will be a huge decision. Painful and costly. The more I read, the more I want to get these implants out and address this infection.

Do you think that if the infection can be eventually removed, eradicated, etc., that having implants again (in the future) is a good idea, or should I get a partial? I don't like the idea of a bridge, and having to compromise two additional teeth. I suppose this question is something to sort out over time, however.

I will definitely consider this course of action. Thank you so much!

I will try to post any follow ups as they occur. I know that I have read many of the threads here, (and on other discussion forums) and I understand that many people do not return to post the final outcome, but I find it very interesting to see the whole story through to the end.

I have no knowledge or experience with ozone injections, so I would be interested in learning more about them. I don't want to waste time on something that won't really work, of course. :) But any alternative to losing these implants is appealing.

nukuspot,

I doubt this is a case of peri implantitis and ozone injections given at this time would not be helpful. They may even be detrimental at this stage because there is a multitude of systemic issues going on that may not react favorably to the immune system being stimulated by ozone. I think they may be beneficial down the road at some point, but I wouldn't do them now.

Bryanna