Bad Cascade of Dental
 

I recently had a root canal retreatment on tooth number #14/upper left side. The day after, it became excruciatingly painful--the whole left side of my face, particularly under my left eye hurt in an arc over my cheek, back to my jaw and down around underneath my bottom teeth--burning, hurting, like I had been punched in the face. No swelling outside or in gums. No fever. Just intense, horrific pain. The tooth itself--agony. My bottom left teeth started to hurt and ache, in particular the last tooth in the back on the left. Yet, all those teeth seemed to hurt or ache in turns. The endo said this was common and would resolve. In this condition, I was placed on four courses of antibiotics every time I called the endodontist and she saw me three times over four weeks: penicillin vk, clindamycin, keflex, and then back to penicillin vk. I stopped after one day of clindamycin as it burned my stomach and made me nauseated. In two weeks, I lost 17 pounds. The following two weeks I lost about ten pounds. I couldn't eat. Finally, my sister, a nurse, called the endodontist, and my mother called the dentist and apparently asked them to do something definitive to end this agony--as I had done nothing but lose weight and lay in bed and cry for four weeks. My dentist then called me and said I had been brave and valiant about the tooth, but now it should be extracted. I was so happy...and crying...The tooth was extracted without incident. The oral surgeon said it was a rough extraction (although I felt nothing) and it might take a little longer to heal. I think, in the meantime, I had a bit of a nervous breakdown from the pain and suffering that came before. I had to see my regular doc and asked her if I could do a short course of klonopin for the anxiety and crying...I was such a mess. I was frightened, in pain, sick...

Things are beginning to calm down now, at two weeks out but I am still having some minor pain across my cheek, in the two teeth on either side of the extraction...and some aching in the lower teeth for which I must take pain medicine (tramadol with breakfast and dinner and vicodin at lunch time). The pain does seem to be slowly receding--and the extraction site is healing--but slowly.

My biggest concern and question is about these bottom teeth...why are they taking turns aching and hurting so badly? They were examined prior to all of this at a regular appointment and were fine, and I had no pain in them until all of this happened. Will this pain resolve?I am terrified that this pain will not resolve. Not sure why anything is still hurting. Is it referred pain from all of the trauma on the teeth and gums above? I am 50 years old. I will never have another root canal so help me. I hesitated about the retreatment root canal but was afraid to "lose the tooth" and ended up losing it anyhow. I have five teeth left with silver amalgam fillings from the 70s--and the rest of my teeth are my own--mostly my front teeth on top and on bottom. As the teeth go bad, I will just have them extracted. I refuse to suffer like I did --ever again.

What do you make of this phantom like pain on the bottom teeth after all the trauma on the teeth above>? What do you make of the pain across my cheek (it also comes and goes--and is lessening in intensity as the days pass)?

Thank you for any response...

BRYANNA/Can You have a look at this?
 

Hi there,
Just looking for someone to have a look at my
"bad cascade of dental"--post! Bryanna--you seem very knwledgable and compassionate...

Thanks all!

Carmella

Hi Carmella,

The "retreatment" indicates 2 things..... one, the tooth had a long standing infection which obviously spread from the tooth to the bone ... second, the retreatment set off a cascade (perfect description) of bacteria that caused further irritation and inflammation to the tooth as well as the already compromised bone surrounding this tooth. No wonder it hurt so bad and of course the dentists were not surprised at the pain you were having! This was to be expected given the history of this tooth because the tooth was overwhelmed with bacteria. All of the antibiotics in the world could not have cured this infection. I'm so sorry you have endured such agony :/

The extraction was difficult because the tooth was very sick and the bone surrounding it was most likely necrotic as well. Thank goodness you didn't feel anything during the procedure..... whew. Was there any mention of a sinus perforation or infection into the sinus cavity? Are you having any sinus congestion or out of the ordinary sinus drainage on that side?

The pain in the lower teeth may be referred pain... both pre and post op the extraction. There are many bundles of nerves that branch off of the upper and lower jaw, so referred pain is common anytime there is infection and/or inflammation.

The sensitivity with the teeth on either side of the extraction is very common and usually temporary. Keep in mind that this area of your mouth has been severely irritated from the second root canal because the tooth was already "hot" with infection when it was retreated. The pressure inside of that tooth from the inflammation and bacteria was unmeasurable. So it is going to take time for this to calm down and heal. You were very wise to not hang on to this tooth.

Continue with the salt water rinses until the surgical site has closed over. Please keep us posted on how you're doing....

Bryanna

Thank you, Bryanna!
 

Bryanna: You really have a healing touch about you--even online, girl! Thank you for responding. Things seem to be calming down each day...I am also still dealing with the mental--well seriously this all started on 3/10 and they didn't extract the re-treatment tooth until 2 weeks ago...so I feel, honestly as if at some point, I have suffered a nervous break down. I have RA--and had a total knee replacement when I was 38--and I have to tell you, I popped up like a daisy after that. I'm not saying it wasn't painful...but every day it got better. Every day at rehab it got even more better. I was off pain meds within a few weeks after I got home. I didn't have a nervous breakdown. I didn't have panic, fear. This is so not like me. But this whole thing has really set me back...

This re--treatment and the subsequent waiting around to "save the tooth"--it was torture and fear...and now I feel like I have to heal from the torture of it all. When the tooth was being extracted, there was a horrific smell--a smell I didn't notice when they removed another a root canaled tooth I refused re-treatment for that had started to hurt me. So I asked the oral surgeon if he smelled it--and he said that with the mask and what not...but he invited me to sit up and have a look at the tooth pieces. It was black, green, purple--and I could smell it from the tray. It was like death. It was then that I vowed again for the third time: NO ROOT CANALS. NO RE-TREATMENTS and the two RCs I have left, I will have extracted the second they start to in anyway hurt. I would do it sooner, but I am so traumatized from all of this...I just need to recover and deal with what has happened to me.

As for your questions, in the midst of this, I did have a head CT scan because, around the second week after the re-treatment, I was visiting a friend who was in the hospital, and I blacked out in her room. So they took me to the ER and ran all the blood, urine, and did the CT. It all came back clear--nothing in the sinus cavity, nothing they could see on anything else in my head. The blood test were all normal, as well. The concluded it was because I was dehydrated and because I had lost 17 pounds in two weeks. They gave me fluids and some anti-nausea meds IV. The ABXs had torn up my stomach so bad...I simply could not eat--and of course the pain...no appetite.

The oral surgeon said everything looked good, but even he said it would be a little bit longer to heal than the first extraction because it was so badly infected and there had been so much pain in that quadrant of my mouth for so long. As for the facial pain under my eye--he also explained about the proximity of the nerves to all the trauma. I know that burning pain is nerve pain, so I have been praying that it heals and there is nothing permanent...which seems to be the case.

Other than the panic attacks, daily--which seems to be a bigger issue right now--the extraction site is healing. The lower teeth...the ache lessens each day--but you can imagine, if I even feel a twinge--I panic, the fear rises and the tears come.

I'm hanging in there with the help of family and friends. Your post was SO re-ASSURING, as well. It's like, I knew these things intellectually--but when you have been tortured and in hell like that...it takes some time to come back and come to terms.

At one point during this whole hell, my dad sat me down and said, "Look--I tried to do the same thing as you in my late 40s...then I had two root canals in a row go bad within six months--and that was it. No more. Just did extractions." He continued: "Your Mom and I did the best we could with your teeth and your sister's and didn't want to see you go through this (losing teeth)...but you have to stop with the root canals. They DO NOT WORK." Bless him. Made me cry.

Subsequently, a friend of mine, my age, stepped forward and told me her whole story of trying to save teeth...root canals gone bad. excruciating re-treats. Finally, she had only a few teeth left--and had them removed under sedation for dentures. I'm not quite there yet, but I guess I am headed that way.

Thank you, thank you. I cannot express my thanks at the relief you have provided. I will let you know how things continue to heal and how I am feeling.

Carmella

Hi Carmella,

Well thank you so much for the kind words... it makes me very happy to know that my explanations and information come across as healing... that means a lot to me.

Thank you for sharing those other stories regarding root canals. They are not a healthy option and come with some extensive risks. People should be informed about that fact prior to having one done. Some people would still choose to have the procedure knowing the risks, but that's why the procedure is called an "option".

The CT scan that you had in the hospital when you had that fainting episode was most likely a basic head scan checking the blood flow and any obvious lesions. A sinus infection might show up if it were very invasive but to check for an infection associated with a tooth or sinus, the scan would be more specific to those areas. But it is good that they didn't find have any other health issues at that time.

I think your body has been through a lot of sickness over this infection especially since it was so long standing stemming from the onset of the first root canal. So it is a really good thing that you removed the source of the infection!! You will heal... it will just take time. The various pain that you
are having is common healing pain. If you develop a sudden symptom that does not dissipate but rather becomes chronic, then that would be a sign something is not right.

Do you have a post op appointment with the surgeon? It is always a good idea to have him check the site... perhaps take one xray to see how the area is healing.

Thanks again for your kinds words and for sharing your story with us. Please keep us posted.....

Bryanna

Will Have a re-check, thanks
 

Bryanna,
I was thinking about the idea of having the oral surgeon maybe just have a look see--he said to call if I had any problems, questions, or concerns. So this falls into the category of concern. Again, no sinus drainage, fever, headaches, nothing. The site looks like it is healing very well. I am having a few twinges in my face still and on that side of my mouth in general...but it wouldn't hurt to have him take a look since things were so bad at the time of the extraction.

As I said, I am having more issues with my emotional well being, which I am addressing with great help all around. I have never been so emotionally debilitated--and up until now, have never had dental anxiety--but I can tell you, I have it now.

As for root canals...oy, where to start. I know I started down the road without so much as an iota of information, as I was in agony...they said they could save the tooth and that sounded great. Then I had like four in a row almost. The last two I had--I never recovered at all and the tooth was extracted within weeks of the treatment.

I think before you go down the road of root canal treatment--you need a real sit down with explanations of what is about to happen, what it costs, what the restoration costs, how long it may or may not last--and also--I think dentists need to stop and take a moment and spend more time reviewing the overall health of their patients. As a person with rheumatoid arthritis, a knee replacement, and also on immuno-suppressing drugs (well, currently, I am not on them during this crisis)...really root canals should be off the table. And in my humble opinion, so should implants (especially if, as I have, patients have had extensive steroid usage throughout their lives for RA flare-ups). I'm just saying.

So I had my rheumatologist send a note, which she was happy to do, to my dentist, concerning these issues. I wanted her to do this to back up my decision that there will be no more root canals, retreatments, no crowns, no permanent bridges...nature is going to take its course for me at this point. All around, I think it would be the best for my health. That means that I will be losing eventually the last 5 silver mercury filled teeth. Probably a good thing to get rid of the mercury anyhow. Ok fine. If they can then help me out with non-permanent partial dentures for a time...or whatever...but anyhow...I am getting ahead of myself here.

I think you get started with root canals because you are in agony--and that is no way to be making decisions. My former dentist never got ahead of any of my teeth going bad. My 6th month checkups were all, "Everything looks great!" In between that, I was waking up every 3-6 mos with tooth aches, then whisked to an endo for root canals. I never could get crowns because, the price of four root canals in a row...who has that kind of money? Then, when a silver filling went bad, he felt he could replace it with the white filling materials. Eighteen months later, abscess and extraction. This kind of got my attention and I started looking and found a new dental practice.

And then as it went along, it was like my body was rejecting the root canals--and they were extracted because of the pain that never resolved after the procedure.

I didn't mean to ramble on and on here--but it is actually therapeutic--and maybe will help someone else along the way. Your information on root canal is eye opening--and yes, people need to know. I guess if you are perfectly healthy, don't have a mouth filled with 30 year old silver/mercury fillings...you could weigh the pros and cons for yourself...but hey, do it before you've been up for a week with a toothache and waiting for an appointment...

Thanks for the help, again. And I will update as I progress--both with teeth healing and the return of emotional stability...

Carm

Oral Surgeon Called Me
 

Hi Bryanna,
The oral surgeon's nurse called me today to check in and see how things were going, three weeks out (tomorrow) and to see if my dentist had seen me since the extraction.

We had a very wonderful nice long chat about my continuing bottom left diffuse pain in the teeth and slight pain still along my left cheek from the re-treatment.

They've known about this, but she was concerned I was still having this pain, although it was not uncommon she said, given the many procedures, the infection, etc.etc. So she spoke to the Doc and got back to me--and they are recommending (1) no more dental procedures at this time until it can be discerned what, if anything dental, is going on. (2) Continue pain medications that are helping (3) see if it continues to resolve. At some point, however, if it doesn't resolve, they suggest seeing a neurologist.

I was kind of already going down that road in my mind, anyhow. I was actually just sitting here this morning wondering if I just needed to call the dentist and go in...and just then, she called. I didn't want anymore procedures...which is why I have been hesitating, hoping that time would bring resolution. Things are better than they were. It just seems so slow. We went all over the issues. She also said I could come in this week to have the oral surgeon have a look at how things were healing, if that would help in any way to ease my mind. Which I think I will do, as I was thinking of it anyhow--but honestly--the extraction site looks and feels good.

This all goes back to the day after the root canal re-treatment--when this pain in my face and lower teeth exploded in agony. The oral surgeon is still saying wait and see...time, healing. I guess I am agreeing and hoping and praying.

I heard the word neurologist and just felt hopeless, though...

Anyhow, that is the update.

Carmella

Hi Carmella,

I think your statement tells the story...

>>This all goes back to the day after the root canal re-treatment--when this pain in my face and lower teeth exploded in agony. <<<

I think there is a possibility that the re-treatment procedure was the onset of a neurological issue that is hopefully only temporary. It is a good sign that things are improving and hopefully you will heal completely. I would emphasize your exact statement to whomever you see pertaining to this situation... in both the medical and dental field. Dentists will be reluctant to make the connection.... where as a neurologist may be more inclined to see it.

I just want to reiterate that it is a GOOD sign that things are improving! Yes, I think the oral surgeon should take a post op look at you and perhaps a single x-ray of that area. If the pain continues or worsens, then a consult with a neurologist might be the next step.

I'm sorry you are going through this.... I really wish your dentist had informed you more thoroughly about the risks of root canal treatment.

Keep us posted....
Bryanna

Every Day Gets a Little Better
 

Bryanna,
Lesson learned. An horrific, painful, life altering at the moment, but definite lesson learned. Let my story be a warning unto fellow travelers--and I rarely post to message boards--and only have done so here, because of the kindness and compassion and knowledge you share, B. Also, if I can in any way help others--especially people with autoimmune disorders (such as rheumatoid arthritis or any of the others in the spectrum--we have enough to deal with--and are fragile as it is with the disease, the meds, and all that it means to our lives) or if you already have other health/pain issues with which you must deal on a daily basis, or even if you are perfectly healthy--to make very thoughtful, well considered decisions about something like root canal therapy. Me, personally, after what I have been through--I would never permit an RC retreatment, and of course RC--never again. I assure you, there are worse things than losing teeth.

Anyhow, every days gets a little better, so I hope I am on the mend. Lots of good signs of healing. I feel lucky, today, at this moment and hope to keep trending that way.

Will keep you posted, as I go forward from hell.

Best,
Carm

Carmellann,

Thank you so much for your insightful posts. I have no doubt that they have helped others or at least given them something to think about.

I'm in dentistry for over 30 yrs... I have no doubt whatsoever about the systemic risks associated with root canaled teeth. I do think the information will become public one day because more and more people like yourself are making the connection.... most often due to personal experiences.

Hang in there.... hopefully you will continue to heal well :)

Bryanna