Update for Bryanna
 

Hi,
I just thought I would update on what is happening with me. I am still battling this sinus issue. Although it feels a little better, these last two days seem to have gotten worse again. I have been to a total of 4 ENT's and two Oral surgeons now. The ENT's are saying my sinuses are beautiful, I do not have a sinus problem. All of them have said that. I have had 4 ct scans and 1 MRI. Both of the oral surgeons say there is no problem with the extractions. They are friends, so I am thinking that the new one didn't want to step on the other one's toes. He didn't do much of a check up. I am going to try to go to the original oral surgeon one more time. But my symptoms are still there, the site still hurts sometimes, I am still getting pieces of bone out, I am still getting the sour taste that seems to be coming from the site. They say the site is completely healed and it wouldn't be coming from there. Also, my post nasal on that side feels like there is stuff in it and I still have a crusty nose. (And they say there is not a sinus problem!) i also have constant ringing in my left ear.it really feels like there is still something wrong. It has been 8 months now. My plan is to go back to the original oral surgeon and if he doesn't find anything than I need to find the very best oral surgeon that is good at figuring out what is going on. I am willing to go anywhere in the country for that. Bryanna, do you know anyone that could help me? I know you have suggested that the doctors talk to each other but how could they talk to each other when they don't think anything is wrong. Also, I am worried about how much radiation I could be having. Would an MRI show more? Isn't that less dangerous? I am sure the ENT would order one for me. I am so tired of living like this. I really want to feel normal again.

Angels,

Please re read all of the posts you wrote on this forum along with my replies regarding your dental situation. There are some discrepancies which leads me to believe that it's possible you may not be asking questions of the doctors and dentists that you see.

In January you had a CT scan and you stated ... <<ENT thinks there may be root tip remnants. Oral surgeon says no.>>
Without question, this oral surgeon and that ENT need to collaborate on your case. The ENT will tell the surgeon of his CT findings, the surgeon will recheck the scan if for no reason other than to cover his own butt, they will discuss your symptoms and complaints, etc.

In May you saw a NEW ENT who acknowledged something is wrong. He also diagnosed you with Klebsiella Oxytoca in your sinus via specimen and culture. The other ENT missed this and in all probability it was not a new infection. It also clearly means you had/have a sinus infection. How did you get that? Likely from the infected teeth. It could also still be lingering if there is a piece of infected root or bone or some other irritant still present in that site. By any chance, did the ENT ever retest you after the antibiotics were done? If so, what were the results?

In June you stated << everyone says there is something in the sinus, maybe it's packing that was placed after the extraction>>
I replied to that statement asking what packing were they referring to. Did you ask them to elaborate on that? Can you understand that "packing" material is not something that should still be present months after a tooth extraction? Were they talking about bone graft material? These are questions that need answers.

Also in June you stated << dental don't see anything, ENT and radiologists do, yet the sinuses are fine>>

So my questions to you are ... Who sees what? How can the sinuses be fine if you still possibly have Klebsiella Oxytoca? What packing are they referring to? How can everything be fine if you still continue to have definitive symptoms of an infection and problems with not just the sinus but the jaw bone as well? Do you still have periodic swelling in your neck?

To be honest with you, at this point any new dentist you go to is going to be reluctant to take your case because given the history it's fairly clear that something is wrong and in all probability it's been wrong from the get go. Anyone new that intervenes with surgical treatment or other will be concerned that they are opening up a can of worms and they don't want to be the one blamed for anything. I know that sounds unfair but can you appreciate why they would be reluctant? Also, there is no logical reason to have had 4 CT scans in addition to an MRI. That is a lot of radiation and you should be mindful about subjecting yourself to anymore of it for several years unless due to an emergency situation. It takes years to clear yourself of radiation that has been accumulated over a short period of time. Your profession subjects you to an abnormal amount of radiation as it is, never mind repeated CT scans of your head. Please do not let anyone talk you into doing another scan.

I would recommend that you choose an oral surgeon, perhaps the original one, along with the ENT that stated something is wrong and diagnosed the Klebsiella and get them to collaborate. If the original oral surgeon is not willing to collaborate with the ENT, then I would recommend that you tell him you want a copy of his surgical report and all notes in your chart. He has to legally give you a copy of both of those. Take those papers to another oral surgeon and have that oral surgeon collaborate with the ENT.

Until you get the ENT who acknowledges a problem and an oral surgeon (irrelevant of his findings) to talk to each other, you are not going to get off this merry go round. It is up to you to get a collaboration going.

Bryanna

Hi Bryanna,
The packing they referred to was the bone graft. This ENT looked at my latest CT scan and said there were roots in my sinus. Then he asked if there was a bone graft and I said yes. He said that is what it is then, he is seeing the bone graft. . The latest test came out with a small amount of Klebsiella. I have been putting antibiotic cream in my nose for that. The ENT said it shouldn't be causing the problems I am having. My symptoms are still pointing to a problem where the teeth are extracted though. I KNOW that there is a problem there, I can feel it. But everyone keeps writing me off. How do they figure that out without scanning the area? That is why I asked about the MRI. It was the MRI that found the dental problem in tooth 15 not the CT scan. I haven't had an MRI since I had 15 removed and that is where I feel the problem.
Yes, I am still having a problem with my neck swelling on the left side and I have thick mucus that seems to originate from above the area where the teeth were removed.
I think that they are looking for sinus infection or sinus disease in the ct scans and I have neither.
So in answer to your question about who sees what is the oral surgeon sees nothing wrong and the ENT thought he saw roots in my sinus but now says it is the bone graft material.
I understand that I am a hard case, but something is really wrong. I am not crazy and I am not a baby. I can take a lot of pain. For many years I had cavities filled without novacane.
I am just so sick of being uncomfortable and have nobody listen to me. I am going to go back to the oral surgeon one last time. He does seem like a very egotistical guy, so I am sure he will say nothing is wrong. Then I will go see the ENT again, I am just not getting anywhere. I honestly don't know where to turn after that. Thanks for your help.

Angels,

Thanks for the clarification.

I completely believe you have an ongoing problem but your case did not have to become this difficult. I also believe if the ENT and the OS had collaborated at the onset, intervention by one or both would have taken place by now. Or the ENT, after speaking to the OS, may have referred you to another surgeon if he felt this guy was not willing to address the problem. Your symptoms, your complaints, are all frequently seen and heard with dental patients who had infected root canaled teeth extracted, especially in cases where there is sinus involvement. So this is NOT an unusual case for them ... it's just been poorly handled in my opinion.

Here's some things that could be contributing factors and if you put them together like a puzzle the situation may make more sense to you.....

1) You had a long term, chronic and active infection in your teeth that spread to the jaw bone, the ligaments, and the sinus. The infection had also become further systemic as indicated by your swollen glands.

2) **Re read this paragraph as you review the others**
Any debris left in the extraction sites, meaning pieces of tooth, infected and/or splintered bone, periodontal ligaments, root canal material, infection in the sinus, that was not removed at the time of the extraction surgery has continued to fester or at least kept the infection alive.

3) If I recall correctly you were prescribed Levaquin by the OS. This drug should only be prescribed very carefully and with caution. The FDA, of which I am not really a big fan of, has issued strict warnings on this drug to be administered with extreme caution. The potential side effects of Fluoroquinolone drugs are to be considered very seriously before prescribing this medication. In spite of taking this medication, you continued to have assorted symptoms of an infection along with swelling in the neck. So the risk of taking it may not have outweighed the benefits. I would urge you to use caution if you are prescribed a Fluoroquinolone drug again.

4) Then the ENT diagnoses a Klebsiella infection in the sinus. So how effective was the Levaquin and did the oral surgeon explore the sinus when he extracted the teeth?

5) Placing bone graft material in a site that still harbors infectious bacteria, whether it be from the "debris" that I mentioned or from a sinus infection, is not going to heal properly. The patient will continue to feel unwell, glands will swell, pain may be present, mucus may discharge from the mouth and/or the sinus, post nasal drip from the nose down the throat, sour or unpleasant taste, etc.

6) When bone graft material is placed in a clean and healthy site of the jaw bone, within a few months the graft material has integrated well enough with the healthy bone that it would not stand out on an xray or a scan as something that resembles a piece of tooth. When grafting does not integrate well with the jaw bone, it can give a radiograhic appearance of a tooth root or resemble a blob rather than bone. These are things that would be discussed between the ENT and the OS.

7) You have had enough scans to detect and diagnose the problem.

In my opinion, I think the oral surgeon figures when he goes in to do the implant he will explore and may debride the site at that time. Or he may not do either of those things and just place the implant and then prescribe more antibiotics. Unfortunately the later is often what is done in cases such as yours and the outcome is often unfavorable. Ideally the surgical site and the sinus should already be free of infection and all irritants "long" before the implant is placed.

Have you asked the ENT to discuss your case with the Oral Surgeon?

Bryanna

Hi Bryanna,
I went to the oral surgeon on Monday. He did a CT Scan, panoramic and X-rays and could not find anything wrong. He says that if I don't do the implant now then I will have many other problems. I am losing bone and the opposing tooth is rising up. If I don't get it I will end up having to have a root canal on the opposing tooth. I am scheduled to get the implant later today because I didn't know what else to do. Meanwhile, I woke up today and am having all sorts of sinus issues on the left side. My left ear is constantly ringing and there is a lot of fluid on that side, not to mention the pain where the teeth were extracted. (Which the second oral surgeon called phantom pain) . I called the oral surgeon that gave me a second opinion because I remember him saying that he disagreed with the first oral surgeon that all sinus issues should be ok before I do it. I thought I could bring my new X-rays to him but he basically just blew me off. So the ENT says nothing is wrong and so does the oral surgeon. But, something is definitely not right to me and nobody will listen. I have been crying all morning because I am really sick of this and I am so frustrated that nobody can find anything. There is something wrong and nobody cares. My appointment is at 2:30 today he said that it won't affect my sinus one way or the other.

Well it has definitely made my sinus problem worse. He showed me where it didn't affect my sinus and showed me on the X-rays where the implant was. I really don't know what to do now. My sinus and nose are really messed up and my left ear is ringing louder than ever. Can this be fixed? Can they take the implant out? I never should have let him talk me into it. He really scared me if I didn't do it. I should have listened to myself. Now I am going to look into going to the Mayo clinic. I really need to get to the bottom of this, I really can't live like this anymore. M
It looks as though the Mayo clinic in Minnesota also has a dental part. I know this is being caused by my teeth but unfortunately nobody in San Diego will listen.

Angels,

I am so sorry this is happening to you. But I am surprised that you returned to the original OS who kept ignoring your physical symptoms and allowed him to go ahead with the dental implant in spite of the long term symptoms you have been having. I don't, for the life of me, understand how he could have placed that implant if he was aware of your symptoms and dental history pertaining to that area of your mouth and sinuses. He has also bombarded you with radiation multiple times only to give you nothing more than the same inconclusive diagnosis. I think he would have had a different tone about your case if the ENT who acknowledged there was a problem had spoken to him about his findings on that scan.

To be completely honest with you... the situation has become even more complicated now since the placement of the implant. You will be hard pressed to find someone to take your case on because they won't want to get caught up in it. Due to the longevity of the problems and now this surgery, who ever is brave enough to step in to treat you will likely get blamed if the outcome of their treatment is not favorable. Not a good position to put themselves into. This is why the second oral surgeon who you contacted just before the placement of the implant was reluctant to get too involved.

I would suggest that you write a letter to the oral surgeon who did the extractions and now the implant requesting all of your scans and xrays, all surgical and consulting notes, and all chart notes. Everything pertaining to this area of your mouth from the very first time you walked in his office up until the last time. You will need this information wherever you end up going as the history of this is imperative and you should have copies for your own records as well. Send that letter certified mail receipt. This way you will receive a receipt from the post office that your letter was received and signed for so that no one can tell you it wasn't. The office may call you and tell you there is a fee to provide you with everything. You have a choice you can pay it or you can argue it. Either way, get your stuff from them.

Regarding the progression of the sinus problems. Your symptoms previous to the implant were indicative of infection and/or inflammation in the area ... bone, tissue, sinuses, etc. It is irrelevant as to whether the implant was placed into or near your sinuses or not. The implant is likely exacerbating the problem that has been present the whole time.

To answer your question about removing the implant ... yes it can be removed and it should be done sooner than later if that is what you decide to do. Meaning the longer it is present, the more difficult it will be to remove and the more progressive your ongoing problems will become. In addition to all of the other dental paperwork, it is imperative that you have the surgical report of the placement of the implant so that the surgeon who removes it knows what took place at the time of the placement. Meaning, what bone graft materials (if any) were used, what type and size the implant was, etc.

It is not that nobody in San Diego will listen. It is that your case became complicated early on and the doctors needed to collaborate. I know you are sick of hearing me say that, but that lack of collaboration is a huge part of what has led to this degree of complexity. The original oral surgeon had his opinion which seemed to disregard your ongoing physical symptoms and there was no one challenging him when there could have been. The fact that you kept going back to the original surgeon most likely led the others that you consulted to believe you wanted to stay with the original surgeon. Can you understand how this has evolved into you standing alone and almost at the mercy of the original oral surgeon?

I know you wanted to believe this guy and put your trust in him. Everyone wants that same thing with their doctors and dentists. Unfortunately, trust or competency is not something we can ever assume is going to take place, especially when problems arise and they're not taken seriously. He rushed you into doing the implant scaring you about bone loss and opposing tooth eruption. Perhaps he should have taken that energy and used it on figuring out what the hell has been going on all this time!

It is best if you can find an oral surgeon who is local to you because you may have complications that follow any treatment that is rendered to you. Can you call the ENT who confirmed he saw something on a scan and ask what oral surgeons he refers to you or what OS he has collaborated with on other cases? Tell him you had felt that he wanted to help you and you should have asked for this previously but still felt confident with the oral surgeon you were seeing. As time as gone on, you realize you need some collaboration and would like to work with someone that he is familiar with as you are not sure what to do at this point.

What do you think of the idea of contacting the ENT and so forth??

Bryanna

Hi Bryanna,
I am now in the process of contacting the ENT. We are playing phone tag, but my plan is to try and get in and have him order an MRI of the maxofacial. That seemed to catch the infection before that the CT scans didn't. Since the implant was done the whole left side of my face is messed up, from my eye all the way down my neck and shoulder. My left ear is ringing loudly also. I think I am having a lot of anxiety over this and I am trying to calm myself down. Especially when you say nobody would want to take my case on. Am I supposed to live my life with this? I know now that this whole time my problem has been my teeth. Since the implant the symptoms have really isolated to the left side. (Left side of hose plugged up, cheek and eye hurt on left side etc.) It almost feels like there is an infection in the jaw bone somewhere. Will that show up in an MRI? I am still getting the bitter taste coming from that area, which the oral surgeon say is not. He says that the area where the bone graft is, is all closed up,and it couldn't possibly be coming from there. Couldn't it seep through the skin? Because I know it is coming from there. I even think that even the bacteria in my nose was caused by this infection. The second Oral surgeon that I went to was referred to me by the ENT. So, I am not really sure what to do now. I did try to get the ENT and first oral surgeon to collaborate but they really didn't seem interested. I have a follow up appointment with the oral surgeon next week, should I have him take the implant out? I will get all the notes etc. He is on vacation this week.
I called my insurance company today and they sent me 12 names of maxofacial surgeons near me. Also, I need a plan if nobody finds anything after the next round of doctors. So, I am thinking of trying to get in to the Mayo Clinic in Minnesota. They are in network. My insurance company said they will try to get me an appointment. Luckily I fly for free and my best friend lives there. I really don't want to have to go that route but I really need to get to the bottom of this. Meanwhile, I am trying to live my life, uncomfortably, but if I stay busy I don't think about it as much. I have had Maui layovers the last three weeks and have done yoga on the beach and believe it or not, it helps! I am a very active and healthy person and I just pray every day that I can get this horrible thing resolved and feel good again!

There is a dentist in San Francisco named Ed Zinman who is also a lawyer who may be able to help you figure out what to do. Good luck!

Cleo,

Just curious, how do you know about this dentist/attorney? They are very hard to find because it is an unusual combination of degrees.

Thanks, Bryanna

The attorney will come later. I just need to get myself better. Yesterday I started with a little cough and now I have just woken up in the middle of the night finding it hard to breathe. My chest feels heavy and it feels like there is fluid in there, kind of like when I have bronchitis. I have a terrible taste in my mouth also. My chest is burning. Can I get pneumonia from this? This is starting to really scare me. I may be heading to the ER soon.

Angels,

I cannot personally vouch for the attorney that Cleo provided you the name of, but I would ask you to consider contacting him with your situation and see what he advises you to do.

Dental problems affect our overall health, not just our oral health. You continue to have one physical ailment after another which you feel, and you may be right, that they are connected to your dental problems. You have also been subjected to a lot of radiation in a short amount of time which also affects your overall health. If the infection is still brewing in the area of the dental implant or any of the surrounding area, sinuses, etc., antibiotics are not going to cure that infection. In fact, they will lower your resistance even further. The problem needs to be diagnosed and treated properly and it has become very obvious that the first oral surgeon is not going to explore this any further.

In your recent post you stated, and I believe for the first time, that the ENT had referred you to the second oral surgeon. Those were the ones who needed to collaborate on your case. If you did ask and they didn't seem interested, you needed to insist upon it. It is not too late to do that. However, keep in mind that because you kept going back to the original oral surgeon and because you let him go ahead with the implant ... it is not going to be easy to get any dentist or ENT on board because of the liability concerns to undue or correct what has already taken place. But you cannot keep going on like this so it may behoove you to try and communicate with that ENT.

I also want to point out that medical doctors, even those in the ER are not going to know if your current situation is oral health related or not. They are taught next to nothing about teeth and oral health related problems. They will likely prescribe an antibiotic and send you on your way.

When you speak to the ENT and to the referred oral surgeon, do not mention the possibility of speaking to an attorney. That will scare them away. However, it may behoove you to contact that attorney and consult with him about your case.

Bryanna

I went to the referred oral surgeon. He didn't really do anything except look at my ct scan, feel the outside, told me he was friends with the first oral surgeon and send me on my way. He was no help whatsoever. Today I did go to the ER. I felt like death, was running a fever and worried I might go septic, the ER doc did exactly as you said, gave me antibiotics and sent me on my way. No blood test, but he offered to do a ct scan, I refused and told him I wanted an MRI but apparently they don't do that on weekends. He gave me an antibiotic shot. I have been coughing a lot, but he said my lungs are clear. This was at San Diegos best hospital. One more question, would they be able to take out the implant and the two bone grafts, clean it out real good and then redo it?I do have a call into the ENT to get an MRI. But of coarse, they never called back. I am really at a loss of what to do, I am ready to give up.

I can vouch for any dentist who went on to practice LAW. Contacting one isn't always about malpractice. It's mostly about being sent to oral surgeons who have seen the worst cases... If they need your records the lawyer will request them from ALL docs involved. Going to Mayo across the globe will be as useless as the ER visit! It's your choice

I've been nerve damaged for many of years to have heard it all :eek:

So this guy could give me a referral? I just want to get this fixed. I feel like I am dying.

Cleo,

You can vouch for ANY dentist that went on to practice law? How is that? I know of some dentists/lawyers and would be hard pressed to trust them. I don't know about the one you mentioned, that's why I asked how you knew of him.

I do agree that contacting one is not an automatic lawsuit by any means.
I also agree that going to the Mayo clinic would most likely not be all that helpful or worth the trip.

Bryanna

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?

Hi Bryanna,
I just heard from the ENT office and they keep telling me also there is nothing wrong. After I explained that I was still having symptoms they offered to do an MRI. The last time I had an MRI it was of my neck and keep telling them that it was the maxofacial MRI that caught it before. He says the neck MRI will show the dental area. Is that true? I am so frustrated, nobody will listen to me.

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

Angels,

MRI's just like CT scans are done according to what is written on the script. It has to specifically be written to view the area of concern.

Who has the MRI that was already taken that showed the area? That is the MRI that you need to get a hold of.

Also, did you speak directly to the ENT or someone else at that office? Is this the ENT that saw something suspicious on that other MRI?

Before you go any further, besides feeling better, what do you want to happen? Do you want an ENT and an oral surgeon to collaborate on your case? Are you willing to force that issue if you have to? Are you confident with anyone that you have consulted with so far? If so, who?


Bryanna

Ok, I just called the oral surgeons office and he did a 3D ct scan the day he did the implant. He said he didn't see anything. No the ENT did not find anything on the other MRI. The doctors will not collaborate because they don't think anything is wrong. I think they think I am a hypochondriac or something. I really am not, I just want to feel good again. Meanwhile, I sit and suffer. Not sure what to do. Nobody wants to pursue this any further.

I didn't pass the nice, polite patient profile with flying colors after what happened to me in 2001. I was most likely every dentist/doctors worst nightmare. The chairside assistant was fired and the other one wouldn't even step foot in the same room with the dentist and I, I would still suggest you seek legal help. Or you can just step away and keep going to ER

Legal help is not going to fix the immediate problem. I realize that I will need that, but I feel like I am dying here.
Also, I am married to an attorney.

Angels,

Okay .. so your husband is an attorney. Then he can probably tell you how difficult it would be to win a case against a dentist. However, it can be done, but the plaintiff needs to have an incredibly "rare" attorney who will not hesitate to take it on. The plaintiff also needs to have ALL of their ducks in a row. By any chance does your husband know of the attorney that Cleo recommended? Any chance your husband could give him a call on your behalf or even go with you to a consultation?

You may need to pursue legal help sooner than you would like if you cannot get an oral surgeon and an ENT to collaborate and take your situation seriously. You can't keep getting scans and ending up in one dead end after another. What does your husband say about all that is going on?

Bryanna

Legal advice.... never gets this 'fixed". But, you have a better chance at finding out what the problem is by getting more opinions from doctors/dentists the attorney recommends. Knowing what's wrong sure puts you in a different state of mind! It's won't kill you under normal circumstances....

Right now I am not even thinking of lawsuits, I just want to be fixed. San Francisco is on the other end of California. It is too far from here and I am sure he would be expensive. I went to the doctor and I have bronchitis. I also have some sort of infection on my soft palate and my nose is a mess. I know this is being caused by the teeth. I think I just need everything taken out. It is hurting me just to breathe right now. I just cry all the time and this isn't me. Is it possible that there is still infection in there but it isn't showing up on the scans? My husband doesn't know what to do. He is a very mild mannered man and is not a take charge person. He keeps saying be patient they will figure it out. But nobody does. He is the son of a brilliant surgeon so he puts a lot of faith in doctors.

Crying makes a chronic pain condition worse. No one can help you but yourself at this point. If you think it all needs to come out? Call the dentist who put it in and tell them to take it out!

Angels,

Please listen to me. I am NOT saying or insinuating that you should sue your oral surgeon at this time or even ever. Let me state that again ... "I" am NOT the one saying you should take legal action against your oral surgeon at this time. The purpose of consulting the attorney, even via the phone, is to see if he can offer you some direction as to where to get the most comprehensive care based on your particular situation. I do not believe he is a "referral service" as it's been insinuated (not by me) on this forum. But if he feels your situation warrants intervention he is likely to refer you. This does not mean you would be obligated to sue your previous surgeon. The only way to know for sure what he would do for you, is to call him and find out.

I would not be encouraging you to contact the attorney, if you had another reputable source to refer you to an oral surgeon and an ENT that you could trust to take care of you.

I am gathering some information for you and in a few minutes will send you a personal message. Before you do anything else, please check your PM and let me know your feedback.

Bryanna

Cleo,

I'm sure Angels knows that she has to help herself and she would do that if she felt more confident in going in one direction over another.

Angels has posted that the oral surgeon that placed the implant scared her into doing it. He also has not been forthcoming with any findings on her panoramic xrays or scans both prior and after the surgeries. He has also repetitively dismissed her ongoing symptoms of ill health. Perhaps he is not the one she should continue to rely on for her dental care.

Also, you may not know this but it is not that simple to just go to the surgeon and say.. take this implant out. The surgeon legally has to agree that there are reasons beyond any doubt to remove it. If he doesn't agree and something goes wrong or something unexpected occurs after the surgery, he can be sued big time for performing surgery that he did not think was warranted.


Bryanna

Angels.. attached diagram of a tooth
 

Angels,

In my PM to you I've asked you to check back here as I would attach a diagram of the anatomy of a tooth. The dentin tubules.... which are many many hundreds of microscopic canals.... are depicted in this diagram.

Bryanna

Hi Bryanna,
I know I am going to need to get this implant taken out regardless. My left ear is ringing so bad now and I can't hear out of it very well. What worries me is if they take it out can that affect the trigeminal nerve? In looking at pictures it doesn't seem like it is anywhere near tooth 14. Tomorrow I have the MRI. I am praying that it sees something. When I zoom in on the tooth I can't see it anymore. Also, how is a bone infection detected?

Angels,

Removing the implant would only be a part of the remedy, but not the cure. First the proliferation of the infection and bone deterioration of your upper left maxillary arch and sinus, needs to be determined as best as possible before any oral surgery is done. Otherwise, the surgery will be incomplete. The proliferation of the systemic infection, meaning in your blood system, needs to be evaluated with specific blood tests prescribed by a knowledgeable practitioner (perhaps infection disease specialist) who knows what key markers to look for in the blood. A culture of the findings is also very helpful to determine the proper antibiotic(s) to use. This is not just a routine blood test.

A planned surgical approach to remove the implant and debride the areas of infection from the bone and sinus is then presented and executed in conjunction with the administration of the proper medication.

Jaw bone infection is determined by several things. The more pronounce the infection the easier it is to pick up. It can often be seen radio graphically on some 2 and usually 3 dimensional xrays, 3D CT Scans, some MRI's, bone scans, and when a surgeon goes in to extract a tooth or place a dental implant the infected bone has an odor that is hard to miss ... it can usually be seen and/or felt with surgical instruments as the infected bone is not solid or the same color as healthy bone.

The trigeminal nerve has many sensory branches which feed into other nerve bundles throughout the head, face and neck. Each tooth in the mouth is intimately connected to sensory nerves that stem off of the trigeminal nerve.
Residual infection in the jaw bone of extracted 14 and 15 and/or in the sinus of same area ... in addition to the dental implant in 14 site could easily be irritating and inflaming the sensory nerves of the TN that affect the ear, thus the ringing in your ear, etc.

Bryanna

I am going in for an MRI in a few hours. the whole area where the implant was placed is aching and hurting off and on and I am getting a very sour taste in that area. Even my jaw is hurting. The left side of my neck is swollen and my left ear is ringing loudly still. I feel horrible like I have an infection still. It has been a tough day as I almost lost my puppy who had a severe anaphylactic shock after she got stung by a bee this morning. Thank god I threw her in the car and took her to,the ER. Hopefully I will be able to sleep in the MRI tube. I really hope it shows something, I truly don't know how I will live with this much longer.

Angels,

You do have an infection and it needs to be properly diagnosed. You cannot go on much longer like this without further problems developing. I hope the MRI is diagnostic of that area. However, I would not solely rely on the opinion of your oral surgeon or the ENT because they have both be dismissal and non informative in the past.

I hope your puppy is okay... how scary!!

Please keep in touch here....
Bryanna