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diaba
08-23-2011, 12:54 PM
Hi, I have an infected root canal tooth(molar) with jaw involvement that will be removed next week. The surgeon gave me the option of having cadaver bone graft placed for an x-tra $500. He left it up to me and didn't recommend one way or the other what I do. Do I need to do this, will it heal better? I do have ms/lyme so am concerned putting a foreign substance inn there might set things off. He didn't know about that aspect of it.

thanks




Bryanna
08-23-2011, 06:50 PM
Hi diaba,

Good to hear that you are having that infected tooth removed.... your immune system will thank you for that :-)

With regard to having a bone graft after the removal of that tooth...

One.. bone graft should not be placed in an extraction site if the jawbone is infected. Ideally in that case, a small second surgery would be done in the surgical site about 2-4 weeks after the extraction of the tooth. Bone graft material and infected bone do not mingle well together. Sometimes, the infected bone is able to be debrided at the time of the extraction and so long as there is a good solid bone remaining with a good blood flow, the graft can be placed with much success.

Two... Bone graft material is placed in the socket of the extracted tooth to stimulate new growth of bone. The body eventually resorbs the graft material and replaces it with your own bone.... which helps to keep a fuller more natural curvature of the bone instead of a hollow depression where the tooth use to be.

Three.. There is some concern and controversy about placing bone graft material in patients who have any chronic medical condition such as lymes or any autoimmune disorder. The pros and cons should be discussed with your dentist and possibly your physician as well. It is an individual decision based on your overall health history and present well being.

Please let us know how everything goes... I'm sure you will be just fine :)

Bryanna


Hi, I have an infected root canal tooth(molar) with jaw involvement that will be removed next week. The surgeon gave me the option of having cadaver bone graft placed for an x-tra $500. He left it up to me and didn't recommend one way or the other what I do. Do I need to do this, will it heal better? I do have ms/lyme so am concerned putting a foreign substance inn there might set things off. He didn't know about that aspect of it.

thanks

diaba
08-24-2011, 03:35 PM
Thanks bryanna, he does plan to debride the jaw infection before placing the cement. Does the bone graft help it heal faster or make it take longer?

thanks again, diana

Bryanna
08-24-2011, 05:45 PM
Hi diana,

If the jawbone is healthy and there is no residual infection prior to placing the bone graft material, then the bone graft helps with the healing process because it stimulates your own bone to grow into the graft which ultimately creates a higher, thicker bone level. Similar to what was there before the tooth was removed.

When you have a tooth removed, there is a large hole in the bone where the tooth use to be. The bone on the sides of the hole collapse down to partially fill that hole but the end result is a thinner, flatter, level of jawbone. All extractions cause 50% or more bone loss at the site of the extraction if bone graft material is not placed in the hole.

Hope this information is helpful. Please keep us posted on how you're doing!
Bryanna




bone.Thanks bryanna, he does plan to debride the jaw infection before placing the cement. Does the bone graft help it heal faster or make it take longer?

thanks again, diana

diaba
08-26-2011, 05:15 PM
Thanks again for your help. It doesn't appear my bio dentist is going to get ahold of me to give me any advice before I have this done, so very happy to have this info from you. I'll let you know how it goes.

Also, am I supposed to be on antibiotics after this, if so who gives them to me?

thanks again, diana

Bryanna
08-26-2011, 09:41 PM
Hi Diana,

The dentist will determine if antibiotics are necessary.... sometimes they are, sometimes not. It depends on what he finds when he removes the tooth. He will also be the one to prescribe them to you if needed.

.......You are very welcome.... I am happy to be of help :)

Bryanna






Thanks again for your help. It doesn't appear my bio dentist is going to get ahold of me to give me any advice before I have this done, so very happy to have this info from you. I'll let you know how it goes.

Also, am I supposed to be on antibiotics after this, if so who gives them to me?

thanks again, diana

diaba
09-03-2011, 08:06 PM
okay had it done on Monday, other than a migraine from the meds I thought it went pretty well. Did get chills for several days, nasal and forehead sinus' feel inflamed,and I don't feel very well. The pain which wasn't much at the start is actually starting to increase(due to healing i hope?)How will I know if I'm getting an infection? the original infection didn't cause much pain, will I need a new x-ray taken?

Just concerned since I'm not feeling very well right now.

thanks, diana

Bryanna
09-03-2011, 09:38 PM
Hi diana,

Glad to hear the surgery is all done. Usually, the surgical site will start to feel better after a few days, not worse. You may get various sensations of pressure and some achiness, you could feel a bit ill for a few days, but at this point you should start to feel better and the pain should not increase.

Try to determine if the pain is actually worse or just different. When you do go back to see the surgeon?

Bryanna


okay had it done on Monday, other than a migraine from the meds I thought it went pretty well. Did get chills for several days, nasal and forehead sinus' feel inflamed,and I don't feel very well. The pain which wasn't much at the start is actually starting to increase(due to healing i hope?)How will I know if I'm getting an infection? the original infection didn't cause much pain, will I need a new x-ray taken?

Just concerned since I'm not feeling very well right now.

thanks, diana

diaba
09-05-2011, 12:38 PM
I think it's worse but maybe just different, so I'm not totally sure. I go back to see the surgeon tomorrow.

Bryanna
09-05-2011, 01:32 PM
ok, keep us posted!

I think it's worse but maybe just different, so I'm not totally sure. I go back to see the surgeon tomorrow.

diaba
09-08-2011, 12:46 PM
The surgeon said it looks okay. I asked how I would know if it was getting infected and he didn't really have an answer for me. Joked that wishes he could hook people up to a computer to tell--what??

Anyway the pain is less now, so that's a good sign I think.

On the other side I have what he thinks is an infected root(has pain too) Would antibiotics be enough to kick that, or does another tooth have to go. He said I'd have to talk to my dentist about that. Your opinion?

thanks, diana

Bryanna
09-08-2011, 06:38 PM
Hi Diana,

I'm glad to hear that your extraction site is healing well and feeling better!

With regard to the other side of your mouth with the "infected root".... what that actually means is that the inside of the tooth and at least the surrounding bone is infected. I'm sorry but antibiotics will not cure the infection, nor will a root canal or an apicoectomy simply because the infection has proliferated into the tiny canals within the tooth. These canals are not accessible by any means. So realistically, you are dealing with a chronic infection irrelevant of what dental treatment you have done to "retain" the tooth.

Did your dentist tell you about this other tooth or was this a surprise?

Bryanna




The surgeon said it looks okay. I asked how I would know if it was getting infected and he didn't really have an answer for me. Joked that wishes he could hook people up to a computer to tell--what??

Anyway the pain is less now, so that's a good sign I think.

On the other side I have what he thinks is an infected root(has pain too) Would antibiotics be enough to kick that, or does another tooth have to go. He said I'd have to talk to my dentist about that. Your opinion?

thanks, diana

diaba
09-09-2011, 09:07 PM
An unpleasant surprise. In my surgical consult I mentioned that I wasn't sure how I was going to chew since a tooth on the opposite side was even more painful. He said that's because there's some infection there. My dentist didn't pick it up and i'm not sure she's in agreement with him. Is there a better way to tell than the cone bean x-ray?

diana

Bryanna
09-09-2011, 10:03 PM
Hi Diana,

If the surgeon says there's infection in the jaw, then that's what I would believe over your general dentist. Unfortunately, many general dentists are not always accurate on picking up radiographic pathology thus frequently missing or misdiagnosing a dental infection. I know, this sounds stupid... but I've seen it happen too frequently to discount it.

The surgeon tends to be more accurate in diagnosing radiographic pathology because his extensive education covered this topic far greater than the general residency program. It is also what he sees and treats every day.

Sometimes people post an xray here for me to view. If you wanted to do that, I would be glad to take a look and may be able to explain what the surgeon is diagnosing. Just make sure none of your personal information is on the film.

Bryanna




An unpleasant surprise. In my surgical consult I mentioned that I wasn't sure how I was going to chew since a tooth on the opposite side was even more painful. He said that's because there's some infection there. My dentist didn't pick it up and i'm not sure she's in agreement with him. Is there a better way to tell than the cone bean x-ray?

diana

diaba
09-11-2011, 01:18 PM
I wish I could post the cone beam here, but my computer won't even open it up.

It's been almost 2 weeks now, am still having symptoms of right(surgery) side nasal and forehead sinus' feel inflamed(feel congested but aren't), sometimes traveling up to my head, and right sore throat. Could I be battling an infection? How would I know if it's a sinus infection or a jaw infection? Could I be rejecting the bone graft? Could I still be reacting to the ozone treatment of the jaw? Still feeling unwell too(more than usual with the lyme/ms).

Sorry I have so many questions. This is all so complicated.

diana

Bryanna
09-11-2011, 05:52 PM
Hi Diana,

The infected tooth that was removed as well as the surgery and bone grafting are all contributing factors to what you are feeling now. Once a tooth is infected, the surrounding bone and tissue become inflamed. The longer the infection is present the more necrotic the bone becomes and it can take awhile for everything to calm down after the tooth is removed. Add to that the new graft material and your asking your body to recover and heal at the same time. Having your immune system compromised during all of this can slow down the process. The sinus/forehead pain can be from inflammation or there could be an infection brewing. That is something that would need to be evaluated clinically.

What are some things you are doing to help with the healing? Supplements... probiotics ... nutrition.... keeping well hydrated with lots of good water??

What are you rinsing with? Avoid any mouthwash that contains alcohol, dyes or preservatives because it will decrease the flow of saliva. Salt water rinsing is really ideal after oral surgery.

Did the dentist take a single xray of that hurting tooth?

Bryanna





I wish I could post the cone beam here, but my computer won't even open it up.

It's been almost 2 weeks now, am still having symptoms of right(surgery) side nasal and forehead sinus' feel inflamed(feel congested but aren't), sometimes traveling up to my head, and right sore throat. Could I be battling an infection? How would I know if it's a sinus infection or a jaw infection? Could I be rejecting the bone graft? Could I still be reacting to the ozone treatment of the jaw? Still feeling unwell too(more than usual with the lyme/ms).

Sorry I have so many questions. This is all so complicated.

diana

diaba
09-13-2011, 09:16 PM
whew, bad sinus day yesterday but not as bad today. I think i'm eating pretty well, can only chew soft foods still. Doing smoothies/juices too. Taking probiotics once a day. Rinsing few times a day with warm salt water. I guess I'm just going to have to wait and see as long as it's tolerable, again, calmer today.

They did a since x-ray of the tooth that was removed but not of the more painful one on the other side. That was picked up on the cone beam.

Just want to say how much I appreciate all the info/support you have given me. My dentist is a poor communicator and if I didn't get the advice from you my stress would be much worse, so thanks again.

diana

Bryanna
09-14-2011, 03:38 PM
Hi Diana,

Glad to hear that you are feeling a bit better.... hopefully things will improve with each day.

Thank you for the kinds words... much appreciated =)
Dentists/doctors can be very bad communicators and quite often they do not cover enough of the particulars of the problem or the treatment or the aftercare as they really should. I think it's a good idea to have a patient care counselor present in the office who is knowledgeable enough to discuss all of these things with the patient. Then the patient is better informed, less worried and knows what to expect. Also when something of concern does occur they have someone to talk to.

I'm here as often as possible.... feel free to reach out... and if I can, I will help!

Hope today has been a good day for you!!

Bryanna


whew, bad sinus day yesterday but not as bad today. I think i'm eating pretty well, can only chew soft foods still. Doing smoothies/juices too. Taking probiotics once a day. Rinsing few times a day with warm salt water. I guess I'm just going to have to wait and see as long as it's tolerable, again, calmer today.

They did a since x-ray of the tooth that was removed but not of the more painful one on the other side. That was picked up on the cone beam.

Just want to say how much I appreciate all the info/support you have given me. My dentist is a poor communicator and if I didn't get the advice from you my stress would be much worse, so thanks again.

diana

diaba
10-16-2011, 04:24 PM
I'm back with an update. Still having what feels like inflammation in my nasal and forehead sinuses and the feeling often moves onto my scalp and gives me a headache.

Yesterday I got intermittent pain in what felt like my ear drum on that side. It's been 6 weeks, I'm concerned that it is infected. How will I know?, do I contact the surgeon or a dentist, or my doctor?

If infected do they need to clean it out or can I just try clindamycin or more ozone. I really hoped it would help to remove an infected tooth, instead it has just caused more trouble.

Oh well, need to resolve it somehow...

thanks, diana

Bryanna
10-17-2011, 06:23 PM
Hi diana,

I'm sorry to hear you are having so much trouble with this. I know you feel discouraged but try to look at it from a positive perspective in that it really was best to remove that infected tooth. There is a very good chance that these on going problems are related to having the root canal which caused several things to occur including the infection to spread to the jaw. Anatomically, an infection in the jawbone creates a slue of things to occur in the skeletal structure surrounding the infected tooth. It can become very complicated but let's just say one area is connected to another and another.......

What you are experiencing is frequently the aftermath of keeping an infected tooth instead of removing it. Of course your dentist didn't give you this information at that time, just like most other dentists with their patients. What you are experiencing occurs to some degree in most people with your original dental situation... either soon after the extraction or sometime down the road. I know this doesn't make it better...

One way to help diagnose an infection is to have some blood work done. A CBC w/differential and a C-Reactive Protein which is a marker for inflammation that often coincides with infection. Talk to your physician about other infection/inflammatory markers.

If there is an infection still in the jawbone at the surgical site, treatment would depend on clinical findings, your blood work, your xrays and your symptoms.

Again, I am so sorry you are dealing with this. Have you decided what to do about the infected tooth on the other side?

Bryanna



I'm back with an update. Still having what feels like inflammation in my nasal and forehead sinuses and the feeling often moves onto my scalp and gives me a headache.

Yesterday I got intermittent pain in what felt like my ear drum on that side. It's been 6 weeks, I'm concerned that it is infected. How will I know?, do I contact the surgeon or a dentist, or my doctor?

If infected do they need to clean it out or can I just try clindamycin or more ozone. I really hoped it would help to remove an infected tooth, instead it has just caused more trouble.

Oh well, need to resolve it somehow...

thanks, diana

diaba
10-19-2011, 09:49 PM
Thanks, it actually does help to hear that this does happen, and it's not just me. I have an appt with a new dentist early next month to get a second opinion of the poor crown/possibly infected tooth and the extraction site.

I had to wait to make the appt, I just couldn't deal with it for awhile.

I'll also ask my doc for some blood work.

thanks, I'll keep you posted.

diana

Bryanna
10-22-2011, 02:28 PM
OK... hope you feel better.... keep us posted :-)

Bryanna


Thanks, it actually does help to hear that this does happen, and it's not just me. I have an appt with a new dentist early next month to get a second opinion of the poor crown/possibly infected tooth and the extraction site.

I had to wait to make the appt, I just couldn't deal with it for awhile.

I'll also ask my doc for some blood work.

thanks, I'll keep you posted.

diana

Vowel Lady
09-27-2012, 07:29 AM
bump

This situation is very similar to my own.

Since my extraction and bone graft on the same day, I've had pain, but also low grade fever. IT has been 3 weeks+.

I've had lots of blood work....about 16 vials taken. I've had a blood culture. I believe I had the c reactive taken and am awaiting one more related to inflammation (not back yet). I have a history of lupus, but was discovered to have Sjorgens Syndrome (I've had the symptoms for awhile now, but didn't recognize them...although my dentist was adament that my mouth was unusually dry).

Today, I am removing the bone graft. I am using an Oral Surgeon. The Surgeon (but the dentist prior to surgery could AS WELL) can see inflamation all around the tooth (extracted tooth) area down low in the jaw.

From what I can discern, unless there is certainty of no infection (and my guess that would really be a rare case...because probably the majority of extractions are due to infection) AND the patient has unusually good health, the dentist should wait a good while (a minimum of a month) to make sure the infection is entirely gone.

I am not a dental professional, but I have been reading whatever I can get my hands on and I've seen two oral surgeons who have hinted (the current one strongly) this very thing...which coincides with what I have read on line. BTW, the first oral surgeon refused to take out the graft saying I should have my dentist take care of it. I am fortunate to have this oral surgeon today help me.

This has been one of the most difficult and frightening experiences of my life.

Please keep good thoughts for my graft removal today.

Thank you.

Bryanna
09-27-2012, 08:50 PM
Vowel Lady,

How did the surgery go today?

Hope you're doing okay...

Bryanna


bump

This situation is very similar to my own.

Since my extraction and bone graft on the same day, I've had pain, but also low grade fever. IT has been 3 weeks+.

I've had lots of blood work....about 16 vials taken. I've had a blood culture. I believe I had the c reactive taken and am awaiting one more related to inflammation (not back yet). I have a history of lupus, but was discovered to have Sjorgens Syndrome (I've had the symptoms for awhile now, but didn't recognize them...although my dentist was adament that my mouth was unusually dry).

Today, I am removing the bone graft. I am using an Oral Surgeon. The Surgeon (but the dentist prior to surgery could AS WELL) can see inflamation all around the tooth (extracted tooth) area down low in the jaw.

From what I can discern, unless there is certainty of no infection (and my guess that would really be a rare case...because probably the majority of extractions are due to infection) AND the patient has unusually good health, the dentist should wait a good while (a minimum of a month) to make sure the infection is entirely gone.

I am not a dental professional, but I have been reading whatever I can get my hands on and I've seen two oral surgeons who have hinted (the current one strongly) this very thing...which coincides with what I have read on line. BTW, the first oral surgeon refused to take out the graft saying I should have my dentist take care of it. I am fortunate to have this oral surgeon today help me.

This has been one of the most difficult and frightening experiences of my life.

Please keep good thoughts for my graft removal today.

Thank you.

Vowel Lady
09-28-2012, 10:13 AM
I am here. The removal was ok and he took a culture. The Dr spent much time manually cleaning the area with an antibiotic. Last night was very painful, but today I feel better. Right this moment, my ear pain is only a two or three, but that fluctuates and I've been fooled many times thinking it is better and then it gets very painful. I have a low grade fever of 100.1 still and my blood pressure remains high, sometimes dangerously so. I have an emergency appt with a cardiologist very soon. I'm on a high dosage of antibiotics, have doubled my bp medication and am to start a Medrol pack in about a day. I am hopeful that things will improve. This toothp started with no pain six months ago when the
Onlay fell off....worsening all the time. The last 3 to 4 weeks have been over the top disturbing. I am trying to keep optimistic with this surgery and tx. I tell everyone to be extra cautious with dental tx these days.

Bryanna
09-28-2012, 06:06 PM
I hope things improve very soon. Glad the OS took a culture... please let us know what the results of that are when you get them.

Antibiotics can interfere with blood pressure medications resulting in either elevated or lowered blood pressure. It depends on the type of antibiotics, the type of blood pressures meds and the individual. You may want to talk to your doctor or pharmacist about what and how much you are taking. Especially before you start taking the Medrol.

Hang in there.... hopefully the worst is over!
Bryanna




I am here. The removal was ok and he took a culture. The Dr spent much time manually cleaning the area with an antibiotic. Last night was very painful, but today I feel better. Right this moment, my ear pain is only a two or three, but that fluctuates and I've been fooled many times thinking it is better and then it gets very painful. I have a low grade fever of 100.1 still and my blood pressure remains high, sometimes dangerously so. I have an emergency appt with a cardiologist very soon. I'm on a high dosage of antibiotics, have doubled my bp medication and am to start a Medrol pack in about a day. I am hopeful that things will improve. This toothp started with no pain six months ago when the
Onlay fell off....worsening all the time. The last 3 to 4 weeks have been over the top disturbing. I am trying to keep optimistic with this surgery and tx. I tell everyone to be extra cautious with dental tx these days.

Vowel Lady
10-03-2012, 09:56 AM
I am being treated for very bad high blood pressure.This started when extraction and bone graft were put in on the same day.

My meds had to be increased significantly per a cardiologist.

The graft was removed....the stiches are not out yet.

At issue (at this moment) is severe ear pain.

I'm very concerned.

Please take a look at my other post from this morning 10/3.

Thank you very much.

100YEARS
11-12-2012, 11:56 PM
Can someone please offer some thoughts on what's happening with my extraction?
I have never had an extraction prior to this and have no immune issues. I am vegan and on no medication. I don't know how/why I would be having these complications unless my diet is related--though I think it's generally healthy and well-rounded.

I had an extraction/bone-graft in the same day (2 weeks ago) and had trouble right away. On the 3rd day, pain started to get worse and it started to smell bad. I wasn't eating soft foods, however. I think it was food and plaque build-up in the area, and maybe this led to an infection. The extraction was because of a failed root canal and the dentist said there was probably a low-grade infection, though I don't recall my dentist doing any cleaning in the socket, so I don't know if he left behind some infection or what. At any rate, the smell/taste was very frustrating, as I couldn't clean it. He didn't inform me until the 5th day that I should be doing salt-water rinses.

The pain got worse and the gums around the extraction have been swollen since the 4th or 5th day. Periodically, the area gets more swollen and hot, so I'm fairly sure there's infection going on. I removed the stitches myself on the 7th day because they seemed to be trapping food and plaque and were cutting into my swollen gums and I felt like they were delaying the healing process. Maybe this was a bad idea, but the smell has gotten MUCH better since then.

However, the area is VERY red and raw and bleeds when anything touches it. I'm pretty sure the infection is still active and I don't know if it's the graft or if antibiotics will heal it or if I should have my dentist curette the area or what. I try to be as natural as possible and avoid antibiotics when possible. I've been eating about 5-6 cloves of raw garlic for the last week and putting garlic on the extraction site for about 10 minutes a day, hoping its antibiotic properties will help heal things.

I'm so frustrated because I've never had an extraction or surgery of any kind, and I hate being so affected by this! I am worried I'm never going to get over this infection and I don't want to do more damage to my poor mouth. All of the molars on that side of my face are sore and the area throbs a lot. Today, my cheek muscle has been twitching a lot, though I have to admit I do sort of push on the area a lot. It drives me nuts that it's so painful.

It feels a lot like it did when I needed the original root canal--very tender. The roof of my mouth is also very very tender and swollen around that site.
I can't stand this, and I don't know if I'm making it worse by the garlic (also, I have been putting oregano oil on it, as well) or if this is normal or what. I've read that antibiotics can't heal a bone graft infection, and I'm afraid that's what this is. The site is red and raw with the exception of a big splotch of yellow in the middle, which may be collagen, I think? Or infection? I have no idea what the **** is happening, but I'm disturbed.

It sort of looks porous when I look at it in the mirror. Is it possible my body is rejecting the graft? I wouldn't put it past my body to pull some kind of crap like that.

Bryanna
11-19-2012, 02:37 PM
Hi 100 years,

Well by now you have probably been to your dentist to check this out. Or hopefully you have....

I agree to be as natural as possible.... however, please NEVER put anything on any oral surgical wound. Garlic is the BEST natural antibiotic when taken internally, however, garlic placed on an open wound can burn the tissue. Also, it is imperative to not disturb the bone graft which means to stay away from it as much as possible until the site has healed closed.

Oregano oil is also a great antibacterial, but never place it on an oral wound. It will irritate, even burn the tissue and can interrupt or prevent the site from healing.

With all of that said..... infected root canaled teeth means infected jaw bone. It is risky to place bone graft material in bone that is infected. Perhaps the bone infection is a contributing factor to what is going on with you.

What has your dentist said? How is the site feeling now?

Bryanna


QUOTE=100YEARS;930961]Can someone please offer some thoughts on what's happening with my extraction?
I have never had an extraction prior to this and have no immune issues. I am vegan and on no medication. I don't know how/why I would be having these complications unless my diet is related--though I think it's generally healthy and well-rounded.

I had an extraction/bone-graft in the same day (2 weeks ago) and had trouble right away. On the 3rd day, pain started to get worse and it started to smell bad. I wasn't eating soft foods, however. I think it was food and plaque build-up in the area, and maybe this led to an infection. The extraction was because of a failed root canal and the dentist said there was probably a low-grade infection, though I don't recall my dentist doing any cleaning in the socket, so I don't know if he left behind some infection or what. At any rate, the smell/taste was very frustrating, as I couldn't clean it. He didn't inform me until the 5th day that I should be doing salt-water rinses.

The pain got worse and the gums around the extraction have been swollen since the 4th or 5th day. Periodically, the area gets more swollen and hot, so I'm fairly sure there's infection going on. I removed the stitches myself on the 7th day because they seemed to be trapping food and plaque and were cutting into my swollen gums and I felt like they were delaying the healing process. Maybe this was a bad idea, but the smell has gotten MUCH better since then.

However, the area is VERY red and raw and bleeds when anything touches it. I'm pretty sure the infection is still active and I don't know if it's the graft or if antibiotics will heal it or if I should have my dentist curette the area or what. I try to be as natural as possible and avoid antibiotics when possible. I've been eating about 5-6 cloves of raw garlic for the last week and putting garlic on the extraction site for about 10 minutes a day, hoping its antibiotic properties will help heal things.

I'm so frustrated because I've never had an extraction or surgery of any kind, and I hate being so affected by this! I am worried I'm never going to get over this infection and I don't want to do more damage to my poor mouth. All of the molars on that side of my face are sore and the area throbs a lot. Today, my cheek muscle has been twitching a lot, though I have to admit I do sort of push on the area a lot. It drives me nuts that it's so painful.

It feels a lot like it did when I needed the original root canal--very tender. The roof of my mouth is also very very tender and swollen around that site.
I can't stand this, and I don't know if I'm making it worse by the garlic (also, I have been putting oregano oil on it, as well) or if this is normal or what. I've read that antibiotics can't heal a bone graft infection, and I'm afraid that's what this is. The site is red and raw with the exception of a big splotch of yellow in the middle, which may be collagen, I think? Or infection? I have no idea what the **** is happening, but I'm disturbed.

It sort of looks porous when I look at it in the mirror. Is it possible my body is rejecting the graft? I wouldn't put it past my body to pull some kind of crap like that.[/QUOTE]

Vowel Lady
11-26-2012, 11:36 PM
Hopefully, all will be well. It is good to think positive, but at the same time, be diligent. I had excessive problems with some dental work, which led to the tooth (which never hurt originally) being removed and a bone graft on the same day. Since then, I have been very ill and In Severe pain...likely nerve pain. I am
Frightened and my life has l been changed in a negative way, likely permanently. Always get a second opinion or third with dental surgery and ask around when choosing a dentist. AND don't always assume something is an infection. True, that always has to be seriously considered, but nerve damage is also a real and horrendous possibility that few if anyone talks about.

Vowel Lady
11-27-2012, 12:04 AM
I find it interesting how often these dentists want to do grafts on the same day of an extraction and how often they refuse to give advice or answer good questions related to their own profession or treatments.

Again, think positive, but don't hesitate to get a second opinion from an oral surgeon and even your gp.

Sometimes, our bodies just need extra time to heal. But if your instincts tell you something could be wrong, double check.

Be very careful. I was careful, but still ended up with severe medical problems that should never have happened.

neilnigsy
12-10-2012, 10:16 AM
Hi, I have an infected root canal tooth(molar) with jaw involvement that will be removed next week. The surgeon gave me the option of having cadaver bone graft placed for an x-tra $500. He left it up to me and didn't recommend one way or the other what I do. Do I need to do this, will it heal better? I do have ms/lyme so am concerned putting a foreign substance inn there might set things off. He didn't know about that aspect of it.

thanks

this is a classic example of dentristry profitering he knows exacly what hes doing and wants to make as much money as he can.his work might well be good but he wants as much out of it that he can

Vowel Lady
01-05-2013, 04:08 PM
Especially since you have MS you need to be ultra careful when it comes to nerve damage. If you even suspect your dentist isn't being ultra careful or is doing any procedures that are unnecessary or risky, get another dentist or at least a second opinion.

asquirrel
01-26-2013, 04:18 AM
Especially since you have MS you need to be ultra careful when it comes to nerve damage. If you even suspect your dentist isn't being ultra careful or is doing any procedures that are unnecessary or risky, get another dentist or at least a second opinion.

I just had my molar #14 extracted yesterday and the surgeon didn't do a bone graft. I had planned to talk with him about getting one done at the time of the extraction and mentioned it to his staff when I called to set up an appointment but I forgot. Then the procedure began and I only focussed on the crunching and grinding sounds of bone and hoping to god that I would get out of the procedure safely.

I was going to call his office on monday and find out what my options are. Is it more risky to do now because it wasn't done during the extraction? What things should I be concerned about?

My initial reason to do this is in case I want to get an implant or bridge in that spot later. Or I think even with a flipper it won't sit right because of the bone loss because I didn't get it done with the extraction. Now I bet that spot will be all squishy and if I put a flipper or a bridge on it I won't even be able to chew food on it.

How soon should I go back to get the bone graft if it's even possible at this point? And now I'm freaking because I'm going to have to go through more grinding and crunching...I think. If someone could give me some advice it would be really appreciated. I feel like an idiot for not bringing this up right away. I think even if I had wanted a bone graft he couldnt have done it because he had someone on deck after me and was kind of backed up. Plus, I'm not sure how much more work it would have been to put the graft in. maybe only a few more minutes. I have no idea. Sorry for rambling.

Bryanna
01-26-2013, 10:53 AM
Hi asquirrel,

Bone grafting is generally recommended at the time of the extraction providing there is no infection in the bone. However, not every extraction requires a bone graft. It all depends on the size and quality of the bone after the extraction. I am surprised that he didn't discuss this with you himself??
Was it a root canaled tooth that was removed?

It is not too late to do a bone graft. Some surgeons wait 2 weeks post op the extraction some a bit longer. It depends on the health of the bone at the time of the extraction.

To place a bone graft using synthetic bone material is not a big surgery. It only takes a few minutes. Just so you know.... :)

Call the surgeons office and ask to speak to the surgeon (preferable) or have someone there speak to them about doing the graft. Better to do that than wonder about it.....

Bryanna



I just had my molar #14 extracted yesterday and the surgeon didn't do a bone graft. I had planned to talk with him about getting one done at the time of the extraction and mentioned it to his staff when I called to set up an appointment but I forgot. Then the procedure began and I only focussed on the crunching and grinding sounds of bone and hoping to god that I would get out of the procedure safely.

I was going to call his office on monday and find out what my options are. Is it more risky to do now because it wasn't done during the extraction? What things should I be concerned about?

My initial reason to do this is in case I want to get an implant or bridge in that spot later. Or I think even with a flipper it won't sit right because of the bone loss because I didn't get it done with the extraction. Now I bet that spot will be all squishy and if I put a flipper or a bridge on it I won't even be able to chew food on it.

How soon should I go back to get the bone graft if it's even possible at this point? And now I'm freaking because I'm going to have to go through more grinding and crunching...I think. If someone could give me some advice it would be really appreciated. I feel like an idiot for not bringing this up right away. I think even if I had wanted a bone graft he couldnt have done it because he had someone on deck after me and was kind of backed up. Plus, I'm not sure how much more work it would have been to put the graft in. maybe only a few more minutes. I have no idea. Sorry for rambling.

asquirrel
01-26-2013, 03:05 PM
Hi Bryanna

Thank you so much for responding!

I think I was too worried about the extraction and I totally forgot to ask him about the bone graft. But in retrospect I guess he probably should have brought it up given that I was scheduled for an extraction.

Here’s a breakdown of my journey to an extracted tooth. This thing cracked back as early as 2004 from I guess a filling that gave out from my family dentist. Another old school 70’s style office. Been using this guy since I was a little kid. Silver amalgam fillings (whatever that old school stuff was).

I chose this new dentist because he was referred to me by my sister and brother in law. He had a nice office with lots of new equipment. Yeah. I should have looked for a personal reference or just went back to my family dentist. Expensive lesson learned.

So I went to the new dentist. The tooth (#14) that was extracted just had a temporary crown on it. The tooth was cracked laterally and I was in constant pain from the moment the dentist prepped it to the time the molar was extracted by the oral surgeon. The temp crown was put on 1/9/13. We had an appointment to put the permanent crown in for 2/11/13. Total price was $1731 for the crown. He also had to redo a filling that the crown was going to be next to for $315 because the crown wouldn’t fit right if he didn’t do it. I paid half down ($1024.50) with the balance due on the final appointment.

Afterward the procedure I was having shooting pain through the left upper and lower jaw plus a constant dull pain on number 14 (the one that was prepped with the temp crown put on). On 1/14 I went back to the dentist for a solution and he ground the crown down on #14 some more. He thought it was due to an uneven bite and said give it about 3 days for the tendons to relax. On 1/19 I was in severe pain. I was eventually able to speak with him on the phone and he thought the tooth was infected. He prescribed penicillin and hydrocodone (6 pills). On Sunday I called him back and told him my tooth was still hurting. He prescribed another 6 hydrocodone pills. He cancelled my emergency appointment that we set up for Monday because I was in so much pain and recommended that I contact a local endodontist for a root canal.

On Monday I was able to get an appointment set up with an oral surgeon for an extraction with whom my mom had gone to with good results. My sister had just had her #14 extracted from a holistic dentist place who advised her against a root canal. I had done my research and came to the same conclusion. That’s why I decided to get the tooth pulled.

Unfortunately, the appointment wasn’t until the following Thursday (1/31). I was put on a standby list and would be called if there was a cancellation. At that time I spoke with the surgeon’s nurse about getting a bone graft. She told me the range would be between $550 and $975 depending on whether there was …barriers? (something like that). She said to speak with the surgeon when I came in for the extraction. I mentioned the penicillin I was taking and she said the bone graft may not be able to get done in one visit because of the infection but to speak with the surgeon when I came in for the extraction.

I called my dentist for a refill for the pain meds and he said no. He suggested I try to get in with another dental professional. He said he’d call the lab to cancel the crown and charge me a reasonable hourly rate for the work he did thus far.

On Tuesday (1/22) I called the dentist and spoke with his wife. I asked if he could send me something as far as what he’s proposing for a credit. She told me she’d ask him and then said that he called the lab and that the permanent crown had been completed.

On Wednesday I was able to get in touch with my dad’s endodontist. I was in so much pain I was seriously considering anything that might relieve it. The endodontist was a nice guy who’s been doing endodontics since the 70’s. Probably spent about 10 minutes on the phone with me. I described my symptoms and there was no question in his mind the tooth was infected and that the nerves were inflamed and dying. I told him my concerns with a root canal and he said that although there’s risk involved he’s had a lot of success. Wednesday night I was up reading horror stories from people who had failed root canals even after initial success. Really bad infections going into the sinus cavities.

On Thursday I cancelled with the endodontist and spoke with his wife who was very understanding about my concerns. I called the oral surgeon to see if he had any cancellations. The nurse said they just had one and I was able to get in yesterday (1/25) for 9:45 a .m.

The surgeon was also a nice guy. The digital xrays sent over by the dentist of #14 via email were 35kb (kilobytes) and were too low resolution and blurry to be of any use. The surgeon said that if the tooth was cracked laterally there was fair chance the tooth couldn’t be saved to begin with. He did take new xrays but honestly I didn’t even remember what the results were. He’s office isn’t state of the art (old school xrays with the shield and stuff like that). He’s been doing this a long time. He’s also been in practice since at least since the early 70’s. I was just looking at him and his tool kit. It looked like an auto mechanic shop kit and my brain shut off. The procedure went as well as expected. I got some pain meds and was told to keep taking the penicillin I got from the dentist until it ran out. Total price for the extraction was $315 + 28 for the xrays. Pretty fair considering I called around and the next oral surgeon wanted about $130 more even looking at worse case scenario from the surgeon I went to and was about $400 less than the next oral surgeon if the bone graft was only $550.

So that’s the rest of the story.

I’ll give the surgeon a call on Monday. What’s the longest I can put this off before I get bone loss? How do they get back in there to put the bone material in? I suspect Novocain, then cut hole open with scalpel and then stick the bone stuff in and then stitch it up?

What’s the best material to use? I heard there’s like harvested bone from cadavers and also from bovines. Plus there’s your own bone scraped off and ground up (I think I want to pass on that). Is there something else? What would you suggest? I also heard that the bone powder stuff doesn’t stick around and solidify. It gets absorbed into your body and then your body makes it’s own bone to fill in the hole?

The reason I wanted to get the bone graft is that I MIGHT get an implant. Still worried about getting anything else drilled or screwed into my mouth after this ordeal. Most likely I was thinking of getting a Nesbit dental bridge. I think I read about it on the site here from a google search. My concern is if I don’t get the bone graft the area will either be too uneven or squishy for the Nesbit.

Thanks again for your help. I was really lucky to find this forum!!

Vowel Lady
02-03-2013, 07:48 PM
I'm not a dental professional, squirrel. I'm someone who ended up with lots of pain, likely permanent, as the result of questionable dental care. I'm also someone who has been, lets just say, profoundly disappointed in this field.

Some dental professionals are now saying that root canals are not good for you. Others vehemently disagree.

I think, most, if not all surgeries, should be done by an oral surgeon. And almost all procedures should be double checked with a second opinion. Easier said than done, since sometimes it is very hard to get an appointment.

Especially if a person has any autoimmune issues....issues like diabetes, lupus or MS, extra care needs to be taken.

Please post when you are able and send an update. I hope you are getting excellent and safe dental care and are feeling well.

asquirrel
02-04-2013, 10:25 PM
I'm not a dental professional, squirrel. I'm someone who ended up with lots of pain, likely permanent, as the result of questionable dental care. I'm also someone who has been, lets just say, profoundly disappointed in this field.

Some dental professionals are now saying that root canals are not good for you. Others vehemently disagree.

I think, most, if not all surgeries, should be done by an oral surgeon. And almost all procedures should be double checked with a second opinion. Easier said than done, since sometimes it is very hard to get an appointment.

Especially if a person has any autoimmune issues....issues like diabetes, lupus or MS, extra care needs to be taken.

Please post when you are able and send an update. I hope you are getting excellent and safe dental care and are feeling well.


Hi Vowel Lady!

I went to see the oral surgeon today and got an appointment to get the bone graft done. It will be done in about 30 days. The surgeon said he'd like some time for the site to heal and 30 days isn't too long to lose bone.

The site where my tooth pulled feels horrible. I feel like there's two spines in the gums that didn't come out which are sore when I touch them. There's a huge gouge in my gum line. Feels like he used wire cutters to cut a big "V" into the gum to get the tooth out. The extraction hole feels fine though which is a relief.

I feel your pain. Literally. Getting any surgical or dental procedure can result in permanent damage. And it seems like professionals are reluctant to say that one of their colleagues made a mistake (unless they're an expert witness). Maybe they're thinking, "there but for the grace of god go I."

I totally agree with you that all procedures should be checked with a second opinion. Only problem is I have pretty limited means (and probably most people do). High deductible health insurance and no dental insurance. So second opinions are an expensive proposition unless someone went really bad and you HAVE to go see someone (yeah, kind of like my dentist tossing me out in the rain when I was in pain). I'm still sore about the hole thing...literally (again). Alright, no more puns.

Anyway, I'm somewhat apprehensive about my bone graft but I'm hopeful things will go well. The surgeon has been doing this stuff since the 70's and I should be confident he knows what he's doing. :) I'll keep you posted. Thanks for your response!!!

Bryanna
02-05-2013, 08:40 AM
Asquirrel,

How did I miss your other post????? So sorry about that :/

Anyway... the two spines you talk about are probably bone spurs or bone splinters. This can sometimes occur if a tooth is badly fractured or breaks apart during the removal. It can also occur if the instrumentation was not angled properly or too much force was put on the bone when removing it. FYI.... older dentists who have never altered their original methods, those practicing for 25+ yrs or so tend to extract with more force than necessary. That is how they were taught. The technique has changed over the years to be more what is called A traumatic which is gentle, persistent and less aggressive.

Sometimes the gum gets torn during an extraction. The huge gauge in your gum is a great description of what can happen when an east/west elevator is used.... which are typically used by "older" dentists. Those elevators are generally used less often now since there are others that are a bit gentler on the gum tissue. Hopefully the tissue will heal without a huge indentation in it.

Did this surgeon offer you options of bone graft material? Honestly, was this surgeons office clean and somewhat up to date...?? I ask that because there still are dentists, young and old, who skimp on certain aspects of sterilization and disposable items because they think that stuff is over rated. I know scary..... but true. I'm just a little leery based on your description of things so far.

Bryanna



Hi Vowel Lady!

I went to see the oral surgeon today and got an appointment to get the bone graft done. It will be done in about 30 days. The surgeon said he'd like some time for the site to heal and 30 days isn't too long to lose bone.

The site where my tooth pulled feels horrible. I feel like there's two spines in the gums that didn't come out which are sore when I touch them. There's a huge gouge in my gum line. Feels like he used wire cutters to cut a big "V" into the gum to get the tooth out. The extraction hole feels fine though which is a relief.

I feel your pain. Literally. Getting any surgical or dental procedure can result in permanent damage. And it seems like professionals are reluctant to say that one of their colleagues made a mistake (unless they're an expert witness). Maybe they're thinking, "there but for the grace of god go I."

I totally agree with you that all procedures should be checked with a second opinion. Only problem is I have pretty limited means (and probably most people do). High deductible health insurance and no dental insurance. So second opinions are an expensive proposition unless someone went really bad and you HAVE to go see someone (yeah, kind of like my dentist tossing me out in the rain when I was in pain). I'm still sore about the hole thing...literally (again). Alright, no more puns.

Anyway, I'm somewhat apprehensive about my bone graft but I'm hopeful things will go well. The surgeon has been doing this stuff since the 70's and I should be confident he knows what he's doing. :) I'll keep you posted. Thanks for your response!!!

Vowel Lady
02-05-2013, 11:26 AM
I'm pretty "sore" about dentists as well. I don't know whether to laugh or cry, but I get it. Sometimes it is best to find a little humor in things that are difficult or in my case profoundly disturbing.

A friend of mine went to a dental school to have her work done due to expenses. It was less expensive, etc.

She had a cracked tooth. Interesting thing, they never fully explained why they did what they did....although I'm sure after what happened to me, my friend would ask a million questions.

Anyway, they told her no root canal. They recommended pulling the tooth and waiting three months for the area to heal, and then do the implant. They did not do or even mention a graft. She was very happy with their work and had little pain and no problems. She has an autoimmune disorder, fairly well controlled. They took everything slowly.

Wishing you a positive, safe experience with quick and steady healing.

Bryanna
02-05-2013, 12:16 PM
Vowel Lady,

Your situation is so unfortunate and probably more common than diagnosed. It is understandable for you to feel upset and be leery of trusting anyone!

Your friend who went to the dental school for dental treatment was unusually fortunate to see someone who didn't try to sell her on a rct. Evidently this student/dentist is of the mindset that fractured teeth are not usually salvageable. He also understands the risk of using bone graft material in a patient who has an autoimmune disease and chose to forgo the graft. Not all patients are good candidates for bone grafts and each patient needs to be screened on an individual basis.

Do you know which dental school she went to? Was it in the US? NYU in NYC or Temple in PA by any chance?

Bryanna



I'm pretty "sore" about dentists as well. I don't know whether to laugh or cry, but I get it. Sometimes it is best to find a little humor in things that are difficult or in my case profoundly disturbing.

A friend of mine went to a dental school to have her work done due to expenses. It was less expensive, etc.

She had a cracked tooth. Interesting thing, they never fully explained why they did what they did....although I'm sure after what happened to me, my friend would ask a million questions.

Anyway, they told her no root canal. They recommended pulling the tooth and waiting three months for the area to heal, and then do the implant. They did not do or even mention a graft. She was very happy with their work and had little pain and no problems. She has an autoimmune disorder, fairly well controlled. They took everything slowly.

Wishing you a positive, safe experience with quick and steady healing.

asquirrel
02-05-2013, 04:58 PM
Asquirrel,

How did I miss your other post????? So sorry about that :/

Anyway... the two spines you talk about are probably bone spurs or bone splinters. This can sometimes occur if a tooth is badly fractured or breaks apart during the removal. It can also occur if the instrumentation was not angled properly or too much force was put on the bone when removing it. FYI.... older dentists who have never altered their original methods, those practicing for 25+ yrs or so tend to extract with more force than necessary. That is how they were taught. The technique has changed over the years to be more what is called A traumatic which is gentle, persistent and less aggressive.

Sometimes the gum gets torn during an extraction. The huge gauge in your gum is a great description of what can happen when an east/west elevator is used.... which are typically used by "older" dentists. Those elevators are generally used less often now since there are others that are a bit gentler on the gum tissue. Hopefully the tissue will heal without a huge indentation in it.

Did this surgeon offer you options of bone graft material? Honestly, was this surgeons office clean and somewhat up to date...?? I ask that because there still are dentists, young and old, who skimp on certain aspects of sterilization and disposable items because they think that stuff is over rated. I know scary..... but true. I'm just a little leery based on your description of things so far.

Bryanna

Hi Bryanna!

No problem about missing my old post. People have lives to lead so I appreciate all feedback you folks give me. I am so glad I found this forum. You and vowel lady have been great to talk with about my dental experience. :)

This surgeon is real old school. He's been doing this since the early 70's and his office decor and materials reflect it. :) The place is old school but looks clean as you can get if you didn't do any updates for 40 years. I saw nothing that could be described as high tech except for those magnifying things he has on his glasses to see up close.

The floor was swept clean and may have been washed. Rugs looked vacuumed. No mice or cockroaches running around on the floor. It's just an old surgeon with an old office. Picture umm... lots of yellow plastic that used to be clear but has aged through the years. No plastic chairs though. They were comfortable. The guy seemed nice enough though. He put is hand on my shoulder letting me know things are okay when I was reading that disclaimer of all the bad things that could happen with a bone graft. Geesh, I'm freaking out now..not totally. I'll be okay. :)

It is a HUGE indentation. I'd take a picture of it but I think you'd freak out if you saw it. :O Maybe I will anyway and upload it. Might be interesting to get some feedback.

The bone spur things. Are they okay to stay in? Man, I'd hate to have even more surgery done. I'm thinking I should have gone to this holistic place in Haverhill, MA that my sister went to but it's a little after the fact at this point. They charged her a lot but she was very happy with the work and they were super sterile. They had this mercury protocol thing they used. They gave her vitamins and herbs to take home. Stuff like that.

The surgeon didn't give me any options on bone graft material. The stuff he recommended to me what human cadaver bone. He did get into great detail though as to how it was sterilized and not to worry about it. I don't think he's got any skeletons in his closet that he's scraping material off of. The price was going to be either $550 or $975 depending on whether he has to put a ....barrier...in? Anyway, he agreed to do it for $550 b/c he know about the fiasco I went through with the dentist I saw before him and now I'm even more broke. :O So he said to the nurse something like... "we'll use more packing material?" Hopefully it's just more cadaver material to fill the hole and not newspaper. :D I think I mentioned he had me sign a long liability waiver... :O I did speak with the nurse about other options and she mentioned sometimes they will do a bone graft using the patients own bone form another donor site but that would be a hospital visit. Think I'll pass on that option.

Speaking of passing. I think you're probably going to pass out after reading all this. :hug:

Vowel Lady
02-06-2013, 06:04 PM
My friend did not go to any of those schools you mentioned. PM if you would like to know where. The dentist was unusually quiet, but then again, she was frightened and was not in the mindset to ask questions. She is so fortunate that she got good dental care.

As part of my routine, I go to acupuncture now three x a week. I am spending $240 a week that I can NOT afford to spend. However, along with my meds, this seems to help with the severe pain.
She (The Acupunturist/Dr.) has other patients with facial neuralgia...that's why I chose her. Today I asked her what percentage came to her after a dental experience. She said one patient had a brain tumor removed and ended up with the neuralgia. ALL the others were due to bad dental experiences.

Bryanna
02-08-2013, 01:28 PM
Hi asquirrel,

Post a picture of it..... I've seen everything, this will not scare me... ;)

There is nothing wrong with old or worn .... but there is a concern in dentistry about dentists who have not updated their office (since the 70's or 80's) for the simple reason that carpets hold bacteria, mold, chemicals, and are highly contaminated with mercury after all the years of using these materials. So updating means cleaning up the contamination, not just making it pretty or new. These same dentists tend to perform antiquated procedures and also tend to not update too much of anything, including their sterilization techniques. I mention these things because most people do not think about them.... and I get the feeling you might me one who does... ?? ;)

The "high tech things on his eyes" that he uses to see with are called loops. They use them when their eyesight is going bad :/ Only kidding....... hee hee. Actually they are used frequently by most dentists because they can make the object about 4 times bigger than normal size.

I'm sure he's very reassuring... that is truly a credit to his character to be so compassionate with you.

The "packing material" is not newspaper........ although the older dentists use to use ... ...... ......! Nah, I'm sure it's not that.
Actually he may be referring to "collagen" which is used often on top of a bone graft to help keep the area filled with blood so it can heal well.

The bone spurs may need to be removed if they are bothersome or large. He may do that when he does the graft.

I cannot tell you where to go for your dental care and it's important for you to feel comfortable wherever you go. But becaue I've been in dentistry for 30+ yrs and have worked in many offices both as a temp/fill in and permanent assistant, I can tell you that I personally would not choose a dentist who has not updated his office in 20 yrs because I know first hand what's behind door #2....! Now maybe this guy is different... ?

Keep us posted and thanks for always making us laugh ~'.'~

Bryanna



Hi Bryanna!

No problem about missing my old post. People have lives to lead so I appreciate all feedback you folks give me. I am so glad I found this forum. You and vowel lady have been great to talk with about my dental experience. :)

This surgeon is real old school. He's been doing this since the early 70's and his office decor and materials reflect it. :) The place is old school but looks clean as you can get if you didn't do any updates for 40 years. I saw nothing that could be described as high tech except for those magnifying things he has on his glasses to see up close.

The floor was swept clean and may have been washed. Rugs looked vacuumed. No mice or cockroaches running around on the floor. It's just an old surgeon with an old office. Picture umm... lots of yellow plastic that used to be clear but has aged through the years. No plastic chairs though. They were comfortable. The guy seemed nice enough though. He put is hand on my shoulder letting me know things are okay when I was reading that disclaimer of all the bad things that could happen with a bone graft. Geesh, I'm freaking out now..not totally. I'll be okay. :)

It is a HUGE indentation. I'd take a picture of it but I think you'd freak out if you saw it. :O Maybe I will anyway and upload it. Might be interesting to get some feedback.

The bone spur things. Are they okay to stay in? Man, I'd hate to have even more surgery done. I'm thinking I should have gone to this holistic place in Haverhill, MA that my sister went to but it's a little after the fact at this point. They charged her a lot but she was very happy with the work and they were super sterile. They had this mercury protocol thing they used. They gave her vitamins and herbs to take home. Stuff like that.

The surgeon didn't give me any options on bone graft material. The stuff he recommended to me what human cadaver bone. He did get into great detail though as to how it was sterilized and not to worry about it. I don't think he's got any skeletons in his closet that he's scraping material off of. The price was going to be either $550 or $975 depending on whether he has to put a ....barrier...in? Anyway, he agreed to do it for $550 b/c he know about the fiasco I went through with the dentist I saw before him and now I'm even more broke. :O So he said to the nurse something like... "we'll use more packing material?" Hopefully it's just more cadaver material to fill the hole and not newspaper. :D I think I mentioned he had me sign a long liability waiver... :O I did speak with the nurse about other options and she mentioned sometimes they will do a bone graft using the patients own bone form another donor site but that would be a hospital visit. Think I'll pass on that option.

Speaking of passing. I think you're probably going to pass out after reading all this. :hug:

asquirrel
02-27-2013, 07:38 PM
Hi Bryanna!

Sorry, this time I missed your message!!!

Today with the help of my wife I was able to get some pictures of the extracted tooth area.

FYI, this area has been healing since 1/25. I have an appointment set up with the oral surgeon on 3/14 to do the bone graft. I'm again seeking your opinion as to whether the extraction looks normal (plus a million more questions at the bottom of this odyssey).

What I'm trying to show in the pics is that there's like a gouge, a "V" shape and at the top there's a couple of bumps that look like bones still in there. I get all queasy when I touch them. Eww... :( I'm just thinking with that huge gouge there...there's no way I could put a nesbit / flipper thing in there so it would sit normally and I could chew on that side again. :(

So I called a local place where I live that has a indigent clinic and they said they were not qualified to give an opinion....??? Would have been nice since it would have been like $45 for a consult. Okay..so, there's this place in MA that my sister went to. But they would charge about $200 for a consult. I'm struggling financially and my HSA account is getting precariously low. I have super high deductible health insurance in case I get run over by a bull or something and end up in ICU. But I digress.....

I'm just trying to figure out if getting a bone graft is a waste of time at this point because the area seems too cut up with the "V" and warped and with the hole that nothing I put in would fit evenly. Also, the bumps on that top of my gum (the bone thingies...I was able to get the one white bump / bone on the right to show in the pic but the left wasn't showing up...must have taken 30 shots just to get these to come out clearly) have those bone thingies in there and they'd rub against whatever I'd ultimately stick in there, whether it's a bridge, a denture, a flipper.....or other...things that you put in the area of a missing tooth.

I don't want to put an implant in there because 1. it's going to be WICKED expensive (4k+) and 2. I am super worried that there's going to be a problem that I can't fix (like this horrible weird "V" thing I can't get rid of that nothing will fit evenly and comfortably. Plus, those bone spurs would rub against whatever appliance I put in there. Then I touch those bone spurs and the "V" it makes my knees get weak and think I've got mangled gums now :( )

So I'm freaking out basically. My sister says..."hey, you might not want to go back to that guy and go see the holistic dentists I went to. It's only going to be about $200 per consult. (she's doing well financially). Maybe they'll give you a discount if you have them do the work." And then I'm thinking, "They did good with my sister but what if they do the work on me and then they screw my gums up even more?? The first guy is an oral surgeon (a doctor) but he's old school and did that "V" thing on my teeth with those elevator things. But if I go to the other place I could end up getting Doctor Giggles as my dentist!!" Actually, the person who extracted my sister's teeth looked like Dr. Jonathan Crane / Scarecrow from Batman Begins. She was creeped out but he did a good job. (see below why I know this)

So I'm at a get together with my sister and I wanted to look at her extracted gum hole. (yeah, I'm weird like that). So I looked and it looks like they did a good job with her extraction. She didn't have any "V" thing and no bone spurs. I asked if she wanted to see my gouge but she declined. Anyway, sufficient to say I'm didn't get the relief I was hoping for thinking my gums are just fine after looking at hers.

Woah, I just wrote another book. Sorry.

So, what I'm concerned..freaking out about is.

1. The time clock. The deadline to my gums flattening out from no graft must be getting close. If I don't do something soon I'll have a flat gum! So I gotta do something fast!

2. The "V" bone spur thing. Nothing will fit in there right even with a bone graft. Those bone things make me freak out and I'm sure it's gonna hurt if I put something over it like a flipper or a bridge. And I'm afraid if I ask the oral surgeon to fix it he's gonna get ****** and annoyed and grind them down with a sander or something! Or worse! (I don't know for sure what worse could be...but I can imagine some things. I don't want so say here because it might happen). :O

3. Who do I go with for the bone graft? Do I stay with the oral surgeon or go with the holistic dentists? (I guess that depends on whether you think it's pretty normal the way things look right now).

4. should I get a bone graft? Do I need one if I'm totally not going to get any more surgery in my mouth (especially no implants which get screwed into my jaw... :O) That would be a recipe for disaster. But maybe the graft will help with a flipper or a bridge or a nesbit or whatever else to make things nice and even and smooth so I can chew on my left side again. So whatever I put in there should ultimately will be comfortable. That's why I was thinking about the bone graft.

5. I probably missed something but I'll wait until you take a look at the pics and see what you think. Maybe there's cause for concern or maybe not. With this dental adventure things just haven't gone so well. You know the history. The only thing good so far is that tooth is out (which should have been extracted to begin with) and I'm not feeling any pain there now.

Anyway, sorry again for the novel. I start and then realize how much I wrote. :O

Bryanna
02-28-2013, 09:44 AM
Hi asquirrel,

Sounds like you are having some challenging times in your life..... but fortunately you still have your humor :)) And you always make me laugh ;)
AND thanks for posting those great pictures!!!! You and your sister did good!

I see all of your concerns and will answer your questions in capital letters. No I am not hollering, it just makes it easier to distinguish between your words and mine.

<<1. The time clock. The deadline to my gums flattening out from no graft must be getting close. If I don't do something soon I'll have a flat gum! So I gotta do something fast!>>

IT IS BEST TO HAVE THE GRAFT DONE WITHIN THE FIRST FEW MONTHS OF THE EXTRACTION. GRAFTING ALSO HELPS TO FILL IN THE MISSING BONE SO THAT THE SITE DOES NOT BECOME CONCAVE.

<<2. The "V" bone spur thing. Nothing will fit in there right even with a bone graft. Those bone things make me freak out and I'm sure it's gonna hurt if I put something over it like a flipper or a bridge. And I'm afraid if I ask the oral surgeon to fix it he's gonna get ****** and annoyed and grind them down with a sander or something! Or worse! (I don't know for sure what worse could be...but I can imagine some things. I don't want so say here because it might happen). :O>>

THE V IS NOT THAT BAD AND IT'S GOING TO FLATTEN OUT/FILL IN A BIT MORE. YOU MAY ALWAYS HAVE A SLIGHT INDENTATION THERE BUT THAT SHOULDN'T POSE A PROBLEM IF YOU WERE TO WEAR A NESBIT OR PARTIAL DENTURE. IF YOU DID THE IMPLANT THEN THAT AREA OF GUM TISSUE MAY BE ALTERED SLIGHTLY BUT NOT ALL THAT MUCH.

<<3. Who do I go with for the bone graft? Do I stay with the oral surgeon or go with the holistic dentists? (I guess that depends on whether you think it's pretty normal the way things look right now).>>

I WOULD CONSIDER SEEING THE HOLISTIC DENTISTS BECAUSE...... YOU DO HAVE SEVERAL LITTLE BONY SPICULES PROTRUDING FROM NOT ONLY ALONG THE GUM BUT FROM THE EXTRACTION SITE ITSELF. THESE ARE SPLINTERED BONES AND TEND TO INDICATE A FORCEFUL EXTRACTION. SO I WOULD BE BIT HESITANT TO MOVE FORWARD WITH THIS PARTICULAR DENTIST. ON HIS BEHALF....SOMETIMES TEETH ARE REALLY FUSED TO THE BONE AND IT CAN TAKE SOME FORCE TO GET THEM OUT. BUT I CAN SEE BY THE REDDENED AND INFLAMED AREAS ALONG THE BONY RIDGE THAT THERE WAS QUITE A BIT OF TRAUMA TO THIS AREA DURING THE EXTRACTION.

<<4. should I get a bone graft? Do I need one if I'm totally not going to get any more surgery in my mouth (especially no implants which get screwed into my jaw... :O) That would be a recipe for disaster. But maybe the graft will help with a flipper or a bridge or a nesbit or whatever else to make things nice and even and smooth so I can chew on my left side again. So whatever I put in there should ultimately will be comfortable. That's why I was thinking about the bone graft.>>

BONE GRAFTING DOES HELP TO ENCOURAGE NEW BONE GROWTH TO HELP REPLENISH A SIGNIFICANT AMOUNT OF BONE THAT IS LOST ONCE THE TOOTH IS REMOVED. THE MORE BONE RESTORED, THE BETTER FIT FOR ANY REPLACEMENT. WHETHER OR NOT TO DO A BONE GRAFT IS SOMETHING THAT A DENTIST WOULD HAVE TO DETERMINE BASED ON X-RAYS AND PHYSICAL EXAMINATION OF THAT AREA.THE HEIGHT, WIDTH AND THICKNESS OF THE BONE. KEEP IN MIND THAT THE NESBIT IS NOT MEANT TO BE KEPT IN WHEN YOU EAT. IT IS WORN TO PREVENT THE MOVEMENT OF THE TEETH ON BOTH SIDES OF THE SPACE FROM CLOSING INTO THE SPACE WHILE KEEPING THE OCCLUSION LINED UP. IT IS ALSO FOR ESTHETICS SO THAT YOU DON'T RESEMBLE A PUMPKIN WHEN YOU SMILE :>

<<5. I probably missed something but I'll wait until you take a look at the pics and see what you think. Maybe there's cause for concern or maybe not. With this dental adventure things just haven't gone so well. You know the history. The only thing good so far is that tooth is out (which should have been extracted to begin with) and I'm not feeling any pain there now.>>
NO YOU HAVE NOT MISSED ANYTHING! THE SITE LOOKS PRETTY NORMAL WITH THE EXCEPTION OF THE BONY SPICULES (WHICH FREQUENTLY OCCUR). THE NEW DENTIST WOULD PROBABLY DISCUSS REMOVING THOSE SPICULES....AND USUALLY THIS IS NOT A BIG DEAL. OR HE MAY SAY LET'S SEE IF THEY WORK THEMSELVES OUT OR EVEN LET'S RECHECK THEM AGAIN IN 4 WEEKS OR SO. AN XRAY COULD BE HELPFUL IN DETERMINING HOW MANY THERE ARE AND HOW DEEP THEY ARE.

Okay?? Feel better now?? By the way... how did you acquire the
name "asquirrel"??

Bryanna

asquirrel
02-28-2013, 02:07 PM
Hi Bryanna!

Thanks so much for the fast reply and for your comforting advice! :)

I’ll start at a random spot. I usually have a nickname called "angrysquirrel" on gaming sites. I am a big fan of squirrels. I live in NH and we have lots of them. They’re so cute! Plus an angry squirrel paints a very vivid picture in my minds. Cute and strange at the same time. Possibly a dangerous adversary or trustworthy backup in an online game. People like to have angry squirrel on their team. 
So the “asquirrel” is just a shortening of the angrysquirrel. Plus, I think if I named myself “angry squirrel” on here, nobody would want to talk with me. 

Now for the dental stuff:

So, I'll be cancelling the appointment with the oral surgeon and going to the holistic dentists then. I’ll schedule a consult with the spicules and the bone graft. Hopefully, they will give me a discount seeing as they did my sister’s work. This is getting really expensive but I’m I don’t have much choice if I want to chew on left side of my mouth with teeth instead of gumming the food to death. 

Thanks for the info on the Nesbit. I was thinking that because it looked squishy and comfortable but it’s not going to help me chew on the left side. So if I don’t want to go the surgical route should I be looking for a partial denture? Would that be the most comfortable and least invasive solution? If those spicules don’t come out, will my gum get irritated if I put the denture over it? The spicules….does the body just push them out sometimes? That’s pretty neat! So…if they don’t come out on their own do they have to cut my gums open and remove them?!?!? Yikes! Good thing I’ll be in the chair when I faint… :O I’ll keep you posted!

Bryanna
03-01-2013, 10:13 AM
Hi asquirrel,

Interesting squirrel thing you have... "cute and strange at the same time" :)

I like the "angrysquirrel" nickname.... gives the impression of someone who is a bit .... squirrely :)) You can be on my team anytime!!!

You can tell the holistic dental team about your recent dental experience and how it has left you a bit unsure about how to move forward with this due to these bony spicules. Let them do some xrays first. Then question removing the spicules and if the bone graft could be placed at that same time. Question bone graft options and ask for their recommendation in your particular case. It is always important to give full disclosure of your medical history including all medications as this can have a profound affect on your dental plan and the ultimate outcome.

MOST dental offices other than managed care clinics, will offer some discount for paying cash up front. So don't hesitate to ask for something like that. I've worked in dental offices in various areas from small rural towns to very affluent and it is common for people to ask for this type of discount.... so don't even think twice about it!

Based on the photos that you provided... you are not really a candidate for a removable partial denture because you have full dentition on your upper right side. These appliances are designed to replace missing teeth on both sides of the arch. The nesbit would work well in replacing this tooth but as I said, it is not recommended that you eat with it in because it could dislodge and you could choke or swallow it.

Other replacement options would be:
1) A conventional 3 unit bridge. This would require the tooth adjacent teeth, #'s 13 and 15, to be cut down. The bridge would crown #13 and 15 and would hold a fake tooth in the middle replacing #14.

2) Another type of bridge called an inlay/onlay bridge. This would require the tooth adjacent teeth, #'s 13 and 15, to be cut down less than the conventional bridge and it would also hold a fake tooth in the #14 spot.

The bony spicules...............
Sometimes the body does push them out. Other times they need to be removed if they are a constant irritant and source for infection. An xray will show their size and depth. Most of the time this is not a big deal. The area is anesthetized and they are removed with a dental tweezers. But first the xray to see where they are.

So there you have it! Did I explain all of that ok? Let me know if you have any other concerns.... :))

Bryanna




961448]Hi Bryanna!

Thanks so much for the fast reply and for your comforting advice! :)

I’ll start at a random spot. I usually have a nickname called "angrysquirrel" on gaming sites. I am a big fan of squirrels. I live in NH and we have lots of them. They’re so cute! Plus an angry squirrel paints a very vivid picture in my minds. Cute and strange at the same time. Possibly a dangerous adversary or trustworthy backup in an online game. People like to have angry squirrel on their team. 
So the “asquirrel” is just a shortening of the angrysquirrel. Plus, I think if I named myself “angry squirrel” on here, nobody would want to talk with me. 

Now for the dental stuff:

So, I'll be cancelling the appointment with the oral surgeon and going to the holistic dentists then. I’ll schedule a consult with the spicules and the bone graft. Hopefully, they will give me a discount seeing as they did my sister’s work. This is getting really expensive but I’m I don’t have much choice if I want to chew on left side of my mouth with teeth instead of gumming the food to death. 

Thanks for the info on the Nesbit. I was thinking that because it looked squishy and comfortable but it’s not going to help me chew on the left side. So if I don’t want to go the surgical route should I be looking for a partial denture? Would that be the most comfortable and least invasive solution? If those spicules don’t come out, will my gum get irritated if I put the denture over it? The spicules….does the body just push them out sometimes? That’s pretty neat! So…if they don’t come out on their own do they have to cut my gums open and remove them?!?!? Yikes! Good thing I’ll be in the chair when I faint… :O I’ll keep you posted![/QUOTE]

asquirrel
03-06-2013, 08:49 PM
Hi Bryanna,

Sorry for the late reply. My dad just went into a hospital ICU and lots of things have slid off the grid, including my email back to you. Sorry about that. I'm going to follow your advice and have the work done with the holistic dentists. Hopefully, they will be able to remove the spicules if necessary. From what I've been reading online I thought it was a job for an oral surgeon because they are going to have to cut into the gum. But maybe not from what you're telling me. Doesn't hurt to check. In either case, I'll have the bone graft done with the dentists. I'm probably getting close to falling out of the window before the area goes flat but until my dad is out of the woods everything else is on hold. Anyway, I'll keep you posted on my progress. Thanks so much for your help!

Bryanna
03-07-2013, 12:23 AM
Hi asquirrel,

Oh no! I am so sorry to hear about your dad being ill. I will keep him in my prayers. Please take care of yourself.... I know how difficult it is for a loved one to be in the ICU. Keep yourself focused on positive things :)

It is okay for a general dentist to remove the bony spicules so long as he is comfortable doing that. The same goes for the bone graft. However, when you see the new dentist, you can discuss this subject with him and ask for a referral to an oral surgeon who thinks like minded to him.... if that happens to feel like a better choice at the time.

You have some time to do this.... so no falling out the window!!!
Your dad is the priority right now so that is what you focus on. This other stuff can wait.

Please keep in touch here and let us know how your dad is doing...ok..

Be well .....
Bryanna





Hi Bryanna,

Sorry for the late reply. My dad just went into a hospital ICU and lots of things have slid off the grid, including my email back to you. Sorry about that. I'm going to follow your advice and have the work done with the holistic dentists. Hopefully, they will be able to remove the spicules if necessary. From what I've been reading online I thought it was a job for an oral surgeon because they are going to have to cut into the gum. But maybe not from what you're telling me. Doesn't hurt to check. In either case, I'll have the bone graft done with the dentists. I'm probably getting close to falling out of the window before the area goes flat but until my dad is out of the woods everything else is on hold. Anyway, I'll keep you posted on my progress. Thanks so much for your help!

justducky
04-12-2014, 08:59 AM
Hi Bryanna,

I really appreciate this forum and all of your knowledge that you share so generously! Last week, I had a back molar on the bottom extracted that had been a root canal. I had been getting ear infections on that side, I'm thinking that the ear infections were coming from the root canal tooth, maybe?... I also had horrible hayfever with sinus & ear problems before the extraction. My dentist seems pretty good--he's the only one within a couple of states that does zirconium implants, which is what I'm planning on doing to replace all of the root canal teeth that I've extracted (it will be 8 total--3 of them in front!)
The biological dentist that I had been going to doesn't do implants and says that they are all bad for your body, but I think having a mouth full of bridges that I can never floss, and losing bone continuously is worse. Anyway, sorry..Okay, so I don't think that my new dentist debrided the extraction site or did much cleaning of the bone after the extraction. I asked about if there was any infection in the bone, would he be sure to clean it out and I was assured that he would. He immediately placed a bone graft. I was feeling kind of sick for a few days after, and had a horrible taste in my mouth, so I was really worried (I had 4 bone grafts placed at the time, and a titanium implant removed as well), so I was pretty sore--3 hours of dental work at once!
Anyway, after searching your site, I am realizing that I probably shouldn't have had the bone graft placed immediately, and should have gone to my biological dentist for the extractions... I continue to have an ear infection that I haven't been able to shake--which is unusual. Usually, a couple of rounds of peroxide in the ears and no dairy products clears them right up. I have been putting garlic in my ear and taking it orally as well, and it has helped a lot, but it's still there a bit. I'm worried about the bone graft adhering and the infection possibly being buried. What do you think is the best course of action? If the infection goes away in the next few days, do you think I should be okay? My dentist took a cone beam beforehand, he said that no infection showed up on the conebeam, but I know you have said that most general dentists will miss it even if its there.

Bryanna
04-12-2014, 08:01 PM
Hi justducky,

Thanks for the kinds words.... and welcome to our site!

I will re-post your concerns and reply in bold type. It just makes it easier to follow sometimes..

<<<Last week, I had a back molar on the bottom extracted that had been a root canal. I had been getting ear infections on that side, I'm thinking that the ear infections were coming from the root canal tooth, maybe?>>>

YES, INFECTED TEETH CAN CAUSE OR CONTRIBUTE TO INFECTIONS ELSEWHERE IN THE HEAD OR ANYWHERE IN THE BODY. ONE THING TO KEEP IN MIND IS THAT WHEN AN INFECTION HAS SPREAD TO ANOTHER AREA THAT SECOND SITE CAN BE DIFFICULT TO ERADICATE OF INFECTION BECAUSE IT IS MOST LIKELY LONG STANDING AND CONTAINS MULTIPLE STRAINS OF BACTERIA. SOMETIMES THE SITE NEEDS TO BE SWABBED AND CULTURED TO DETERMINE WHICH ANTIBIOTICS ARE SENSITIVE TO THAT BACTERIA.

<<<... I also had horrible hayfever with sinus & ear problems before the extraction.>>>

YES, SINUS ISSUES ARE COMMONLY ASSOCIATED WITH INFECTED TEETH.

<<< My dentist seems pretty good--he's the only one within a couple of states that does zirconium implants, which is what I'm planning on doing to replace all of the root canal teeth that I've extracted (it will be 8 total--3 of them in front!)>>>

OMG!! I AM GLAD TO HEAR THAT YOU HAD THEM RC TEETH REMOVED. DO YOU HAVE MORE RC TEETH STILL IN YOUR MOUTH? JUST CURIOUS WAS THIS AN ELECTIVE THING OR WERE THEY ALL CAUSING YOU PAIN?
ZIRCONIUM IMPLANTS SUPPOSEDLY HAVE A FEW ADVANTAGES OVER TITANIUM. THEY ARE METAL FREE, THEY ARE ESTHETICALLY PLEASING ALONG THE GUM LINE IF THERE IS RECESSION, AND PLAQUE TEND TO ADHERE TO THEM LESS TITANIUM. I WILL DISCUSS IMPLANTS REPLACING ROOT CANALED TEETH LATER IN THIS POST.

<<<The biological dentist that I had been going to doesn't do implants and says that they are all bad for your body, but I think having a mouth full of bridges that I can never floss, and losing bone continuously is worse.>>>

THIS BIO DENTIST MAKES A GOOD POINT. ANY FOREIGN OBJECT SCREWED IN THE JAW BONE CARRIES SOME SYSTEMIC RISKS. THE MOUTH IS VERY VASCULAR MEANING THE BACTERIA THAT RESIDES IN THE MOUTH AND JAW BONE IS CONTINUALLY RUNNING THROUGHOUT THE BLOOD STREAM. NOT EVERY PERSON IS A "GOOD" CANDIDATE FOR DENTAL IMPLANTS AS ANYONE WITH AN AUTO IMMUNE DISEASE OR OTHER CHRONIC MEDICAL CONDITION, SMOKERS, ALCOHOLICS, PEOPLE ON CERTAIN MEDICATIONS FOR OSTEOPOROSIS MAY BE IN A HIGHER RISK CATEGORY OF FAILURE OR SYSTEMIC ISSUES RELATED TO THEIR DENTAL IMPLANTS.
THIS DENTIST MAY NOT HAVE OFFERED YOU THAT INFORMATION AND JUST SAID HE'S NOT A BIG FAN OF THEM. HE ALSO MAY BE LEARY OF REPLACING ROOT CANALED TEETH WITH IMPLANTS AS HE KNOWS THE BACTERIA ASSOCIATED WITH ROOT CANALED TEETH AND ALSO KNOWS IT IS IMPERATIVE FOR THE BONE TO BE DISEASE FREE AND HEALTHY PRIOR TO THE PLACEMENT OF AN IMPLANT.

REGARDING BRIDGEWORK.... IT HAS IT'S PROS AND CONS. IF THE MOUTH IS HEALTHY, THE DENTAL WORK IS DONE WELL AND THE ANCHOR TEETH ARE HEALTHY THEN BRIDGEWORK CAN BE PERMANENT AND WITHOUT PROBLEMS. IT IS IMPERATIVE FOR ALL OF THOSE THINGS TO BE IN PLACE AND EQUALLY IMPORTANT FOR THE PATIENT TO HAVE IMPECCABLE ORAL HYGIENE AND SEE THEIR DENTIST EVERY 6 MONTHS. RECESSION OCCURS FROM PLAQUE ACCUMULATION, PERIODONTAL DISEASE, POOR OR IMPROPER ORAL HYGIENE, MISALIGNED BITE, AND/OR CLENCHING/GRINDING HABITS. OTHERWISE IN A HEALTHY MOUTH RECESSION IS MINIMAL AS WE AGE.

<<<.Okay, so I don't think that my new dentist debrided the extraction site or did much cleaning of the bone after the extraction. I asked about if there was any infection in the bone, would he be sure to clean it out and I was assured that he would. He immediately placed a bone graft. I was feeling kind of sick for a few days after, and had a horrible taste in my mouth, so I was really worried (I had 4 bone grafts placed at the time, and a titanium implant removed as well), so I was pretty sore--3 hours of dental work at once!>>>>

FIRST..... WAS THIS A GENERAL DENTIST OR AN ORAL SURGEON WHO DID ALL OF THIS SURGERY?
IT IS IMPERATIVE FOR THE SOCKET TO BE DEBRIDED THOROUGHLY OF THE PERIODONTAL LIGAMENT, ALL DISEASED TISSUE AND BONE AND IRRIGATED WITH COPIOUS AMOUNTS OF SALINE SOLUTION PRIOR TO EVEN CONSIDERING THE PLACEMENT OF A BONE GRAFT. DID HE DO ALL OF THAT?

THE 4 BONE GRAFTS..... ONE WAS IN THE SITE OF THE NEW EXTRACTION ... I ASSUME ONE WAS PUT IN THE SITE WHERE HE REMOVED THE TITANIUM IMPLANT.... WHERE WERE THE OTHER 2 DONE?? HOW LONG AGO WERE THOSE TEETH REMOVED? WHY WAS THE IMPLANT REMOVED?

<<<Anyway, after searching your site, I am realizing that I probably shouldn't have had the bone graft placed immediately, and should have gone to my biological dentist for the extractions... I continue to have an ear infection that I haven't been able to shake--which is unusual. Usually, a couple of rounds of peroxide in the ears and no dairy products clears them right up. I have been putting garlic in my ear and taking it orally as well, and it has helped a lot, but it's still there a bit.>>>

IF THE SITE WAS NOT DEBRIDED THOROUGHLY THEN THE GRAFT SHOULD NOT HAVE BEEN PLACED. ONLY THE DENTIST AND HIS ASSISTANT WOULD KNOW IF HE DID THAT OR NOT. AS I SAID EARLIER... THE SECOND SITE INFECTION CAN BE A BUGGER TO ERADICATE EVEN AFTER THE TOOTH IS REMOVED. I AM A BIG ADVOCATE OF SUPPLEMENTING WITH GARLIC, USING GARLIC OIL IN THE EARS AND BANNING DAIRY PRODUCTS FOR AN EAR INFECTION. HAS A PHYSICIAN CONFIRMED THAT YOU HAVE AN EAR INFECTION?

<<< I'm worried about the bone graft adhering and the infection possibly being buried. What do you think is the best course of action?>>>

BONE GRAFT MATERIAL DOES NOT ADHERE TO ANYTHING. IT MIXES TOGETHER WITH THE BLOOD WHICH STIMULATES THE IMMUNE SYSTEM TO CARRY CELLS TO THE BONE TO BUILD NEW BONE WITHIN THE SITE. THE ACTUAL GRAFT BREAKS DOWN OVER TIME AND YOUR OWN BONE FILLS IN THE SOCKET. THIS IS WHY THE SITE NEEDS TO BE HEALTHY OR THE MIXING DOES NOT OCCUR PROPERLY AND THE IMMUNE SYSTEM ATTEMPTS TO GET RID OF THE GRAFT.
YOU CAN QUESTION THE DENTIST ABOUT HIS SURGICAL PROTOCOL RELATING TO YOUR EXTRACTION. ASK HIM IF HE REMOVED THE PERIODONTAL LIGAMENT (HE SHOULD SAY YES)..... HOW INFECTED WAS THE BONE (HE SHOULD GIVE YOU A CLEAR ANSWER) .... DID HE REMOVE ALL OF THE DISEASED BONE (HE SHOULD LET YOU KNOW IF HE FOUND ANY OR NOT) ... WAS THE SOCKET DRY (NOT A GOOD SIGN) OR WAS THERE A CONTINUOUS AMOUNT OF HEALTHY BLOOD WHILE YOU WERE ADDING THE GRAFT (THAT IS IDEAL) .... TELL HIM ABOUT YOUR NOT FEELING WELL AND PAINFUL EAR.

<<< If the infection goes away in the next few days, do you think I should be okay?>>>

I CANNOT ANSWER THAT. IT DEPENDS ON THE INFECTION.... HOW WELL THE SURGERY WAS PERFORMED AND YOUR HEALING CAPABILITIES.

<<< My dentist took a cone beam beforehand, he said that no infection showed up on the conebeam, but I know you have said that most general dentists will miss it even if its there.>>>

EXACTLY. ALL ROOT CANALED TEETH HAVE BACTERIA AND NECROTIC TISSUE INSIDE OF THE ACCESSORY CANALS. HOWEVER THESE CANALS ARE NOT VISIBLE ON XRAYS AND THE BACTERIA HAS TO SUBSTANTIALLY PROLIFERATE THE CANALS INTO THE LARGER AREAS OF THE TOOTH TO BE PICKED UP ON THE XRAY. IT IS POSSIBLE THAT THE BACTERIA HAD NOT PROLIFERATED YET.

nienna777
05-15-2014, 05:09 PM
Hi Bryanna!

I loved reading this board! It was so comforting not only to see people with common troubles, but to see such an amazing support system and a wealth of knowledge!!

In my case, I had a tooth extracted, that, as the dentist put it, had a small abscess. He stated that he cleansed it well, and when he seemed confident it was ok, he then proceeded with the bone grafting.

Now, from what I've seen in pictures, mine seems to be healing up fairly well (I'm 24 hours into it now) However, I noticed a pin prick sized yellow spot, that made me nervous. I am currently taking an antibiotic (Z-Pack)

How should I care for this??

Bryanna
05-15-2014, 07:05 PM
Hi nienna,

The yellow spot may be plaque. Keep rinsing with warm salt water a few times a day until the gum closes over. If you are doing well and then on the 3rd or 4th day you develop pain, go back in and see the surgeon to evaluate the site. Being diligent with the sw rinses will keep the bacteria and food debris to a minimum.

Hi Bryanna!

I loved reading this board! It was so comforting not only to see people with common troubles, but to see such an amazing support system and a wealth of knowledge!!

In my case, I had a tooth extracted, that, as the dentist put it, had a small abscess. He stated that he cleansed it well, and when he seemed confident it was ok, he then proceeded with the bone grafting.

Now, from what I've seen in pictures, mine seems to be healing up fairly well (I'm 24 hours into it now) However, I noticed a pin prick sized yellow spot, that made me nervous. I am currently taking an antibiotic (Z-Pack)

How should I care for this??

nienna777
05-15-2014, 07:07 PM
I just KNEW I would get comfort from posting here! Thank you so much Bryanna! Also, is it safe for me to drink black coffee/tea with a teaspoon of sugar in it, 24 hrs after the procedure?


Hi nienna,

The yellow spot may be plaque. Keep rinsing with warm salt water a few times a day until the gum closes over. If you are doing well and then on the 3rd or 4th day you develop pain, go back in and see the surgeon to evaluate the site. Being diligent with the sw rinses will keep the bacteria and food debris to a minimum.

Bryanna
05-15-2014, 07:43 PM
Nienna,

It is "best" to avoid the sugar simply because sugar is unhealthy. Can you substitute with honey in your tea or stevia in your coffee?

I just KNEW I would get comfort from posting here! Thank you so much Bryanna! Also, is it safe for me to drink black coffee/tea with a teaspoon of sugar in it, 24 hrs after the procedure?

nienna777
05-15-2014, 07:45 PM
Makes sense. I do use organic honey in my tea. I had simply hoped I could get away with one teaspoon of sugar in my coffee, hehe. Stevia and other sweeteners don't work out too well for my digestion wise, so I tend to stay away from it. I'll just stick with tea and honey :)

Nienna,

It is "best" to avoid the sugar simply because sugar is unhealthy. Can you substitute with honey in your tea or stevia in your coffee?

Bryanna
05-15-2014, 08:10 PM
nienna,

Artificial sweeteners are often not tolerated well by many people. The body does not recognize them as food and cannot metabolize them properly. Most of them also have common allergens in the ingredients.

A short list of healthier substitutes are:

Local raw honey.
Stevia called Sweet Leaf (other ones have added refined sugar)
Xylitol called Xylosweet (derived from birch trees or non gmo corn)
Coconut palm sugar (organic)
Maple Syrup (organic)


Makes sense. I do use organic honey in my tea. I had simply hoped I could get away with one teaspoon of sugar in my coffee, hehe. Stevia and other sweeteners don't work out too well for my digestion wise, so I tend to stay away from it. I'll just stick with tea and honey :)

nienna777
05-15-2014, 08:24 PM
I never thought of using maple syrup before! Funny thing is, I usually strayed away from it, because when I would have it on pancakes it would hurt my teeth, but I'm assuming that's not the all natural version you're referring to :)

I did talk to my dentist today and told him what's gone on in the last 24 hours. He seemed to think everything sounded normal, so I guess I'm ok. Just got so scared with the abscess, and never had received bone grafting, so I wanted to make sure everything was just right! :)

nienna,

Artificial sweeteners are often not tolerated well by many people. The body does not recognize them as food and cannot metabolize them properly. Most of them also have common allergens in the ingredients.

A short list of healthier substitutes are:

Local raw honey.
Stevia called Sweet Leaf (other ones have added refined sugar)
Xylitol called Xylosweet (derived from birch trees or non gmo corn)
Coconut palm sugar (organic)
Maple Syrup (organic)

nienna777
05-16-2014, 10:30 AM
So, some things have changed since yesterday. I woke up today, and noticed the abscess site, located on the inside, right where my tongue likes to rest, has seemed to get bigger, but is not producing any puss. It's just a hole, and is a bit sore, with an irritated feeling. I know the antibiotic is supposed to do most of the work, but I'm scared I'm not doing enough for it to heal. I'm also afraid my tongue makes it worse, and feel like there's nothing I can do about it! :(

Also, I cleared my throat this morning, and several "Strands" of blood came out. It's not doing that anymore, but I'm scared of where the blood came from!!

I'm not used to feeling so in the dark about these things, and now of course I can't call my dentist, since he's not there. :(

I never thought of using maple syrup before! Funny thing is, I usually strayed away from it, because when I would have it on pancakes it would hurt my teeth, but I'm assuming that's not the all natural version you're referring to :)

I did talk to my dentist today and told him what's gone on in the last 24 hours. He seemed to think everything sounded normal, so I guess I'm ok. Just got so scared with the abscess, and never had received bone grafting, so I wanted to make sure everything was just right! :)

Bryanna
05-16-2014, 01:37 PM
Nienna,

Could you tell me exactly which tooth was extracted? Had the tooth been root canaled prior to the extraction... if so, about how long ago?

It is common to have some blood in your saliva for a few days as you have swallowed some blood during the extraction. Also during the early stages of healing there may be some bleeding when you sleep as your tongue may be overly curious with the open hole. All of this is normal.

It would also be normal for the site to feel sore for a few days. If over the course of the next 3-4 days the site becomes painful, very swollen or throbs often... call your dentist to evaluate it.

Be sure to eat nutritiously, drink plenty of water throughout the day (do not use a straw) and do the salt water rinses. Most of the time the site will heal really well so long as you take care of it and yourself :)



So, some things have changed since yesterday. I woke up today, and noticed the abscess site, located on the inside, right where my tongue likes to rest, has seemed to get bigger, but is not producing any puss. It's just a hole, and is a bit sore, with an irritated feeling. I know the antibiotic is supposed to do most of the work, but I'm scared I'm not doing enough for it to heal. I'm also afraid my tongue makes it worse, and feel like there's nothing I can do about it! :(

Also, I cleared my throat this morning, and several "Strands" of blood came out. It's not doing that anymore, but I'm scared of where the blood came from!!

I'm not used to feeling so in the dark about these things, and now of course I can't call my dentist, since he's not there. :(

nienna777
05-16-2014, 01:46 PM
Ok, first of all, it's a HUGE relief to hear those symptoms are normal, thank you :)

So here is the saga with this tooth. 2 years ago, I got 2 of my left bottom molars capped. Everything was great, except the 2nd to last bottom left molar was capped WAY too high. This caused me to bite down harder on that side than the right side.

When I noticed this, I went to the dentist right away. (Please note, I do NOT see this dentist anymore) When I explained the issue with the cap, I told them I was scared the upper left molar would break as a result of the lower molar cap being too high. His response was, "A cap can't break bone." I advised him that I already knew the upper left molar was weak, but he didn't care. They did nothing to fix this. A couple of months later, the upper left molar breaks, and I lose about 1/4 of that tooth. So, I went and found myself a new dentist to address this. He looked, said the tooth cannot be saved, and I should see a prosthodontist instead, because most likely I will need a full upper implant for all of my upper teeth.

So, the tooth that was removed and bone grafted, was the upper left molar that broke. In the 2 years it's been broken, I had cared for it using temprin to block off the broken part and keep it clean. Truthfully I was happy I got away with it for as long as I did. But now, this is my first step towards getting the implants, which I hope to deal with the rest of the teeth in the next 4-6 months.

But yes, I've been doing everything you've suggested in the last 48 hours, so thankfully I think I'll be ok :P

Nienna,

Could you tell me exactly which tooth was extracted? Had the tooth been root canaled prior to the extraction... if so, about how long ago?

It is common to have some blood in your saliva for a few days as you have swallowed some blood during the extraction. Also during the early stages of healing there may be some bleeding when you sleep as your tongue may be overly curious with the open hole. All of this is normal.

It would also be normal for the site to feel sore for a few days. If over the course of the next 3-4 days the site becomes painful, very swollen or throbs often... call your dentist to evaluate it.

Be sure to eat nutritiously, drink plenty of water throughout the day (do not use a straw) and do the salt water rinses. Most of the time the site will heal really well so long as you take care of it and yourself :)

nienna777
05-17-2014, 03:45 PM
Ok, so day 3 of healing...

I noticed today that some of my stitching came loose. I was told this was normal, so I didn't panic. However, I just checked it, and noticed part of the stitching looped around a small chunk of the bone grafting, and that came loose with it! It does appear that there is still bone grafting underneath the chunk that came loose, but should I be worried about this? Does it mean that it's being rejected??

Ok, first of all, it's a HUGE relief to hear those symptoms are normal, thank you :)

So here is the saga with this tooth. 2 years ago, I got 2 of my left bottom molars capped. Everything was great, except the 2nd to last bottom left molar was capped WAY too high. This caused me to bite down harder on that side than the right side.

When I noticed this, I went to the dentist right away. (Please note, I do NOT see this dentist anymore) When I explained the issue with the cap, I told them I was scared the upper left molar would break as a result of the lower molar cap being too high. His response was, "A cap can't break bone." I advised him that I already knew the upper left molar was weak, but he didn't care. They did nothing to fix this. A couple of months later, the upper left molar breaks, and I lose about 1/4 of that tooth. So, I went and found myself a new dentist to address this. He looked, said the tooth cannot be saved, and I should see a prosthodontist instead, because most likely I will need a full upper implant for all of my upper teeth.

So, the tooth that was removed and bone grafted, was the upper left molar that broke. In the 2 years it's been broken, I had cared for it using temprin to block off the broken part and keep it clean. Truthfully I was happy I got away with it for as long as I did. But now, this is my first step towards getting the implants, which I hope to deal with the rest of the teeth in the next 4-6 months.

But yes, I've been doing everything you've suggested in the last 48 hours, so thankfully I think I'll be ok :P

Bryanna
05-17-2014, 05:17 PM
Nienna,

It is normal for some of the bone graft material to fall out as the socket is healing closed. Keep in mind that the socket is deep and it is over filled with graft material. So it is okay if some comes out. It is not okay if large chunks come out. But from your description I don't think that is what happen.

The sutures may come out or disintegrate as the site heals. That is okay too.

If you are feeling well and your little to no pain... throbbing or signs of infection... then just continue with what you have been doing.



QUOTE=nienna777;1070044]Ok, so day 3 of healing...

I noticed today that some of my stitching came loose. I was told this was normal, so I didn't panic. However, I just checked it, and noticed part of the stitching looped around a small chunk of the bone grafting, and that came loose with it! It does appear that there is still bone grafting underneath the chunk that came loose, but should I be worried about this? Does it mean that it's being rejected??[/QUOTE]

nienna777
05-17-2014, 05:53 PM
Once again you've quelled my fears Bryanna thank you!!

I've been so concerned with making sure the grafting doesn't get rejected, because I've been looking forward to finally getting the full upper implants.

Underneath the portion that separated, it appears to be even with the gum line. I was originally under the impression that everything that was put in would be absorbed, which is why I was concerned about the excess.

As far as pain goes, I took one dose of pain medication at 10am, and it is now almost 6pm and I haven't needed to take another dose yet.

There hasn't been any throbbing pain, and no sign of infection that I can tell. I just took my day 4/5 antibiotic as well, so I have that as an insurance policy to keep infection away :)

I can't thank you enough for checking this board so frequently, and being so helpful. I was so worried I'd have to wait until Monday to ask the dentist about this, but thanks to you, I think I will be safe until my checkup on Thursday :)

Nienna,

It is normal for some of the bone graft material to fall out as the socket is healing closed. Keep in mind that the socket is deep and it is over filled with graft material. So it is okay if some comes out. It is not okay if large chunks come out. But from your description I don't think that is what happen.

The sutures may come out or disintegrate as the site heals. That is okay too.

If you are feeling well and your little to no pain... throbbing or signs of infection... then just continue with what you have been doing.



QUOTE=nienna777;1070044]Ok, so day 3 of healing...

I noticed today that some of my stitching came loose. I was told this was normal, so I didn't panic. However, I just checked it, and noticed part of the stitching looped around a small chunk of the bone grafting, and that came loose with it! It does appear that there is still bone grafting underneath the chunk that came loose, but should I be worried about this? Does it mean that it's being rejected??[/QUOTE]

nienna777
05-22-2014, 06:17 PM
Hi Bryanna,

So I went in for my follow up today, and it was all good news!! Stitches were taken out, and was told that it's healing nicely :)

My only concern now is within the last couple of hours my allergies have gotten really bad, so I can't breathe very well. Normally, I would take my inhaler and be ok, but since I have a pulled tooth, I'm concerned about using it with the suction issue. Is it safe to try this or should I try other methods to relieve my asthma?

Once again you've quelled my fears Bryanna thank you!!

I've been so concerned with making sure the grafting doesn't get rejected, because I've been looking forward to finally getting the full upper implants.

Underneath the portion that separated, it appears to be even with the gum line. I was originally under the impression that everything that was put in would be absorbed, which is why I was concerned about the excess.

As far as pain goes, I took one dose of pain medication at 10am, and it is now almost 6pm and I haven't needed to take another dose yet.

There hasn't been any throbbing pain, and no sign of infection that I can tell. I just took my day 4/5 antibiotic as well, so I have that as an insurance policy to keep infection away :)

I can't thank you enough for checking this board so frequently, and being so helpful. I was so worried I'd have to wait until Monday to ask the dentist about this, but thanks to you, I think I will be safe until my checkup on Thursday :)

[/QUOTE]

Bryanna
05-22-2014, 07:09 PM
nienna,

If you normally use an inhaler for asthma and you are now having trouble breathing, then use the inhaler.

Hi Bryanna,

So I went in for my follow up today, and it was all good news!! Stitches were taken out, and was told that it's healing nicely :)

My only concern now is within the last couple of hours my allergies have gotten really bad, so I can't breathe very well. Normally, I would take my inhaler and be ok, but since I have a pulled tooth, I'm concerned about using it with the suction issue. Is it safe to try this or should I try other methods to relieve my asthma?

[/QUOTE]

nienna777
05-22-2014, 07:13 PM
Thanks Bryanna!!

I was only worried since I JUST got the stitches out, and wasn't sure if it was stable enough to handle that kind of suction.

Thanks again for your support!!

nienna,

If you normally use an inhaler for asthma and you are now having trouble breathing, then use the inhaler.

[/QUOTE]

KathyJ
06-05-2014, 04:19 PM
….and thank you so much for the advice you give, since this is all new stuff to me!

On 5/28, I had a 15 molar extraction and bone graft done. Tooth 15 had a crown; the wisdom tooth is gone and tooth 14 has a root canal. The plan was to also do the implant insertion but during the procedure it was discovered that there was an infection (on the 4th day of augmentin) and that there was less bone there than expected, especially the side cheek wall. I recall the surgeon telling me that he took some tissue from my cheek wall for needed tissue in the surgical process. I was in the dental chair from 9:15 until 11:45, not because it took that long but because he surgeon was called out of the room 3 or 4 times for emergency reasons/consultation.

I was scheduled for a followup on 6/5, but on 6/3, it felt that sutures (or something else) were hanging down and I was concerned that something was wrong so I called and left a message. They had me come in one day earlier on 6/4 and he quickly saw me in the consultation room. He said everything looked OK…no problem with the sutures but it looked as if I had touched it with my tongue and that I needed to leave it alone. I know not to touch it with my tongue and thought I had not done so unless it was unconscious or in my sleep. He said it was OK but there was a scab and the flap needed to be left alone to stay in place. BTW, for several years I’ve worn a small mouth guard on my 2 front teeth so my back teeth do not touch and grind in my sleep and when I asked, he told me to continue wearing it.

When I woke up this morning, I could not ignore the end of a suture that falls down below my back tooth. I am not touching the surgery part but I can’t miss the end of this suture hanging below my last tooth #14. I went to the drugstore and bought a dental mirror and this is what I can see. Along side my last tooth, there is the end of a suture hanging down and a bunch of suture threads knotted in a wad along the back side of my tooth 14. As for the surgery area, I see something exposed that is white. I guess that is the bone graft but part of it is exposed and not covered by gum tissue. Should this be exposed? Should gum tissue be sown over it?

My next followup visit is scheduled for 6/11 and today is 6/5. I’m concerned about this now but I had to be a pest calling the oral surgeon again, after seeing him just yesterday. Should I call or wait the 6 more days until my visit? I’m surprised he could not see the end of the suture hanging there. I feel it all the time, not by touching the surgery area but because it hangs below my last tooth. I can seeing it hanging below my last tooth and so can my spouse. If the sutures are not keeping a flap of tissue over the white exposed bone grab, will the tissue grow over it on its own? Is this normal?

Bryanna
06-05-2014, 06:07 PM
Hi KathyJ,

Okay without a picture I have to go by your description only.

If you have a string of suture hanging very low and you can get in their with small scissors, then clip it but stay away from the gum. Clip it just enough to stop it from hanging so low.

Your description of the wad of suture knots indicates that the surgeon had some difficulty suturing that tissue closed. Do not cut into those knots as they are most likely connected to a long line of sutures holding another area closed.

The white that you see could be bone, debris, or the formation of the clot, sort of like a scab. Don't try to remove it. Just rinse with warm salt water as instructed by the surgeon. Not all extraction sites need to be closed over with sutures and as long as the surgeon has gotten primary closure, the wound will heal.

Unless you develop pain, swelling or symptoms of an infection, it sounds like you are healing okay.

In case you have not been informed it is very important to know that your root canaled tooth #14, like all root canaled teeth, is not healthy. RC teeth will always contain necrotic nerve tissue inside of the microscopic canals which causes the tooth to be chronically inflamed and infected. This causes unfavorable changes to occur in the surrounding bone and beyond. Eventually the bacteria also proliferates to the adjacent teeth and bone. The loss of bone that you had around the buccal (cheek) portion of tooth #15 may be correlated with the bacteria coming from tooth #14. So considering this ongoing bacterial problem, it is always risky to put a dental implant next to a root canaled tooth.

I hope this information is helpful to you.

KathyJ
06-05-2014, 07:11 PM
Hi KathyJ,

Okay without a picture I have to go by your description only.

If you have a string of suture hanging very low and you can get in their with small scissors, then clip it but stay away from the gum. Clip it just enough to stop it from hanging so low.

Your description of the wad of suture knots indicates that the surgeon had some difficulty suturing that tissue closed. Do not cut into those knots as they are most likely connected to a long line of sutures holding another area closed.

The white that you see could be bone, debris, or the formation of the clot, sort of like a scab. Don't try to remove it. Just rinse with warm salt water as instructed by the surgeon. Not all extraction sites need to be closed over with sutures and as long as the surgeon has gotten primary closure, the wound will heal.

Unless you develop pain, swelling or symptoms of an infection, it sounds like you are healing okay.

In case you have not been informed it is very important to know that your root canaled tooth #14, like all root canaled teeth, is not healthy. RC teeth will always contain necrotic nerve tissue inside of the microscopic canals which causes the tooth to be chronically inflamed and infected. This causes unfavorable changes to occur in the surrounding bone and beyond. Eventually the bacteria also proliferates to the adjacent teeth and bone. The loss of bone that you had around the buccal (cheek) portion of tooth #15 may be correlated with the bacteria coming from tooth #14. So considering this ongoing bacterial problem, it is always risky to put a dental implant next to a root canaled tooth.

I hope this information is helpful to you.

Thank you for such a speedy response Bryanna. I'm not in any pain that an occasional ibuprofen can't address and that is only an occasional need. I've continued to rinse with warm salt water and yesterday he told me to gently rinse with chlorhexidine, so I'm doing that at bedtime. If the white patch that is exposed seems to get larger rather than smaller, should that be a concern?

I'm afraid to use a small scissors to cut the suture that is hanging down.

As to your advice about tooth 14, that is a whole other issue that I don't know if I can focus on it now, but perhaps I should. This is the first I've heard of this when I started reading this website. Oh my gosh! If this is true, why are root canals done? Why would they be accepted dental practice? Why would an oral surgeon - or dentist - not bring this up? Just last year, I spent lots on tooth 14 for a root canal and crown. I'm somewhat overwhelmed by what I've read on this site about root canals. Are there other links or sources you could refer me to so that I may learn more about the toxic nature of a root canal? Is this fact??