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tooth extraction when root is in sinus cavity

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Unread 12-01-2012, 09:32 AM   #231
Bryanna
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Hi Lynney,

The enamel on the tooth may have never formed completely, which means the "hole" was there all along and may or may not have gotten bigger. The rest of the tooth could look perfectly normal in size and shape. The only way to know if this has been there all along is to be able to compare previous xrays of this tooth. OR as I said, bacteria has caused decay to occur which again would look like a hole on an xray.

Irrelevant of why the hole is in this tooth, if the xray is indicating an infection and/or deterioration of the jawbone and/or it is negatively affecting your second molar...... and you are having symptoms of this, then the tooth needs to be removed.

If you have never had a wisdom tooth removed or you have difficulty opening your mouth wide for any length of time, you may want to consider having the IV sedation for this extraction. The IV anesthesia that is commonly used for tooth extractions is referred to as Twilight sedation and it is not at all like general anesthesia. Most people come out of Twilight very quickly with no after affects. This sedation allows your jaw muscles to relax enabling the oral surgeon to hold your mouth open with a mouth prop so he can remove this tooth quickly. If you just do the oral anesthetic, your jaw will be tight and access to this tooth will be difficult which means the extraction will take a bit longer to do. Even with IV sedation a local anesthetic is used to numb the entire area for several hours afterwards.

Feel free to keep in contact here.... absolutely!!

Bryanna

Quote:
Originally Posted by Lynney View Post
Thank you for your reply. I could see the 'hole' the surgeon was referring to, which was a dark shape in the middle of the unerupted wisdom tooth. The tooth looked a normal size, but underneath the gum. I just didn't understand how that could have happened. Could the 'hole' always have been there? And only now causing me problems (I'm 55) or could it have developed recently...?

I know I have to go ahead with the extraction (not looking forward to that - the tooth is upper jaw and I have a small mouth!!!)

I've opted for just a local anaesthetic, not IV, perhaps I'm being stupid rather than brave! Don't have a date yet, but can I keep in touch while I wait anxiously for the appointment?

Thank you
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Unread 04-08-2013, 06:24 AM   #232
Lynney
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Hi Bryanna

Believe it or not, I have only now got a date for the surgery (NHS). So here I am, the week before, thinking, "do I really need to have this procedure?" I still don't get any pain in the wisdom tooth, only discomfort in the tooth 2 along from it. The surgeon didn't say he had found an infection, just that the hole in the tooth wasn't normal and should be extracted.

But... I have osteoporosis (no bisphosphonates) and I'm worried the surgery will damage my jaw. So now I'm thinking of pulling out..... yikes I'm in a real muddle about this!!

Lynne

Quote:
Originally Posted by Bryanna View Post
Hi Lynney,

The enamel on the tooth may have never formed completely, which means the "hole" was there all along and may or may not have gotten bigger. The rest of the tooth could look perfectly normal in size and shape. The only way to know if this has been there all along is to be able to compare previous xrays of this tooth. OR as I said, bacteria has caused decay to occur which again would look like a hole on an xray.

Irrelevant of why the hole is in this tooth, if the xray is indicating an infection and/or deterioration of the jawbone and/or it is negatively affecting your second molar...... and you are having symptoms of this, then the tooth needs to be removed.

If you have never had a wisdom tooth removed or you have difficulty opening your mouth wide for any length of time, you may want to consider having the IV sedation for this extraction. The IV anesthesia that is commonly used for tooth extractions is referred to as Twilight sedation and it is not at all like general anesthesia. Most people come out of Twilight very quickly with no after affects. This sedation allows your jaw muscles to relax enabling the oral surgeon to hold your mouth open with a mouth prop so he can remove this tooth quickly. If you just do the oral anesthetic, your jaw will be tight and access to this tooth will be difficult which means the extraction will take a bit longer to do. Even with IV sedation a local anesthetic is used to numb the entire area for several hours afterwards.

Feel free to keep in contact here.... absolutely!!

Bryanna
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Unread 04-08-2013, 08:39 AM   #233
Bryanna
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Hi Lynne,

Do not put this off. There is a problem with the wisdom tooth that is or will cause a problem with the second molar.

I am re-posting from our other conversation here:

<<My question is - have you ever heard of an unerupted wisdom tooth having a hole/infection in it - how does that happen if it hasn't come through?!!!>>

YES. IRRELEVANT OF WHETHER THE WISDOM TOOTH COMES THROUGH THE BONE AND GUM OR NOT DOES NOT ALTER THE FACT THAT WISDOM TEETH DO NOT ALWAYS FORM COMPLETELY. THE DEFORMITY COULD BE WHAT THEY ARE REFERRING TO AS THE HOLE IN THE TOOTH. OR... BACTERIA HAS ACCUMULATED IN BETWEEN THE WISDOM TOOTH AND SECOND MOLAR AND ACTUALLY CAUSED TOOTH DECAY IN THE WISDOM TOOTH. THIS WOULD CAUSE AN INFECTION TO START BREWING AND IT IS IMPERATIVE TO HAVE THE TOOTH REMOVED.

ALSO, IT IS VERY POSSIBLE TO HAVE REFERRED PAIN FROM THIS SORT OF SITUATION. HOPEFULLY THE PROBLEM IS ISOLATED TO JUST THE WISDOM TOOTH. WHEN THEY REMOVE IT, THEY WILL HAVE A BETTER LOOK AT THE SECOND MOLAR.

Lynne, a hole in a tooth is decay. Decay is the rotting of tooth structure and it is bacterial which means yes, you have infection in that wisdom tooth. It is not wise to put this off because sooner than later the bacteria will spread, the area will become very inflamed and you will end up with an emergency situation.

I know you are concerned about the healing due to your osteo..... it will heal better if you get it done before it spreads any further.

I don't know what nutritional supplements you take but these will help in the healing process. I will tell you what brands I personally use and recommend to patients because the I believe the quality is superb. I have no affiliation with these companies and of course you can use whatever you want to.......

Vitamin C ... called "Potent C Guard Powder by Perque".
Magnesium....called "Magnesium Plus Guard Perque".
Vitamin D3 ... called "Bio D Mulsion Forte by Biotics Research".
Calcium.... called "Calcium D-Glucarate by Life Extension".
Vitamin K.... called "Full Spectrum Vitamin K by NutriCology".
Probiotics.... I use Culturelle but Kyo-dophilus is another good one.

It is important to use nutritional supplements synergistic-ally... meaning take together the ones that compliment each other for the full benefit and to ensure that you are not causing an imbalance by taking one without the other. These all work synergistic-ally and help with the rebuilding of bone.

If you have any other questions.... feel free to stop by and ask
You will be okay after this is over .... just please follow through with it.

Bryanna




Quote:
Originally Posted by Lynney View Post
Hi Bryanna

Believe it or not, I have only now got a date for the surgery (NHS). So here I am, the week before, thinking, "do I really need to have this procedure?" I still don't get any pain in the wisdom tooth, only discomfort in the tooth 2 along from it. The surgeon didn't say he had found an infection, just that the hole in the tooth wasn't normal and should be extracted.

But... I have osteoporosis (no bisphosphonates) and I'm worried the surgery will damage my jaw. So now I'm thinking of pulling out..... yikes I'm in a real muddle about this!!

Lynne
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ginnie (04-08-2013)
Unread 04-17-2013, 11:37 AM   #234
Lynney
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Default Update!

Hi Bryanna

Thank you for your kind reply.

I had the impacted wisdom tooth extraction 2 days ago, under local anaesthetic. The root had connected with the sinus cavity (I think she said it was a small perforation). I have stitches, and didn't have excessive bleeding from the mouth, but am coughing up phlegm that is coloured red. Is this to be expected?

I have to not blow my nose for a month, when I return to have it checked out.

Incidentally, the tooth was not decayed, but had a hole from resorption, she told me the body was trying to absorb the tooth internally. Does that make sense?

Thanks for your help again

Lynne


Quote:
Originally Posted by Bryanna View Post
Hi Lynne,

Do not put this off. There is a problem with the wisdom tooth that is or will cause a problem with the second molar.

I am re-posting from our other conversation here:

<<My question is - have you ever heard of an unerupted wisdom tooth having a hole/infection in it - how does that happen if it hasn't come through?!!!>>

YES. IRRELEVANT OF WHETHER THE WISDOM TOOTH COMES THROUGH THE BONE AND GUM OR NOT DOES NOT ALTER THE FACT THAT WISDOM TEETH DO NOT ALWAYS FORM COMPLETELY. THE DEFORMITY COULD BE WHAT THEY ARE REFERRING TO AS THE HOLE IN THE TOOTH. OR... BACTERIA HAS ACCUMULATED IN BETWEEN THE WISDOM TOOTH AND SECOND MOLAR AND ACTUALLY CAUSED TOOTH DECAY IN THE WISDOM TOOTH. THIS WOULD CAUSE AN INFECTION TO START BREWING AND IT IS IMPERATIVE TO HAVE THE TOOTH REMOVED.

ALSO, IT IS VERY POSSIBLE TO HAVE REFERRED PAIN FROM THIS SORT OF SITUATION. HOPEFULLY THE PROBLEM IS ISOLATED TO JUST THE WISDOM TOOTH. WHEN THEY REMOVE IT, THEY WILL HAVE A BETTER LOOK AT THE SECOND MOLAR.

Lynne, a hole in a tooth is decay. Decay is the rotting of tooth structure and it is bacterial which means yes, you have infection in that wisdom tooth. It is not wise to put this off because sooner than later the bacteria will spread, the area will become very inflamed and you will end up with an emergency situation.

I know you are concerned about the healing due to your osteo..... it will heal better if you get it done before it spreads any further.

I don't know what nutritional supplements you take but these will help in the healing process. I will tell you what brands I personally use and recommend to patients because the I believe the quality is superb. I have no affiliation with these companies and of course you can use whatever you want to.......

Vitamin C ... called "Potent C Guard Powder by Perque".
Magnesium....called "Magnesium Plus Guard Perque".
Vitamin D3 ... called "Bio D Mulsion Forte by Biotics Research".
Calcium.... called "Calcium D-Glucarate by Life Extension".
Vitamin K.... called "Full Spectrum Vitamin K by NutriCology".
Probiotics.... I use Culturelle but Kyo-dophilus is another good one.

It is important to use nutritional supplements synergistic-ally... meaning take together the ones that compliment each other for the full benefit and to ensure that you are not causing an imbalance by taking one without the other. These all work synergistic-ally and help with the rebuilding of bone.

If you have any other questions.... feel free to stop by and ask
You will be okay after this is over .... just please follow through with it.

Bryanna
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Unread 04-17-2013, 12:44 PM   #235
Bryanna
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Hi Lynney,

YAY!!! So glad that is done!

A small sinus perf in a healthy bone will usually heal on it's own. Be mindful of not blowing your nose as she said and sneeze with your mouth open... while holding a tissue of course

Coughing up some red colored mucus is normal after a tooth extraction because you swallowed blood during the surgery. So now it's making it's way out. If it becomes a lot or a problem, then call the dentist and let her know.

Yes tooth resorption can occur. It would have eventually decayed and caused an infection. So it's good that it's out!

Take good care of yourself... drink plenty of filtered water and rinse gently with the warm salt water as she recommended.

Keep us posted...
Bryanna




Quote:
Originally Posted by Lynney View Post
Hi Bryanna

Thank you for your kind reply.

I had the impacted wisdom tooth extraction 2 days ago, under local anaesthetic. The root had connected with the sinus cavity (I think she said it was a small perforation). I have stitches, and didn't have excessive bleeding from the mouth, but am coughing up phlegm that is coloured red. Is this to be expected?

I have to not blow my nose for a month, when I return to have it checked out.

Incidentally, the tooth was not decayed, but had a hole from resorption, she told me the body was trying to absorb the tooth internally. Does that make sense?

Thanks for your help again

Lynne
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Unread 04-18-2013, 07:53 AM   #236
Lynney
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Default Thanks again

Thanks again Bryanna

I'm still coughing up a little bloody mucous/phlegm, but you have put my mind at rest, so I'll see how it goes. Must remember to drink more water! I have osteoporosis, so I just hope the bone is good enough to heal itself. I'm keeping my fingers crossed.

Lynney
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Unread 04-18-2013, 01:22 PM   #237
Bryanna
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Lynney,

Studies have shown that people with osteoporosis are often deficient in vitamin D. The vitamin D council and knowledgeable physicians recommend a specific blood test called 25-hydroxy vitamin D as it measures how much vitamin D is circulating in your body. According to the most recent literature the optimal blood levels should be as follows...
A few years back they were 40 to 60 nanograms per milliliter (ng/ml), but more recently the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml.

Just wondering.... have you had that specific test done?
By any chance are you on a bisphosphonate drug?

Bryanna




Quote:
Originally Posted by Lynney View Post
Thanks again Bryanna

I'm still coughing up a little bloody mucous/phlegm, but you have put my mind at rest, so I'll see how it goes. Must remember to drink more water! I have osteoporosis, so I just hope the bone is good enough to heal itself. I'm keeping my fingers crossed.

Lynney
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ginnie (04-18-2013)
Unread 04-18-2013, 04:29 PM   #238
SamanthaJ
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Default Question for Bryanna

Hello,
I am a new member and see that you have a vast amount of information on dental issues and was wondering if I could get your take on my situation. Tooth#2 had a root canal 12 years ago and #3 had a root canal 3 years ago. 6 weeks ago I developed a pressure feeling right between these 2 teeth and it initially felt as if I had something caught down in the gum tissue. Went to my regular dentist who did a root planing and scaling of the teeth and told me that if that didn't fix the problem they would see me for a root canal re-treat. It did not get better and the pressure became much more including the roof of my mouth near #2 and #3 was sensitive to hot and cold and it was hurting pretty good. Decided to find a holistic dentist for a 2nd opinion. He took a 3D scan and told me that there was an inactive infection that reached into my sinus cavity but was all fine now and that I just needed my bite adjusted and that my pain would go away. It did not go away, in fact it intensified with my neck being so stiff I could barely move it, my face felt like it was in an ever tightening vise grip, my ears were feeling like I was losing my hearing, low grade fever, lips and tongue slight swelling and just was so fatigued with a lot of brain fog. Another week went by and I went back to the holistic dentist and begged to have #2 and #3 removed to take care of the pain. He said there was no way the pain could be coming from them because the nerves were gone and he became very exasperated with me and gave me a referral to an oral surgeon, though he did give me a prescription for amoxicillian and pain pills and told me it could be my sinuses. I asked him if he could speak with the oral surgeon to request a holistic extraction (periodontal ligament and surrounding area properly cleaned) but I could see that at this point it was now time for me to get another opinion. I did find another holistic dentist a 6 hour drive from me which I traveled too. Again, they said they didn't see anything on the X-rays but could understand that I felt that a root canal wasn't healthy. He agreed to pull them and was shocked when he saw that #2 had a huge abcess sac pressing in between 2 and 3. He removed both teeth, removed the ligaments, and cleaned the surrounding bone. It has now been 48 hours since the extractions and I am feeling as if I have phantom tooth pain. It feels just like between 2 & 3 but of course they are gone. Is this normal? If so how long does this last? The good thing is that I can move my neck now, and my hearing and sense of smell have returned.
Thank you,
Samantha
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Unread 04-18-2013, 05:28 PM   #239
ginnie
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Default Hi Samantha

I just wanted to welcome you to Neuro Talk. Bryanna is tops, no question about it. Regarding your own situation, that first dentist wasn't straight up and honest with you. Glad you had those teeth out. As far as healing duration, I don't believe it will take long at all. Bryanna will answer I am sure. I had my own RC teeth removed, as there is no such thing as an inactive infection. No RC tooth is a good one. Get well soon. ginnie
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Unread 04-18-2013, 07:10 PM   #240
Bryanna
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Hi Samantha,

I'm sorry you have gone through so much pain. You traveled 6 hours to a dentist??? That's unreal! The advice that you received from those "holistic" dentists surprises me as they usually are more apt to remove root canaled teeth because they know they are infected. Perhaps their idea of holistic has little to do with oral infection and systemic health. I am glad however that you found someone else who was better informed.

Considering the length of time those teeth were chronically infected and that the scan showed a communication with the sinuses... what did the last dentist say about the sinus when he removed the teeth?

It is reasonable to have pain after these two teeth are extracted. You had a long term chronic infection in both of these teeth... the one dentist stirred up the infection by scraping the area which did nothing but add insult to injury...then having both teeth removed and the bone surgically debrided also creates additional inflammation.

Also, it is not unusual to feel referred pain or for other teeth in the same quadrant to start hurting because they all share the same bundles of nerves and ligaments. So if you can imagine all that this area of your mouth has been through, it is understandable to have pain until it all calms down.

It is important to follow the post operative instructions. Do not rinse with any chemical mouthwash, only warm salt water. Eat a soft nutritious diet and drink plenty of filtered water.

Are you still on the antibiotic and pain meds?

Bryanna





Quote:
Originally Posted by SamanthaJ View Post
Hello,
I am a new member and see that you have a vast amount of information on dental issues and was wondering if I could get your take on my situation. Tooth#2 had a root canal 12 years ago and #3 had a root canal 3 years ago. 6 weeks ago I developed a pressure feeling right between these 2 teeth and it initially felt as if I had something caught down in the gum tissue. Went to my regular dentist who did a root planing and scaling of the teeth and told me that if that didn't fix the problem they would see me for a root canal re-treat. It did not get better and the pressure became much more including the roof of my mouth near #2 and #3 was sensitive to hot and cold and it was hurting pretty good. Decided to find a holistic dentist for a 2nd opinion. He took a 3D scan and told me that there was an inactive infection that reached into my sinus cavity but was all fine now and that I just needed my bite adjusted and that my pain would go away. It did not go away, in fact it intensified with my neck being so stiff I could barely move it, my face felt like it was in an ever tightening vise grip, my ears were feeling like I was losing my hearing, low grade fever, lips and tongue slight swelling and just was so fatigued with a lot of brain fog. Another week went by and I went back to the holistic dentist and begged to have #2 and #3 removed to take care of the pain. He said there was no way the pain could be coming from them because the nerves were gone and he became very exasperated with me and gave me a referral to an oral surgeon, though he did give me a prescription for amoxicillian and pain pills and told me it could be my sinuses. I asked him if he could speak with the oral surgeon to request a holistic extraction (periodontal ligament and surrounding area properly cleaned) but I could see that at this point it was now time for me to get another opinion. I did find another holistic dentist a 6 hour drive from me which I traveled too. Again, they said they didn't see anything on the X-rays but could understand that I felt that a root canal wasn't healthy. He agreed to pull them and was shocked when he saw that #2 had a huge abcess sac pressing in between 2 and 3. He removed both teeth, removed the ligaments, and cleaned the surrounding bone. It has now been 48 hours since the extractions and I am feeling as if I have phantom tooth pain. It feels just like between 2 & 3 but of course they are gone. Is this normal? If so how long does this last? The good thing is that I can move my neck now, and my hearing and sense of smell have returned.
Thank you,
Samantha
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ginnie (04-19-2013)
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