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Root Canal Infection-Diabetes

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Unread 02-16-2013, 03:40 PM   #11
Jeanie.F
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Just had an email again after I answered the questions and mentioned my blood sugars lowering.

He said that I had had an acute infection in the tooth he worked on, that could cause BS increases but he dealt with this acute infection.

And that the other tooth extracted had a chronic infection and would not have caused blood sugars to rise or cause any sypmtoms at all really...

Does anyone have info about this opinion?

As far as Im aware any sort of infection or stress on my body raises my blood sugars??
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Unread 02-16-2013, 05:38 PM   #12
Bryanna
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Hi Jeanie,

YAY!!!! Kudos to you Jeanie for sticking to your guns and staying focused on YOU and not what anyone was trying to sell you. YOU know what is in your best interest better than anyone else!!

I will answer your questions in BOLD....

<<After I sobered up I bit and was chatting to the nurse I asked if they had got all the abscess out and she said yes most came out with the tooth and we sucked the rest out. I'm a little worried now as with everything that was going on I didn't mention the removal of the ligament and think this may not have been done? Should I be worried?>>

I DON'T WANT YOU TO WORRY BUT I DO SUGGEST THAT YOU CALL THE ORAL SURGEON AND SPEAK DIRECTLY TO HIM AND NOT THAT STUPID "NURSE" AS SHE DID NOT KNOW WHAT SHE WAS TALKING ABOUT. THERE IS NO WAY TO SUCK OUT THE INFECTED LIGAMENT OR BONE. IT JUST DOESN'T WORK THAT WAY. THE LIGAMENT NEEDS TO BE SURGICALLY SCRAPED OUT AND THE BONE NEEDS TO BE SURGICALLY DEBRIDED. THE SUCTION CAN ONLY SUCK UP WHAT IS PHYSICALLY SCRAPED OFF THE BONE. ASK THE SURGEON IF HE INTENTIONALLY REMOVED THE PERIODONTAL LIGAMENTS AND SCRAPED THE INFECTED JAWBONE CLEAN. WAIT FOR HIS ANSWER AND TELL HIM THAT IS WHAT YOU EXPECTED HIM TO DO.

Jeanie.... you know more about the procedure than that "nurse"!!!!

<<He told me to go to the dentist to get my mould for temp denture and to come back to him in 10 weeks to see how everything was healing and then discuss implants after about 3 months. He said that diabetes can cause implants to fail but thats the worst possible outcome and might not happen.>>

DO NOT SEE YOUR DENTIST FOR THE MOLD FOR AT LEAST 3-4 WEEKS. THE SURGICAL SITES HAVE TO HEAL A BIT FIRST. SECONDLY, DIABETES IS A RISK FACTOR IN DENTAL PATIENTS FOR MANY REASONS WHEN IT COMES TO DENTAL IMPLANTS. HE SHOULD HAVE TOLD YOU THAT INFECTION IS THE NUMBER ONE CONCERN. SECONDLY IMPLANT FAILURE OCCURS BECAUSE THE HEALING FACTORS IN DIABETICS ARE TYPICALLY UNPREDICTABLE. THE RISK GOES DOWN WHEN THE PATIENT HAS CONTROLLED INSULIN LEVELS FOR QUITE SOME TIME.

<<I thought I might have to leave the area for a good year before even trying for implants..is it ok to try implants so soon? Also are implants safe after having an infection and diabetes etc, am I just inviting more future problems?>>

ANYTIME YOU ARE REPLACING INFECTED TEETH WITH DENTAL IMPLANTS, IT IS BEST TO WAIT AT LEAST 6 MONTHS BEFORE DOING THE IMPLANTS. THIS ALLOWS ENOUGH TIME TO BE CERTAIN THAT THE BONE HAS NOT BEEN COMPROMISED BY THE INFECTION. IN DIABETICS .... IT IS WISE TO WAIT UNTIL THE BONE IS HEALTHY AND TO MAKE SURE YOUR INSULIN LEVEL HAS BEEN MAINTAINED FOR SEVERAL MONTHS AS WELL.

With regard to the recent questions and statements made by your endodontist.... Bullsh**! He is now concerned about one thing... covering his own behind. Keep in mind that he does root canal therapy for a (lucrative) living and in order to keep his job, he has to convince others that keeping their infected teeth has minimal if any systemic consequences. For him to say that either of these infected teeth were not jeopardizing your health... is totally ridiculous. As your physician even told you differently because infection most definitely will affect not only someone with diabetes but every living being. Endodontists should be ashamed of themselves for misleading and misinforming the public!

<<Other than the shock of having the teeth out now and the annoying email I think everythings going well so far. My bloods had been around 11-13mml day of and days before the extraction. Lastnight they had dropped to 4.1mml for the first time since December. They have consistently been between 4.8-8.5 for the past 24 hours. It could be some sort of placebo or that stress is less now but I dont think so.>>

ABSOLUTELY STRESS IS LESS NOW. BUT SO IS THE BACTERIA THAT HAS BEEN FILTERING THROUGH YOUR BLOODSTREAM. THIS IS NOT ROCKET SCIENCE.... IT IS PLAIN OLE COMMON SENSE.

Eat a soft food diet... like eggs, mashed potatoes (yams or sweet are very nutritious), soups, eat vegetable and fruit smoothies with a spoon and put in whatever you want to and blend altogether. Rinse gently with warm salt water today and be a tad bit more aggressive with the rinsing tomorrow. Use only warm salt water... no mouthwash. Brush with baking soda instead of toothpaste... just wet your toothbrush and put a little bit of baking soda on it and brush. Floss all of your teeth! )

Jeanie... I know this was not easy... but you did it!!!!!!!
Keep us posted ok.
Bryanna





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Originally Posted by Jeanie.F View Post
Well they're out!!

I went to the oral surgeon yesterday with a letter from my GP saying my blood sugars are not in control and if he deemed extraction necessary could he do as soon as possible.

He asked me a few times if I was sure I wanted them out and if I wanted him to ring my Endodontist to discuss the matter further. I said I couldn't afford more RCT anyway and there was no point. He looked at the xrays and asked was I sure I didn't want to try and save the recently rct'd tooth and I said Id rather have them both out and try to get rid of the infection. He sedated me and numbed the area and after about 10 mins began to extract the teeth. It seemed to be a general extraction as there was no cutting or slicing which is what I thought surgical extraction would be. When the teeth were out he used some suction device for a few seconds and that was it.

After I sobered up I bit and was chatting to the nurse I asked if they had got all the abscess out and she said yes most came out with the tooth and we sucked the rest out. I'm a little worried now as with everything that was going on I didn't mention the removal of the ligament and think this may not have been done? Should I be worried?

He told me to go to the dentist to get my mould for temp denture and to come back to him in 10 weeks to see how everything was healing and then discuss implants after about 3 months. He said that diabetes can cause implants to fail but thats the worst possible outcome and might not happen.

I thought I might have to leave the area for a good year before even trying for implants..is it ok to try implants so soon? Also are implants safe after having an infection and diabetes etc, am I just inviting more future problems?

I got a missed call from the Endodontist yesterday, he wanted to know why I was not finishing treatment etc. I emailed him last night explaining my diabetes had been compromised and I had opted for extraction for health and financial reasons. he wrote back a long email of questions. Would you have an opinion about any of these questions he asked and answers I am going to give Bryanna..

Did the cleansing and reshaping he did ease pain? The burning pain did ease, and I was able to eat food and drink again, but I still had a sore jaw and face, was rundown and blood sugars were still high.

I had told him that the new dentist I saw did an xray and said there was a very large abscess at the end of the molar. He said that he had examined my chronically infected molar that needed to be retreated and said it was asymptomic and would not be causing me pain or problems with my diabetes? The tooth did not hurt but I feel that any infection/abscess would hinder my blood sugar control.

Did I mention to the oral surgeon that he thought I may have neuraliga or neuropathy and was I goin to go to the specialist he referred me to for this?
I told my medical doctor this idea and she said the pain could be infection and after the teeth are out if the pain comes back we could look into this specialist. But her priority was to deal with the infection.

He said he would have liked to be contacted and consulted by the oral surgeon and other dentist I saw before anything was done and also that he could have helped them with the treatment plan.

The surgeon did ask me if I wanted him contacted to discuss things and I said no as I would not continue rct.

He asked if He could call the oral surgeon Monday? If he likes he can.

Other than the shock of having the teeth out now and the annoying email I think everythings going well so far. My bloods had been around 11-13mml day of and days before the extraction. Lastnight they had dropped to 4.1mml for the first time since December. They have consistently been between 4.8-8.5 for the past 24 hours. It could be some sort of placebo or that stress is less now but I dont think so.

I have been eating yogurts since yesterday and tried some soft boiled egg a while ago which I think was a bad idea as I have food stuck in the extraction sites now!. Going to rinse with some salt water in a little while.

Anyway sorry for all the questions..again!
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Unread 02-16-2013, 05:48 PM   #13
Bryanna
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Jeanie,

Didn't see this post when I answered the other one.

The endodontist is mistaken. ANY infection in a diabetic person is a concern. ANY place on the body especially the mouth. The irony here is... any chronic infection in the mouth for any person is a cause for systemic consequences. For example.... periodontal disease which is usually a long term chronic bacterial infection (the same as root canaled teeth) is linked to heart disease, kidney disease, lung problems.... and DIABETES!!

This dentist is a jerk. I'm sorry to be so blunt but he does know better. He is just a jerk.

Don't waste your time on this nonsense. You did what you felt was in your best interest and thank God this guy was not able to convince you otherwise. He's probably ****** because he wants his money for the rct and
he's probably wondering if you are going to ask to be reimbursed for anything that you've already paid!!

Bryanna


Quote:
Originally Posted by Jeanie.F View Post
Just had an email again after I answered the questions and mentioned my blood sugars lowering.

He said that I had had an acute infection in the tooth he worked on, that could cause BS increases but he dealt with this acute infection.

And that the other tooth extracted had a chronic infection and would not have caused blood sugars to rise or cause any sypmtoms at all really...

Does anyone have info about this opinion?

As far as Im aware any sort of infection or stress on my body raises my blood sugars??
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Unread 02-17-2013, 07:05 AM   #14
Jeanie.F
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Thanks so much for your support Bryanna. Im so relieved to have them out!

Im definatley worried about the ligament not being removed. Im going to try and get some info Monday if I can but I have a bad feeling it was not done. As it was a very short few seconds of suction after the extractions and that was it. I had talked to the dentist about the ligament removal and he said the oral surgeon would do this anyway. And I think when I finally got to the appointment I was so preoccupied with getting him to agree to take them out as soon as possible that I didn't even think of the ligament removal until they were out!

If this is the case what is the likelyhood of me getting rid of the infection completely?? Also how do I know?? Would it just be a case of wait and see when the xray is taken in a few months time?

Its good to hear your views on the Endo because he had me doubting myself for a while, but I think your're right he sounds very desperate. Lying to someone with an autoimmune disease about infections not being a problem! Im so happy I didn't let him do anymore damage.

Also re the implant. I can't actually afford any work in the next few months so I will definately hold off so that I can save some money and get my HBA1C as low as possible before doing anything.

With regard to food im so sick of yogurt and it its only been two days haha. Going to try some soup today and fruit smoothies sound like a nice treat.

Im a bit worried about the bit of food I have stuck in the molar extraction site. I decided to try soft boiled egg yesterday as a break from yogurt and now there is a little bit of white stuck in the middle of the site! Its surrounded by what looks like some sort of clear/white gel stuff that might actually be there for a reason but I can't tell. Should I just leave it alone or try and get it out? Terrified of dry socket so don't want to be too heavy handed..

Again Bryanna I can't thank you enough for your support and guidance

Jeanie
xx
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Unread 02-17-2013, 03:38 PM   #15
Bryanna
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Jeanie,

There is no reason to doubt your actions.... you did what you knew was in your best interest because you cannot risk infection. The only reason the oral surgeon questioned you about your decision is because he had to be certain that that was what you wanted (for legal reasons) especially since the endodontist had already started treatment. They cover each others back and are careful not to step on each other toes. However, if the oral surgeon did not agree with you and your physician to remove those infected teeth he could have refused to do it.

Most oral surgeons remove the periodontal ligament and debride the bone after extractions. However, what makes me wonder about your case is the "nurse" telling you they suctioned the infection out. So when you speak to the oral surgeon just tell him you are asking the question because of what the "nurse" told you and you know that the ligament and the diseased bone both have to be physically removed. Tell him you dentist told you this had to be done as well as your extensive research on the internet.

It is important for the ligament and the bone to be debrided. If those things are not done then there is a chance that the infection will remain in the bone. If you have lingering pain several weeks to months down the road and/or xrays at that time show that the ligament is still present and/or the bone has not filled in properly..... then you know the debridment was not done at the time of the extraction. That would need to be addressed depending on the severity of the condition. For now... the best thing to do is speak directly to the oral surgeon and ask him. That way you are not worrying about it... you will know one way or the other.

It is best if you can eat a variety of foods. You are going to be on a soft food diet for a couple of weeks or longer. So figure out what you can eat and make sure you have plenty of it. Also drink lots of water throughout the day to help flush out the toxins and keep your kidneys hydrated. Don't worry about a little food debris in the socket. Just continue to rinse with warm salt water several times a day and you can be a bit more aggressive with the rinsing as the days go on. Don't try to stick anything in the socket as you could disturb the clot. A dry socket does not form because food gets in the socket....it forms when the clot has been disturbed.

Hope this is helpful.... you sound like you are doing OK!!

Bryanna

Quote:
Originally Posted by Jeanie.F View Post
Thanks so much for your support Bryanna. Im so relieved to have them out!

Im definatley worried about the ligament not being removed. Im going to try and get some info Monday if I can but I have a bad feeling it was not done. As it was a very short few seconds of suction after the extractions and that was it. I had talked to the dentist about the ligament removal and he said the oral surgeon would do this anyway. And I think when I finally got to the appointment I was so preoccupied with getting him to agree to take them out as soon as possible that I didn't even think of the ligament removal until they were out!

If this is the case what is the likelyhood of me getting rid of the infection completely?? Also how do I know?? Would it just be a case of wait and see when the xray is taken in a few months time?

Its good to hear your views on the Endo because he had me doubting myself for a while, but I think your're right he sounds very desperate. Lying to someone with an autoimmune disease about infections not being a problem! Im so happy I didn't let him do anymore damage.

Also re the implant. I can't actually afford any work in the next few months so I will definately hold off so that I can save some money and get my HBA1C as low as possible before doing anything.

With regard to food im so sick of yogurt and it its only been two days haha. Going to try some soup today and fruit smoothies sound like a nice treat.

Im a bit worried about the bit of food I have stuck in the molar extraction site. I decided to try soft boiled egg yesterday as a break from yogurt and now there is a little bit of white stuck in the middle of the site! Its surrounded by what looks like some sort of clear/white gel stuff that might actually be there for a reason but I can't tell. Should I just leave it alone or try and get it out? Terrified of dry socket so don't want to be too heavy handed..

Again Bryanna I can't thank you enough for your support and guidance

Jeanie
xx
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Unread 02-18-2013, 06:38 AM   #16
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I just phoned the surgeons office, he is not there at the moment, his secretary told me that she did not know if he did take the ligament out but that he had sent a letter to my dentist describing what treatment he had done.

I rang my dentist and spoke to his secretary, she made an appointment for me for two weeks time to have a checkup and xray, she said that she would think that all oral surgeons would remove the ligament. She said that the letter had not arrived yet from the surgeon and might not mention that the ligament was removed, but that she could do some investigation for me if the letter is not clear about it.

If it's a case that it was not removed and there was pain further down the road would the area have to be opened up and ligament taken out then??

I wish I had have made sure before I went ahead with extractions at the clinic on Friday now!

I think I just thought that things would be done properly as it was an oral surgeon doing it and the dentist had said they would definately deal with the ligament, I was so dozy after the iv sedation I couldn't even think of what I was supposed to ask at that stage..
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Unread 02-18-2013, 07:05 PM   #17
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Jeanie,

How are you doing?? Are you eating ok?

To answer your questions...
The periodontal ligament and all diseased bone is suppose to be removed at the time of the extraction. Unfortunately, we can never assume that the dentist or oral surgeon is going to automatically do this. Most oral surgeons will do it but if they are in a hurry or are lazy.. they do a sloppy job at best. General dentists rarely remove the ligament or diseased bone... they actually shy away from doing that unless they have been educated on how and why to do it. I know.... sounds so stupid. But it unfortunately is the truth of the matter.

It's like that "nurse" who told you he suctioned the ligament out..... that would only be true if he had scraped it loose from the bone first. Which he may have done. But she either didn't know that or didn't want to give you too much information. His surgical report probably will say... extracted #? under iv sedation, patient handled procedure well. It is his clinical notes that would probably be more detailed than the surgical report. That's why I suggested to speak with him directly so he could tell you what he actually did.

It is always best and easiest to remove the ligament and debride the bone at the time of the extraction. When it is done later on.... it can be a bit more complicated. Not necessarily painful, just more of a chore to remove it.

Please do not beat yourself up over this... you were in pain... you were trusting the surgeon and you were sedated!! It was his responsibility to take good care of you and follow the proper surgical protocol. If he is offended by your questions, tell him your concerns and you are not casting judgement you just have the right to know.

Let us know how you're doing.
Bryanna





[/i]
Quote:
Originally Posted by Jeanie.F View Post
I just phoned the surgeons office, he is not there at the moment, his secretary told me that she did not know if he did take the ligament out but that he had sent a letter to my dentist describing what treatment he had done.

I rang my dentist and spoke to his secretary, she made an appointment for me for two weeks time to have a checkup and xray, she said that she would think that all oral surgeons would remove the ligament. She said that the letter had not arrived yet from the surgeon and might not mention that the ligament was removed, but that she could do some investigation for me if the letter is not clear about it.

If it's a case that it was not removed and there was pain further down the road would the area have to be opened up and ligament taken out then??

I wish I had have made sure before I went ahead with extractions at the clinic on Friday now!

I think I just thought that things would be done properly as it was an oral surgeon doing it and the dentist had said they would definately deal with the ligament, I was so dozy after the iv sedation I couldn't even think of what I was supposed to ask at that stage..
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Unread 02-19-2013, 08:10 AM   #18
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Hey Bryanna,

Im doing ok I think. My jaw is a bit sore still and the gum and mouth are very tender and sore especially after eating and using salt water, but seem to calm down after a while. I had some vegetable soup yesterday along with the usual yogurts and sugar free jelly throughout the day. The salt water seems to be doing the trick with removing the food too.

Im a bit stressed about this ligament removal, Im going to ring the dentist secretary tomorrow and ask her to find out for me for definite. If its yes then that's great, if it's a no Il have to find out if I can get it done. I don't want to go through the healing of extractions over the next few weeks and then have to open everything up again and fix the problem. Plus theres the extra costs this work would be...Its all so stressful!

I think I better stop thinking about it for a while cause im starting to drive myself mad
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Unread 02-19-2013, 01:34 PM   #19
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Jeanie,

Please try to broaden the food that you are eating. You will be able to eat most soft foods and it's important to eat as nutritiously as possible. Glad the salt water rinsing is helping!

Try to stop stressing over the ligament issue. Again, I would not speak to any staff member at that office because they may not know the answer and just tell you what you want to hear. It also let's him off the hook because he can later say... I never spoke to the patient about the ligament. Hopefully he performed a thorough surgery and all will be well!!

Keep your thoughts positive... and give yourself time to heal. This has been a tough journey but you will do okay!!

Bryanna

Quote:
Originally Posted by Jeanie.F View Post
Hey Bryanna,

Im doing ok I think. My jaw is a bit sore still and the gum and mouth are very tender and sore especially after eating and using salt water, but seem to calm down after a while. I had some vegetable soup yesterday along with the usual yogurts and sugar free jelly throughout the day. The salt water seems to be doing the trick with removing the food too.

Im a bit stressed about this ligament removal, Im going to ring the dentist secretary tomorrow and ask her to find out for me for definite. If its yes then that's great, if it's a no Il have to find out if I can get it done. I don't want to go through the healing of extractions over the next few weeks and then have to open everything up again and fix the problem. Plus theres the extra costs this work would be...Its all so stressful!

I think I better stop thinking about it for a while cause im starting to drive myself mad
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Unread 02-20-2013, 10:48 AM   #20
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Thanks again Bryanna,

Iv graduated to mashed potato and turnip, some hummus and some almond nut butter today. So getting a bit more of a selection.

Today and yesterday Iv had a burning sensation in the gum area around the extractions sites. Also a stinging pain in the inside mouth and into eye again, kind of like the nerve pain I had which made me go to the dentist in the first place but not as intense. Is this something to worry about..maybe to do with infection? Of would this be normal nerve pain 5 days after extraction??

I finish my second course of amoxocillan tomorrow, my GP gave me a prescription for another week if I need it, Im not sure whether to fill the presciption or just stop taking tomorrow when I finish.

The reason Im questioning whether he did a full surgery was because although he was an oral surgeon it was a basic extraction as far as I can tell, very easy and quick, but like you say I was a bit out of it!

I rang his secretary again but I can't get hold of him personally as he's not there today either! Im going to give myself the rest of the week to calm down and heal up a bit, then try to get a straight answer after the weekend. The secretary in the dentists said she would find out for definite for me if it wasn't clear on their notes received so I think she'l have more luck getting direct communication then I have.

Would it be wise if the answer is no he did not do the full removal to ask for it to be done now?? What is the likelihood of a surgeon doing this weeks after extraction at patients request?

Also if it was done would it be the same kind of healing time frame as extractions would take or not so simple?

Also if he was planning on discussing implants with me in a few months time would he have had to make sure the ligament was removed in order to this or would he not think this was an important issue?

Sorry for all the questions, I know you can't tell what the man is thinking! But just appreciate your opinion.

Jeanie
Xx
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