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can periodontal scaling damage root?

User Level:
Patient
Posted by: rturnbull  (2 years ago)
Can periodontal scaling spread bacteria deeper into the gum and eventually damage the nerve of a tooth?

Last year scaling was performed between teeth 12 and 13 – the gum was slightly inflamed, and would occasionally bleed when flossing. The gum had marginally separated from one tooth, but produced no pain. The procedure was performed by a hygienist, rather than the dentist, and appeared to go well. However in the weeks to come increasing deep pain began - deep bone pain at the center of a bicuspid, which would radiate outward into other teeth, the skull, the eye; the lymph nodes on the left side of the face also swelled.

The first dose of cephalexin did not entirely remove the pain, which progressively grew again. The separation between tooth and gum had by then healed, and a specialist was sought while a stronger dose of cephalexin undergone. Despite good digital x-rays, the specialist could find only swelling of a ligament. These x-rays are available for review. The pain and related symptoms have since intermittently returned for the last six months and recently began very deeply at the bicuspid again, which shows a thickening of the ligament under new x-rays. The pain has spread up again into the left eye and the lymph nodes are swollen again. A cold test for # 13 indicates increased sensitivity. Amoxicillin reduces the pain. Root canal therapy has been proposed.
Which is the more accurate cause and effect in this scenario?

A: the patient would experience no pain from an infected tooth root, which eventually slightly swelled and separated the gum from the tooth, and only after the separation was repaired through scaling the patient began to experience ongoing profound pain for six months in the root of the tooth followed by the related symptoms of swollen lymph nodes, etc.

B: during the scaling bacteria was pushed deeper into the gum, which then closed, locking and spreading the bacteria against the tooth; eventually, due to prolonged infection, the tooth root was irreparably damaged.

Thank you and kind regards,

RT
User Level:
Dentist
Can periodontal scaling spread bacteria deeper into the gum and eventually damage the nerve of a tooth?

Last year scaling was performed between teeth 12 and 13 – the gum was slightly inflamed, and would occasionally bleed when flossing. The gum had marginally separated from one tooth, but produced no pain. The procedure was performed by a hygienist, rather than the dentist, and appeared to go well. However in the weeks to come increasing deep pain began - deep bone pain at the center of a bicuspid, which would radiate outward into other teeth, the skull, the eye; the lymph nodes on the left side of the face also swelled.

The first dose of cephalexin did not entirely remove the pain, which progressively grew again. The separation between tooth and gum had by then healed, and a specialist was sought while a stronger dose of cephalexin undergone. Despite good digital x-rays, the specialist could find only swelling of a ligament. These x-rays are available for review. The pain and related symptoms have since intermittently returned for the last six months and recently began very deeply at the bicuspid again, which shows a thickening of the ligament under new x-rays. The pain has spread up again into the left eye and the lymph nodes are swollen again. A cold test for # 13 indicates increased sensitivity. Amoxicillin reduces the pain. Root canal therapy has been proposed.
Which is the more accurate cause and effect in this scenario?

A: the patient would experience no pain from an infected tooth root, which eventually slightly swelled and separated the gum from the tooth, and only after the separation was repaired through scaling the patient began to experience ongoing profound pain for six months in the root of the tooth followed by the related symptoms of swollen lymph nodes, etc.

B: during the scaling bacteria was pushed deeper into the gum, which then closed, locking and spreading the bacteria against the tooth; eventually, due to prolonged infection, the tooth root was irreparably damaged.

Thank you and kind regards,

RT


Occasionally in gum disease cases, whether scaled or not, bacteria from the pocket can enter lateral canals in the root and infect the root. This is probably what happened. You may need a root canal. Pulp testing should be done first, though, to test the diagnosis.
Posted 2 years ago
User Level:
Patient
Posted by: rubbedlung  (1 years ago)
I was curious if after you've had full scaling on your teeth could this also make your lymph nodes swell? I read that you were supposed to wash with hydrogen peroxide afterward for awhile but the dentist did not did not tell me this. Any ideas?
User Level:
Dentist
First i will give you suggestion on full scaling on your teeth.You should follow the advice of your dentist.
Posted 7 months ago
User Level:
Patient
Posted by: jimhassel  (7 months ago)
Periodontal pocket will almost never resolve after scaling in a combined perio-endo lesion. For this reason, if the periodontal pocket has indeed resolved, the pain is more likely to be caused primarily by an endodontic (pulpal) problem. This in no way leads to the presumption that everything with the gum is OK. It is very common to have both periodontal and pulpal involvement of the same tooth.
User Level:
Dentist
I was curious if after you've had full scaling on your teeth could this also make your lymph nodes swell? I read that you were supposed to wash with hydrogen peroxide afterward for awhile but the dentist did not did not tell me this. Any ideas?

I have never had a scaling patient develop inflamed lymph nodes. Infection like this is not likely. The same bacteria that were in the pocket before are in the pocket after the scaling. We are not introducing any new bacteria. Of course, anything is possible.
Posted 7 months ago
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