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Two-year old tale of woe, getting worse

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Patient
Posted by: sylvia  (1 year ago)
Hello,

If I had not come to my wits’ end, I wouldn’t turn to you with the following detailed long story. But maybe you have some advice for me?

A total of 17 (!) physicians (5 dentists, 2 orthodontists, 2 university dental clinics, 2 skin doctors, 2 general practitioners, 1 eye doctor, 2 neurologists, and 1 ENT specialist) are all at a loss. Here is my (almost) endless tale of woe:

In November of 2008, my dentist at the time discovered a case of dental caries under a bridge in my upper left jaw (reaching from teeth 2.3 to 2.6 – tooth no. 2.4 is missing the cavity (at tooth no. 2.5) could be seen on the X-ray. He proceeded to remove the cavity and perform a root canal treatment on that tooth. Since the previous bridge had to be removed in the process, the entire area was subsequently provided with a temporary bridge made of plastic.

About three days after this intervention, a swelling the size of a lentil formed on the inside of the palate about one centimeter above the edge of the gums between the treated tooth (2.5) and the tooth directly behind it (2.6); the swelling was slightly sensitive to pressure.

In conjunction with (and, in my opinion, originating from) this swelling, the following discomforts appeared:

- the left nostril sometimes closed up
- a slight pulling on the left inner side of the nose towards the eye
- a feeling of pressure behind the left eye (as if someone was pressing the eye softly with a finger from the back towards the front and out of the eye socket) combined with a slightly impaired vision
- a light earache

After I described these symptoms to my dentist, he performed a root canal treatment on the canine (2.3), but without success; the discomforts continued. The same was the case when he subsequently performed a root canal treatment on the last tooth (2.6) underneath this bridge.

After that, he sent me to an orthodontist who was supposed to remove the swelling with the aid of a laser. This was indeed done, but the “lump” returned after about 4 - 5 days…

My dentist referred me to the university hospital in Witten, where a tissue sample was surgically taken and histologically examined, without any further findings (“inconspicuous, normal tissue”).

Of course, during this entire time, several X-rays images were taken, but none of them led to any diagnosis.

After half a year had gone by, I had tooth no. 2.5 pulled in June of 2009 – as it turned out during the procedure, it had been completely fine. The discomforts remained…

Subsequent visits to eye and skin doctors, as well as to an ENT specialist, led to a CT, MRT, and EEG, all without any findings. According to two neurologists (independently from one another), the trigeminus nerve had not been affected either.

So then my dentist proposed confronting the whole issue with a jaw measurement and the subsequent use of a metal-supported, long-term temporary bridge in combination with a bite splint as he now suspected cranio-mandibular dysfunction of the jaw. But even months after this procedure took place, the discomforts continued.

Then, at the end of 2009, after a recommendation, I changed dentists. The new one took a DVT (a 3D image) of my head, but again, there were no visible findings. And so I tried to accept the discomforts and problems as a fact, especially since medications (antibiotics) did not bring about any relief.

Until about March/April of this year [2010], I had accepted my issues to some extent. But after another surgery (varicose veins) under (my first) general anesthesia in March, they became increasingly worse. And the problems already mentioned have since been joined by the following discomforts:

- “Pinching” or sensations and irritations above the left eye in the area of the eyebrow
- A feeling as if hair is brushing softly across the forehead (although there is none)
- A feeling of liquid or a drop running down underneath the skin, from the upper left eye socket to the left nostril
- The feeling of an inflammation/a slight burning sensation in the left mouth and throat area as well as on the tongue
- A slight feeling of nausea
- A feeling as if I were chewing into rubber on the left side
- The swelling on the inside of the palate changes: Sometimes it swells up and sometimes it gets smaller; sometimes it is softer and sometimes it is rock-hard. And sometimes, its surface is rough too, and feels like sandpaper.

Since I could no longer bear these discomforts, I removed the long-term temporary bridge myself in May of this year (since I suspected I was allergic to it) and discovered that the spot underneath the temporary bridge, where the no. 2.5 tooth had been extracted from about one year earlier and where the swelling continues to persist, was fiery red and inflamed. Regarding this fact, my dentist said that it’s not conspicuous and that it can sometimes happen underneath a temporary bridge...

Since then, I’ve been wearing my “old” plastic temporary bridge but haven’t noticed any improvement. To be on the safe side, my dentist opened the spot – after the inflammation had subsided somewhat – and debrided the bone. The discomforts continued…

The last “remaining” (rear) tooth of the bridge (2.6) has also been causing particular problems for a while.

In this area, I often feel a slight tapping, throbbing, stinging, or pulling. However, this tooth is not sensitive to poking (when tapping it with an instrument).

Primarily, the gums around this tooth (2.6) are sensitive (to pain), as well as slightly swollen and reddened. Until recently, only the front of the tooth was affected by this, but for several weeks now, this symptom has been reaching around to the back of the tooth. What’s more, even with light pressure on the affected gums, the above-mentioned sensations increase, especially the pinching in the area of the eyebrows.

Incidentally, all this doesn’t occur simultaneously, but in an alternating fashion or in any combination. Besides that, these symptoms appear in phases, i.e., sometimes they subside, but then they return more intensely so that there is a net increase in the level of aggravation.

To be on the safe side, my current dentist performed a treatment a few weeks ago, i.e., opening the gums and taking a look at the root of tooth no. 2.6, in order to be able to rule out a possible hairline crack in the root. However, this brought about no new finding either.

Other than that, all the dentists agree that the root canal treatments performed look perfect.

In addition to that, a doctor I know recently preformed a test for anaerobic bacteria by taking three smears at three locations in the oral cavity (on the tongue, in the area of the swelling and in the area of the gums). After incubating the smears, sporadic bacteria of the “prevotella” and “candida albicans” types were found (besides the “common” bacteria in the oral cavity.

For the sake of completeness, let me say that none of the examinations by my family doctor yielded any conspicuous findings; my blood values and other data (blood pressure, EKG, etc.) are all fine.

Since April/May 2010, none of the following medications prescribed by various physicians brought any relief:

- The antibiotic “Amoxicyclin”
- An antibiotic treatment (of 10 days) with “Clont” and “Amoxicylin” in combination
- The antibiotic “Azithromycin”
- The antibiotic “Doxy-CT”
- The antibiotic “Cefuroxim AL 250”
- An enzyme treatment with “Wobenzym”
- An enzyme treatment with “Enzyme Plus”
- Biochemic cell salts (in accordance with Schüssler)
- Various mouth rinses (Chlorhexamed, Mundil, black cumin oil, etc.)

My dentist does not want to pull the no. 2.6 tooth, in which area the pain is primarily located now, because he views this as bodily harm (for no justifiable reason). Instead, he would like to place implants and thus re-establish “equilibrium and peace” in the upper jaw. But I have grave reservations about having implants placed in a (suspected) focus of inflammation, i.e., before the cause(s) of all of these problems have been found.

In any case, I thank you very much in advance (just for reading up to this point) and I look forward to your answer…

Best regards,

Sylvia
User Level:
Patient
CheckDent
Dear Sylvia!

Could you please upload the X-rays, preferably those before, during, and at the end of the treatment...?
User Level:
Patient
Posted by: sylvia  (1 year ago)
X-ray # 1 (OPG) dated July 14th, 2008/prior to the start of treatment

Hello,

Thank you very much for your prompt feedback. And first of all, I want to express my utmost appreciation to you. I am very impressed by the fact that you are interested in and committed to other people’s problems. That is very honorable of you…

I'll gladly provide you with the X-rays regarding my problems now. Furthermore, I’d like to add the latest information:

- After the most recent examination, the problematic tooth – no. 2.6 – in opposition to all the other teeth, has a rather deep pocket of > 1 cm.
- A few days ago, paper points were placed on some of my teeth, i.e., between the tooth and the gums, in order to investigate a bacterial infection. When the paper point was placed at tooth no. 2.6, the pain almost made me “go through the roof.” The very severe pain occurred like an “electric shock,” as if one were biting on a piece of aluminum with a metal filling.

But this is just a bit of additional information for you. This is X-ray #1; the others will follow further down…

Heartfelt thanks and best regards,

Sylvia
User Level:
Patient
Posted by: sylvia  (1 year ago)
X-ray # 2:

Teeth:
2.5 (still present)
2.6 (yet untreated)
2.7

Taken on February 26, 2009 (during the treatment)
User Level:
Patient
Posted by: sylvia  (1 year ago)
X-ray # 3 (OPG):

Taken on March 31, 2009 (during the treatment)
User Level:
Patient
Posted by: sylvia  (1 year ago)
X-ray # 4:

Teeth:
2.5 (still present, treated with a root canal)
2.6 (treated with a root canal)
2.7

Taken on April 20, 2009 (during the treatment)
User Level:
Patient
CheckDent
Dear Sylvia!
- after the most recent examination, the problematic tooth – no. 2.6 – in opposition to all the other teeth – has a rather deep pocket of > 1 cm.
- A few days ago, paper points were placed on some of my teeth, i.e., between the tooth and the gums, in order to investigate a bacterial infection.


With a pocket depth of more than 1 cm, the examination was pointless – of course you are suffering from Periodontitis, otherwise you wouldn’t have these pockets... Smears should only be taken if the classic periodontal treatment didn’t bring about any success...

As for the X-ray, it should be mentioned that – as far as can be determined – tooth #16 should be revised and that the prosthetic construction of the provision in the lower jaw is not ideal – distally overhanging structures aren’t good. So that was prior to the treatment...

Next, I see root canal treatments on the nos. 25 and 26 teeth – well executed. Tooth no. 27 shows sclerotized canals – here, one should check whether the dental nerve could have been injured by the crown cut (as with the no. 26) as well.
User Level:
Patient
Posted by: sylvia  (1 year ago)
Hello,

Thank you very much for your quick answer. Now I still have a few questions I would like to ask you:

Periodontitis? What can be done about this (since I have already “tried out” pretty much every antibiotic?) and is this even “curable?” Would the tooth that hurts, no. 26, be pulled? And could this have anything to do with the swelling in this region (focus of infection) that has been present for almost two years?

What do you mean by, “tooth #16 should be revised?”

And, (regarding tooth no. 27), what are “sklerotized” canals?

Once again, thank you very much in advance for your answer! Have a nice day and best regards,

Sylvia
User Level:
Patient
CheckDent
Dear Sylvia!

Periodontitis? What can be done about that (since I have already “tried out” pretty much every antibiotic?) and is that even “curable”?

Yes... [Parodontitis]

Would the tooth that hurts - no. 26 - be pulled? And could that have anything to do with the swelling in this region (focus of infection) that has been present for almost two years?

It is not absolutely necessary to pull it, but there could be a correlation with the swelling...

What do you mean by, “tooth #16 should be revised?”

On the X-ray – which, unfortunately, is not very clear – it looks as if the root canal treatment on the tooth was not done well. Upload the image in a larger resolution, then I can tell you more...

And, (regarding tooth no. 27), what are “sklerotized” canals?

Please excuse my imprecise wording. Both teeth on this side have crowns and one can no longer recognize the dental nerve. One cause could be that the dental nerve was damaged by the cutting of the crown (possibly years ago). This leads to a “calcification” of the pulp cavity. In such a case, the image of the dental nerve in the X-ray no longer appears clearly delimited, but fuzzy. Physicians call this condition “sklerotized.” Both teeth might have to be treated with root canals – a cold test [Kältetest] can offer more information...
User Level:
Patient
Posted by: sylvia  (1 year ago)
Hello,

Once again, thank you very much for your quick answer. Now I’m a bit better informed as to what “sklerotized” means...

Here now, as requested, is a larger image of the area of tooth no. 26. (In order to be able to upload it, I had to delete the previous images since apparently only a total of about 60 kB are available for images...).

Eagerly awaiting you response...

Best regards and have a nice day,

Sylvia
User Level:
Patient
CheckDent
Dear Sylvia,

The root canals on nos. 5 and 6 are well done; no. 7 could be non-vital... As I said before, one cannot recognize any canals. The swelling and discomforts could have their cause there. I’d be interested in tooth no. 6...
User Level:
Patient
Posted by: sylvia  (1 year ago)
Hello,

I can’t thank you enough for your quick responses...

No. 7 (on the left) is still alive as a cold test has shown...

And what about no. 6 on the right side? I’m a bit surprised that you are asking about this tooth (for which I don’t have a current X-ray, unfortunately, since it has not been treated until now), especially since it is exactly that tooth, i.e., the equivalent on the other side, which also begun to hurt slightly about two weeks ago.

I am aware of the fact that humans are marvelous, but also very “complicated” beings that are amazing in so many ways. But can the “other” side really have something to do with the significant discomforts that are getting worse all the time?

Once again, best regards,

Sylvia
User Level:
Patient
CheckDent
Dear Sylvia!

No. 7 (on the left) is still alive as a cold test has shown...

Stick with it! In many cases, teeth show a residual vitality, even though the tooth suffers from pulpitis...

And what about no. 6 on the right side? I’m a bit surprised that you are asking about this tooth (for which I do not have a current X-ray, unfortunately, since it has not been treated until now), especially, since it is exactly that tooth, i.e., the equivalent on the other side, which also begun to hurt slightly about two weeks ago.

In one of the orthopantomograms, it seems as if one canal has been filled, while the others haven’t…The reason for this may be:

* a bad X-ray
* a bad image
* or a bad root canal treatment, after all
User Level:
Patient
Posted by: sylvia  (1 year ago)
Hello,

I will stick with it for sure. I won’t give up! Next Monday, I will get the findings of a new bacteria test from the tooth pockets and they will also try to localize a possible focus of infection by means of an EAV (an alternative diagnostic method, I suppose, which I didn’t know about before). I would be happy to keep you updated, if you don’t mind...

Best regards,

Sylvia
User Level:
Patient
CheckDent
Dear Sylvia,
I will stick with it for sure. I won’t give up! Next Monday, I will get the findings of a new bacteria test from the tooth pockets

As I said, this won’t do anything for you at the beginning, but rather, will show that the practitioner has little knowledge, wants money, or some combination thereof...

…and they will also try to localize a possible focus of infection by means of an EAV (an alternative diagnostic method, I suppose, which I had not known about before)

I would not try any alternative procedures, but trust in proven methods. Otherwise, an alternative problem could develop, which could become difficult to treat...

I would be happy to keep you updated, if you don’t mind...

Not at all... all the best!
2 Persons like this
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