[ { "id": 1, "title": "Dental implant sinus lift surgery question", "dialogue": "Amy5757: I wanted to provide a brief history before my dental implant and sinus lift surgery:\n\nIn 2019, I had a root canal that failed, and I developed an infection. I went to an oral surgeon who removed the infection and bone graft material was inserted so that I could later have a dental implant. I was unable to pay the $5,000 (out of pocket) OOP cost at that time, so the dental implant was never placed. In September 2023, my general dentist advised me to get a dental implant. The dentist was unable to perform the surgery because a dental cone beam CT scan showed that I didn’t have enough bone height in the upper jaw for a dental implant so he recommended I go to an oral surgeon for a sinus lift and dental implant surgery. I was then referred me to an oral surgeon.\n\nHistory with Oral Surgeon:\n\nOn 11/20/2023, I went in for a sinus lift and dental implant surgery. I was prescribed Chlorhexidine, Ibuprofen, Dexamethasone, and Oxycodone. I experienced several complications, which I documented below:\n\n\n-After the surgery, I developed an extremely painful sinus infection. I had my second visit with the oral surgeon on 11/28/23. The scan showed I had a perforated membrane, and there was bone graft material in my sinus cavities. I was prescribed Amoxicillin-clav 875mg. and pseudoephedrine 30 mg tablet. The surgeon indicated that membrane perforation is a well-documented complication that occurs in a sinus lift surgery, but most of the time the membrane heals on its own without any intervention.\n\n\n-I had a 3rd visit with my surgeon on 12/7/23 due to significant pain in my right ear and the gum around the implant was throbbing. The surgeon prescribed Amoxicillin-clav 875mg, and more mouth rinse Chlorhexidine. I was on the amoxicillin for so long that I had diarrhea for several weeks.\n\n-I had a 4th visit with my surgeon on 12/15/23 because my symptoms had still not improved. I was prescribed more amoxicillin $2.57. The pain in my ear was so severe that he referred me to an ENT.\n\n*During each of my visits with the surgeon, he continually repeated that he’s never seen this happen before and doesn’t know of anything else he can do to help my situation.\n\n\nENT history:\n\nMy first visit with the ENT was on 12/18/23. The Physician’s Assistant (PA) said there was significant sinus inflammation and prescribed an oral steroid, Prednisone 20mg and a nasal spray, Azelastine. After a few days, there was minimal improvement, and I continued to endure severe ear pain due to developing eustachian tube dysfunction (ETD).\n\n-I went back to the ENT for a second visit on 1/2/24. The PA placed an ear tube in my right ear to help the middle ear drain and relieve pressure since I had ETD. I was also given a steroid injection in my ear, Triamcinolone acetone. I was prescribed oral eardrops, Neomyocin-polymyxine-hc ear solution and muscle relaxer, Tizanidine.\n\n-On 1/24/24, I went to the ENT for a 3rd visit where a CT scan of my sinuses was ordered. The PA also prescribed allergy medication, Cetirizine $11.95 to help reduce sinus inflammation caused by some seasonal allergies.\n\n\n-The CT scan was completed on 2/1/24.\n\n\n-I went back to ENT for a 4th visit on 2/20/24 to discuss CT results and I received another steroid injection, Triamcinolone acetone. CT scan showed mild hypertrophy of the right inferior turbinate and mild deviation of the nasal septum to the left with a bony spur indenting the left inferior turbinate.\n\n- I had this sinus lift surgery over 6 months ago, and I am still dealing with chronic sinus pressure that has been very difficult to relieve. Currently, I am still experiencing a constant itching, and tingling sensation around the dental implant. I was supposed to get a crown placed back in February but have been unable to because anytime I eat or move the implant, the itching and tingling sensation worsens.\n\n-I went to my general dentist on 4/25/24 to discuss my concerns. An x-ray was taken, and he was unable to find any signs of infection. He prescribed an antibiotic, Cephalexin 500mg. Unfortunately, the antibiotic did nothing to improve my symptoms.\n\n-I have never experienced any sinus issues in the past. However, after the implant surgery, I developed chronic sinusitis and ETD. I was in constant agonizing pain for almost 3 months and could not perform my normal activities and I missed weeks of work.\n\nBetween the office visits to the ENT and prescriptions, I’ve had to spend over $1,300 OOP. I have also spent hundreds of dollars outside of the office visits and prescriptions trying to relieve the sinus pressure. \nI'm not sure what to do from here. Has anyone ever seen this happen before? Looking for advice. frankmurphy: Wow, I am really sorry to hear about all the complications you've been experiencing. It sounds incredibly frustrating and painful. While I'm not a medical professional, I can empathize with the toll this has taken on your daily life and finances. Have you considered seeking a second opinion from another oral surgeon or ENT specialist? Sometimes a fresh perspective can make a big difference. I hope you find relief soon. Hang in there!" }, { "id": 2, "title": "Full dental implants even though I have 22 good teeth.", "dialogue": "Floridaroofer: I was scheduled for full dental implants and told I was a perfect candidate. I have 17 healthy teeth and 5 that need capped. I could use a couple of moler implants. But why pull so many good teeth ? Is it for the 40k they want to charge. Dr M: Sounds like you need to get a 2nd opinion from another dentist. I would not recommend removing teeth, if other options have not been considered as well. desrosiersdental: If you have 22 healthy teeth, full dental implants might not be necessary. Implants are typically considered for replacing missing or severely damaged teeth. It's best to consult with a dental professional to assess your specific needs. Admire Dental Care can provide expert advice and personalized treatment options based on your dental health. blakey72: I've just had a full upper, I had 4 bad teeth left so I really needed it. I personally wouldn't get any teeth removed if they can be fixed. You want to keep your own teeth as long as you can, nothing else is ever as good. If you are willing to pay $40k on implants I'd be spending a lot less on fixing what is there. Even if you want to get a few single implants just do that. \n\nHaving the surgery is no walk in the park! It's long and painful. Then the days following my face is blown up like a balloon and bruised everywhere. Not to mention more pain than the surgery itself. I know everyone is different and some may fair better than me and some worse. Don't take this procedure as an easy fix to make yourself look better, it's a big surgery. I'd be looking at implants as a last resort. Only my opinion of course. Good luck with what you decide" }, { "id": 3, "title": "Question about Oroantral Fistula Closure (OAF) - Bone graft or no bone graft.", "dialogue": "boloxchops: I had Molar # 2 removed 3 weeks ago (it was a root canal that went bad after 15 years). There was a sinus communication detected during extraction (large lesion and radicular cyst likely compromised sinus floor). Periodontist tried closing it. After stitches came out communication was felt again.\n\nFirst oral surgeon is talking about block bone graft and then Buccal Fat. ($5.5k procedure - won't work with insurance)\n\n2nd opinion said bone graft will likely fail and to just do Buccal Fat and Buccal flap to close it first, then consider bone graft later on if bone situation improves. ($1.1K procedure out of pocket).\n\nMoney not the issue. Doing the right thing is.\n\nThe boney defect is 10.97mm across.\n\nAny experienced oral surgeons have an opinion? Is the 2nd opinion more conservative or way too conservative? He said if bone graft doesn't take, because of the size of the defect, and the thin surrounding bone, I will have dead bone floating in there causing chronic infection.\n\nAttached is the CBCT image (2 angles) of the defect in the sinus floor.\n\nI appreciate any input. Just trying to make the best decision." }, { "id": 4, "title": "Short Plateau Implants -- safe and advisable?", "dialogue": "Eric2005: Recently the dentist told me that he can avoid a sinus lift by using short implants. I had resisted the sinus lift as it seemed more than I could endure. I have two missing molars. The dentist seems convinced that a short implant is possible for one, possibly both molars. I'm 72 years old, in generally good health. Is this a good idea? Dr M: Depends on the amount of bone that is left. Would need an x-ray to give an opinion. But overall yes, it is possible." }, { "id": 5, "title": "Neurophatic pain ? (CT attached)", "dialogue": "k_ace: I have mysterious pain more than 1 year, in the marked toothless area on the attached ct picture, No diagnosis yet. The pain is very strong shooting electric like nerve pain inside the alveloar process. I feel i have a nerve that is irritated in that point. Sometimes i can trigger with pressure, sometimes not, the shooting just happen. I can pinpoint exactly the location with my finger. The pain is come and go for weeks, or months. Pleases somebody can examine my ct picture? No painkillerrs working for this shooting pain. Can somebody see something that area, or my pain is neurophatic? If need more picture i can do it . Dr M: Can't see any root remnants on the CT or PAN, but it does seem that you have multiple other teeth with problems. Although it could be neuropathic pain, it might also be referred pain from one of the other teeth. I would suggest starting there. Sort them out and then see if the symptoms persists." }, { "id": 6, "title": "Seen oral medicine specialist, what now?", "dialogue": "aqz: Saw a oral specialist last week, she took candida swabs, and smear. But has prescribed nystatin as she thinks its fungal. I have noticed the whiteness that its usually coated in is not there after taking the meds for a week now. I finish 10 days of meds on sat. So was this just oral thrush all along for the last 6 years!\nI go back to specialist in 3 months, is this being dealt with the right way. Should they biopsy? I will attatch image of it after 7 days of nystatin. I am glad i have some answers but still unsure what to do next. Without results of smear she prescribed antifungal was that the correct thing. I know i am in the best place as i have waited 6 months to be seen by oral specialist. But why make me wait 3 months still to re acess ?? Below is a pic of it today. @Dr M \n1st image is now\n2nd image is jan 2024" }, { "id": 7, "title": "How does it feel like getting dental implants?", "dialogue": "Dentist90: For those who got implants placed during oral surgery, how did that feel like? Did you feel a lot of pressure and drilling or it’s not that bad? I hear different stories. Two older women said it’s just a bit of drilling and pressure but you barely feel anything. Another one said it’s a lot of pressure. What was your experience like? Dr M: You will experience pressure for sure, although the amount of pressure is relative. The pain is also minimal, but again this differs from patient to patient due to their different pain levels. smithwilfer: Hi , my mother in law got implanted few months ago. She had well adjusted to it. In beginning there was swelling and pain with sensation, but now she feels comfortable. flomodental: Getting dental implants at a Dental Clinic can be a breeze! They'll numb the area for comfort, so you'll mainly feel pressure during the procedure. Afterwards, expect soreness, swelling, and an adjustment period as your mouth gets used to its new smile. FLoMo Dental can help you manage discomfort and ensure smooth healing with their aftercare instructions. Remember, healing takes time, so follow their advice carefully to avoid problems. If you're anxious, talk to FLoMo Dental about sedation options! thomasrobert: When I underwent oral surgery for implants, I was quite anxious due to the varying stories I'd heard. In my case, the procedure involved some pressure and drilling, but it was manageable and not as intense as I feared. The discomfort was minimal, and the dental team ensured I was comfortable throughout. It's important to remember that everyone's experience can be different, but overall, oral surgery for implants was not as daunting as I had anticipated." }, { "id": 8, "title": "To save a tooth or not", "dialogue": "gloria5: Tooth 31 started hurting and endodontist couldn’t see infection but did a root canal and saw a crack. He said there’s a chance I will need to pull the tooth. Ever since the root canal my teeth are catching and biting my cheek when eating or talking but endo unconcerned. I’m scheduled to see my dentist next week. How do I figure out whether it’s worth it to save this tooth? I should mention that I had #3 extracted a few years ago and I’m getting an implant this summer. Thank you." }, { "id": 9, "title": "UK Molar Extraction", "dialogue": "ChrisX: Hello, I live in the UK. I just had a molar extracted by an NHS dentist.\n\nIn my area, these are quite rare these days. Most dentists do not offer much \"on the NHS\" so the choice is between waiting many months for a cheaper treatment on the NHS or paying far more for \"private treatment\".\n\nAnyway, I wanted to see if my experience is normal or not. This is my first extraction as an adult (I'm 64). Upper molar, the filling had dropped, somehoe I split the tooth and the filling fell out. One week later they took it out. It cost £73.50.\n\nThe first injection was insufficient. When she started work and it was very painful, so she injected a lot more. That second injection also hurt a great deal.\nAfterwards my left eye felt strange and twitched and I found later that I could no longer flare my nostrils.\nI didn't know that was a thing I did, but when it went away it was very noticeable. These symptoms lasted a day. Is that normal?\n\nI don't know how they extract teeth, but there was a lot of repetitive sideways pressure and after maybe 20 cycles of the, the took came out, or rather broke off.\nHow do they do it - is it just pliers and brute force?\n\nWhat I was shown, was the part of the tooth above the gum line - no visible root at all.\n\nShe said I would need another appointment to get the root parts out \"somewhere that has the right equipment\". Is that normal?\n\nIt's the next day now, and the pain is beginning to subside. The blood clot is behaving itself.\n\nNow I'm dreading the next appointment. They will presumably have to cut open the guml have just healed, and put me back in pain, and after that experience, I'm really dreading it.\n\nMaybe it would be worth paying 4 times as much for that work privately?\n\nThanks for any thoughts you can offer.\nChris Dr M: It does sound like it was a difficult, but normal extraction. Sometimes it does take more than one injection to numb a tooth, and sometimes the effects can linger for 24 hours. The movements you explained, also sounds correct. Unfortunately, there is always a risk that the tooth can fracture during the extraction procedure. And if the practice doesn't have the right equipment to remove the roots, you unfortunately would have to go back for another visit, which might include surgical removal of the tooth roots MattKW: Not unexpected. We rarely get the chance to extract sound teeth, so fracture during extraction is quite common, esp if your tooth has already got a split.\nI teach extractions at my university, and getting students to understand it is quite hard - it really takes years of practice to develop the \"feel\". Having said that, the dentist should be prepared to follow through after a fracture with the appropriate technique. It's really not that hard to section an upper molar.\nI'd go somewhere else and spend the $." }, { "id": 10, "title": "Hard, white gum after implant", "dialogue": "cabie000: I got my fifth dental implant done yesterday, and noticed something different this time: the gum surrounding the implant is hard and white. Not the entire gum, just the part immediately around the implant.\n\nIs this typical? Cause for concern? Dr M: It might be due to the implant crown exerting pressure on the gum tissue. This should resolve within a few hours. If it doesn't, you will have to go back to your dentist in order to relieve the crown. The white colour is due to the lack of blood supply to the immediate area. cabie000: Day 6 and the white color is question is no longer there, but I'm noticing this hard thing on my gum that's not going away. I've never experienced this before. Any ideas? Dr M: This looks fine. The area around the implant is still healing. The gum tissue forms scar tissue first, which is yellow-whiteish in colour. It will gradually transition into a normal pink colour. MattKW: That looks like a catgut suture, and will dissolve by itself." }, { "id": 11, "title": "Choice of dentist for Implants", "dialogue": "ulia2092: Hello, please does anyone reside in Georgia and has done implants with no regrets. \nI am trying to make a choice and checking out with people." }, { "id": 12, "title": "Teeth brittle due to radiation and years of acid reflux", "dialogue": "kevinwjchevy: Dentist says I will need oral surgery to extract 9 teeth and that my sinuses will certainly be exposed afterwards. I've been out of work for 2 years now with treatments and surgeries with no income. Since esophageal surgery my food must be well chewed or pureed to swallow. My question is if anyone knows of any programs to assist with cost of the oral surgery needed to remove the teeth or suggestions. I got an estimate of 9600.00 which is impossible for me. Any suggestions are appreciated" }, { "id": 13, "title": "Implants teeth with bridge, do they look right", "dialogue": "Yasmin: Yasmin: Hi\n\nI have extreme fear of dental work, so please be gentle with me. I’m from the uk, I travelled to turkey with family and was really pushed by my relatives to have two of my teeth removed and get a implant, one front bottom teeth already fell out two years ago and one was on its way and another was infected, I was sooo devastated after because I felt rushed to it in taking that teeth out but I think it needed to come out and I also had my front bottom Molur removed because it was infected( I didn’t get implants for that one.\n\nI waited in turkey for two and half \nMonths and I got those implants with a bridge few days ago and I’m really disappointed, it’s not what I expected, they feel very stiff and like block of teeth rather seperate teeth, they look like dentures to me, but I have zero experience with implants, I have gum disease, was told in the Uk implants might not be a option but I. Turkey they said there is enough bone to do it and that in the long term my Jew might go into self with out a bone there.\n\nPlz help and be gentle with me, I need to know I can get through this,\n\nI’m seeing the guy tomorrow and I need to go to him with a plan, I would get pressured from my family to just leave it as it is but I don’t like it Dr M: Okay, considering what you had to work with, this is not a bad outcome. Unfortunately I agree with the UK dentists. The fact that a tooth \"fell out\", tells me that you have periodontal disease. Dental implants is not recommended for people with periodontal disease, if the disease has not been treated and stabilized.\nThe reason why the bridge feels like a denture, is because they had to add pink porcelain to the bridge, to close gaps, since you did not have enough bone and therefore soft tissue to support implants.\nI would not have done implants in your case. This is why going to Turkey for alternative treatment options, sometimes ends badly, since you end up having compromised treatment. Yasmin: Hi thank you.\n\nIs there anything I could do now or should I keep those teeth’s.\n\nI know it’s probably not a good idea, but what could I put in my mouth, is what they are saying true about losing more bone in the mouth if I didn’t put anything in? Yasmin: What could treat my gum my disease do you think.\n\nI feel a bit sad the lost teeth and the one they took out.\n\nI’m going to share my x tray, he was saying the teeth needed to go Yasmin: Yasmin: Can I just confirm they did put the screws in so was wondering why couldn’t he do normal implants. Dr M: The best option would be to see a periodontist in your case, since your periodontal disease needs to be managed first. It is true that implants keep bone in the area, like normal teeth do, but it is irrelevant if you have active periodontal disease, which will leads to bone loss anyways. Start with a periodontist. He can manage the gum disease and give you an opinion on the implants as well. Marian Mejia 2”A”: I think so, but it has to look aesthetic and natural, otherwise it will look fake and that's not good." }, { "id": 14, "title": "Does this look like my teeth roots are preforating my sinuses?", "dialogue": "kortney: kortney: Teeth are completely healthy. \nHave had chronic post nasal drip for years!\nAnd blood work is normal.\n\nI have no idea what's going on with me\nDentist says it's a sinus issue\nAnd ent says it's a dental issue\n\nHELP! \nalso it's on both sides! Dr M: Did your dentist check the associated teeth for any carious lesions? On the one image, it looks like your UL7 has a carious lesion. Any carious lesions, affecting the nerve and leading to pulpal involvement, might lead to pseudocysts or polyp formation in the maxillary sinuses.\nThis will then be a combination of a dental and sinus issue. \nStart with a thorough evaluation of the teeth first" }, { "id": 15, "title": "Mouth Feels Fine After Wisdom Tooth Extraction...Is That Okay?", "dialogue": "EstelleLauren03: This may sound so dumb, but I had my wisdom teeth removed this morning and have had almost none of the symptoms that I was warned of and it's making me nervous. In fact, I keep forgetting I even had oral surgery today... I got all four removed, three of which were impacted and the other of which I had a severe infection around earlier this year. One thing to add is that I had a pretty intense abdominal surgery when I was 13 and was up and walking same day, so I know my immune system is strong. Nonetheless, does this mean my immune system is strong or should I be concerned? TIA! Dr M: It is still early days. Worst post op pain is usually 3 days after the procedure. But if you don't have any pain, count yourself as lucky. Ajay Bhandarwar: While it's good your mouth feels fine, some discomfort after wisdom teeth removal is normal. Monitor for swelling, pain, or other issues in the coming days." }, { "id": 16, "title": "Should I have my impacted wisdom teeth removed?", "dialogue": "chwagre: Hello, guys! I'm male, 27, and all of my wisdom teeth are impacted, they are completely enclosed in the gum with nothing showing in the mouth. I've only ever had slight jaw pain once or twice for a day or two. Also my upper right central incisor has become slightly crooked after orthodontic treatment but that could have been because they never gave me any aligners to wear after they removed my braces. Other than that, I haven't had any issues with them. I've attached 2 panoramic images, the first is from 2021 and the second is from last week, I have a couple of questions:\n\nShould I get them removed? Do impacted wisdom teeth like these always cause problems? What could happen if I don't get them removed?\n\n\n\n\t\t\thttps://preview.redd.it/should-i-have-my-impacted-wisdom-teeth-removed-v0-h3nub6h016oc1.jpg?width=5888&format=pjpg&auto=webp&s=b70a06e386ad6e5a03164f34bf71a4274ab8bb92\n\t\t\n\n\n\n\t\t\thttps://preview.redd.it/should-i-have-my-impacted-wisdom-teeth-removed-v0-2a2ql5h016oc1.jpg?width=2218&format=pjpg&auto=webp&s=772d77982e8dc1daeea68f7f33f8f56e69ad9b52 Dr M: Wisdom teeth should not be removed, if completely covered by gingival tissue and/or bone, and if you don't have symptoms that appear more frequent. I would monitor these teeth for now only. Monitor your symptoms as well as the adjacent teeth. If the pain becomes more frequent or if a part of the tooth protrudes through the gum, then only would I consider removal." }, { "id": 17, "title": "All on 4", "dialogue": "vivian: Has anyone had that procedure??? All on 4. I’m 67 years old." }, { "id": 18, "title": "All on 4.", "dialogue": "vivian: I am 67 should I get the all on4 I’m very so afraid" }, { "id": 19, "title": "Oral surgery and Medicare", "dialogue": "MChang: Need to have a tooth extracted and bone graft done. Code is D7953. Medicare does not covert cosmetic dental procedures, but this isn't cosmetic. The toot is decaying at the gum under a crown and is liable to break off. Can/is this covered under medicare if an oral surgeon does it?\n\nThanks.\n\nBrian MChang: I chatted with Medicare, they said it was covered. I call the oral surgeon, they said it wasn't. Called medicare and all an agent did was read the verbiage off their web site to me. Said it was listed as covered, but no amount was listed. Chatted with medicare again and was told listed, but the covered amount was $0. Clear as mud! Brian" }, { "id": 20, "title": "Surgeon refuses extraction", "dialogue": "kilzok: I am an 83 year old man. For many years I have taken bisphosphanates for osteopenia. I have no insurance but have funds that should cover any exigency. My dentist has told me that an upper molar is decayed and should be extracted. The surgeon \nhas refused the job because of the fear of jaw necrosis. What are my options? I don't want decay to infect my skull. Dr M: Ask the dentist if he can remove the nerve of the tooth. If necrosis is a risk factor, root canal treatment, with submergence of the root is an alternative options." }, { "id": 21, "title": "Need opinions from others experiences.", "dialogue": "MChang: My wife has some upcoming dental work and we're trying to figure out what to do. We are retired and have no dental insurance. Seemed to us it did not offer much coverage with annual maximums vs annual costs. We are fortunate we can afford to pay for this out of pocket, but working to find best cost benefit option. \n\nShe has a bridge in front on her top row of teeth that goes over to and includes #11. My wife spends a lot of time caring for her teeth, flossing, brushing , water pick etc...She has a problem with #14. It has a crown and is showing decay at the gum and we are being told to remove it and do a bone graft, have a post installed with a fake tooth and crown. Total between oral surgeon and dentist is looking to be @ $6400. After getting better pictures of the area we are told #13 has an inflamed root and we need to do a root canal on this tooth in between the extraction and abutment work. Guessing another $1600. #12 seems to be OK. They showed a number of her teeth with inflammation at the root. \n\nShe had a permanent bridge from when she was 26 that failed some years ago and we had a new bridge made that she puts in and takes out. No one has presented us with options to just remove #14 and see how it feels or remove 12, 13 & 14 and do a new bridge that includes these into the area covered with her current bridge. She does well with the bridge she has, it is not uncomfortable. \n\nI don't want to make a money decision for her, it's not my mouth, but we can see a lot of dollars going into her mouth of the upcoming years and $8,000-$10,000 a year is not practical for us. \n\nSeems to me dentistry wants to do perfect dentistry and not take into consideration that people have budgets.\n\nThanks for any input.\n\nBrian" }, { "id": 22, "title": "My bite and my bridge", "dialogue": "lola1: My right upper lateral incisor tooth is broken and my dentist told that it could be good to put a bridge.\n\nHowever, my dentist told me also because my lower right lateral incisor and my lower central incisor are a little bit one on top of the other when I will bite these two teeth will put pressure on my bridge and as a consequence my bridge may not last a long time.\n\nI would like to know what I can do to fix this problem Dr M: It depends on how bad the occlusal problem is. You can consider doing aligner therapy at the bottom, to try and align the bottom teeth, or you could perhaps consider a dental implant instead of a bridge. It all depends on the size of the discrepancy. lola1: I would like to know if a solution could be to shorten the bridge Dr M: Usually the bridge is designed in such a way that minimal or no pressure is put on it. It just all depends on the space available. lola1: The bridge covering my broken right upper lateral incisor will be cemented to my right central incisor so I would like to know if the bridge cannot be too short because otherwise there would not be enough space to cement it to my right right central incisor" }, { "id": 23, "title": "Extracting 3 teeth?", "dialogue": "Damien: Hello everyone.\n\nI just saw a stomatologist for a cavity on my molar. After looking at my X-ray, he decided to extract the 3 teeth marked in red (hopefully only 2 but probably all 3). I hoped I could at least save the vertical one even though it's damaged. What do you think?\n\nI didn't receive any explanation about what comes after the operation. Will I be able to get implant? I don't have bones there, everything is so low. How will this work out? I'm afraid my bottom teeth will move to the right and my top teeth will fall. What would you do after such an operation?\n\nThank you in advance for your inputs!!!! \n\nXray : https://download.drive.shadow.tech/s/WmC5Rqp99t5yzMf Dr M: Unfortunately I agree with his assessment. You can discuss replacement options with him next time you see him.\nYou will have to allow some healing to take place first." }, { "id": 24, "title": "Extraction or root canal? Got different opinions from Endodontist and oral surgeon with dentist opinion. Do I need to extract #47? Second lower molar.", "dialogue": "Stackflow: My tooth gum on second lower molar is painful. Went to dentist and took X-rays. He said x-rays are normal. But gum was so painful when he probed and touched or rubbed those gums.\nI have bad breath in the mouth all the time. Even after brushing and using moth rinses. I feel bad taste and smell in the mouth.\n What does it mean to have bad breath and bad taste in the mouth ?\n\nIts painful on the distal side of the tooth. And around the gum margin on that tooth. Tapping and pressing that tooth doesn't hurt.\n\nBut touching and pressing the gum hurts. It hurts so much in the gum and throbbing like burning pain.\n\nI have yellow hard tartar buildup only on that molar and rest teeth are fine. Have been scheduled for cleaning. Dentist probed that gum and it was so painful and I was screaming with pain. \n\nHe sent me to Endodontist and oral surgeon referral. Endo said to try root canal and see if my gum pain gets better. Just like a trial root canal. He said it might or might not help me. \n\nThe oral surgeon told me to better extract it as I have extracted the first molar because of same type pain issue. So he said I can better remove this also to see if my symptoms gets better. Been struggling with this pain for more than 3 years. Have chronic jaw pain. I do use a night guard and didn't help much. \n\nNo dental work done on 47 except several occlusion grinding adjustments has been done on it as Dr suspect my misaligned bite could be reason for jaw.Did several adjustments and ended up having uneven bite now.\n\nI didn't have any finding on 46 but it was painful for tapping,biting etc.So they did root canal &followed by several retreatments¬hing helped. Did extract # 46, 9 months ago and still have pain in that gum.\nHad several cbct& came out normal.\n\nDo I need to do root canal or extraction on 47? \nOne dentist in reddit forum told me that I have some root stumps left on #48 region. \nI asked about root stumps left on my#48 socket area and my surgeon said he don't see anything like that. Do I need to get second opinion on this? I have severe pain on distal side of 47 gums. \n\nIs extracting 47 a good idea? Brause: I was in a similar situation with first molar 46.\n\nRCT did not work at all...it did nothing for pain. Tooth was subsequently extracted.\n\nA friend of mine had 47 (or 37) extracted and lived happily thereafter without implant...as it is so far back.\n\nHaving the same issue with tooth 36 right now...and will not go for endodontic treatment. Unless there is caries (which does not apply here), the bacteria pathway must be some kind of fracture...in wich case a RCT will be unsuccessful.\n\n\"Trying a RCT\"...is an expensive experiment. Even if it worked initially, the patient is sitting on a time bomb as a RCT does not last forever. flomodental: It's understandable that you're confused with differing opinions on your #47 tooth. Here's some info to help you decide:\nUnderstanding the Options:\n\nRoot Canal: This procedure removes infected pulp, cleans the canals, and seals the tooth to preserve it. Endodontists typically perform root canals.\nExtraction: This involves surgically removing the entire tooth, including the roots. Oral surgeons often handle complex extractions.\nWhy the Difference in Opinions?\nBoth specialists likely have valid reasons for their recommendations. Here are some factors they might consider:\n\nSeverity of Infection: An endodontist might favor saving the tooth if the infection is treatable with a root canal.\nTooth Structure: An oral surgeon might recommend extraction if the tooth has severe cracks, fractures, or extensive root damage.\nRestorability: If the remaining tooth structure is insufficient for a proper crown after a root canal, extraction might be preferable.\nNext Steps:\n\nDiscuss the Reasons: Talk to your dentist about the rationale behind each specialist's recommendation. Understanding their reasoning will help you make an informed decision.\nX-rays and Medical History: Review your X-rays with your dentist to see the extent of damage and discuss any relevant medical history that might influence the choice.\nConsider Your Preferences: Think about your comfort level with procedures, recovery time, and budget. Root canals are generally less invasive than extractions. Implants are an option to replace extracted teeth, but they usually cost more.\nAdditional Tips:\n\nIf you're still unsure, consider getting a consultation with another endodontist or oral surgeon for a second opinion.\nDon't delay treatment. Leaving an infected tooth untreated can lead to further complications.\nFinding the Right Dental Professional:\nFor both root canal therapy and oral surgery consultations, you can consider a general dentist practice like FloMo Dental. We can examine your tooth, review your X-rays, and provide a referral to a qualified endodontist or oral surgeon within our network based on your specific needs.\nRemember: I cannot give medical advice. The best course of action is to discuss these options with your dentist and the specialists involved to determine the best course of treatment for your specific situation." }, { "id": 25, "title": "Implant Course Marketing", "dialogue": "aumcrae: Hey All,\n\nI am part of a group starting All-In Implant Academy and need some advice.\n\nWe are trying to reach new general dentists who want to learn more about how to do guided implant surgeries and eventually learn the ALL-IN Workflow to maximize positive extraction outcomes. It is a 3 day live patient course in a modern clinic in the heart of the jungle of Belize.\n\nEssentially the idea of the all in system is to virtually extract the tooth and roots prior to the procedure and be able to design a custom milled healing abutment that perfectly fits the socket left over.\n\nWould love to get any ideas of how and where to market this best to those types of young and hungry general dentists for our guided surgery course and then where to market it to any doctors already placing implants for the All In Master Course." }, { "id": 26, "title": "Use of a Round Burr in Extractions?", "dialogue": "Brause: Do some oral surgeons use a round burr for loosening teeth in complicated extractions? My #46 came out in one piece but I felt heavy vibrations and one of the tools used looked like this. Dr M: They do sometime use a round bur, to remove some bone, in order to create a leverage point to facilitate an easier extractions. Brause: My interpretation: used to remove bone during extraction of tooth 46. The vibrations were very heavy. \n\nMy mouth was kept open with a mouth prop on the left-hand side. The rebound of the hard rubber must have damaged some teeth.\n\nTooth 21 showed symptoms of pulpitis 4-5 days later (and was unsuccessfully endodontically treated), and tooth 36 (no restorations) has been acting up for a month now...to the point that I can't sleep anymore.\n\nWill see an endodontist next week. My take: extract if there is any sign of pulpitis...tooth 36 has to take so much stress that RCT and crown won't last long." }, { "id": 27, "title": "Is it better to extract the root of a lateral incisor tooth or leave as it is?", "dialogue": "lola1: I would like to know if it is better to extract the root of my lateral incisor right tooth which is broken or to leave it as it is because it does not hurt me because the nerve of this tooth was removed several years ago when a decay was repaired and I read that when the root of a tooth is extracted there is always the risk that the adjacent teeth are damaged. \n\nHence, I would like to know if it is worthwhile to take this risk lola1: English is not my first language so I am worried if I ask this question to my dentist because he may not understand me properly and it is why I ask this question in writing in this forum Dr M: Depends on how broken the tooth actually is. But teeth, with one root, usually can be extracted easily without serious risk to the adjacent teeth, if done by a proper dentist. lola1: In case I use a bridge to cover my right lateral incisor tooth which is broken, I would like to know if I extract the root of this broken tooth the bridge will last longer.\n\nIn particular I would like to know if the bridge will be inserted in the hole left by the extraction of this tooth and as a consequence there is less risk that the bridge will fall. Dr M: You will have to extracted the root. You never leave a root behind below a bridge, because it can lead to future failure of the bridge. lola1: I read that after the extraction of the root we have to wait several months before putting a bridge to wait that it heals and its shape to stabilize.\n\nIt is inconvenient to have to wait so long before having a bridge and there is also the possible complication due to the extraction of the tooth\n\nHence, I would like to know if the nerve in the root has been removed and the part of the root which sticks out is removed by the dentist if we can put a bridge without extracting the root.\n\nMoreover, I read that the hole in the gum left by the extraction is only temporary and as a consequence it will not be possible to insert part of the bridge in it to make it last longer. Dr M: You have to remove the entire root. Your body sees it as a foreign body and even if you only begin with removing the top portion that sticks out through the gum, the other portion will also come out eventually. Your body pushes it out.\nWhen removing the root piece, you have some bone loss in the area. That is why we usually recommend waiting 3 months at least before starting a bridge." }, { "id": 28, "title": "Vibrating Tool used for Extraction", "dialogue": "Brause: I had a mandibular first molar extracted recently. The surgeon used a motorized, low-frequency, strongly vibrating tool and kept on telling me repeatedly that I would hear a crack soon. \n\nWhat tool would that be? \n\nAnd: could the vibrations traumatize other teeth, even maxillary ones? Dr M: It sounds like maybe the tooth was split surgically in order to facilitate an easier extraction. This is a normal procedure that is often done.\nThere is usually no risk to the adjacent teeth, if the dentist is splitting the tooth in half{ if done by an experienced dentist.} Brause: No, tooth came out in one. It took over an hour (the temperary filling indicates the non-completion of endodontic treatment). If bruxism can cause trauma that leads to microcracks, pulpitis, and eventually to periapcial abscesses, why should biting on hard rubber while having to absorb these shock waves not have the same effect? Brause: It was a round burr (Rosenbohrer) that had caused the vibrations." }, { "id": 29, "title": "Necessity of extracting my loose tooth", "dialogue": "Ivory12: Hi,\n\nMy loose tooth has been loose for c. 15-20 years (I'm 84 yo.), and with my denture in place gives me some pain when chewing on an apple or a piece of pork chop. Several dentists have commented on my apparent bone loss.\n\nI've been to a D.M.D. that helped fix a chipped tooth, but I don't know any good-to-very-good oral surgeons.\n\nDoes it seem as if the extraction of my loose tooth is a necessity at this time? (The scan is one from October of 2023.)\n\nIvory12 Dr M: I would recommend extracting the loose tooth. Any dentist can do this type of instructions. Ivory12: Okay, thank you!" }, { "id": 30, "title": "Son's Wisdom Xray...Thoughts?", "dialogue": "RICKHOLLOWAYS: New item by Rick Holloway\n\t\t\t\t\t\n\n\n\n\n\n\n\t\t\t\t\tphotos.app.goo.gl\n\t\t\t\t\n\n\n\n\nI am told from Xray that all 4 are impacted and need to be extracted. Your thoughts? Dr M: I agree. It does not seem like there is sufficient space for the teeth. The lower teeth are at angle where sometimes part of the tooth gets exposed to the oral environment, and this could lead to pericoronitis or even food impaction, with cavity formation on the adjacent teeth." }, { "id": 31, "title": "How to see if there is tartar under the teeth", "dialogue": "lola1: I read that if we have tartar under our teeth we need an in-depth cleaning (I think what we call a scaling) and not only a simple cleaning.\n\nI would like to know if the dentist see whether or not there is the tartar under the teeth by looking in the mouth or he has to do first a simple cleaning. Dr M: You can sometimes see sub-gingival calculus or the signs thereof, on an x-ray." }, { "id": 32, "title": "Can we screw a post crown instead of only cemented it to prevent it from falling?", "dialogue": "lola1: My lateral incisor teeth of the right broke some years ago because previously I have a decay and it was repaired and I think that during the repair the nerve of the teeth was removed and for this reason this tooth was weakened and as a consequence finally it broke and it remains only the root of the tooth in my gum.\n\nSome years ago a dentist drilled a hole in the root and cemented in it a crown with a rod what I think is called a 'post crown'\n\nHowever, because this crown with a rod was cemented but not screwed in the root of the teeth it finally felled out. It was cemented back several times but it kept felling out.\n\nFinally, I remained during a period of time without putting back this post crown and when I wanted to put it back the root of the teeth should have moved and I was not anymore able to insert this crown with a rod into the hole in the root of the tooth.\n\nI would like to know if it is possible that instead of cementing a crown with a rod in the hole of the root of a tooth to screw it so that it does not fell \n\nI need to know this to know if I have to extract this root of tooth or I can keep it to screw in it a post crown lola1: I would like to know if we can screw a post crown in the root of a tooth instead of only cementing it lola1: English is not my first language so I am worried if I ask this question to my dentist because he may not understand me properly and it is why I ask this question in writing in this forum. lola1: I do not ask for medical advice because the information that I request does not concern only me.\n\nIt is a technical issue about whether or we can screw a post crown on the root of a broken tooth and not only cement it" }, { "id": 33, "title": "Allograft or Xenograft?", "dialogue": "Capstone_marker: So I'm looking at dental implants and it was suggested I get some grafting done to help insure that the implants stay in place. The place I went to said they work with allografts. I discussed other potential options with them as I wasn't exactly comfortable with the idea of my grafts being made from cadaver. They said they would look into other options for me. They sent me an email stating that while they can offer xenografting, it has a increased risk of generating an immune response. They also stated that they wouldn't work with synthetic/artificial since it has a higher chance of fracturing.\n\nAny thoughts or advice? While the idea of an allograft may make me a bit uneasy, I think I could put it aside if it means a better chance of the bone grafts succeeding." }, { "id": 34, "title": "Wisdom Teeth Extraction Gone Wrong, Need Advice", "dialogue": "woahitsonyx: EMERGENT, PLEASE HELP: A patient (M, 17) came in to the office two weeks ago to get his wisdom teeth removed. Swelling was noticed immediately, but at the time was still considered normal. He developed an infection that has escalated greatly, along with his swelling. He is not responding well to antibiotics. The infection is not in the socket nor his sinus. When admitted to the er, he was discharged due to them not being able to locate an infection in the ct. His face is now swollen and double the size it used to be in just one day. He has come in twice now to surgically drain his infection. He has been draining his infection multiple times a day, only for it to get worse. After the drainage, swelling does go down momentarily only for it to reoccur. Please provide insight on what may be occurring and how we can treat him. Dr M: This sounds serious. More information is required. Has the patient been placed on any cortisone to help reduce swelling?\nAny known allergies?\nDo you have a copy of any x-rays or the CT scan?\n\nCan't be of more help without more information." }, { "id": 35, "title": "Day 4 (night) healing from molar extraction", "dialogue": "leoniparry: I’m on day four after having one of my top molars taken out (upper right 7) and I can only just about see the clot. It seems to have retracted quite a bit and looks a bit empty. However the clot seems to still be there, just further inside the hole. Is this normal healing? Almost everything I read says that it shouldn’t look like a dark hole and if it does then it’s a dry socket, but I don’t have any pain, so it shouldn’t be. Dr M: If you are not in pain, then most likely it is not a dry socket. On the photo everything still appears normal. Give it more time. This wound should heal nicely enough on its own, without any intervention" }, { "id": 36, "title": "Normal tongue features or not?", "dialogue": "aqz: I have no pain, is this normal i feel as though my left side back of tongue is more prominent then the right side. Just under the papillaes at back under tongue its slighty raised in arrowed bit. But nothing is visable just can feel it with finger but on right side it is not same. Do back foilate papilles look normal. Should i be concerened? And is meant to to be the same on both sides or will there be a difference. I just dont know if this is normal for myself? To the eye my left side looks more prominent. Please help? \nThanks Dr M: The papillae is slightly more prominent, but it is nothing to be concerned about. Slight differences exist between left and right. It is not exactly symmetrical aqz: Dr M said:\n\n\n\n\t\t\tThe papillae is slightly more prominent, but it is nothing to be concerned about. Slight differences exist between left and right. It is not exactly symmetrical\n\t\t\nClick to expand...\n\nOk thanks for reply appreciate it. What about the slightly raised area that i can feel that i have marked with arrow? Will a dentist be able to check this? I am very stressed about this now. Dr M: Might just be a lymph node. Lymph nodes sometimes feel swollen or in your case, raised, if you are sick or beginning to get sick. I would still advise only observing for now. No need to panic as yet. aqz: The tongue has lymph nodes? I thought lymph nodes are in neck chin etc never heard of them being directly on the tongue? This is quite interesting ive always had a more prominent left side of that area with no pain or symptoms. Could it be normal? Dr M: Could be normal. The distal portion of the tongue has some lymph nodes as well aqz: Thank you for your replies i will just leave it and not think about it too much as im sure when you start searching you will find all sorts. And it doesnt help if there no symptoms leave it be i guess." }, { "id": 37, "title": "Leftover tooth", "dialogue": "Cardician: Years ago I had implants for a lower denture (cap and socket which locked the denture down) Now I have full dentures with no implants. However there is part of the tooth that still under the gumline and causing some discomfort. I use motrin to keep it at bay. My question what type of dentist should I see, just a regular dentist? A specialist? I do have dental insurance but not sure who to schedule with. We have Aspen dental but have read many horror stories so pretty wary of them. Thanks!\n\nPat Dr M: You can see a normal dentist. They should be able to make an incision to remove the residual root piece if it is superficial enough to cause discomfort." }, { "id": 38, "title": "Oral hygiene or complications during the implant process", "dialogue": "DentalCenter: Dental implant infections, often associated with Implant Dentaire, can arise from poor oral hygiene or complications during the implant process. Symptoms include swelling, pain, and discomfort. Timely professional intervention is crucial to address infections, prevent complications, and ensure the success of the dental implant procedure for optimal oral health." }, { "id": 39, "title": "Nobody can offer me any explanation", "dialogue": "Annino1219: Hi all!\n\nI’ve posted here before. Long story short, root canal on #2 upper right molar in 9/2022. Tooth was hurting and uncomfortable persistently. Got the tooth extracted in 01/2023. Still not right. Pain and discomfort. Got the socket debrided twice. Then got the socket debrided and a tissue sample was taken. Lab results were normal. Now I’m 9 months post debridement and the area is STILL bothering me. \n\nI get a painful full sinus feeling and pressure in the area. I’ve had multiple CBCTs done by oral surgeons and was advised that all looks clear. Attached is a CBCT taken last month. Also attached is an xray taken last week by my GP. Note the little vertical white thing in the Xray. Oral surgeon says likely just an xray artifact. However, that object has been there since after my root canal. \n\nAny ideas would be appreciated! Thanks! Dr M: Issue seems complex. Not more than I can add. What do the oral surgeons suggest? Annino1219: Dr M said:\n\n\n\n\t\t\tIssue seems complex. Not more than I can add. What do the oral surgeons suggest?\n\t\t\nClick to expand...\n\nUnfortunately no suggestions given. I’ve consulted an ENT and neurologist. Had a brain MRI. Neurologist prescribed pregabalin. I may have to increase dosage Dr M: Sounds like they are thinking it might be nerve related and not tooth related. Like a neuralgia. Don't think it falls within the scope of a normal dentist any longer : Joseph-Grant: Prior.: Sounds like it is a sinus problem, not just the tooth. Do you eat wheat/gluten a lot? I had sinusitis all the time until I stopped that and I had a root canal on tooth-~18 for an abscess. \n\nDoes it hurt more when you're around electronic devices? or at home versus outside? metals from a vaccination? are any of your old fillings leaking causing aluminum to be present? did you sniff something toxic around then?\n\nIt could be build-up of toxins like plastic and heavy metals in the mouth. Refined sunflower oil or refined sesame oil can oil-pull deep toxins out.\n\nWe need more memory/knowledge of what occurred during or around the time of the incident." }, { "id": 40, "title": "Healing Time after Molar Extraction?", "dialogue": "Brause: Had #46 removed 6 days before Christmas 2023. Wound is healing well. Was given Chlorhexidine for 3 weeks.\n\nHow long does it usually take until the socket is firm again/not tender anymore? I am 60.\n\nLong-term prospect: is an implant or a bridge necessary? Dr M: It can sometimes take a month for the socket to fill with immature bone and then only be fully mineralized after 3 to 6 months. But usually the socket should be a lot more firm after a month.\nYou can get an implant in this area. I would recommend an implant, since it is a lot less damaging to the teeth next to it, when compared to a bridge.\nYou will have to wait 3 months in order for the bone to heal, before considering an implant." }, { "id": 41, "title": "Dental Implant Infection", "dialogue": "beantownace: Hello all,\n\nI recently a few days ago had an implant put in. Prescribed a 5 day course z-pac but having some pain today and wondering if could be getting an infection. My oral surgeon said I would not be restricted in what I eat after the implant was put in versus the pulled tooth and bone graft as that was stitches. I had some chinese food last night (not a good idea lol) and pain probably from moving my jaw so much so going softer next few days. Attaching image is it possible an infection is developing as there is white stuff it looks over about half the implant now and white spots around the gum where the implant is. Dr M: White stuff is granulation tissue or scar tissue. If the pain is not severe, I would just continue keeping the area clean. If the pain becomes more severe, it is best to go see the oral surgeon for a follow-up." }, { "id": 42, "title": "Unexplained bone pain under the gum.", "dialogue": "k_ace: Hey. First sorry for my english. So i have a chronic pain from started 9 months a ago. My pain sharp shooting nerve like pain at randomly under the gum from the alveolar bone in the upper right region. I can trigger it by pressing my gum in that area, then feeling is some nerve jerking verry painfully. Yes jerking is the right word. . So i didnt have a single tooth that area because so bad condition that i have to removed all. But this problem started before the extractions, so its not related to the extractions. So i went to the oral surgeon and he opened my gum alredy twice at that section. He said that some soften bone and a hole inside the bone, maybe a inflamation. He cleaned everything but next day shooting pain continued. So please help, what can it be ? What the meaning that alveloar bone is soften on that small area from my pain come from?. Or maybe i have neurophatic pain and i have to find a neurologist?. Painkiller medicines not working for this shooting pain. . This pain sometimes went remissions for days and months and get return again from nowhere. When the pain is in remission then trigger point is also \"disabled\". So what can cause painfully nerve jerking feeling inside the gum.? This pain totally random, not related to hot and cold, and eat. It is localised, didnt hit my face or ears, only fell inside the bone. I can provokating with press my gum that point. The worst part is that sometime the shootings happen when i didnt doing anything, and this is affect my quality of life because always afraid when the next shoot of pain coming. I alredy did a cone beam scan but show nothing wrong on that area. So can you help me what this can be? Thank you. Dr M: Do you have recent x-rays that you could share? Did the oral surgeon mention the possibility of neuropathic pain? k_ace: xray is coming, yet my dvd drive not working so i need time to read and share. MY oral surgeon sad deffinetly not neurophatic. But he did a verry deep clean my bone that area, but the next day the shooting pain started again, and after 1 day suddenly stopped. Now 2 days with pain free, but im very afraid it going to return, because sometimes pain got remission for days, and weeks, and the suddenly start again. But despite that my oral surgeyon sad i star to belive that this is neurophatic." }, { "id": 43, "title": "Extractions", "dialogue": "tooth#11: I had som resent extractions of two upper teeth and was hoping for some expert opions on what is left. Or what I may still have showing. Thank you. Dr M: Difficult to see clearly on the photos, but if you are not in pain, I would think everything is normal. The yellow that you see, is scar tissue or granulation tissue. This will gradually transition to a pink colour." }, { "id": 44, "title": "Dentist took X-ray for removal of wisdom teeth and noticed a pocket near left sinus that concerned him. What might it be? Should I be worried?", "dialogue": "bravesfan132: " }, { "id": 45, "title": "Post-immediate implant in the aesthetic zone with horizontal bone defect", "dialogue": "Tudor: Hi everyone, I have an interesting case I want to discuss and get your thoughts.\n\nI'm 35, based in London, fit, healthy, and doing my best to maintain impeccable hygiene. \n\nWe had to extract the left lateral incisor due to an infection that went unnoticed for too long. We've done a socket preservation and the site has healed. I'm about 6 months post-extraction at the time of writing. \n\nThe bone has resorbed and there is a horizontal defect. The bone width is between 2 and 3.5 mm at best. Vertically it's fine, with no defect.\n\nIdeally, I'd want to have a post-immediate implant with GBR and gum graft in one session. The other alternative is to have the GBR, let it heal for 3-4 months then place the implant.\n\nI have 4 treatment plans so far, 3 from London and one from Budapest from a world-renowned doctor who invented the Sausage Technique \n\nLondon 1 said he would try to do a one-step procedure, with GBR, implant, and gum graft but it would depend on what he sees during surgery and if the odds are not favorable he would opt for the delayed solution. It would take around 3-4 hours plus sedation.\n\nLondon 2 said he could do the implant with his eyes closed (he rectified after and said of course it's involved and so on) with a 97% success chance, 1:15 hours, with xenograft material and no sedation but with no gum graft. He said a graft would be hard to maintain, and high odds of failure so there's no reason for it. This would be the most convenient option for me but I'm concerned about the long-term durability of such an implant and the soft tissue architecture therefore I'd like to get your thoughts on this. He did say there will some some recession.\n\nLondon 3 said there is no way he can even attempt a one-step surgery and he would do a block graft followed by the other steps. Under no way I'm going to have a block graft in this day and age for that area so it's out of the question however he did raise some good points about London 2's option with a one-step procedure and the xenograft. He was concerned about the success odds, the durability of the implant, and the risk of my bone fracturing during the procedure because of the narrow width.\n\nBudapest said 2 steps, first GBR, then the implant. However, it would be virtually impossible for me to travel 4-6 times and stay 7-14 days on some occasions.\n\nI have at least 2 other opinions lined up for next week from some reputable doctors in London but it seems there's more consensus for a 2 step procedure vs a single-step procedure. For me, it would be ideal if I could get it done in one procedure because it's been a long process and I'd like to finalize it but I have to weigh in the success rate, the long-term survival rate, and the most predictable strategy backed with data not just convenience.\n\nI will update the thread once I get the other opinions but any thoughts that can help me make a more informed decision would be appreciated.\n\nMany thanks.\n\nTudor." }, { "id": 46, "title": "Second molar extraction", "dialogue": "Itsjustmeee: I had my second molar on the bottom left extracted yesterday. It all came out in one piece so no stitches. I’m sure it’s healing right but I tend to overthink things like this. Bad habit. Does this look like it’s healing right so far? It’s still extremely new and fresh. It has the blood clot from what I can see. But it’s starting to turn white on top of the clot I think. Dr M: Everything is looking normal. The white or yellow tissue forming is granulation tissue or scar tissue Itsjustmeee: Dr M said:\n\n\n\n\t\t\tEverything is looking normal. The white or yellow tissue forming is granulation tissue or scar tissue\n\t\t\nClick to expand...\n\nThis is what it is looking like today. I have a dull ache in my jaw that comes and goes. But nothing too unbearable right now. The blood clot is still in the socket. So I assume everything is as it should be. \nIt still is pretty sore around and looks a little irritated. Itsjustmeee: I’m worried it’s becoming infected or something. It seems more swollen today. And sharp pains in the jaw. It’s still extremely tender. This is what it’s looking like right now. Dr M: If the pain increases, there is a chance that you might have a dry socket. I think it is best to arrange a follow-up visit with your dentist, so that the socket can be rinsed out. A dry socket is more common in lower teeth, 3-5 days after an extraction Itsjustmeee: Dr M said:\n\n\n\n\t\t\tIf the pain increases, there is a chance that you might have a dry socket. I think it is best to arrange a follow-up visit with your dentist, so that the socket can be rinsed out. A dry socket is more common in lower teeth, 3-5 days after an extraction\n\t\t\nClick to expand...\n\nI called the dentist and they’re unable to get me in on my scheduled post op appointment due to me testing positive for strep Sunday night. I explained everything over the phone and was told that my pain doesn’t sound like the pain you’d have with dry socket. So it couldn’t “possibly be dry socket”. At this point I’m managing to the otc pain relief and currently on antibiotics for the strep. \nI’m keeping a close eye on the extraction site. Blood clot seems to still be there but it’s starting to sink in on one side. I’m 5 days post extraction. The pain isn’t excruciating, it’s more of a dull ache that comes and goes in my jaw. Dr M: A dry socket is a self limiting disease, meaning eventually it will heal on its own. The antibiotics you are taking for the strep, should also assist with any infection. Try taking any anti-inflammatory OTC medicine. If the pain is not better in two days, seek a second opinion from another dentist. Itsjustmeee: Dr M said:\n\n\n\n\t\t\tA dry socket is a self limiting disease, meaning eventually it will heal on its own. The antibiotics you are taking for the strep, should also assist with any infection. Try taking any anti-inflammatory OTC medicine. If the pain is not better in two days, seek a second opinion from another dentist.\n\t\t\nClick to expand...\n\nThank you!" }, { "id": 47, "title": "Sinus perforated 3 months ago, not healed.", "dialogue": "ALGAL: I had 2 rear upper molars surgically removed over 3 months ago. One of my molar's roots punctured my sinus wall. My surgeon said at the time it was approx 4 mm opening. It has now been over 3 months and I do not have closure on the opening. It feels almost as big as day 1 post op. My oral surgeon wants me to continue to wait for spontaneous healing, which of course I do as well, to avoid another surgery, however the opening is very stressful to me as it continually wants to fill with food particles and liquid & and risks infection in the area. It feels like there is a large pocket up in the area above the hole in my gum and I feel like I need to try to keep it cleaned out somehow but do not want to upset any healing. Should x-rays be taken? Is it practical & safe to continue to wait for spontaneous healing? \n\nThank you very much for any insight, and/or advice. Dr M: 3 months is a long time to wait. I don't know why the surgeon advised you to wait, since usually only 2mm openings and smaller spontaneously heal. A 4mm opening should usually be addressed as soon as possible, preferably on the same day the opening was intially caused. I would suggest seeking a second opinion from another oral surgeon. They will most likely suggest rinsing out the sinus, to clean out any debris, and then close the hole with a surgical flap. Don't wait any longer. ALGAL: Thank you so very much for your reply and advice! My surgeon advised me immediately after the surgery that this perforation had occurred and that he placed stitches in it. Also sent me home with instructions how to protect the area, such as sneezing with mouth open, very gentle nose blowing, no straws, etc. On day 4 post op, suddenly I felt something had just happened, then had nasal bleeding and pain kicked in. Upon seeing him the following day & explaining this he seemed bewildered, just said we would wait now and watch it, never mentioned that I maybe had lost the blood clot and now had dry socket. So I powered thru it during all this time, seeing him a cpl times re infection concerns, etc. My current surgeon has many many years of experience & great credentials so I am very disappointed to be finding myself in this situation. Is this a difficult surgery to perform properly? And is it a difficult recovery for the patient? \n\nI have read extensively about my situation and everything concurs exactly as you have advised. Only 2 sources (one I believe was NCBI) says to wait 3 to 4 months before referring for surgery. That is the only reason I have held out hope.\n\nAgain, thank you so very much for your time, concern and advice. It is very well taken. Dr M: Usually the surgery is not too difficult to perform, and the recovery time afterwards is not too long either. It might be a bit more complicated since some time has lapsed, compared to performing the closure at the time of the sinus opening. ALGAL: Thank you. Ideally, should my oral surgeon have closed it back up immediately (or soon thereafter) when on day 5 post op I told him something changed and that I now had bleeding & pain? He never mentioned that there was any reason for concern, and I didn't know that I had lost the clot & maybe was having dry socket pain. I do have appt for 2nd opinion next week." }, { "id": 48, "title": "Implant at a dental school clinic?", "dialogue": "danielsomers: I need to have one implant done and would love some advice on having it done at a dental school clinic. My understanding is that supervision is good enough so that the quality of work usually quite good. But reading some reviews online (mostly on Yelp) of the clinics in and around Boston (I'm in w. Mass.) there are a lot of people giving bad reviews about the experience. Not about the work itself, but just a lot of complaints about lots of very long appointments and feeling not too well cared for--and it'll also be a 2 hour drive for me just to get there. Still, there are a few very good reviews--but honestly, the majority are bad and most of the clinics have an average of 2 stars. How legit and realistic do you think this is? Maybe it's just the people who've had a bad time who go to the trouble to write the reviews, and those who've found it ok don't bother? I'm fine going wherever I need to to be able to afford it, but if it's just a bad experience...that would be not so fun. Thanks for any thoughts or advice!\n\np.s. I do understand that it will always take longer at these clinics, as the work has to be supervised and checked. I'm totally fine with a certain amount of that, just have been a little concerned from these reviews that it might be a lot worse than I've been thinking." }, { "id": 49, "title": "Root extraction - White stuff and damaged gum", "dialogue": "Nhq: After having a broken tooth (with just the root showing above the gum) taken out a few days ago, is it normal to have white stuff from the socket? Was wondering whether the dentist failed to remove it completely or it is some bone fragments, or maybe an infection as it is painful. Also, the gum at the side of the socket looks horrific as it has split open. Shouldn't the dentist put stitches in or will it heal itself? Any advice would be greatly appreciated.\n\nThe first two photos was taken two days after the extraction and the last is day three. alakuni: The white stuff you're seeing could be connected with the recuperating system, for example, tissue or bone parts, which may ultimately determine as your body recuperates. Notwithstanding, it's crucial to discuss your interests with your dental specialist or oral specialist to guarantee everything is advancing true to form.\n\nGum harm can likewise be troubling. Recall that legitimate post-employable consideration and following your dental specialist's proposals for oral cleanliness and wound administration are essential for a smoother recuperation. Assuming you notice any uncommon or diligent issues, contact your dental expert for direction and consolation.\n\nYou're in good company to confront these difficulties, and your dental group is there to help you during your recuperating venture. Your prosperity and solace are their first concerns, so make sure to your interests and look for the help you want." }, { "id": 50, "title": "I NEED HELP", "dialogue": "Noya: I need to undergo surgery on 11 teeth, including extractions, fillings and structure, the surgery takes about five hours, with an NG tube, I understood that this type of surgery has higher risks. I want to know if this is really a more dangerous operation than normal general anesthesia, and should such an operation really take five hours or is it too much? Dr M: Why is this a higher risk? A NG tube is standard when working in the oral cavity. The operation time is most likely due to the high amount of work that needs to be done. Less time, sometimes means sub-par quality of work. You will still be getting normal anaesthesia. Noya: Dr M said:\n\n\n\n\t\t\tWhy is this a higher risk? A NG tube is standard when working in the oral cavity. The operation time is most likely due to the high amount of work that needs to be done. Less time, sometimes means sub-par quality of work. You will still be getting normal anaesthesia.\n\t\t\nClick to expand...\n\nthats what the doctor told me. that this tube means a higher risk than a \"normal\" surgery because the tube is inserted through the nose, and not the mouth. such as loss of vision,paralysis , inabillity to move my face/jaw. internal bleeding. Dr M: I think this might be a bit over-dramatic. For a more accurate assessment of the risks involved in this surgery, as well as with any general anesthesia, speak to your anesthetist. Noya: Dr M said:\n\n\n\n\t\t\tI think this might be a bit over-dramatic. For a more accurate assessment of the risks involved in this surgery, as well as with any general anesthesia, speak to your anesthetik\n\t\t\nClick to expand...\n\n\n\n\nDr M said:\n\n\n\n\t\t\tI think this might be a bit over-dramatic. For a more accurate assessment of the risks involved in this surgery, as well as with any general anesthesia, speak to your anesthetist.\n\t\t\nClick to expand...\n\nthats who told me all of that-in the pre surgery meeting with the anesthetist. Dr M: This most likely formed part of your informed consent process. Although these are real risks, they are present with most surgeries. Dental surgery is done on a regular basis and is usually considered less dangerous compared to most other surgeries." }, { "id": 51, "title": "How long does it take for Novocain to work?", "dialogue": "KMMP: I had a wisdom tooth a few weeks ago and it was very painful. I was given Novocain but when the dentist started to pull the tooth I felt a very sharp pain. The dentist stopped and gave me another shot of Novocain, put the needle down and immediately picked up the pliers and pulled the tooth. Should he have waited a few minutes for the second shot of Novocain to work? I was wondering if the dentist should have waited a few minutes for the second dose of Novocain to work before continuing to pull the tooth? MattKW: Ideally the tissue is tested with a sharp probe before even picking up forceps (or drill). The most likely teeth that are difficult to numb are lower molars, and the major test is a sharp probe in the gum next to the lower eye-tooth (canine). KMMP: MattKW said:\n\n\n\n\t\t\tIdeally the tissue is tested with a sharp probe before even picking up forceps (or drill). The most likely teeth that are difficult to numb are lower molars, and the major test is a sharp probe in the gum next to the lower eye-tooth (canine).\n\t\t\nClick to expand...\n\nThank you so much for your reply." }, { "id": 52, "title": "Is my bone graft healing correctly?", "dialogue": "Dyintoliv206: I had a sinus lift and a ridge augmentation one month ago and I’m concerned it’s not healing correctly. The oral surgeon says it looks good but I don’t think it should still look like this after a month, it’s all red and the incision keeps getting bigger" }, { "id": 53, "title": "Problem with bone graft after extraction", "dialogue": "Kris44: I have had an extraction of a front lateral incisor tooth and a placement of a bone graft by a surgeon. Extraction was uneventful. The pain started 2 days later above the extraction site and adjacent tooth. I then got nerve pain up the nose to forehead, sinus pains and pain to ears and painful lymph nodes. Antibiotics for 12 days made all better, but the pain returned. Surgeon did not want to give more antibiotics, although he did agree that most likely bacteria most likely irritate the nerve. He said my body will take care of it. It does not do so after 2 months. I asked for a removal of graft. He told me there is nothing wrong with graft, he will not remove it. Two Months later I still have nerve pain, my face is now numb above mid lip. Something is very wrong. I did bring up to the surgeon that maybe mouth bacteria got between graft and socket, or perhaps I was one of the unlucky people not tolerating this particular donor graft. The dentist told me, he cannot do any more for me, and he released me with the pain and the problem. There is no swelling above the extraction, but I assume, I do not tolerate this graft.\n I think I want the graft removed, but how difficult is this? I see no value to turn to neurologist for lifelong pain treatment.\n Does anyone have any input? MattKW: There was no indication for antibiotic Rx after the extraction. The fact that it made things better would be largely coincidental.\nBone graft is not a source of pain. Never heard of this before, and no biological reason why it should.\nWould suggest you see neurologist or a pain clinic for proper assessment of your signs and symptoms. Ask surgeon for referral so he can include your records.\nKeep us updated back here! Kris44: Thank you for taking time and giving me your thoughtful reply, Matt. I hear you.\n\nSince other people may read this post, I like to add this for anyone being ever in the same situation.\nOn the topic of antibiotics, sometimes antibiotics are indicated, particularly when people are at risk for osteonecrosis or osteomyelitis. I belong in that category. Since my own surgeon agreed, he thinks in my case bacteria are irritating the facial nerve, I think my raising this point is appropriate. I think, and the surgeon thinks, antibiotics are not to be summarily dismissed. I happen to not be able to take Doxycycline which this surgeon offered to prescribe, so I did not get a prescription. On the topic of bone grafts. 6% of bone grafts fail, I guess for non- compatibility reasons. After all, they are transplants when from cadaver. This information is widely available. Most bone grafts from cadavers I believe are pretreated with antibiotics, so I guess, it only happens very rarely that they contain bacteria, but it does happen.\nHas anyone had a problem with a bone graft." }, { "id": 54, "title": "Wisdom teeth to pull or not", "dialogue": "toothy123: Hi there\n\nI have a healthy 17 yo child. The dentist said go to oral surgeon for wisdom tooth evaluation.\nThe oral surgeon says have all four removed. I know removing wisdom teeth is rather common practice in the US for prevention.\nThere is no pain or ongoing issues with the teeth. \n\nThe oral surgeon treatment plan says each tooth is \"impacted - partial bony\" and no nerve involvement.\nI can see from the X-ray one likely needs removal due to being sideways.\n\nMy questions are what are the cons of having all 4 removed? I have read about loss of bone and other issues (other than just surgical complications).\n\nThanks MattKW: Yes, get them all out while young. So much easier to perform the op, and much better healing in a young person.\nThe lower wisdoms in your OPG are the most worrisome. Tooth 48 is likely to develop occasional pericoronitis, and possibly occlusal decay. Tooth 38 provides a plaque trap against the root of 37 - this very often leads to decay of the 37. Treating decay of the 37 is quite hopeless, so when patients eventually come in with pain due this problem, I have to extract the 38 AND the 37.\nBone loss after extraction of wisdom teeth in young people is insignificant. However, it will happen in older people who leave it till problems surface..\nSee attached image (FDI numbering).\nSee attached article with highlights, esp p6 and p7 toothy123: Hi MattKW\n\nThanks for responding. I have decided to have all 4 done. I did some further reading and your response helps to solidify my decision.\n\nThanks again" }, { "id": 55, "title": "Help with implant and removal of teeth", "dialogue": "Tee time: I am 62 years old and never took good care of my teeth. Now I’m missing three upper teeth and a over bite. Went to two oral surgeons and both are telling me I need to have 13 teeth removed . Very much want this implant but too scared to pull the trigger and get this done. I lived a healthy simple life with no surgeries and never had an IV before. Any suggestions anyone can help. Thanks MattKW: Not sure about your concerns. The surgery will be probably OK, although I'd prefer a GA for 13 teeth.\nAs for implants, that will have to wait at least months for initial healing to have occurred, so I assume you'll be getting a denture during this time.\nPlenty of time to seek opinions about implant suitability. Tee time: Tee time said:\n\n\n\n\t\t\tI am 62 years old and never took good care of my teeth. Now I’m missing three upper teeth and a over bite. Went to two oral surgeons and both are telling me I need to have 13 teeth removed . Very much want this implant but too scared to pull the trigger and get this done. I lived a healthy simple life with no surgeries and never had an IV before. Any suggestions anyone can help. Thanks\n\t\t\nClick to expand...\n\nWhat is GA for the surgery ? Maybe this could be covered by my insurance we’re dental insurance is not good. Thanks Canary: General Anesthesia. I can’t imagine having to remove 13 teeth let alone all in one sitting. I’m 61 and lost 6 teeth 4 just recently. With one implant that was a difficult experience that took nearly 6 months to complete. Glad I did now that it's over. John Morgens: I understand that you are feeling scared and anxious about the prospect of having multiple teeth removed and getting dental implants. It is completely normal to feel this way, especially if you have never had any surgeries or IVs before. Here are some suggestions that may help alleviate your fears and make the process more manageable:\n\nCommunicate with your dentist: It is important to have open and honest communication with your dentist or oral surgeon about your fears and anxieties. Let them know about your concerns and ask any questions you may have. They can address your fears, provide reassurance, and discuss the steps they will take to ensure your comfort during the procedure.\nConsider sedation options: If you are particularly anxious, your dentist may offer sedation or anti-anxiety treatments to help you relax during the dental implant procedure. This can help alleviate your fears and make the experience more comfortable for you.\nPlan ahead: Start planning for dental implants even before your tooth extraction. Let your dentist know that you are interested in replacing your missing teeth with implants as soon as possible. They can discuss treatment options with you and may even perform socket preservation during the extraction to expedite the implant process.\nEducate yourself: Take the time to learn more about the dental implant procedure, including the steps involved and the expected recovery process. Understanding the process can help alleviate some of your fears and give you a sense of control.\nSeek support: If you are feeling overwhelmed, consider seeking support from friends, family, or even support groups for individuals going through similar dental procedures. Talking to others who have been through similar experiences can provide comfort and reassurance.\nRemember, dental implant surgery is a common and routine procedure performed by experienced professionals. With proper communication, planning, and support, you can overcome your fears and achieve a healthy and functional smile.If you want to get more information you can visit mylifesmiles one of the best dental clinic . Tee time: This was very helpful and thanks for sending this. I am looking to have this done 2-3 weeks from now and anxious about how I’m going to feel after. jorge: Tee time said:\n\n\n\n\t\t\tI am 62 years old and never took good care of my teeth. Now I’m missing three upper teeth and a over bite. Went to two oral surgeons and both are telling me I need to have 13 teeth removed . Very much want this implant but too scared to pull the trigger and get this done. I lived a healthy simple life with no surgeries and never had an IV before. Any suggestions anyone can help. Thanks\n\t\t\nClick to expand...\n\nhi Im Jorge and I am an odonto student yet, but I think you should try the new dental implants technology.,, don't be afraid maybe would help you a lot.. and always remember that a good hygiene its so important. DariaMerritt00: Help with implant and removal of teeth involves dental procedures related to tooth replacement and extraction. Implants are used to replace missing teeth by surgically inserting a metal post into the jawbone and attaching an artificial tooth. Teeth removal, on the other hand, involves extracting damaged or problematic teeth. Dentists and oral surgeons provide these services to restore oral health, improve aesthetics, and alleviate pain or discomfort. These procedures are essential for maintaining dental function and appearance." }, { "id": 56, "title": "Upper molar extraction", "dialogue": "jonp: Hi. I had an upper molar tooth and dentigerous cyst removed under a general anaesthetic on 31st of August this year. I have no pain but I do notice that when drinking or rinsing my mouth that there is some tenderness (heat sensitivity) when fluid goes near the area of surgery. All the sutures have gone. Is this normal?" }, { "id": 57, "title": "Chance of symptoms from Lingual Nerve Damage during an Alveoloplasty?", "dialogue": "zackp: I am suffering from constant pain from a bony ridge pressing into my gums. The operation to grind down this bone is called an Alveoloplasty. The location of the bone is behind where I had a lower Wisdom tooth extracted almost a year ago.\n\nA surgeon has agreed to perform this operation but has warned that the Lingual Nerve will “likely be somewhat stretched\" in the process. He could not put a percent number on this happening as he says it would depend on my anatomy.\n\nMy question: If the Lingual Never is stretched to a moderate degree, does it always cause symptoms? If so is there a way to intelligently guess if the damage will be serious and long lastly or is more likely to be minor and temporary?\n\nThank you for any and all feedback. MattKW: I'm not an oral surgeon, but have done many wisdom teeth extractions. It sounds like some paraesthesia is likely that might last from 2 weeks to months. Really, the surgeon should be in a better position to advise you more specifically. For example, ask if he will stop treatment if he thinks you are at risk of more permanent damage. \nAlso, I don't understand your problem. What is this bony ridge pressing into your gums? Do you mean a torus? Do you have CBCT pics to show us?" }, { "id": 58, "title": "Possible still infection after tooth extraction?", "dialogue": "beantownace: Hello. Hoping I can get some feedback on this. I had a tooth extracted based on an infection that was a good size dark spot near the tooth they ended up extracting that had a crack in the root of a previous years ago root canaled tooth. I could not see the fracture but the oral surgeon said it many times is a hairline crack that allows bacteria in. I am 13 days out from the extraction was on amoxicillin for 8 full days twice a day the site is healing well it seems but I am now seeing the same pus spot come up again and that is concerning me as that was the purpose of removing and cleaning out the infection. Any advice? Tx all Posted pic as well of extraction area and pus spot. John Morgens: I can offer some general information based on your description. If you're concerned about possible infection after a tooth extraction, it's important to consult with a healthcare provider for accurate advice and diagnosis.\n\nIn some cases, even after a tooth extraction and antibiotic treatment, there might be lingering infection or complications. Here are a few things to consider:\n\n\nPost-Extraction Healing: It's normal for the extraction site to have some degree of pus-like discharge (known as exudate) during the initial stages of healing. However, if you're noticing persistent or worsening pus, it could be a sign of ongoing infection.\nIncomplete Removal: If the infection was not fully removed during the extraction process, there's a possibility that some infected tissue or bacteria might remain, leading to the recurrence of pus and infection.\nResistant Bacteria: Sometimes, the bacteria causing the infection might be resistant to the antibiotics prescribed. This could result in the infection not being fully eradicated.\nReinfection: If proper oral hygiene practices are not maintained, reinfection can occur. Bacteria from the mouth can enter the healing site and cause complications.\nForeign Object Reaction: Occasionally, a small piece of debris or foreign material might remain in the extraction site, causing irritation and discharge.\nDelayed Healing: Some individuals experience delayed healing, which might lead to prolonged discharge. This could be due to factors such as medical conditions, immune response, or the body's healing process.\nGiven the recurrence of pus and your concerns, it's important to reach out to your oral surgeon or dentist. They can examine the area, possibly perform tests, and provide appropriate guidance based on your specific situation. They might recommend further treatment, antibiotic adjustments, or additional cleaning of the area if necessary.\n\nRemember, only a qualified healthcare professional can provide accurate assessment and guidance. If you have any worries about ongoing infection or complications, it's best to seek professional advice to ensure proper healing and prevent any further issues. MattKW: That is most likely to be due to a residual bone chip following the extraction - over time most of these little bits work to the surface and fall out. In rare cases maybe a bit of tooth remains.\nYou can go back to the dentist and he takes an Xray. Dead bone chip will look like live bone chip (so won't show up and therefore assumed), so would then numb you up and clean out the wound with a curette; simple. If it's a bit of tooth, it would show up on Xray but would also curette it out easily." }, { "id": 59, "title": "Question about extraction", "dialogue": "gabbymessenger1497: Hi, I just had a wisdom tooth pulled today. They gave me 3 shots of lidocaine and then just pulled it out. I’ve never had a tooth pulled and this was not a pleasant experience. I was told to just take ibuprofen so I’m in a lot of pain. But what I’m concerned about is it looks like a piece of jaw is attached to the tooth. The tooth is giant the biggest tooth I’ve ever seen lol. Is this my jaw attached to the tooth? If so will it grow back is this something to be concerned over? Even the dental assistant was like what is this weird bone growth on the tooth and the dentist just shrugged it off. I didn’t give it much thought at the time, mainly because I was in shock. Also he didn’t stitch the hole or anything and I don’t know I’m just kind of freaking out a little because I’ve never had a tooth pulled and I’m just in pain and now just worrying myself. MattKW: Pain relief: best to take a combination or paracetamol and ibuprofen for first few days, and then taper down as it improves (see attached).\nThat looks like an upper 2nd molar? It's common for such teeth to come out with a bit of the weak surrounding bone; nothing to be concerned about in your case.\nMolars do leave a big hole, but they heal up well in young people. Initial healing of a thin layer of skin occurs within 2 weeks; for the socket to completely heal up and the bone to reshape takes 3 months.\nStitches don't often do much for closing the hole for a single extraction. I would be placing stitches for 2 or more teeth taken out at the same time, mostly to help bring post-op bleeding under faster control. gabbymessenger1497: Thank you for the reassurance. It was my upper left wisdom tooth. I think they called it number 16. I’m 26 and it’s been completely grown in for years now it had room to come all the way down. But I couldn’t reach it very well when brushing so it started to decay so that’s why I went ahead and just had it pulled bc I didn’t want it to start effecting the tooth next to it or worse it becoming infected and getting an abscess or something. So good riddance to it! I think I just stared over thinking it lol!" }, { "id": 60, "title": "White stuff hanging down from extraction site normal?", "dialogue": "beantownace: Hello is it normal after tooth extraction and bone graft to have this white material or tissue where it is hanging down some from the extraction socket area. I think maybe granulation tissue but I was eating soup and realized slurping also not a good idea just like straw so stopped that but it was forming anyway yesterday. Dr M: Unclear photo, but could be granulation tissue yes MattKW: Can't be sure, probably tissue layer sloughing off. Nothing to worry about. beantownace: Thank you both yes seems to be just healing tissue. beantownace: Thanks one more question attached photo. The extraction socket seems in good shape and healing but I am noticing a white patch on the gum in between the tooth in front of where the extraction was done and they also did a bone graft. This seems new I did not notice that before. I am on antibiotics as well but that looks odd to me and it is whiter than the photo attached here shows. Anything to be concerned about? MattKW: Soggy semi-keratinised tissue. I suspect you haven't been brushing too often in this area recently, so you have built up a soft skin layer (keratin) that will brush away and is of no significance. John Morgens: After a tooth extraction and bone graft, it is normal to see white material or tissue hanging down from the extraction site. This white material is usually granulation tissue, which is a normal part of the body's healing process. Granulation tissue is composed of blood vessels, collagen, and white blood cells, giving it a white color. It serves to protect the site until new gum tissue or bone can form.Sometimes, surgical gauze may also be visible in the socket, which will also be white in color. As long as it is not causing any discomfort, it is best to leave it alone as the body will eliminate it on its own.However, if you are experiencing severe pain along with the white material, it could be a sign of a complication such as an infection or dry socket. In such cases, it is important to contact your dentist for further evaluation and appropriate treatment." }, { "id": 61, "title": "How soon after extraction/bone grafting can an implant be done?", "dialogue": "Eric2005: The oral surgeon who extracted the molar (and did bone grafting) in May said the implant could be done in October. A dentist thinks it can be done as early as July - says there is advanced technology to make this possible. I'm confused. MattKW: Wait till Ocotober for a more assured result. You don't want to take any risks just to save a bit of time. Eric2005: I thought implants could be done the same day as extractions, no? Dr M: You had additional bone grafting done. Sometimes the oral surgeon needs to make sure that the procedure was successful before placing the implant. Follow the advice of your oral surgeon." }, { "id": 62, "title": "Wound is not closing after the extraction", "dialogue": "dentalwoes: My 7yo had two adjacent primary molars extracted 2 weeks ago. The wound still looks open with a large gap. Is this normal presentation, or should this have been sutured? Is there anything that should be done at this point? Photo attached. MattKW: Not a great photo, but appears to be healing well for 2 weeks. It is extremely rare for children to have poor healing unless they have a systemic disorder. Sutures are not always essential for such wounds." }, { "id": 63, "title": "Slight pain on my implant when chewing, what's going on?", "dialogue": "TeaMatcha: Hi all,\n\nJust got my dental implant crown screwed on on the 15th July. The first day, I experienced some tightness between the crown and my premolar. The next day, the tightness is gone, and everything was fine. However, on the 3rd day evening time, I experienced some pain whenever I'm eating. It's not that painful but noticeable. I tried using my finger to press down in the implant crown but it doesn't hurt that way but it does hurts a little whenever I chew food with it.\n\nI currently have a temporary filling on for this implant crown, the dentist will fill it with composite filling on my next visit if everything is okay with the crown.\n\nAnyone ever experience the same thing? Not sure what's going on. Dr M: It might be that the implant crown is too high. I suggest making an earlier appointment with your dentist to check the occlusion on the crown. Any excessive forces around an implant, might result in bone loss TeaMatcha: Dr M said:\n\n\n\n\t\t\tIt might be that the implant crown is too high. I suggest making an earlier appointment with your dentist to check the occlusion on the crown. Any excessive forces around an implant, might result in bone loss\n\t\t\nClick to expand...\n\n I'm going back to the dentist today. Not too sure if it's the height of the crown. When I floss between the crown and my pre-molar, it hurts. But it doesn't hurt when I floss between the crown and my second molar. Dr M: Better to have a clinical look, I agree. Might be impinging on some soft tissue as well TeaMatcha: Dr M said:\n\n\n\n\t\t\tBetter to have a clinical look, I agree. Might be impinging on some soft tissue as well\n\t\t\nClick to expand...\n\nJust came back from the dentist. Dentist mentioned that it's my premolar that's hurting whenever I chew. I ate some really tough cracker few days back, dentist say that I could have hurt my tooth ligament. She say the implant seems fine. She took out the temporary filling in the implant crown and replaced it with a composite filling. It feels alot better now. Not sure if the temporary filling could make it hurt. She say to give that tooth a rest for a week and don't chew anything too hard on it and see how it goes." }, { "id": 64, "title": "Fractured jaw makes noise", "dialogue": "june123: A few weeks ago I had one of my deep wisdom tooth removed. While removing that tooth my jaw got fractured. One part of the fractured bone was leaning to the upside; it was not in its natural position. 2 days later I underwent an operation to fix a titanium plate to keep the bones in place so as to help bone healing. Now my swelling is totally gone and I am able to chew slightly and can speak normally, even though I cannot stress my jaw even a bit more while speaking or eating. 2 days ago I heard my jaw making creaking sounds, these sounds came from the fractured part and it came every now and then. These creaking noises had happened once earlier too, just a few days after the operation; the dental surgeon said that its normal and that I should wait for that to heal.\n\nAre those noises a cause for concern? What should I do?" }, { "id": 65, "title": "I have lip incompetence and the gap between my lower and upper lips is 1cm. How can it be treated?", "dialogue": "Naveen: How effective will a lip repositioning surgery be? I'm indeed visiting a dentist, but please answer my question so that I can have a good conversation with him." }, { "id": 66, "title": "Hello", "dialogue": "zlatka: hello, I've been seeing something on the end of my tongue on the right for a long time, it doesn't hurt, it doesn't itch, on the left I don't see that I have it MattKW: Looks like a circumvallate papilla, and they are on both sides of tongue. Google it. zlatka: Thank you for your answer and why is it so red covered with blood? Thank you very much for your answer" }, { "id": 67, "title": "How accurate are oral swab tests for oral thrush?", "dialogue": "Jawbreaker001: I was wondering: how accurate are oral swab tests for oral thrush?\n\nI’m asking because I tested negative. Despite the results, I still get a white build up that bleeds slightly when I brush it. On top of that, my angular cheilitis just healed.\n\n(I should add that I was never clinically diagnosed by my dentist or oral surgeon. I’m just confused why my tongue keeps bleeding.) MattKW: What type or brand of test did you use? When it says \"positive\", was there a measurement reading, i.e. CFU mL?\nWhy haven't you been to a dentist or oral biologist (or even your usual doctor)?\nDo you have photos? Jawbreaker001: Neither my GP nor my dentist thought it was oral thrush upon first impression, but my dentist swabbed my tongue to be sure.\n\nI don’t recall the test my he used. I just know that he used an oversized q-tip and liberally swabbed my tongue. A few days later, he told me the sample was negative for oral candidiasis.\n\nHowever, sometimes my tongue bleeds when I brush, and I read that typically bleeding is caused by not a fungal infection.\n\nI’ve included 3 photos below for reference:\n\n1. Typical presentation when I wake up in the morning.\n2. The worst bleeding I’ve had after brushing/scraping my tongue — usually it’s only 1/2 taste buds bleeding.\n3. My tongue after a cleaning (no issues with bleeding). MattKW: This is not a Candida infection, it's a typical non-harmful \"hairy tongue\" caused by long filiform papillae. There is no need to brush your tongue so aggressively to wear them down. \nEveryone has Candida in their mouth, so just getting a positive reading means nothing without a quantitative measurement, and there is always going to be an underlying problem of either immunosuppresion or overuse of antibiotics. A Candida infection will typically peel off with finger rubbing." }, { "id": 68, "title": "Wisdom tooth extraction need to be done asap? Xrays attached.", "dialogue": "Stackflow: Is this wisdom tooth need to be taken out asap? Or can I wait and watch?" }, { "id": 69, "title": "Dark spot on gum", "dialogue": "aqz: Hi, i have noticed this dark spot on gum under tooth which i had a filling on years ago. Its not bothering me apart from noticing it by chance. Just wanted to know is this due to filling or just pigmentation. I do have pigmented gums in general. Just this spot is darker then other areas. Thanks in advance View attachment 5968 Dr M: It does look like pigmentation. Keep an eye on the area for any changes. aqz: Dr M said:\n\n\n\n\t\t\tIt does look like pigmentation. Keep an eye on the area for any changes.\n\t\t\nClick to expand...\n\nThanks for the reply, could it be a tatoo due to filling also? Dr M: Amalgam fillings can sometimes cause a tatoo yes." }, { "id": 70, "title": "Dark spot on gum", "dialogue": "aqz: Hi, i have noticed this dark spot on gum under tooth which i had a filling on years ago. Its not bothering me apart from noticing it by chance. Just wanted to know is this due to filling or just pigmentation. I do have pigmented gums in general. Just this spot is darker then other areas. Thanks in advance" }, { "id": 71, "title": "As a kid, i had 10 perfect teeth removed cosmetically, and i would like 4 of them re-mplanted.", "dialogue": "hopeful: they weren't problematic, and i am grieved about it now,\ni was supposed to have 34 teeth,\nand the dentist took out 10 to make it an average 24 teeth.\nthere was a concern about overcrowding,\nbut - the jaw doesn't stay the same size, it grows too!\nthey weren't extra teeth, they were MY teeth.\ni wish that the decision makers had just waited,\nseen if there was a problem,\nand if there was, maybe remove a couple of teeth and SEE what next.\n\npeople will think, 'you've got straight teeth, what's the problem'\n\nwell, i have four crowns now,\nthat's because my bite pressure is now distributed over FEWER teeth,\nso my teeth have chipped and broken off over time\nand now i have NO SPARE TEETH.\n\nso mostly i just want to warn others off this, for your kids.\n\nand also, i KEPT my barbarically extracted teeth, perfectly good teeth,\nand i wonder if they can be implanted,\nif four of them can be put back additionally.\ni think it can be done\ni need to find a dentist who can hear my situation and explore possibilities.\n\ni have hope about it, and that would take away my regret hopeful: furthermore,\nwhat is wrong with bite shape with variation in how teeth align?\nnothing !\nit's character, personality, and natural, compared to trying to achieve lego block teeth\n\nmy surgery might go something like\npreparing my teeth in a solution or even placed under my skin to see if they become viable or activated.\nthen ...\ndentist make sockets, not sure after that hopeful: i looked through images of crooked teeth, \ni fail to see the problem with teeth that aren't ruler straight hopeful: it's a forgiveness process hopeful: please do not take your kids in to the dentist to get left with minimum quantity of teeth. \nmaybe wait till there is actually a problem or imminent problem. \ndo not go looking for problems that aren't there. \nwait till the kid is a bit older, \nthe jaw and skull grow more and the teeth don't look so exaggerated. \ndefinitely don't go looking for problems with wisdom teeth if there are no apparent or likely problems. \nthese specialists are scaring people into getting perfectly good teeth taken out by surgery and drilling, for good money. \nthe kid is maimed for life. \n\na little variation in the tooth line-up is good, natural, \nand it gives personality and character. \nkeep it that way ! hopeful: bone surgery is exhausting and a shock to the system, \nand teeth are the very structure of your FACE.\n\ndon't get parts of your skeleton permanently removed for fashion hopeful: my qualifications:\ni was subjected to licensed torture and excessive permanent removal of adult teeth,\nwith no option to say no, \nas i was a kid,\nand i'm still without those teeth \nand i don't want anyone else to have that done to them as it's inhumane and unnecessary and disadvantageous\n\nwhat's with the obsession to have 206 bones in your body [skeleton] ?\npeople vary, they may have 220 bones and that's perfect as well hopeful: i looked up dentures, \ni wish i could've done the comparisons at age 7,\ndentures have 7 or 8 teeth per quarter,\nmy dentist couldn't even leave me with that\n\ni'm down two canines and i haven't got premolars, \nthey were extracted in a grievous assault.\n\neven the dental assistant flinched a bit at the amount of teeth, blood, horror, and wrenching, \nand not a noise from me\n\ni'm glad i took my teeth with me, thank god, \nthey were in my school pocket in a bloodied tissue, \ni got a sticker or something and bloody sockets where teeth should've been.\n\nsimilarly a couple hundred years ago, \nsome women had operations to remove the lowest rib to be slim waisted for looks;\nthat's removal of skeletal structure for cosmetic reasons. \n\ni looked up 'supernumery' teeth,\nwell who says they're extra? \ni might've had four 'extra' teeth (long skinny single root) that would prove to be problematic\nbut we don't know that and i wish ... i wish a few things hopeful: the dentist scammer mutilater who took out my 10 teeth died young, \nmany years ago,\nmaybe aged 50,\ni'm not sure how he died. \n\nmany years later, another scammer mutilater dentist - the one that recommended and proceeded to take out all my wisdom teeth - unnecessarily - by mechanical obliteration and utmost disrespect - he died some days ago - \nwhen i was told, i said 'oh well'.\n\na pompous self important large-scale mutilater of people's (kids') very skeletons, \nmade money by scamming and scaring people into getting an operation on teeth that are barely formed, deep inside the jaw bone and showing zero sign of problem -\nhad the sports car with personalised plates - \nmenace to society - licensed masochist - rude as hell - \ni also had memory difficulties after the 'surgery' which required general anaesthetic. \n\nit makes me sick and greatly regretful to know that i am down more than one third of my teeth,\nat the hands of deceptive mutilaters, \nfor the rest of my life. \n\nI WISH he had said something like, \n'your wisdom teeth aren't a problem,\nif they do cause a problem,\nwe can do something about it'.\nand then i would've gone to see him about it!\nwith regret, that never happened.\n\nwhat a shameful disgusting life to lead, did mr mutilater. \nthe life of an absolute low acting money-grabbing destroyer of my being, \nthrowing away my teeth like they were garbage and a threat to my life -\nno, it was he who was garbage and threat to my life." }, { "id": 72, "title": "Foliate Papillae or lateral lingual tonsil?", "dialogue": "ozeekay: Background:\n2nd week march 2023, sudden sharp pinchfelt around tonsil/throat while riding bike.\n\nContinuous feeling after that of a tonsil stone, yet none.\nDeveloped runny nose, then blocked nose, mild cough. Lasted 4-6 days but went away (after klaricid and dayquil/nyquil). Tonsil stone sensation and cold symptoms both went away.\n\nDuring all this while searching for the tonsil stone, noticed the inflammed foliate Papillae on the right side of the tongue. \n\nWent to dentists, eventually oral surgeon who did not find any ulceration. These are soft curtain like and move like flappers. Oral surgeon took dental Xray and found 4-5 infections at the roots of different teeth. Concluded this is an inflammation of the lymphoid tissue. Fast forward a month had extractions(all teeth marked in red are extracted) of 2 wisdom, 2 anterior and 1 upper tooth (except for wisdom all were already treated with root canals at different times in preceding years). Been a week now post extractions, I do feel that the more pronounced/angrier looking foliate Papillae have become more mellow and subtle yet still my anxiousness makes me look at them everyday.\n\nThere is no pain there, however prior to extractions the area on the top of the tongue (not side) used to feel like burning, but hasnt happening post the extractions. Post extractions i also have a more tendee TMJ and on and off pain around the ear but not as frequent.\n\nI just want to get this off my head and not look at this every day." }, { "id": 73, "title": "Extraction", "dialogue": "Natz40: Hello new here .\nSo I have an upper left molar that needs removing due too having an old silver filling that’s been in a long time and the tooth can no longer be saved plus this filling has leaked and I had an infection a few months ago .\nI know it needs too come out but I am petrified, I’m autistic and sometimes feel like people aren’t always understanding and generally don’t realise how distressing dentists can be for us or anything medically.\nI know we all have different pain tolerance but I’m struggling too understand that even though I’ll be numb I won’t be able too feel anything at all .\nI’m so scared I don’t have great teeth have never smiled properly and sometimes have bad thoughts about just wishing I want around because my teeth ruin everything.\nI’m not in a position too get them done , I had a bad time at a NHS dentist so now my daughter pays for me too go private and I feel like a burden so it’s so hard .\n\nHopefully someone can help offer advice thanks MattKW: Ask friends and family for recommended dentists.\nPreferably find a dentist who uses \"Happy Gas\" (RA or nitrous oxide) - this could be very helpful for someone like you. Upper molars can be fragile to take out, and although you will be numb, it can be noisy and a bit uncomfortable.\nMake that initial consultation and see if you like them - worth paying for a few consultations if not happy. Emphasise that you are only coming in for standard examination and X-rays, no cleaning. Take your daughter or close friend with you.\nIf you don't like the first dentist, you can ask to take electronic copies of the Xrays (JPGs or BMPs about 500kB) in size to the next dentist. You can put them up here for comment, too.\nTalk to them about your fears, ask if you can have a trial session of RA to get the right mix. You'll have to pay for it.\nThen, get it taken out under RA and local anaesthesia.\nLet us know how it goes. Good luck! Natz40: MattKW said:\n\n\n\n\nAsk friends and family for recommended dentists.\nPreferably find a dentist who uses \"Happy Gas\" (RA or nitrous oxide) - this could be very helpful for someone like you. Upper molars can be fragile to take out, and although you will be numb, it can be noisy and a bit uncomfortable.\nMake that initial consultation and see if you like them - worth paying for a few consultations if not happy. Emphasise that you are only coming in for standard examination and X-rays, no cleaning. Take your daughter or close friend with you.\nIf you don't like the first dentist, you can ask to take electronic copies of the Xrays (JPGs or BMPs about 500kB) in size to the next dentist. You can put them up here for comment, too.\nTalk to them about your fears, ask if you can have a trial session of RA to get the right mix. You'll have to pay for it.\nThen, get it taken out under RA and local anaesthesia.\nLet us know how it goes. Good luck!\n\n\nClick to expand...\n\nDid you read my message? I have a dentist am just asking if it will hurt ? \nNot in a position too pay anywhere’ else MattKW: You said, \"...so now my daughter pays for me too go private...\". Natz40: Yes I’m at a private dentist already \n\n\nMattKW said:\n\n\n\n\t\t\tYou said, \"...so now my daughter pays for me too go private...\"\n\t\t\nClick to expand... MattKW: Well, I've suggested some things to consider? Do you like and trust the dentist? Does he/she offer Happy Gas?... Natz40: MattKW said:\n\n\n\n\t\t\tWell, I've suggested some things to consider? Do you like and trust the dentist? Does he/she offer Happy Gas?...\n\t\t\nClick to expand...\n\nIn the Uk you have too be referred too a dental hospital and yes I do she did my last filling that was broke without local anaesthetic big achievement for me MattKW: OK, so you seem happy with her. So, you should be able to talk to her about the likely way she expects the extraction to go (simple? surgical?) and maybe offer you reassurance, and maybe RA or a benzo to help with your anxiety. Natz40: MattKW said:\n\n\n\n\t\t\tOK, so you seem happy with her. So, you should be able to talk to her about the likely way she expects the extraction to go (simple? surgical?) and maybe offer you reassurance, and maybe RA or a benzo to help with your anxiety.\n\t\t\nClick to expand...\n\nI’m from Uk we don’t have that here they only give you that at the dental hospital which I already said .\nI just want someone to say if it hurts ? MattKW: I just googled \"private dentists uk with nitrous oxide\". RA does not require hospitalisation - perhaps you are thinking of a general anaesthetic.\nAnyway, I have had wisdom teeth surgically removed from me using only local anaesthetic, and while it wasn't a barrel of laughs, it was tolerable. People vary widely in their reaction and perception of pain. I have done very simple extractions that have really upset people, and then I have done some really tough surgical extractions that some people didn't get concerned about. An upper molar such as you describe is more likely to become a surgical extraction, and while it won't necessarily hurt you, it sounds as if you won't enjoy it without some form of anxiety assistance." }, { "id": 74, "title": "Extraction site not closed after two months advice appreciated", "dialogue": "JamesH: Due to a cracked root, I had my upper left first molar (UL6) extracted on 22 February by a dental surgeon on the NHS.\n\nThe procedure was quick, the tooth came out in one piece and the surgeon told me it didn’t look like my sinus had been torn.\n\nWhen I got home and checked the wound, to my surprise, as well as the usual hole in the top of the extraction site, there was a big hole on the outside of the gum where the UL6 had been. Presumably the gum was torn there during the extraction.\n\nIt’s now more than two months since the extraction and the hole still looks a long way from being closed and the area is still tender.\n\nI’m pretty concerned, as the info I’ve read online suggests the extraction site should have closed within one month. I’m starting to wonder if it’s going to heal properly and whether I should book an appointment with a specialist (a periodontist perhaps?) to get this looked at?\n\nI’m happy to spend the money on a private appointment if it’s of benefit, but naturally I don’t want to spend money unnecessarily.\n\nAny thoughts/suggestions from dentists would be massively appreciated. What do you think?\n\nI’ve pasted links to photos below so you can see the progress/rate of healing.\n\nThere was a fair amount of healing in the first month, but there’s really only been marginal signs of healing in the second month as far as I can see.\n\nThank you!\n\n26 Feb (4 days post extraction): https://photos.app.goo.gl/aLZwsjDcg2KXiv8CA\n\n23 March (29 days post extraction): https://photos.app.goo.gl/q3DCYwA6ztrsrcxJ7\n\n26 April image 1 (63 days post extraction): https://photos.app.goo.gl/6fBn1QRH3vb9UGxF9\n\n26 April image 2 (63 days post extraction): https://photos.app.goo.gl/LKp6c825QRk83H8Q7 MattKW: It's certainly achieved basic healing and looks fully epithelialised (covered with skin). Yes, when the tooth was extracted a large chunk of buccal bone came out, and this sometimes happens. It takes at least 3 months for the bone to reshape, but I doubt you'll get much more difference over the next month. This sort of defect is a bit unattractive but does not need further treatment unless you wish to place an implant; in which case you'd need a bone graft. JamesH: MattKW said:\n\n\n\n\t\t\tIt's certainly achieved basic healing and looks fully epithelialised (covered with skin). Yes, when the tooth was extracted a large chunk of buccal bone came out, and this sometimes happens. It takes at least 3 months for the bone to reshape, but I doubt you'll get much more difference over the next month. This sort of defect is a bit unattractive but does not need further treatment unless you wish to place an implant; in which case you'd need a bone graft.\n\t\t\nClick to expand...\n\nThanks very much for looking at it.\n\nSo, it’s likely this is how the gum there is ultimately going to look?\n\nWill the white, light-coloured area harden/toughen up and turn a normal pink gum colour?\n\nAs things stand, the white/light-coloured area is very tender and I think it would tear easily, so I’m mostly eating on the other side of the mouth.\n\nJust this week (after feeling okay for some weeks), the area has started to feel sore and stiff/achey, off and on.\n\nI've started rinsing with salt water again a couple of times a day and Corsodyl original (the chlorhexide digluconate version). Am I doing the right thing?\n\nSome websites say Corsodyl should be avoided as it's too strong, and others that it helps with healing.\n\nIs it worth me booking an appointment with a periodontist or some other type of specialist? I’m hoping perhaps there might be something they can do to treat/remedy this. Any suggestions on anything I can do to improve the ultimate outcome greatly appreciated. Thank you. MattKW: There is no need for further mouthwash or other treatment. I don't understand what you are trying to remedy or what you expect the utlimate outcome to be. You have bone damage that has healed up OK. Because you no longer have a tooth there, any hard food you eat will bump the soft gum and be a bit annoying; that's what happens whatever tooth you have removed, and most people adapt to it. JamesH: MattKW said:\n\n\n\n\t\t\tThere is no need for further mouthwash or other treatment. I don't understand what you are trying to remedy or what you expect the utlimate outcome to be. You have bone damage that has healed up OK. Because you no longer have a tooth there, any hard food you eat will bump the soft gum and be a bit annoying; that's what happens whatever tooth you have removed, and most people adapt to it.\n\t\t\nClick to expand...\n\nFor people I know of who have had a molar extraction (and according to the photos I’ve seen online) within a few weeks the extraction site is a normal pink gum colour and the gum has a strength to match that of regular gum tissue.\n\nIn my case, the ‘newly formed’ gum (if that’s the correct term) where the big tear was is soft/weak/tender/pale white in colour. It lacks the strength of regular gum and would tear easier than regular gum would. So, from my perspective – although it has a skin layer of sorts – the gum in the area hasn’t fully healed.\n\nThe salt water/Corsodyl is to hopefully aid further healing and stave off infection (as I say, the area has started to feel a little sore/achy/stiff) and the salt water/Corsodyl seems to relieve that, which again suggests to me that it isn’t fully healed. MattKW: For people I've extracted teeth from in my 40+ years and 15,000+ extractions, that is in the range of normal healing and requires no further treatment. Please try to stop worrying about it." }, { "id": 75, "title": "Some white growth and red patches on the tongue.", "dialogue": "Stackflow: Hi I notice the red patches at the back of my tongue both sides and white growth on top of tongue. \nI have this white thing for few months now and seen GP for this. She said she don't know what that is. \n\nThis red patches are new and noticed it 5 days ago. It's on both sides. Don't know if this red patches are some serious infection growth?\nI am waiting for dentist appointment which is not until end of May. \n\nAny thoughts here." }, { "id": 76, "title": "[33M] Root canal, extraction only, or extraction + implant? (tooth 31, x-ray attached)", "dialogue": "meenu: Hello! I'm a 33-year-old male, located in the US, non-drinker, non-smoker.\n\nI've been having some pain chewing with my 2nd lower right molar (tooth 31). My dentist thinks that it can be root canal'ed, I went to a second dentist who thought that root canal has a poor prognosis and recommended extraction + implant, and I went to an oral surgeon who thought that I could go either way, and also gave me the option of extraction + bone graft only, or extraction + bone graft + implant in the same session (he said that my tooth looks like it's amenable to doing the implant in the same session).\n\nI like my oral surgeon (he also did my wisdom teeth last year and did a great job), but with so many options, I'm honestly confused on what to do here. I've heard that extracting a 2nd molar without replacement is usually fine for chewing, but risks the upper 2nd molar erupting, and I don't want to lose so many teeth (especially with the 2nd molar on the left side also having some issues that will probably need RCT/extraction down the road - it's just got a filling on it for now).\n\nI'm also not sure if doing an implant in the same session is a good idea - my oral surgeon said I could wait 4 months and come back for the implant if I wanted to take a wait-and-see approach to see if I really want to replace the tooth, and I'm also wondering if doing the implant in the same session has a worse prognosis than waiting for more bone to grow back after the extraction? Or, it doesn't matter, and I should consider myself lucky that I can do it in one session instead of multiple like most situations?\n\nLastly - I'm quite anxious when it comes to dental work, so I've asked for valium for the extraction (+implant) since he only wants to do local anesthesia. It'll be my first extraction while awake (he did my wisdom teeth with IV sedation), so I'm a little nervous about how this extraction would go? He said he'll do a \"surgical extraction\" that takes ~30 minutes (implant an additional 20 min), which sounds rather... scary.\n\nWould love to hear your thoughts. Thank you all so much!\n\nX-ray attached is from Feb 2023. MattKW: Whilst an RCT is technically feasible, the real issue is the final \"restorability\" of the tooth. The RCT access hole will come in from the top of the tooth; add to this the large hole in the back of the tooth (which will be a bugger to fix), and you will be left with a structurally very weak tooth. Even planning a crown at the end will not improve your long term chances - I'd give the tooth a 5 year life after you've spent a fair amount of money. So, I'd go for extraction.\nA surgical extraction for that??? What tosh! The extraction will be dead easy - the tooth is upright, there's quite enough to get a good grip, and it has nice conical (ice-cream cone) roots. A competent dentist would have the extraction done within a couple of minutes. I would suggest just simple local anaesthetic, maybe some \"Happy Gas\" if available, or at most a smallish dose of a short-acting benzodiazepine (triazolam is great, temazepam is good, diazepam (\"Valium\") is good but lasts much longer). If taking an oral benzo, you need someone to transport you. Certainly don't need IV.\nAfter such a simple extraction, I would wait 6 months for bone to heal, and to see if you feel you need to replace it. If you then decided to go ahead with the implant, I doubt you'd need bone grafting - this should reshape nicely and leave sufficient bone for an implant.\nThe opposing upper would become redundant if you don't place an implant, but waiting a mere 6 months won't cause significant over-eruption. meenu: Thank you so much for your advice!! MattKW: Good-o! Let me know how it goes.\nIf you are in the US, then talk to oral surgeon or dentist about taking triazolam. It is marketed under the name \"Halcion\" and comes as 0.125mg tabs. See Wiki for a bit more info.\nThe best way is to plan the extraction first thing in the morning. Take 1 tab the night before to help you relax and get to sleep. In the morning, have a light breakfast and have someone drive you to the dentist, arriving at least 30mins early and take 1 tab 30mins before the appointment in the reception area.\nIf you don't have some food in your tummy before a stressful situation, you are more likely to get even more anxious and faint. I always carried fruit juice in my fridge to give to patients who hadn't eaten before an extraction." }, { "id": 77, "title": "Lingual Frenectomy (Elective)", "dialogue": "danc2050: Hi. I am looking for a dentist who will give me an elective lingual frenectomy. I do NOT have a tongue-tie, but I feel that my mouth will benefit from the extra reach from this operation (able to clean with my tongue more efficiently, for example).\n\nI live in Vancouver, WA and would prefer a provider in WA or OR, but can also fly to other places. I am able to pay out of pocket as I don't believe my insurance would cover it if I do not have a tongue-tie (though it does cover oral surgeries).\n\nAnyways, please contact me here if you are a provider or know of one who would do this. I'm not looking for a consult either -- I just would like to get the work done. Preferably with a laser as I hear that it can open the frenulum more effectively.\n\nThank you!\nDaniel MattKW: Given that there are risks associated with frenectomies (attached), you will need a better reason to satisfy a dentist. No-one will just do it without a consultation and discussion of your expected outcomes (why are you doing this), and the expected benefits (will it achieve what you think it will), and the risks." }, { "id": 78, "title": "Oral Surgery Pathology", "dialogue": "ninety5eclipz: I’ve recently went to the dentist after neglecting my dental health since prior to COVID. It wasn’t as bad as I thought. Need 2 chipped teeth capped and 1 previously capped tooth root canaled. After my exam I started taking better care of my teeth and flossed a lot more. On my lower right side between my back molars and cheek a felt a hard, painless dome shaped bump under my gum. The bump is about the diameter of a small pinky end of the finger. It seems to be pointed toward the front of my mouth and not to the side. In this general area I had a wisdom tooth yanked several years ago. I’m a 49 white male. There is no pain, no headaches, no fever, no problems chewing, no discoloration on the gum, not noticeable from the outside and no sinus issues. (Although I did in the last year have sinus issues caused by cpap that were exaggerated by afrin addiction. I have in the last 3 months detoxed, changed my cpap habits and gave no sinus congestion at all for 3 months). Fast forward to today and I went in and had 1 cap put in. The dentist did a pano X-ray and is referring me to oral surgery pathologist for further scans. I’m freaking out because I have high anxiety which I am on meds for. I am a tooth grinder. I get routine bloodwork done every 3-6 months at my PCM and they have all come back normal for years. Any advice, support or information would be greatly appreciated. Thanks in advance. MattKW: Have you considered it might be a torus? You can Google\"for images of \"buccal mandibular torus\"or go here - I have tori that look like those in the 3rd photo. They're benign, altho catch a bit of annoying food like muesli sometimes. I've only ever referred 2 patients off for removal, and that was because the patients were going to get dentures. ninety5eclipz: Matt, thanks. I guess it can’t be ruled out but I cannot see anything in my mouth that looks like any of the pictures. There is nothing visible as it it tucked way down in the back corner under soft tissue. Poking around is the only way to feel it. I guess I’ll just have to wait to see what comes up on the scans. MattKW: Let us know the results, and I'd be interested to see the scan. There's always something new to learn. Good luck. ninety5eclipz: MattKW said:\n\n\n\n\t\t\tLet us know the results, and I'd be interested to see the scan. There's always something new to learn. Good luck.\n\t\t\nClick to expand... ninety5eclipz: Haven’t been seen yet but here is scan. The problem area is bottom right (as seen from first person pov). Between my last tooth on bottom and cheek under soft tissue. ninety5eclipz: MattKW said:\n\n\n\n\t\t\tLet us know the results, and I'd be interested to see the scan. There's always something new to learn. Good luck.\n\t\t\nClick to expand...\n\nHere are my radiology scans and results MattKW: Interesting. Look like shotgun pellets! ninety5eclipz: MattKW said:\n\n\n\n\t\t\tInteresting. Look like shotgun pellets!\n\t\t\nClick to expand...\n\nThat’s actually funny you say that. About 10 years ago after I got out of the military I went to a civilian dentist. He asked me if I had ever been shot on the face with a BB gun. He said there was something in there that was not biological but to just leave it unless it starts to cause problems. I completely forgot about this until recently. The upper one between the 2 teeth is actually a filling. The lower one is not. I think it was something that was left in there when I had 2 wisdom teeth (1 on each lower side) removed just before I retired from the military. Is this something of concern I should have removed? It causes no pain or issues. Just a bump. MattKW: Of no concern." }, { "id": 79, "title": "Pathology. Red and white patches on tongue", "dialogue": "Stackflow: I have white tiny sharp growth on the tongue which I am seeing the dentist in May. Got appointment for 1st week of May only..I have this growth for few months now. \n\nI noticed some red patches on my tongue which is on the side of the tongue on both sides. It's painful and burning. It's like thick red patches and I noticed this today only. It's on both sides. \nI had some hot meal 2 days ago. I am not sure if it's because of that or something related to my tongue white thing. \n\nI have to wait for my appointment and this is making me really nervous. \n\nAny thoughts anyone if this is sinister. \nBig patch of redness on the side of the tongue beyond the molar tooth. I couldn't open wider beyond this to see it. I have chronic jaw pain and limited opening. I couldn't see the patches clearly behind this. \n\nIt's very painful and sore." }, { "id": 80, "title": "Last year around August/September I had two wisdom teeth removed but pain hasnt gone away (burning gums)", "dialogue": "dreamymoon: What would cause this pain? I have gone to dentist and they did another X-ray which shows nothing. She said to go back to surgeon which I don’t feel up to doing because it’s a long trip and I feel like I am imposing tbh. \nThe pain I feel is a burning pain on each lower left side where I had two wisdom teeth removed. It stings, burns and radiates over my face sometimes. I have had no loss of feeling or numbness so the dentist doesn’t think it’s a nerve. The only thing that helps the pain temporarily is ibuprofen and putting baking soda toothpaste on it (this lasts only a few minutes)." }, { "id": 81, "title": "Any root stumps left on my wisdom tooth extraction and molar extraction?", "dialogue": "Stackflow: I have posted about my tooth and jaw pain before. I have lower jaw pain on the right side and had tooth pain on#30 which was painful for tapping and biting pressure etc. \nIt was so painful and no answers found. Been going on for 3 years. I have extracted#30 tooth too. It's still painful and I posted about it. \n\nOne of the dentist commented that I have root stumps on my wisdom tooth extraction#32. I extracted this tooth ten years ago. \nI have seen so many specialists for this pain and none of them mentioned about this root stumps. Not sure if they missed it. \n\nI extracted molar#30 last year because of this pain. Do I have root stumps left on this molar socket area too?\nPlease let me know how valuable thoughts. Attaching x-rays. MattKW: No root stumps visible where #32 or #30 were extracted. Stackflow: MattKW said:\n\n\n\n\t\t\tNo root stumps visible where #32 or #30 were extracted.\n\t\t\nClick to expand...\n\nOk Dr. That was very confusing for me when a dentist pinged me and said I have root stumps on my wisdom extracted area. They even marked it on my xray. Let me attach the image here. MattKW: Touché! That's what I deserve when I only give a quick glance at the OPG. \nIt's still not a source of the pain you describe. Stackflow: MattKW said:\n\n\n\n\t\t\tTouché! That's what I deserve when I only give a quick glance at the OPG. \nIt's still not a source of the pain you describe.\n\t\t\nClick to expand...\n\nOk sir. Thanks. Appreciate it @MattKW\n\nDo you see any issues on my tooth #31 sir?\n\nMy dentist is leaning towards extraction of that too. As I have similar symptoms on that tooth as my extracted one. So he said I can pull that out and do implants. I don't know if I need second opinion on this. Thanks Dr Matt" }, { "id": 82, "title": "Wisdom tooth extraction. Is this need to be removed soon? Attaching xray.", "dialogue": "Stackflow: I have removed my 3 wisdom teeth before. I have one remaining wisdom tooth. I have right side jaw pain chronic for 3 years with no relief.\nI did upper right wisdom tooth removal only after this jaw pain started. Since the dentist thought my upper right wisdom tooth is causing the jaw pain.\nUnfortunately it didn't help. Still have jaw pain.\n\nSo I just dragged this other extraction. Dentist said I have to remove this left upper wisdom tooth too.\nIs this need to be removed soon? Will that cause more jaw pain?\n\nIs this tooth close to sinus??\nAttaching images of 2019 & 2022.\nJaw pain since 2020.\nAny changes in my jaw joint and condyles in these 2 x-rays?\nI have extracted#30 only because of this jaw pain. No issues on it\nthough MattKW: No rush to have upper left wisdom removed. Very unlikely to be related to any jaw pain. And you had #30 removed due to jaw pain??? Looks like it had been fine.\nWhat do you mean by jaw pain?\n\nSSiteWhere is the pain? Or the maximal site of the pain. \"Jaw pain\" is a vague term.OOnsetWhen did the pain start, and was it sudden or gradual? Include also whether it is getting worse, unchanging, getting better?CCharacterWhat is the pain like? An ache? Stabbing?RRadiationDoes the pain radiate anywhere? i.e. spread anywhereAAssociationsAny other signs or symptoms associated with the pain?TTime courseDoes the pain follow any pattern? Morning, night-time...EExacerbating / relieving factorsDoes anything change the pain?\nEating, hot, cold, painkillers,...SSeverityHow bad is the pain? Stackflow: MattKW said:\n\n\n\n\t\t\tNo rush to have upper left wisdom removed. Very unlikely to be related to any jaw pain. And you had #30 removed due to jaw pain??? Looks like it had been fine.\nWhat do you mean by jaw pain?\n\nSSiteWhere is the pain? Or the maximal site of the pain. \"Jaw pain\" is a vague term.OOnsetWhen did the pain start, and was it sudden or gradual? Include also whether it is getting worse, unchanging, getting better?CCharacterWhat is the pain like? An ache? Stabbing?RRadiationDoes the pain radiate anywhere? i.e. spread anywhereAAssociationsAny other signs or symptoms associated with the pain?TTime courseDoes the pain follow any pattern? Morning, night-time...EExacerbating / relieving factorsDoes anything change the pain?\nEating, hot, cold, painkillers,...SSeverityHow bad is the pain?\n\n\nClick to expand...\n\nThanks for the response @MattKW .\n\nYes I removed #30 only because of jaw pain. I regret it though , because they suspect that tooth is the reason for my jaw pain.\n\nMy jaw pain is in the mandible end lower jaw near the ear where the lower jaw line ends. I have this for 3 years now.\nI went to my dentist when this started. He took an pan xray and said everything fine.\n\nThen he tapped on all teeth on this side. Tooth 30 was painful for tapping. Kind of very sensitive and I just shrink my eyes. And he gave tooth stick to bite on and it was sensitive too.\n\nSo he said I might have some issues on 30. I didn't go in with tooth pain at all. And I was eating on it totally fine until that visit.\n\nI went to dentist after seeing an ENT for this pain. ENT did nasal endoscopy and said no issues. So went to dentist to check jaw.\n\nBut he spotted this tooth 30 issue. Took CBCT scan and nothing found. He said I can see Endodontist. Went to Endo the following week . This is all before 3 years. Then Endo did cold test and tooth was alive. But sensitive for tapping and biting pressure. So he said he will do exploratory root canal and see inside.\n\nDid it and nothing found and no relief. Same symptoms. I have severe jaw pain near the jaw end. But my bad, since the root canal, tooth 30 started hurting which wasn't hurting before that. It was hurting only for tapping and biting before that RCT.\n\nThen had another cbct scan. Nothing seen. The Endo forced me to get crown immediately to see if it helps. Spent thousands of dollars on it and got perm crown the following month. No relief and pain was so much on that molar. It's like pressure on it always and hurts to even touch.\n\nChanged the Endo and saw new Endo. Took another cbct scan. Nothing seen. He said I can try retreat root canal.\n\nSo did retreat root canal on it and no changes. My bad , nothing helped. He retreated again in 2 months. And retreated again in 6 months. So 3 retreats tried till 2022.\n\nNo relief and taken another cbct. Nothing seen.\n\nBut it was so painful in the gums and tooth area. It was also hurting in 31 gums. It was so much painful in 31 gums and I used to scream when they probe those gums. But periodontist said gums ok. But I screamed in his dental chair when he probed it but he dismissed me.\n\n\nEnded up pulling 30 in July 2022 and my bad, I still have all symptoms just minus the tooth. I have pain in tooth socket gum area. And severe pain in 31 gums.\n\nI went back to surgeon several times since pain in the jaw where mandible ends. Same spot. Pain just came back once anesthesia wears off. So called them the next day and same jaw pain. So surgeon said it could be dry socket and poked my socket and removed the stitches. No food debris or nothing in it. It was healing well \n\nHe put clove paste and asked me to come on day 5 and day 7 after ext. Digged again and put clove paste. No changes at all. My pain was the same. Taken several rounds of antibiotics.\n\nI still have pain. I saw him till October and he dismissed me saying xray looks ok.\n\nI have severe pain in tooth 31 gums now. It hurts for touching, brushing and probing just makes me scream and jump out of dental chair.\n\nI extracted this tooth only because it was painful for touching tapping and biting pressure.\n\nMy dentist and Endodontist did another treatment called occlusion adjustments and they grinded all my teeth as they thought occlusion issue could be reason for jaw pain. They grinded all my teeth and bite is totally off. I can't eat anything solid now. I can't eat anything at all on right side.\n\nOn the left side, after these bite adjustments, I couldn't eat anything solid and totally on soft diet for 3 years. \nMy bite is off and not meeting together and touching down even. \n\nI have also seen TMJ specialist, ENT, neurologist for this. Taken MRI and CT of jaw and neck as well. Attaching x-rays before and after root canal and extraction. Few more images In comment.\n\nDo you see anything wrong on my jaw, tooth 30 and tooth 31. Now I have severe pain in 31 and I went to dentist and Endodontist for this. No answers. Don't want to end up pulling that too. Any issues seen on 31? Severe gum pain. Stackflow: More xrays MattKW: I suggest you find a Pain Clinic attached to a major teaching hospital. There is no point pursuing it from a strictly dental point of view. Stackflow: MattKW said:\n\n\n\n\t\t\tI suggest you find a Pain Clinic attached to a major teaching hospital. There is no point pursuing it from a strictly dental point of view.\n\t\t\nClick to expand...\n\nOk Dr. I did see a pain management clinic and pain management specialist tried different nerve medicines on me in the last 2 years. I saw him in 2021. He said he is more focused on my symptoms control rather than finding the root cause or diagnosis. \nI have tried amitriptyline gabapentin Cymbalta Lyrica and currently taking tegretol. He said if it's nerve pain , I should get some relief with these medications. \n\nI have seen orofacial pain specialist TMJ specialist and they said it's like Myofascial syndrome and tried many muscle relaxers and physical therapy. I did more than an year of physical therapy and dry needling.nothing helped. \n\nNow they said my bite is off and could be causing pain. I am arguing that my bite was fine when this started and it got changed only after those bite grinding adjustments and the crown on 30. \n\nBecause my dentist did lots of adjustments on 30 crown when it was placed and adjusted other molars and other teeth so many times. He took tooth 30 out of occlusion by purpose and tried that if it helps with pain. Since it didn't help, Then he adjusted all other teeth to it's height. \n\nI still have same pain in the lower jaw line and constant since day 1 for 3 years now. Now I have severe pain In gums of tooth 31. Do you see any issues on #31? I have severe throbbing pain in that gum. It hurts for touching brushing etc. Looks inflamed. \n\nI recently saw an TMJ specialist and he reviewed my MRI and cbct scan. My MRI report says normal discs but I have got different opinions on my MRI. One oral surgeon said it's anterior displacement without reduction. Other surgeon said normal. Another tmj specialist whom I saw recently said my condyles are positioned different than normal. And that could be the reason for pain. \n\nMy cbct scan report shows condyles laterally positioned and I asked the tmj specialist who ordered the scan. He said that could be my normal anatomy and dismissed me to see chiropractor. He wanted me to see chiropractor and get neck adjustments. I have pain in the side of the neck on the right side and back /base of neck. So he said chiropractor adjustments required. \n\nI am very scared to go to chiropractor because of their adjustments and didn't go yet. Just avoiding going there. \n\nRight now, I am still with dental issues @MattKW. Issues in my 31 tooth as gum pain is severe, bite issues because of occlusion adjustments and this tongue herpes thing which I have. Constant primary pain is in the lower jaw where mandible ends. I even checked about eagles syndrome with ENT. \n\nI also have high inflammation CRP blood work since 2021. So seeing rheumatologist for that. My CRP is high since then. He is testing me every 3 months and the recent CRP blood work was high too. Don't know why it's still high.\n\nWhether condyles or disc issues cause these type of pain for so long ? And affect tooth and gums? I feel like I did an unnecessary extraction of #30. That was so painful and throbbing to touch tap and pressure. But nothing seen on xrays and cbct scans. Ended up pulling it. \n\nI don't want to end up pulling 31 too. Don't know why that gum is so painful. My Endodontist said I have occlusion trauma on that tooth as my dentist adjusted 30 so much and took out of occlusion 3 years ago and 31 has to take all pressure. That was the only tooth touches if I bite down. So he adjusted it again in November. \n\nSince then the tooth is so sharp and still bite feels uneven. I am scared to get more adjustments because my old dentist (I even changed my dentist because of this) did several bite adjustments visit and I saw him for 8 weeks for this grinding on all teeth in 2021. \n\nI feel it's not done correctly and made a mess of bite issues. I can't chew down on anything. And can't even bite on fries. No solid foods. Feel like I can't exert enough force to bite on those. \n\nI feel bad for myself and this mess. Don't know what should be the next step. I moved to a new city and have to find new dentist and other specialists. So searching for a new dentist and oral surgeon to check this from square one. Everytime I feel I am progressing but after every appointment I feel like I am back to square one. \nNo diagnosis and relief. \n\nDo you see any issues on my condyles or discs @MattKW doctor? MattKW: Are you serious? A TMJ specialist suggested you see a chiropractor. How would neck adjustments help with an area served by cranial nerves? I think you're having a go of me. End of conversation. Stackflow: MattKW said:\n\n\n\n\t\t\tAre you serious? A TMJ specialist suggested you see a chiropractor. How would neck adjustments help with an area served by cranial nerves? I think you're having a go of me. End of conversation.\n\t\t\nClick to expand...\n\nI am sorry if you misunderstood my statements.\nTmj specialist is an orofacial pain specialist and one of the very specialized doctor in the US. He took CBCT scan for me of the jaw and send it for reporting. Report came out and it says condyles position laterally and Dr feel that it's my normal anatomy. \nhe tried to give his splint to use for my teeth for my jaw pain. We tried it and it didn't help. So he said he works with upper cervical chiropractor doctors who does check only C1 and C2. Nothing else on the neck. So he wanted me to check if I have any issue in my c1 and c2. He said he had lots of patients who had issues in the cranial discs c1 and c2 and had my similar symptoms sir. \n\nSO he recommended upper cervical chiro. They are specialized in the US for only c1 and c2. \n\nSOrry if I said anything wrong." }, { "id": 83, "title": "Threatened by my dentist", "dialogue": "Jenny0: Is it right for my dentist to tell me that if I don't let him remove my good bottom wisdom tooth that he will not guarantee my upper screwed on denture teeth? MattKW: One photo is not enough. Photo and Xrays of all teeth on that side, pls. Jenny0: Are these pictures okay ? MattKW: Roughly speaking from those images, the wisdom tooth is overerupted and will interfere with the implant prosthesis. Yes, I'd ask you to have the wisdom tooth removed - it is a liability. Jenny0: THE THING I AM CONCERN WITH IS ONCE THE BONE IS LOSS FROM REMOVING THE WISDOM TOOTH THAT IT WILL EFFECT THE TOOTH IN FRONT OF IT. \nMY WISDOM TOOTH WAS THER BEFORE IN STARTED PUTTING IN THE IMPLANTS AND HE NEW I WANTED TO KEEP ALL MY BUTTOM TEETH. HE HAS PUT A FEW IMPLANTS THAT GO ALL THE WAY UPTO MY CHEEK BONE MattKW: No, it will have minimal effect on the adjacent tooth. There is never a need to make an implant prosthesis to go so far back as to occlude with your lower wisdom tooth (tooth 38). The longer you leave your redundant 38 in situ, the greater the risk you will develop decay in it (esp since it is over-erupted), or worse still cause decay in the adjacent tooth. \nIt is very rare to find people with all their 8s in a good position, functioning well, and well-maintained. The opposing upper 8 (tooth 28) was extracted years ago, so what is the 38 doing except posing a risk? Jenny0: It was left years ago because it was good.\nWant to thank you so very much for your input." }, { "id": 84, "title": "What is the timeline of the stages of dental osseointegration of a lower molar implant of a human being ?", "dialogue": "dingdongbell: If the day on which the implant is placed in the lower jaw of a patient is counted as day 1, what are the approximate numerical values of \"?\" in the following stages of dental osseointegration :\nHematosis: day ? - day ?\nInflammation: day ? - day ?\nProliferation: day ? - day ?\nRemodelling: day ? - day ?" }, { "id": 85, "title": "Root canal overcharging", "dialogue": "gidgit69: Hi I recently went to the dentist with back pain on my upper back molar dentist said it was cracked and would need a deep filling and charged me band 2 pricing which is fine he said if pain does not go away that I was looking at either tooth extraction or a root canal on molar but the root canal will cost me £1000 I did not think nhs dentists could charge me over band 3 as thought root canals was covered under band 2 does anyone have any advice as I am still in pain and having to take painkillers all day every day over using them MattKW: Sorry, Australia -based. NHS-ignorant." }, { "id": 86, "title": "What's a good type of cement to re-cement an implant?", "dialogue": "PWB: I've got an implant for a top front tooth. It screws in but was also cemented into place some time ago. The cement has failed and now when screwed in fully the tooth is crooked. I've tried to cement it with zinc polycarboxylate, and also another cement based on zinc oxide, without success. My feeling is that if I can find the right cement it should go back in nicely. Has anyone on here done this, or can anyone suggest a good type of cement for this job?\n\nI'm in the UK and have an NHS dentist - they won't fix it because the NHS doesn't touch implants. MattKW: Doesn't make a lot of sense. They are either screw-in or cemented, not both. Any X-rays to show us? Any details about the brand and model of implant? PWB: Thanks for getting back to me. Implant went in 2017; documents just call it an implant, but I have attached an xray which shows the left central incisor. The \"therapeutic relationship\" with the dental surgeon broke down; the owner of the practice, a GDP in UK terms (a primary care dental doctor), straightened the tooth - I thought she cemented it, but she may have just used some kind of tool, I just can't remember. If this is a screw, which when screwed in fully is now crooked, could I screw it to a straight position and cement it there? If so, what type of cement would be good for this job? MattKW: Can't help you much more; you'd really have to find someone local.What I can see is that you don't have much in the back teeth to chew on, your lower front teeth are severely attritioned, and your upper front tooth is a long crown. This all means that you are putting a lot of unnatural chewing forces on the front tooth which is at a mechanical disadvantage due to the shearing forces. You should really get upper and lower partial dentures to move the chewing forces to the back teeth where they belong. Otherwise I envisage that front crown will keep coming off. PWB: Thanks for your comments on the x-ray. That's the only one I've got and it dates back to 2017. I've got a plate in the lower mouth; NHS treats the attrition with fillings, and I wear a mouth guard at night. \n\nThe gap on the upper right has now been closed with a long bridge - the previously mentioned dental surgeon put in an implant, which failed - he had to dig it out of the sinus cavity. There is a successful implant closing some of the gap on the upper left. The crown on the right central incisor came off a number of times so I have that on a plate now. \n\nMy question was about a do-it-myself repair on the left central incisor. I take it that you don't consider it safe for a patient to do that." }, { "id": 87, "title": "Root canals", "dialogue": "Healthy T: I had consultation done recently where the dentist said that these two last back molars would both need root canals and crowns. \n\nIs that my only option?I have not experienced any pain and the pulp itself seems to be healthy.\n\n A filling has Fallen out on the last tooth, but I don’t see why it can not be refilled as normal filling.\n\nAttached are the X-rays of these two last teeth. Any help in knowing if the if the diagnosis is just, is very much appreciated. MattKW: Very low-res pics and not well aligned, but 1st molar appears to have an abscess, so an RCT is required, followed by a crown. 2nd molar will be a deep filling at best, but I can't tell if it will need RCT. A pulp sensibility test will show 1st molar to be non-vital (\"dead\"), and should show 2nd molar to be vital (\"alive\")." }, { "id": 88, "title": "Pain weeks after wisdom teeth removal", "dialogue": "dreamymoon: A few weeks ago I had my lower left wisdom tooth removed. However, the pain won't go away. The pain is like I still have my tooth there. The pain is a stinging aching pain. I did see the surgeon about my pain when I had my lower right removed about two weeks ago and he said it's fine and it takes 3 months to heal. \n\nI also had my lower right removed about two weeks ago as mentioned above which also has the same pain. \n\nDoes anyone know why I'm hurting so much? Dr M: Good day\n\nIf it was a difficult surgical extraction, it does sometimes take a while to heal. The pain should be getting gradually better however and not stay the same or become worse. I would suggest going for a follow-up with your oral surgeon, or at least your dentist, in order to evaluate if the pain is not maybe related to some adjacent structures. dreamymoon: Dr M said:\n\n\n\n\t\t\tGood day\n\nIf it was a difficult surgical extraction, it does sometimes take a while to heal. The pain should be getting gradually better however and not stay the same or become worse. I would suggest going for a follow-up with your oral surgeon, or at least your dentist, in order to evaluate if the pain is not maybe related to some adjacent structures.\n\t\t\nClick to expand...\n\nOk so I still have pain and it’s been many months now. Do you know what to do? It comes and goes but been steady for two days in left side and a little in right. Dr M: Have you been for a follow-up? New x-rays and scans will be needed in order to determine if the origin of the pain is not related to adjacent structures. Might not be related to the surgical extraction at all dreamymoon: Dr M said:\n\n\n\n\t\t\tHave you been for a follow-up? New x-rays and scans will be needed in order to determine if the origin of the pain is not related to adjacent structures. Might not be related to the surgical extraction at all\n\t\t\nClick to expand...\n\nNo I can’t afford to go back. I have looked myself and I have seen nothing unusual. I did see a white bit near the gum but unsure if that’s normal anatomy. The pain is strong stinging. I’ve tried using baking soda toothpaste and vinegar to help kill any bacteria and germs. Nothing is helping much. I’m going to try tea tree soon dreamymoon: I went to dentist and they did Xray. She says it is normal. Why am I in pain I am so confused. Could it possibly be phantom pain?" }, { "id": 89, "title": "Need advice. White rising thing on tongue.", "dialogue": "Stackflow: I noticed this white thing on my tongue few months ago. I don't remember how it formed. I have chronic pain in jaw and have had several dental work for that. \nDidn't check the tongue and suddenly spotted it one day. \nIt's the same size since then and no changes in size. Hurts if I touch or rub it. \nIt's not falling off and I didn't apply anything on it yet. \n\nWhat does this thing look like? Stackflow: @MattKW and @Dr M can you please advice." }, { "id": 90, "title": "Wisdom tooth extraction", "dialogue": "David35: Can anyone give me some advice on wisdom tooth extraction. What happens to the area were the tooth roots where? Dr M: What exactly do you mean?\nIn very basic terms,the socket in general firstly fills up with blood, that co-coagulates to form a blood clot. This clot, gradually transitions into scar tissue and then into woven bone, which is immature bone. The woven bone gradually mineralizes and becomes normal bone David35: Thank you that explains it fully thanks. Would It be possible to get your opinion on my wisdom tooth. MattKW: Put up an OPG. Quality needs to be at least 350kB, or better 500kB.\nWhat is your age? How many are being removed? David35: Any chance of sending it privately I don't really want to put on a public forum. MattKW: Sorry, no. David35: I will post the xrays. The wisdom tooth grow in at an angle and caused decay in the 2nd molar. This was filled 10 years ago. When I was 25. I kind of think the wisdom tooth should of been removed then when I was younger. I'm now 35. David35: And it's just one bottom left I don't have upper wisdom tooth and the lower right one is erupted normally David35: That's the x-ray from a month ago. David35: And that's the area from 2019. I have had the filling since around 2012/13. I'm not sure why wasn't removed when caused the original decay. MattKW: Yes, it should've been removed well before the decay started; this was an inevitable result. It will be a surgical extraction requiring lifting up of the gum, then severing the tooth in 2 planes - first light green to remove the crown part, and then possibly dark green to divide the roots. For a competent general dentist, that is quite achievable; for an oral surgeon it'll be easy.\nThere are a few risks, as with any procedure:\n\nthe filling in the 2nd molar may be damaged and need repair at another appointment. My first step before raising the gum would be to slice off the back edge of that lumpy amalgam (yellow line) to minimise this issue, and make the extraction easier.\nThe red lines show a major nerve bundle (the IAN) under the root tips. There's always a risk of damaging it, particularly if there has to be any digging around deep in the socket to chase broken roots. I see it as really unlikely.\nIf a root tip DID break during the extraction, it is reasonable to sometimes leave it in place and let the bone heal over.\nThere is another nerve just on the inner side of the wisdom tooth - the lingual nerve. Again, very small risk of damage in your case in hands of competent dentist.\nThen there's the usual issues - pain, bleeding, bruising, possible \"dry socket\".\nI'm guessing you're in early 30s? The bone where the wisdom tooth comes up will fill in with new bone over several months. Because this extraction has been delayed, the bone at the back of the filled tooth (blue arrows) will NOT fill up. You will have to work extra hard to keep the back surface of that clean for the rest of your life. David35: Thanks previous dentists have never mentioned removal not sure why. Thought it has already caused damage. I should still be definitely looking at getting it done? Thanks for such a detailed response MattKW: Yes, still get out ASAP. And any other potentially damaging or redundant wisdom teeth. You don't want to develop problems in your 70s, 80s, or 90s when you might be in Aged Care, plus have other medical conditions to juggle. David35: Thanks again. The filling was done 10 years ago now. I have only this last week started flossing in the area between the wisdom tooth and the second molar and alot of food gets stuck in there that the floss seems to get out. I'm happy to get it done but I'm in no pain at the moment with it or ever have, but am worried about it. Is it going to be better for my oral health with removal? As said earlier I wish I was advised to get it removed 10 years ago before it lead to the filling. That is the only filling I have in my mouth. Thanks for any more advice and all the advice you have given in the first message with the diagram. David35: Would it be generally agreed removal would be best? I really don't want to lose the useful tooth in front (second molar) David35: I occasionally get a creaking sound which I think is maybe coming from the filling when chewing this is not all the time but does it from time to time. David35: Sorry, one dentist said yes to taking it out another said it's borderline so I am unsure. What causes the bone loss if it has caused it? They said the bone loss looked pretty stable between the x-ray from 4 years ago. MattKW: I've given you free advice and you're not taking it. You have to make up your own mind now. End. David35: Sorry, I'm just worried about it. I really do appreciate the advice. David35: I am going to get it removed. I am scared if I leave it cause more problems having already caused the filling." }, { "id": 91, "title": "Dentist refused my request to return my tooth to me", "dialogue": "BuckheadJim: I had a tooth extracted today and requested the tooth. I was told by the dentist the law does not allow him to return my tooth to me saying it is a biohazard. I can not substantiate that claim through a google search. Was I told correctly?\n\nThanks BuckheadJim: Did not realize my question was posted each time I wrote it. Thought the first effort got lost in space. Sorry. MattKW: I couldn't say if it is the law wherever you are, but in general practice in Australia there is no law about it. Kids often want their teeth back, adults usually don't. \nWhen I work within the public hospital dental clinic I cannot give back the tooth for biohazard reasons, but patients are welcome to take a photo of the extracted tooth. BuckheadJim: MattKW said:\n\n\n\n\t\t\tI couldn't say if it is the law wherever you are, but in general practice in Australia there is no law about it. Kids often want their teeth back, adults usually don't.\nWhen I work within the public hospital dental clinic I cannot give back the tooth for biohazard reasons, but patients are welcome to take a photo of the extracted tooth.\n\t\t\nClick to expand... BuckheadJim: I am in the USA. I did go to the Centers for Disease Control website and found an updated page from February 2023. It spoke clearly and concisely to the issue and did allow a dentist to return a tooth to the patient, on request, without concern for bio hazard considerations. With that information in hand the dentist quickly returned the tooth to me." }, { "id": 92, "title": "Dentist refused to return my tooth", "dialogue": "BuckheadJim: Had a tooth pulled and asked for it. Dentist said its a bio-hazard substance and he can not legally return it to me. I can not confirm this through a Google search.\n\nDoes federal law prevent the return of the tooth? Yes, it was pulled because of infection." }, { "id": 93, "title": "Christian missionary needs dental work", "dialogue": "hello: Good afternoon,\nI'm writing here to try to help a very good man. He is a Christian missionary who is currently helping with missionary work in Guatemala. He helps in building schools, hospitals, and is very much involved in these activities around the world.\nHe is very much loved by the community and we are trying to help him in any way possible as he seems to need some dental work done. He lost 2 of his upper teeth (right side from his point of view). Unfortunately he doesn't know how. He is a busy person and it seems he just noticed one day, he was missing two teeth which he says happened due to stress. He thinks he lost the teeth about 2-3 months ago.\n\nIs it very urgent for him to get at least those 2 teeth worked on? Is an infection very dangerous?\n\nCould you please provide an opinion on how you think it would be best to proceed, especially if you are a dentist.\n\nThank you ever so much and God bless you. hello: Here are some attachments hello: Thank you MattKW: It seems he had some x-rays taken. Why don't you ask the dentist who took them?" }, { "id": 94, "title": "Denervation issue", "dialogue": "spir.k: Hi to all. for a month now, I keep going to the dentist for the same issue, for . we haven't moved on to the permanent filling yet because days after the treatment I still have pain when chewing. the doctor doesn't give me a clear picture." }, { "id": 95, "title": "Do they put you to sleep for oral facial surgery?", "dialogue": "paulwatkins929: I will receive my first oral facial surgery by the end of this year. I don't know how the treatment is performed. Please tell me if the doctor puts the patient to sleep before the treatment. MattKW: Depends what you mean by facial surgery. Haven't you talked to your doctor?" }, { "id": 96, "title": "Bone grafting and implant placement performed at the same time or separately a few months apart ?", "dialogue": "dingdongbell: My LR molar #46 has been missing for many years. Now I plan to place a bone graft and a dental implant in its place. \n\nI am taking the drug methotrexate 7.5 mg every week. Does methotrexate affect bone graft healing adversely ? \n\nIf bone grafting and implant placement are performed at the same time, and methotrexate causes the bone graft to fail, my big investment on the implant will be lost. Can this implant be reused for another missing tooth #37 (extracted on 14/11/2022) that does not require bone graft ?\n\n On the other hand, if bone grafting and implant placement are performed separately a few months apart, the overall treatment time will be lengthened. Also, will two procedures cause more risks and more harm to the tissues than one procedure and cause unsatisfactory prognosis to the implant ? MattKW: Not many studies on methotrexate (MTX) and dental implants are available. I attach 2 articles: first one is specifically MTX in a small study using dogs; the second is a review of many articles in immunocompromised people and animals but not specifically MTX.\nOnce an implant has been used, the surface is contaminated and it cannot be reused.\nNot sure about separating the graft and implant. It would seem that if your MTX could be lowered as far as possible, then I would do it all in one op.\nAsk the dentist or whoever is doing your implant what they think. I would want someone with considerable knowledge in plant surgery like a periodontist or oral maxillo-facial surgeon, rather than a general dentist who might have more limited experience. dingdongbell: MattKW said:\n\n\n\n\nNot many studies on methotrexate (MTX) and dental implants are available. I attach 2 articles: first one is specifically MTX in a small study using dogs; the second is a review of many articles in immunocompromised people and animals but not specifically MTX.\nOnce an implant has been used, the surface is contaminated and it cannot be reused.\nNot sure about separating the graft and implant. It would seem that if your MTX could be lowered as far as possible, then I would do it all in one op.\nAsk the dentist or whoever is doing your implant what they think. I would want someone with considerable knowledge in plant surgery like a periodontist or oral maxillo-facial surgeon, rather than a general dentist who might have more limited experience.\n\n\nClick to expand...\n\n\nThank you very much for your reply and the two articles with important points highlighted. \n\nI thought about separating bone graft and implant because I was worried that if the two were done in the same operation and the bone graft subsequently failed, I would have to pay for the implant as well. I just mentioned this to my dentist and he told me that in such a case, I would only have to pay for the bone graft and I would be refunded for the implant. He also talked about the disadvantages in having two operations and he recommended one operation.\n\nI am already on a low dose of methotrexate. I don't know whether it can be lowered, but I will discuss this with my doctor.\n\nThanks again. It is good to have you on this forum. You have helped many people." }, { "id": 97, "title": "Double crown on 2 X Implants fell out. How long can I use Fixodent for?", "dialogue": "colink: Lower molar double crown on 2 X implants fell out.\n\nCurrently secured with Fixodent. I tried to remove with fingers to clean gum and implants but cannot pull it out, I am sure I can remove it with some implement.\n\nClearly removing it every day until a permanent repair will not be practical. I would assume the Fixodent is making a very good seal between crown, implants and gum.\n\nHow frequently should I remove this for cleaning?\n\nAre there any negatives in not having it glued in permanently - ie if I wait months before getting back to my own dentist?\n\nLeaving it out is not an option. Tried for 2 days and it was a magnet for my tongue, ended up with a sore tongue. MattKW: I think every 3 days would be a good idea." }, { "id": 98, "title": "5 weeks post #2 extraction", "dialogue": "Annino1219: Hi all - my saga continues. 5 weeks ago I had my #2 upper second molar extracted. Recovery seemed fine. No dry socket or anything like that. Stitches seemed to fall out around weeks 3-4. \n\nNow what I’m feeling is what I can describe as a pressure type sensation in the gums area. Anyone know what this is? I plan to see the surgeon to talk about it but he’s probably going to say all is healing normally. It almost feels as though there’s food stuck in the hole and I need to pull it out haha\n\nThe extraction site is totally pink with a bit of an indent still." }, { "id": 99, "title": "Extraction with or without bone graft?", "dialogue": "JamesH: I need to have my upper-left first molar (UL6) extracted, as due to a cracked root the tooth is unrestorable.\n\nAfter the extraction, I’m considering getting an implant or I may get some orthodontic treatment first to straighten my front teeth and possibly see whether the extraction gap can be closed orthodontically. Or I may just leave a gap if I can get used to it, but I'd like to keep the option of an implant open.\n\nI’ve seen a specialist who feels I’m likely to be a good candidate for an implant; a CBCT scan shows there is ‘extensive external root resorption affecting both the palatal aspect of the crown and most of the palatal root’ of the cracked first molar, but apparently this isn’t in the more central area where an implant would be placed.\n\nIn case they’re of use…\n\nA CBCT image of the area: https://photos.app.goo.gl/66pfKEmQrWLmVKFx9\n\nAn OPG x-ray: https://photos.app.goo.gl/2EFikk5wexSMc9Ho6\n\nI’ve been offered the option of a graft in the socket at the time of extraction. The specialist says this may help preserve the bone and gum volume, making me slightly less likely to require a bone graft if I decide to get an implant (still thinking about that). And also that I may have a slightly better final aesthetic outcome due to less tissue shrinkage. The graft would be with Bio-Oss (artificial bone made from bovine/cattle bone, which apparently is widely used). He's made clear, however, that I'd need a CBCT scan a few months after the extraction to assess the amount of bone, and that there's no guarantee that a graft done with the extraction would save me from getting a graft later.\n\nI wonder if any dentists could share whether they’ve found a bone graft at the time of extraction (called a ‘socket preservation’ graft I think) to be of value and provide better outcomes?\n\nI’m happy to pay the money if it is worth it, but the benefits seem a bit vague, plus I’ve found some seemingly reputable sources online that suggest maybe it’s not such a good idea. This one for example: https://www.nature.com/articles/s41415-022-4967-2\n\nMany thanks for any input/thoughts/suggestions." }, { "id": 100, "title": "Single wisdom tooth extraction - and pushy NHS referral", "dialogue": "dms84: About 6 weeks ago a lost a chunk of my upper right wisdom tooth. It cracked a few years ago and my dentist did their best to repair it but always expected it to go again. They attempted to repair it again but after drilling away all the decay there wasn't much of the top of the tooth left. They applied what they described as as a \"temporary dressing\" and took an xray to decide whether to refer me to a specialist for extraction. The dentist told me it may be a difficult extraction due to the roots and there may be complications with my sinuses.\n\nNext I know is I get a rather pushy letter from a dental surgeon offering to extract the tooth for free on the NHS (not sure how UK-focused this forum is so realise not everyone will be able to help with the NHS bit). I say pushy because the letter says that normal NHS referrals can take up to a year but they can see me in 2 weeks and it's completely free of charge. I can't help but find this a bit suspicious because why doesn't the NHS refer more people their way if they 're so quiet?\n\nSo general dental question is whether extraction is the best/only option? I've had absolutely no trouble with it in the last 6 weeks and do I need to subject myself to the potentially difficult extraction and risk of sinus implications? I don't mind paying more money if there's a better option available.\n\nAnd UK-specific question is whether there's anything dodgy going on with this referral? I always like a bargain but I'm not short of money. I'd rather pay a private dentist myself if it will result in a better result. It occurred to me that maybe they use trainees or something? Or perhaps they just think it's an easy job but might not end well if things get complicated.\n\nMany thanks in advance for any help with either of the above questions. MattKW: Most upper wisdom teeth are surprisingly quite easy, and the risk of sinus complications small. But some dentists don't like to do them because it is hard to see what you're doing - it is largely by feel. If you have an Xray or two, put them up and I'll be more sure.\n\nIt is very rare that I advise people keep their wisdom teeth. Usually they are hard to clean, and patients either get decay or infections.\nIt's easier to remove a fairly intact wisdom than a rotted one.\nEven worse is that plaque buildup between the wisdom and the next molar in front will cause decay in the adjacent tooth - now you have 2 damaged teeth, and maybe 2 extractions. \nIn the attached image this has occurred to both upper and lower 2nd molar teeth next to the wisdoms (yellow arrows). So, both wisdoms have to be removed PLUS the lower 2nd molar; the upper 2nd molar can be filled but it's going to be very difficult." }, { "id": 101, "title": "Old root canal removal", "dialogue": "bill d: I need a root from a root canal that failed removed, a front tooth, is this a complex job? thank you. MattKW: Depends why it failed. Any Xrays to show us? bill d: sorry, I do not have any X rays. The tooth and the post just came out in one piece. Thank you for the reply. nolenjames30: An old root canal removal refers to the process of removing a previously placed root canal filling and treatment." }, { "id": 102, "title": "Difficult tooth extraction", "dialogue": "Brand2k23: Hi, I have a concern regarding a tooth extraction that I had about 3 weeks ago before Christmas. Now the dentist couldn't actually take the full tooth out and instead she had to break the crown by splitting it apart and she's referred me to a oral surgeon because she couldn't remove the root of the tooth but she still charged me for half the job? I currently am awaiting to be seen in 2 days time by the oral surgeon but would only be a consultation as I'm not registered with them as it was a referral. I have quoted how much for the tooth extraction will be from him and the receptionist said it all depends on how difficult the tooth is and could cost upto £400, now I have a couple of questions which I am going to share with this dentist before any procedures happen. 1. Can an xray show if the teeth are going to be difficult? As the dentist I saw previously struggled and literally said after that she's never seen teeth like mine before....I'm not very confident with that statement to be honest. 2. Let's say the tooth extraction for only the root will cost \"0\" if the full tooth was there and the dentist previously didn't touch it would the extraction again still be \"0\"? Obviously the price wouldn't be 0 I'm just using for example. Because I don't feel comfortable being charged for half the job really. Final question, where I've been referred as an urgent case although it's been 3 weeks already and thankfully not been in pain or anything, can the oral surgeon maybe repair the tooth instead of removing it? Any advice would be appreciated. Dr M: Do you have any x-rays you can share? MattKW: Everything is 20/20 with hindsight. I have extracted ~15,000 teeth over my 40 years (prob average for a general dentist) and now I teach students how to extract. It is very difficult to teach/learn because despite assessing all likely factors - age, root shape, tooth integrity, ease of access, etc there will always be some surprises. \nIf I assess it will be horrendous, then I will refer the case to an OS for removal under general anaesthetic. Even so, I have also had to stop during a couple of planned surgical extractions and admit defeat, tidy up the wound, and refer. \nIn such cases I haven't charged the patient, but legally I would be entitled. As long as it wasn't a foolhardy attempt, e.g. didn't take pre-op Xrays, then it's simply bad luck, and they have done the right thing to relieve you of pain and to refer.\nI can't imagine that the OS would be able to repair the tooth. It was being extracted for a good reason, I assume. Brand2k23: MattKW said:\n\n\n\n\t\t\tEverything is 20/20 with hindsight. I have extracted ~15,000 teeth over my 40 years (prob average for a general dentist) and now I teach students how to extract. It is very difficult to teach/learn because despite assessing all likely factors - age, root shape, tooth integrity, ease of access, etc there will always be some surprises.\nIf I assess it will be horrendous, then I will refer the case to an OS for removal under general anaesthetic. Even so, I have also had to stop during a couple of planned surgical extractions and admit defeat, tidy up the wound, and refer.\nIn such cases I haven't charged the patient, but legally I would be entitled. As long as it wasn't a foolhardy attempt, e.g. didn't take pre-op Xrays, then it's simply bad luck, and they have done the right thing to relieve you of pain and to refer.\nI can't imagine that the OS would be able to repair the tooth. It was being extracted for a good reason, I assume.\n\t\t\nClick to expand...\n\nHi, I've recently seen the oral surgeon and he's booked me in for extraction of the remaining tooth/root that was left, I'm ganna be put out for it. As he's a higher up dentist than the one before and can surgically remove the remaining tooth..he will be able to finish the job? I'm a lil anxious where you said that you've surgically extracted teeth before but have had to stop between and admit defeat....this won't happen will it? I'm concerned for my teeth and the financial side as to get the tooth out it's cost almost £500. Well £85 from the first attempt and been quoted £400 from the oral surgeon. Brand2k23: Dr M said:\n\n\n\n\t\t\tDo you have any x-rays you can share?\n\t\t\nClick to expand...\n\nI don't unfortunately, will I be able to request an xray print out from the dentist do you know? Dr M: Yes you should be able to request a copy." }, { "id": 103, "title": "Tips for full extraction", "dialogue": "LimeInDeCoconut: I will be getting a full mouth extraction soon, and wondered what tips anyone might have to make recovery less scary.\nI've had single extractions, so I know about the salt water, no swishing or sucking, no smoking, take meds as prescribed, take it easy, etc. \nBut should I do anything like order extra gauze pieces, something topical for pain, are there any protectors that can make things feel less uncomfortable? How does one eat when their whole mouth is an open wound, basically?\nI'm not getting the interim dentures. \nThanks! Dr M: You will have to stick to soft foods initially. There is a high chance that food might get stuck in some of the sockets, leading to possible dry-sockets, but if you follow the post-op instructions, you should be fine. The pressure from the interim dentures, usually helps to stop the bleeding, so based on the amount of extractions that is being done, there might be some prolonged bleeding.\nOther than that, follow all the instructions given to you by the treating dentist/surgeon. MattKW: Have soft foods ready in the fridge - soups, noodles, pasta...\nMake sure you are sutured up - it surprises me that some dentists don't always do this.\nHave someone to be with you at home or available to call for at least the first 4 days. \nGet an after-hours tel number from the dentist. They should have a schedule to ring you the following day and thereafter.\nThe best painkillers nowadays are combination acetominophen and ibuprofen, e.g. \"Nuromol\", \"Maxigesic\". I will rarely give an extra 'script for an opiate, but only to be taken at night if necessary. Take a dose of \"Nuromol\" just before surgery, then take it every 6 hrs for the next 2 days, even if you are feeling better. Then change down to acetominophen if possible. NEVER exceed 4000mg (8 tabs) of acetominophen per day.\nExpect bruising. To minimise, have some cold packs ready at home or make your own with ice-cubes in a plastic bag. Always wrap in a cloth (face-washer) and apply for 20mins on, then 20mins off for 1st 24 hrs.\nDry sockets (DS) do not occur because the blood clot is dislodged by food or swishing - long disproven. The risk factors are: extractions of lower teeth, smoking, difficult extractions, contraceptive pill. If DS occurs, it will come on about 3-4 days post-op and be unresponsive to painkillers. The dentist should contact you at about this time to check in.\nSalt water is all very well as a mild antiseptic, but a 0.2% hlohexidine mouthwash, e.g. \"Savacol\" is much, much better. Start it 2 days before the extractions (twice daily) and keep up until you go back for a review (1 week?).\nIf you are well sutured, then bleeding shouldn't be a problem. For high risk (of bleeding) patients, a tranexamic acid mouthwash might be prescribed. A compounding pharmacist can make it up, or I just give patients the tabs with DIY instructions.\nGood luck helps a bit too!" }, { "id": 104, "title": "Third molar extraction complication", "dialogue": "nicholasl91: Hello everyone . I had my left lower third molar extracted in April 2022. I had a complication where Parts of my jaw bone broke snapped leaving sharps protrusion on the ridge below preventing the gum from healing. As a note the dentist that extracted the tooth wants nothing to do with recovery as it was an emergency referal ( this is unfortunately how it works in the UK at the moment due to a broken dentistry system) so I went to a separate private dentist. He tried to smoothen the bone but did not solve the problem and instead ended up removing bone and creating a bit of a trench slightly behind the area where the pain was occuring and was then a bit nervous to do any more smoothening due to concerns of hitting a nerve. Whilst the area he smoothened has since healed and is causing me minimum discomfort I have had chronic pain on my ridge for 8+ months now which is significantly interfering with my daily life. The gum is very thin and unable to heal properly and on touch the ridge is very pointy and sharp. The dentist who tried to help me seems to think I should just learn to live with the pain which seems a bit ridiculous and very depressing prognosis to me. Having reviewed the few pieces of literature available on this topic which appears to be a rare complication called lingual bone dehiscence I believe it should be possible to address the problem by simply smoothening the ridge but in the correct location and by an experienced oral surgeon. On another matter I still have a feeling of trama in the extraction point and surrounding teeth and there are bones sticking out the gum in the extraction site which based on literature is not normal 8+ months after surgery. The gum above the site is also constantly sore. I'm not sure if this is due to me having a bone spicule still trapped inside or my upper molar also being impacted. I will try and upload a picture of the site below. I'm seeing a face surgeon next month for an initial consultation which I'm praying will have some positive options but there are incredibly long waiting times now in the UK before national health service operations can be carried out so I am thinking of consulting with a different private dentist to see if they can resolve the problem sooner. Given the big cost of private dentists I was hoping\n somebody had any thoughts on the issue and whether this is something a good dentist firm should be able to help with and that I've just been unlucky. I will try and post a current picture of the site below. Regards NL nicholasl91: MattKW: Firstly, tooth numbering: the wisdom tooth was the 38, and the one in front is the 37 (FDI).\n\nI doubt that you have pointy bones sticking thru the gums, that looks more like scar tissue from your photo. Similarly, if there was any spicule remaining, it would have either come to the surface by now, or created a small infection. \nTrying to smooth the bone where you have arrowed is a strong risk for lingual nerve damage, and it would be useful to have notes that describe how he went about this issue. I doubt that the nerve has been badly damaged, or you would have a numb tongue on that side.\nThere is also a nerve in the area distally where you have labelled \"chronic sore gum\", the long buccal nerve. Again, how the operation was performed and the types of incisions may explain your problems. \nThere is also the risk that the 37 was damaged either by the 38 before the extraction, or during the extraction.\nI would ask the treating dentist for records of the extraction, including any Xrays, so that you can take them to the OS for review. nicholasl91: MattKW said:\n\n\n\n\t\t\tFirstly, tooth numbering: the wisdom tooth was the 38, and the one in front is the 37 (FDI).\n\nI doubt that you have pointy bones sticking thru the gums, that looks more like scar tissue from your photo. Similarly, if there was any spicule remaining, it would have either come to the surface by now, or created a small infection.\nTrying to smooth the bone where you have arrowed is a strong risk for lingual nerve damage, and it would be useful to have notes that describe how he went about this issue. I doubt that the nerve has been badly damaged, or you would have a numb tongue on that side.\nThere is also a nerve in the area distally where you have labelled \"chronic sore gum\", the long buccal nerve. Again, how the operation was performed and the types of incisions may explain your problems.\nThere is also the risk that the 37 was damaged either by the 38 before the extraction, or during the extraction.\nI would ask the treating dentist for records of the extraction, including any Xrays, so that you can take them to the OS for review.\n\nClick to expand...\n\nThank you. Your advice is incredibly appreciated. Under point 1 it is hard to get a camera at the correct angle but I can literally pick at the bone with a finger. It's hidden behind 37. I hope with Your point 2 that the bone pointing to the ridge does also not present the same nerve ridge. Thanks Again" }, { "id": 105, "title": "Impacted Canine - Exposure - Chain", "dialogue": "cw/braces: Hello everybody,\n\nI have an impacted canine and I fitted clear fixed braces in July 2021. \n\nAfter creating space between teeth with a coil spring, I had surgery to expose my palatally impacted canine in June 2022. It was a closed exposure with bonding of a chain for orthodontic traction. \n\nOn June 10th 2022, I had an online video call and consultation with the surgeon and we talked about the closed exposure and the gold chain. This was my first surgery in life ever. To me it was quite a big deal as I work with my voice, and I told this and made it clear to the surgeon who said I was in ‘good hands’. \n\nThe day of the surgery I was asked to sign an electronic consent form at the clinic, but in the consent form there was written ‘extraction’. I made sure to tell them, and that I wrote next to my signature the word ‘exposure’ before signing. The surgeon also told me not to worry as we discussed about the exposure and that was going to happen. \n\nThe surgery happened, it went well, and I went back home.\n\nAfter a couple of days I started checking my palate and the stitches, and I noticed that the chain didn’t have any loops and it was wrapped around the arch wire with composite. So I started to get suspicious as it didn’t look like the gold chains that always appear online if you just google ‘braces traction chain’. \n\nI went to my next orthodontic appointment on July 7th and as soon as my orthodontist saw me she started to tense saying that there was something wrong with the chain. She went to reception to call the surgeon (I could see her from the cameras in the room that she was quite agitated). She came back after several minutes. She didn’t say much about the chain, just that it was not the right one as it didn’t have any loops and it was difficult for her to tie it and use the traction force as she had never worked with a chain like that before for the traction of the canine. She also said about the chance of having another surgery to replace the chain, but in the meantime she managed to do something using an elastic power chain and she wrapped the chain with composite around the arch wire where I have a coil spring to keep the space open for the canine (picture attached as a reference) and I went home.\n\nNobody told me anything about what was wrong with the chain, but after some online research I found out by myself that what the surgeon attached to my impacted canine during the closed exposure surgery was a retainer. Yes, a fixed retainer wire. I asked the orthodontist and she confirmed. \n\nIn the meantime my orthodontist was no longer available until the end of August due to her being on holiday and I had to have an emergency appointment with the principal dentist who wrapped again the chain around the arch wire as the composite worn down. I started to complain about the situation because I wanted to know more about what happened, but the principal dentist said that as soon as the orthodontist would be back they would have had a meeting with herself, the surgeon and the orthodontist. \n\nSummer went by for me with a huge sense of injustice.\n\nEnd of August I received an email by them saying they had a joint meeting with all staff involved, and would like to offer me a face to face meeting with the surgeon to discuss this with me in person.\n\nDuring my in-person meeting at the beginning of September the surgeon told me that (below there’s an extract from an email they sent me with the summary of the meeting we had):\n“As we discussed, prior to the day of your surgery, I was aware that your procedure was for an “expose and bond”, and this was all checked on the morning of your surgical procedure also. However, due to a miscommunication between myself and the nurse, I had assumed that the gold chain was in the box that he had showed me. As this is a common procedure that I perform in a hospital setting, I had assumed that the same equipment would be available. However, once the tooth was exposed, the nurse handed me an orthodontic wire that I had incorrectly assumed was the material the practice uses, and it was only when I spoke to your Orthodontist after your appointment with her that I realised that this was not the case.”\n\nHe told me in person that it was also due to the fact that the clinic didn’t have an ‘exposure’ option to tick in their booking system, and they only had ‘extraction’ so the nurse probably didn’t know what was needed for the ‘exposure’. And thanks to this, they have made sure that now in the system there is an ‘exposure’ option with all the details. So it’s basically nobody’s fault?! But I am left with the suffering.\n\nOn January 18th 2023 I will have an OPG to see the position of the canine at the moment - I feel it moved but I need the confirmation from the OPG. My question to you all is: with all your knowledge/experience would you advise me to have the second surgery so they change the chain and the traction could go faster? And if so, would you advise an open or closed exposure at this point? Or would you advise me to wait? Has something similar ever happened to anybody?\n\nI am not very keen on having a second surgery as I feel it was quite traumatic for me what happened and also the fact that I work with my voice makes everything since the surgery and the wrong chain quite challenging, plus I will have to take some downtime again. I am currently wearing also two buttons on the inside part of the left upper arch as one tooth started shifting due to the power chain she applied - the retainer chain with the composite is continuously rubbing against my inner lip and it hurts as being a fixed retainer is not supposed to be bent/wrapped. \n\nSorry for publishing this as anonymous (cw/braces) but I am still very sensitive and suffering about this, as I kept it quite until today with everyone. This situation is kind of taking a tool on me, weakening me both from a mental and physical viewpoint as I feel a huge sense of injustice and I don't know how to solve this in the best way possible by myself. The only positive thing from this is that hopefully what happened to me won’t happen to anybody else at that clinic.\n\nThank you so much for reading and for your time in advance, I hope I explained everything right. \n\nC x MattKW: Unfortunately, you'll have to do the surgery again. I've never seen a wire used for extrusion. Ideally, the surgeon should've checked the referral from the ortho or rung the ortho rather than blaming it on his nurse if he was unsure. Rather than you talk directly to the surgeon, politely ask the ortho if they would talk to him about redoing it at no fee. I think the ortho will apply the correct pressure to the OS as the OS could otherwise lose further referrals from the ortho, and word spreads easily. I've changed surgeons and endodontists for my patients when they didn't treat my patients properly. The referrals are like an extension of my own treatment." }, { "id": 106, "title": "Can you get jaw surgery (bimax) with an all-on-4/6 dental implant?", "dialogue": "Attire5515: If you've already got an all-on-4 dental implant or all-on-6 dental implant both in the upper and lower teeth, can you still get jaw surgery aka double jaw surgery aka bimax later to correct jaw recession?" }, { "id": 107, "title": "Which implant is this?", "dialogue": "asvplanet: Hello! I was hoping somebody could be so kind as to help me figure out which implant brand I have by looking at this x-ray. Unfortunately, the dentist that made this procedure with won’t reply to me and he’s located in another country. I still have to finish putting the fake tooth but the dentist where I’m currently located couldn’t make out which implant brand I have and thus he can’t place the fake tooth. Please, it would help me a great deal even if it is a guess… that way I can tell the dentist here. \nThank you very much for your time. MattKW: Your dentist could try this website. Even if he manages to identify it, then you might have to buy the instruments he will need to place the crown, if you can source them. You'd be better off going back to the dentist in the other country. Poor Xray, but looks as if implant goes well into the sinus." }, { "id": 108, "title": "Extraction and status of wisdom teeth", "dialogue": "Julius: Helo,\nI turn to you to kindly have some clarification, given my confusion. English isn't my native language, hope you'll understand.\nI suffer from a problem of halitosis located in the area (lower arch) between the impacted wisdom teeth and the last molars. Every time I brush and floss there, I notice that there are residues of food, but even after cleaning the pungent smell remains.\nI have made several visits and received mixed opinions.\nBasically, there are those who have told me that the included wisdom teeth are decayed, while others have not seen anything; only one person has told me that they are decayed and a cyst is also present near one of them.\n\nYou can well understand that I find it difficult to entrust myself to someone without knowing if there is actually a cyst, or if reaches some conclusions only thanks to my indications, which sounds decidedly not reassuring.\nCan anyone give me some confirmation?\n\nAlso I would kindly need another clarification: with the extraction I have been told that there is a risk of damaging the nerve and losing sensation in the jaw and lip. Are there any ways or technologies to avoid this risk?\n\nI fully understand that it is not easy to make an accurate analysis from here. I attach the foto of Ortopanoramic and some frames of the Cone beam which I hope I photographed well.\n\nThank you in advance! nikroute: Your all 4 wisdom needs to be extracted surgically. I think image is not so clear here , Your cyst is at left side . Your case should be handled by a expert surgeon . Your upper wisdom teeths needs bone grafting along with Extraction" }, { "id": 109, "title": "Infection while on antibiotics after extraction?", "dialogue": "Joee: TL;DR: Was on antibiotics for a couple weeks (at least) before extraction and continue them after extraction. Is it normal to have a flare up of infection symptoms while on the antibiotics right after the tooth is removed? First day after extraction was better, second day after extraction has swollen gums and lymph nodes. My be normal? More detail below.\n\nI had the last molar on the bottom right before the wisdom tooth removed Thursday. It was infected for probably a month (probably longer) before it was finally extracted and I was on antibiotics for the last 2 weeks of that time right before the extraction. They went ahead and extracted it because the antibiotics just weren't taking the infection away. Dr said he could see infection coming out as he was extracting.\n\nI'm now on a new round of Amoxicillin 500mg 4x day. Today is the second day after the extraction (not counting the day it was extracted). On the first day after extraction, I felt a lot better, with the lymph nodes calming down and the pain going away and just not feeling sick from infection. Today, day 2 after extraction,, my gums are now very swollen and tender around the extraction site and my lymph nodes are pretty sore and swollen. It's pretty apparent that there is infection there, probably left over.\n\nSo my question is, does it sound normal to have an improvement like I did on the first day after extraction, and then a flair up of pain and infection symptoms the very next day, even though I'm on antibiotics and had taken them for a while before the tooth was even extracted, or is something wrong? I had kind of figured that since I had the antibiotics built up in my system, once the source of the infection was removed (that poor tooth), the remaining infection would just kind of fizzle out. This seems more like an actual active infection that's being fought and coming to a head and such. Dr M: Do you have any x-rays or such to give us an idea of how large the infection was prior to extraction? How are the rest of your teeth looking? Could be something else entirely contributing to the infection not clearing up. Did you consider that maybe you have a dry socket, which is common 3-5 days after an extraction? Joee: Unfortunately I don't have the x-rays/didn't see them but for second. I do believe it was rather infected though. I'm day 4 post extraction and it's still very sore, but there are signs that the infection is starting to go away. I think it was just a very big infection and that the tooth was contributing significantly, not allowing any of it to clear up while it was present. I'll update the post later on so others get an idea of what's possible when it comes to infections. Thank you for your reply!\n\nIt doesn't appear to be a dry socket. It started out like it should: a red jelly like clot in the socket that eventually filled up to gum level. After a day or so, it's changed to various shades of a white-ish substance that is covering the wound. Hopefully this is the good stuff I've read about there made of blood vessels and such, and not just puss and food particles and doesn't count as protection against dry socket." }, { "id": 110, "title": "Is this a piece of bone fragment in socket?", "dialogue": "Annino1219: 3 weeks post op. No significant pain but some discomfort each day Annino1219: Reporting back that yes it was a long fragment of something. Don’t think it was graft since those are short and round like sand Dr M: Since this is a molar, most likely it could be part of the interradicular bone situated between the roots of the tooth. As healing progresses, it is broken down and resorbed." }, { "id": 111, "title": "3 weeks extraction bone graft feels sore", "dialogue": "Yolyj: The extraction site is filling in with new tissue but is lumpy looking and a little sore today is that normal ? Annino1219: Yolyj said:\n\n\n\n\t\t\tThe extraction site is filling in with new tissue but is lumpy looking and a little sore today is that normal ?\n\t\t\nClick to expand...\n\nHey there. Same here. This Monday will be 3 weeks post op for me. My extraction site feels really weird. If I jump around or get my blood pressure up I can feel it. It looks to be filling in with little tiny red bubbles. So frustrating but I guess normal?? Yolyj: I guess it’s normal but still annoying" }, { "id": 112, "title": "Crown placement", "dialogue": "Patsyp: Will my 2nd right molar teeth shift into open space that I already have a implant placed for my premolar.? I still have my upper braces on but not on my upper 2nd molar right molar cause I had the bracket taken out to put a crown on it 2 month ago,I’ll be getting the abutment and crown in a week time I’m just worried that it might tilt forward. Do you think the space I have is good I’m just very nervous my dentist said everything looks good what do you think.? Dr M: Good day\n\nWhen do you plan on placing the implant crown? Everything should be fine. It takes a while before the teeth shift to close a large gap like that. Patsyp: Dr M said:\n\n\n\n\t\t\tGood day\n\nWhen do you plan on placing the implant crown? Everything should be fine. It takes a while before the teeth shift to close a large gap like that.\n\t\t\nClick to expand...\n\nNext week Monday than I will have to wait another 2 weeks for crown placement. Dr M: Should not be a problem" }, { "id": 113, "title": "**Wisdom tooth non-impacted extracted today the hole looks like there is a piece of bone or two sticking out 12 hours after", "dialogue": "Lovelolalove: Wisdom tooth non-impacted extracted today the hole looks like there is a piece of bone or tooth sticking out 12 hours after. What is this and does it look like I have a blood clot or could I get a dry socket? I sneezed really hard a few hours ago so this is why I looked and found this. Sinus problems: It is normal, i had my tooth extracted in August and these white masses are fluids of the inflammation, it is nothing to worry about. Typically the whole area will get swollen in the next 2 days and then deflate, these will disappear in a month time, i remember i could see some of these white fluid patches till 20 days post extraction till they unified with the gum," }, { "id": 114, "title": "Help! Is this healing ok? discomfort after 14 days.", "dialogue": "Annino1219: Got my molar extracted 14 days ago. The past 3 days the comfort level has improved day by day. Then this morning I woke up with discomfort and all day it’s been a nagging discomfort. I’m feeling very discouraged Dr M: The area looks inflamed. I would suggest going to your dentist for a consult. Depending on the pain level, he might only need to prescribe you some anti-inflammatory meds Annino1219: Dr M said:\n\n\n\n\t\t\tThe area looks inflamed. I would suggest going to your dentist for a consult. Depending on the pain level, he might only need to prescribe you some anti-inflammatory meds\n\t\t\nClick to expand...\n\nI went back to him and he cleaned that white gunk out with a q tip. Now inside the socket is sort of a white layer but the discomfort is still there, though to a lesser degree. I’m 16 days post op. Had an extraction and bone graft. Annino1219: Annino1219 said:\n\n\n\n\t\t\tI went back to him and he cleaned that white gunk out with a q tip. Now inside the socket is sort of a white layer but the discomfort is still there, though to a lesser degree. I’m 16 days post op. Had an extraction and bone graft.\n\t\t\nClick to expand...\n\nHe said it just needs to heal longer and that there’s no infection" }, { "id": 115, "title": "17 days past extraction and graft", "dialogue": "Yolyj: My extraction site has white and red lumps in it and every time I drink or eat it feels loose in the socket is that normal healing ?" }, { "id": 116, "title": "Temple pain and jaw pain", "dialogue": "Yolyj: My dentist said I do not have dry socket today however I have check and temple pain mild right now it’s been 12 days since extraction and graft is that normal ? Dr M: If it is only mild pain, the chances are that it is only surgical pain. I would give it time Yolyj: Today marks 14 days post extraction and bone graft , my cheek is sore and gums above extraction a tad sore . The socket is whitish with red dots is this normal I just get scared as my dentist isn’t open only 3 days a week Annino1219: Yolyj said:\n\n\n\n\t\t\tToday marks 14 days post extraction and bone graft , my cheek is sore and gums above extraction a tad sore . The socket is whitish with red dots is this normal I just get scared as my dentist isn’t open only 3 days a week\n\t\t\nClick to expand...\n\nI’m 11 days post op and have white in my socket. Still some discomfort. I noticed some of the white goes away when I rinse. Doc yesterday told me everything is healing normally. I take Motrin for discomfort Yolyj: Thank you I think we’re past the dry socket stage thank God! Annino1219: Yolyj said:\n\n\n\n\t\t\tThank you I think we’re past the dry socket stage thank God!\n\t\t\nClick to expand...\n\nDo your gums throb a little? Almost like when a wound is healing Yolyj: Annino1219 said:\n\n\n\n\t\t\tDo your gums throb a little? Almost like when a wound is healing\n\t\t\nClick to expand...\n\nNo it’s more the guns above it and tooth near it" }, { "id": 117, "title": "7 days since molar extraction", "dialogue": "Annino1219: Got #31 extracted 7 days ago. The past couple of days the pain seemed to decrease little by little. Last night I had a dull ache all night and day. Not excruciating but annoying. Canker sores too. I have non dissolvable stitches in\n\nIs this normal?! Dr M: Everything looks like it is progressing normally" }, { "id": 118, "title": "8 days extraction with graft is this normal healing?", "dialogue": "Yolyj: This is day 8 dr said it’s not healing to quickly but I still get mild pain is this normal does it look normal? Can I stop being paranoid over dry socket yet ? Dr M: A dry socket would have been accompanied by severe pain and usually occurs 4-5 days after an extraction. If the pain is only mild, I would suggest stop worrying and allow normal healing to take its course. Yolyj: Thank you so much !" }, { "id": 119, "title": "Day 3 Post Op - #31 extraction and graft", "dialogue": "Annino1219: Hello!\n\nOn Monday (11/7) I got my #31 molar extracted and a bone graft by an oral surgeon. The surgeon used non-dissolvable stitches. \n\nOn Tuesday I woke up in a little bit of pain but was able to go to work and manage OK. \n\nTuesday night I woke up a couple of times in a bit of pain, took some meds, applied ice, and went back to sleep. I was largely OK Wednesday. \n\nWednesday night (last night) I woke up with pretty bad pain in the area. I took ibuprofen as well as Tylenol Codeine (first time I took it). The pain can be described as a gnawing/ raw type pain. I have been diligent with my diet, no slurping spitting or anything like that, chewing on the other side, and doing salt water rinses every 2-3 hours. \n\nNow I would describe the discomfort as the stitches pulling and when I drink water it feels like there is a cut (because there is!). \n\nIs this normal to be experiencing this 3 days post op? Dr M: Good day\n\nAlthough post-op pain is normal, the pain should gradually decrease in intensity. What you are describing, could be related to a possible dry socket. This is quite common with bottom molar extractions and usually occurs 3-5 days after an extraction. I would suggest going to see your surgeon for a follow-up visit. Annino1219: Thank you sir! Not to jinx myself, but the pain has subsided and I’ve gotten more comfortable!" }, { "id": 120, "title": "Had an extraction 72 hours ago upper jaw with bone graft does this look normal", "dialogue": "Yolyj: nikroute: Atleast 12 days wait . Than ask about is it looks normal Yolyj: Ok just read dry socket doesn’t happen that late nikroute: Yolyj said:\n\n\n\n\t\t\tOk just read dry socket doesn’t happen that late\n\t\t\nClick to expand...\n\nThere are cases where Dry socket appears months later . Don't Google anything specialy medicine and health issues \n\nGoogle always wrong about disease symtoms and it's treatment\n\nWhat we see is symtoms but what doctor looks for is SIGN Yolyj: Very true , I have no pain and going to have it checked tomorrow I just get anxiety worrying" }, { "id": 121, "title": "Growing Mass on Hard Palate Behind Incisors", "dialogue": "KLAR: This mass has slowly grown larger over the past few months. The piece of metal seen is a permanent retainer. I have been on antibiotics for a while for a separate reason, but the fact it has not changed makes me think it is not due to infection. Any ideas what could be causing this? Dr M: Good day\n\nThis could be a fibrous epulis. This is a growth on the gum, most likely due to plaque or calculus on the teeth related to the retainer, which causes inflammation and growth of tissue. To treat this, the lesion would need to be excised, and then proper oral hygiene should be emphasized. The lesion can recur. If it returns and the retainer makes if difficult to maintain proper oral hygiene, I would recommend removing the fixed retainer and replacing it with a removable retainer that you wear at night. KLAR: Dr M said:\n\n\n\n\t\t\tGood day\n\nThis could be a fibrous epulis. This is a growth on the gum, most likely due to plaque or calculus on the teeth related to the retainer, which causes inflammation and growth of tissue. To treat this, the lesion would need to be excised, and then proper oral hygiene should be emphasized. The lesion can recur. If it returns and the retainer makes if difficult to maintain proper oral hygiene, I would recommend removing the fixed retainer and replacing it with a removable retainer that you wear at night.\n\t\t\nClick to expand...\n\nThis is the updated picture taken last night (one week apart from the originally posted photo.) The anterior portion of the mass is no longer attached to the hard palate and is able to be pulled back. Appointment with the oral surgeon is not until 12/06 and I am concerned with it’s rapidly increasing size. Dr M: This is still normal characteristics for a fibrous epulis." }, { "id": 122, "title": "Horrible Tooth Extraction", "dialogue": "jasonp82: Hi everyone,\nI'm new here as I'm freaking out regarding a tooth extraction I had last Wednesday, the 19th. It was determined I needed a 3rd molar removed that never came through the gums. There was also a wisdom tooth sideways, possibly wedged against it but very close to it nonetheless. I had a consultation at the oral surgeon and screened them quite extensively as I've never had anything like this done before (have all my wisdom teeth other than this one that was extracted). They did a full mouth xay and it was noted they would need to break my wisdom tooth up as it was right with a nerve that ran along my lower jaw. I had some odd requests - I wanted to be awake, and I also required an anesthetic that did not have ephinephrine (not really related, but just putting everything out there)\n\nThe extraction, according to the doctor, was quite difficult. It took about 45 minutes. Obviously, I was awake. The doctor told me \"no one in the country had it worse than you did today\". They told me I'd be quite sore for several days and I was given five prescriptions. \n\nWhen I got home, I thought they must have really given me a lot of anesthetic, because I was still partially numb in my lower left lip area. That's something that has never gone away. I still have only partial feeling there a week later. A week later, I still have horrible pain that I can trace back to the hole that is still healing, but it also seems to be really bad in the lower lip and radiates on the left side of my face as high as my temple and ear. I have been able to hear my heart beating in my left ear since the operation when the pain is present. My teeth and gums seem to hurt at times.\n\nToday, for the first time, I was able to drink something without severe pain. The bouts of severe pain seem to come and go - days have been okay the last two days, night times have been very painful. When I went back for follow up yesterday, they took a look at it and said it looked like it was healing well and offered to put a plastic-looking piece in the hole but said it wasn't absolutely necessary, but I'd have to come back...and with my job, I didn't want to have to go back so I declined. \n\nIt was also mentioned that I likely have some nerve damage/irritation, which is still in the unknown right now given I still don't have complete sensation in my lower lip. They did some pricking, and I can feel everything, but it's just a really distorted feel. My lip was extremely bruised and injured when I left there and remains this way...and this is where the numbness is as well. My jaw (understandbly) is still very sore, and I cannot open my mouth very far. My throat is also bruised as they were pressing down trying to give me \"chin support\". \n\nThis is just not what I expected. While I am hoping that everything resolves once I am all healed up, I am worried to death... Has anyone ever dealt with this? Sometimes the pain is so great, I can't even tell if it's coming from my mouth or not. I can only assume it is though...\n\nI am just frustrated as it appeared during the consultation and required extra x-ray, there was a plan in place...but I noticed the x-ray was not pulled up until half way through the process when complications were evident. I'm just praying this is just slow healing from a bad procedure and it's nothing more... Dr M: Good day\n\nWith a difficult extraction, especially a lower tooth, there is a higher chance of dry socket formation. I am sure that the oral surgeon should have mentioned the risks of dry socket formation to you, prior to the extraction. Usually for a dry socket, you need to to back to the surgeon, so that the area can be cleaned out.\nThe partial numbness could be because of 2 reasons.\n1) If the molar was indeed close to the inferior alveolar nerve, the nerve could have sustained \" bruising \" or damage, due to the extraction process. This is a common risk. It takes time for the feeling to return, Sometimes it takes a few weeks, sometimes a few months.\n2) Alveolitis or infection of the socket, could lead to partial loss of feeling in the area, until the infection is cleared.\n\nMy advice would be to go back to the surgeon for a follow-up visit. jasonp82: Hi there Dr M. I did actually go back for a follow up visit on Tuesday. They said it appears to be healing well and offered to put a plastic-looking thing in the hole, but said I would need to come back and said it wasn't absolutely necessary. I declined. I was glad to hear it was healing well at least. They did clean it out. Though they said the symptoms of tinnitis, and pain in the ear on the left side, etc were not normal, they said I should come back in a month. So I guess it's kind of wait and see as of right now. I just hadn't ever spoken to anyone who dealt with symptoms quite like this before. Dr M: Sometimes patience is all that is required. Our bodies can sometimes heal quite nicely by itself. jasonp82: I hope you are right! I have figured out where the numbness-lack of sensation is. It is definitely the mental nerve. Dr M: Most likely it is the inferior alveolar nerve, especially when it was injured during a 3rd molar extraction. The inferior alveolar nerve does also supply the lip on the associated side. jasonp82: Thank you so much for the information. I know it's just basically a watch and wait game at this point as I am still healing. As I mentioned, the procedure was not easy (their words). Is it normal to still be in pain? I still have two healing holes in my mouth, from each tooth. So I can see why I'm still in pain, and I believe I won't be eventually but it will be 2 weeks since the operation in a couple of days. When I went back before, they offered to put a plastic-like piece in one of the holes but advised it wasn't 'required'. It just seems like everyone else I've known was not in pain after a few days! I am going to try to attach a photo... I hope it's not too scary. On the right side, there is a \"crack\" in my gums...this leads to hole #1, which was one of the teeth extracted under the gums. The other hole is obviously the wisdom tooth." }, { "id": 123, "title": "Weird lump after wisdom tooth removal", "dialogue": "onimal: I'm on day 6 after removing impacted wisdom tooth. Everything feels fine, swelling on the cheek is almost gone. Don't feel pain for most of the time and if i do its 3/10 pain. However, after my tightness went away i notice weird lump nect to the stitches. Can someone help me indentify it? After tooth removal i got antibiotics and mouthwash from pharmacy to use after surgery. I don't think lump causes any pain, it's annoying becasue keep biting on it when trying to fully close my mouth as it gets on thr way between teeth. Dr M: Good day\n\nThis is nothing to worry about. Sometimes the tissue forms a \"knot or lump\" due to the stitches. Over time this will disappear as healing progresses." }, { "id": 124, "title": "Help me identify the issue", "dialogue": "cfrost: Please if someone could tell me identify the problem of my jaw, that would be really helpful. Personally, what i see is a huge assymetry between the right and left side of jaw, but is it normal or is surgery needed? Is the chin the issue? I should note that I had braces a few years ago to close the gaps between my teeth, but as soon as i took them off they started to shift again.. even with night guards. I have a narrow palate, mild open bite and mouth protrusion (the protrusion was bigger before the braces). Im very sorry for these weird pictures, but i want to be as clear as possible. Dr M: Good day\n\nIt seems like both images are of the same side of the jaw. What exactly is your problem? Are you worried about your teeth shifting again? What did the orthodontist say regarding your wisdom teeth? Was jaw surgery part of your original treatment plan?\nToo many unknowns to give an opinion here cfrost: Greetings Dr M. Thank you for your answer.\n\nThis is a panoramic xray as I don't have a cephalometric one. First pic shows the right side and second pic the left one. I turnt both pictures in the same direction, because I thought I would make it more clear. The left side (second picture) looks longer and \"curvier\" than the right side and I cannot tell if both sides of jaws are normal or not. I feel as if my jaw is \"hanging\". In other words, it goes downwards.\n\nI want to know if the protrusion and mild open bite is caused by the jaw (the issue is skeletal) or if the issue is only dental and my jaw is normal.\n\nI had visited a maxillofacial surgeon a few months ago.. He told me to seek an ortho and to have my wisdom teeth removed. He said that looking at bites is not his specialty. He refused to check my jaw..\n\nSurgery was never mentioned cfrost: Dr M said:\n\n\n\n\t\t\tGood day\n\nIt seems like both images are of the same side of the jaw. What exactly is your problem? Are you worried about your teeth shifting again? What did the orthodontist say regarding your wisdom teeth? Was jaw surgery part of your original treatment plan?\nToo many unknowns to give an opinion here\n\t\t\nClick to expand...\n\nGreetings Dr M. Thank you for your answer.\n\nThis is a panoramic xray as I don't have a cephalometric one. First pic shows the right side and second pic the left one. I turnt both pictures in the same direction, because I thought I would make it more clear. The left side (second picture) looks longer and \"curvier\" than the right side and I cannot tell if both sides of jaws are normal or not. I feel as if my jaw is \"hanging\". In other words, it goes downwards.\n\nI want to know if the protrusion and mild open bite is caused by the jaw (the issue is skeletal) or if the issue is only dental and my jaw is normal.\n\nI had visited a maxillofacial surgeon a few months ago.. He told me to seek an ortho and to have my wisdom teeth removed. He said that looking at bites is not his specialty. He refused to check my jaw..\n\nSurgery was never mentioned Dr M: It is highly likely that there might be a skeletal growth issue as well. I agree with the oral surgeon. You will need to seek the advice of an orthodontist. cfrost: Dr M said:\n\n\n\n\t\t\tIt is highly likely that there might be a skeletal growth issue as well. I agree with the oral surgeon. You will need to seek the advice of an orthodontist.\n\t\t\nClick to expand...\n\nThank you Doctor. One last question if I may. I'm just afraid that removing wisdom teeth would have a negative impact on the face. Is that true? Dr M: This is not true. Removing wisdom teeth is often a necessity when undergoing orthodontic treatment as well as jaw surgery" }, { "id": 125, "title": "Membrane fell off 13 days post bone graft", "dialogue": "amhm8990: I had tooth extraction and bone graft done two weeks ago. I followed the aftercare instructions very carefully. The sutures began to loose a couple days ago and today they fell out along with the membrane that was holding up the bone pieces. There is a large hole in the site and I could see some white in there. Do I have to go back to the dentist immediately? My follow up is in 5 days. Thanks.\n\nPicture of before : \n\n\n\nAfter:" }, { "id": 126, "title": "Please Help? Implants and teeth failing", "dialogue": "Rick CFL: Hello. I am in a fix. Have ten dental implants posterior with ill fitting crowns. Adjustments made them worse. Now losing bone everywhere, implants are showing, and mouth has hives. Is there any way to get these explanted, get the failing teeth out too, and go to dentures? This has been going on for over 14 months, driving me crazy (can’t eat) and scared. Thank you Dr M: Good day\nIt is indeed possible to have implants removed.\nThe best option would be to go see a periodontist or oral surgeon, who are both dental specialists, in order to evaluate the condition of the dental implants and surrounding bone, and if it is indeed necessary to remove all of the implants. dansk: Rick CFL said:\n\n\n\n\t\t\tHello. I am in a fix. Have ten dental implants posterior with ill fitting crowns. Adjustments made them worse. Now losing bone everywhere, implants are showing, and mouth has hives. Is there any way to get these explanted, get the failing teeth out too, and go to dentures? This has been going on for over 14 months, driving me crazy (can’t eat) and scared. Thank you\n\t\t\nClick to expand...\n\nHello Rick, I hope you resolved the issue with your implants, if not, do you have you X-rays done already? Rick CFL: Hello. Things are not well. Not sure how to show x rays on here. Another dentist tried shaving things down and it’s all wrong. Rick CFL: Rick CFL: Those are from May. My gums are gone now around my teeth and going too far below the implants. I am out of ideas dansk: Rick CFL said:\n\n\n\n\t\t\tThose are from May. My gums are gone now around my teeth and going too far below the implants. I am out of ideas\n\t\t\nClick to expand...\n\nHi Rick, sorry for late reply, I was so busy last week, we had group of 10 patients from France. My whatsupp number and viber is +38269461431, send me message with your X-rays and I will call you right away. There is solution for your problem. Rick CFL: dansk said:\n\n\n\n\t\t\tHi Rick, sorry for late reply, I was so busy last week, we had group of 10 patients from France. My whatsupp number and viber is +38269461431, send me message with your X-rays and I will call you right away. There is solution for your problem.\n\t\t\nClick to expand... Rick CFL: Is that a US number? Tried to add on WhatsApp" }, { "id": 127, "title": "Is it possible for a wisdom tooth socket/hole to never close from the top?", "dialogue": "holimolicanoli: I'm a bit worried because there's still a small hole 10 weeks after extraction. The healing process might've been slowed down because I mistakenly dislodged the blood clot on day one by gently rinsing my mouth before reading the instructions not to do that. I only wanted to get rid of some of the blood taste.\nThe bleeding stopped after I placed fresh gauze on it several times, which created a blob of blood on top of the hole.\nI assumed this was a new blood clot and I left it alone from then on. Eventually this blood clot just disappeared along with the sutures, and a hole remained visible. Thankfully there was only mild pain, so no dry socket.\nIs there some point where you'd say that the hole isn't going to close? Like 4 months or something? Or does it just take much longer to heal in some cases?\nI'm at 3 months soon and I'm worried that I either have to go back for surgery to close the hole, or that I'll have to keep using this syringe forever to keep the hole clean. Dr M: Good day\n\nHow do you know there is still a hole? Can you see it or do you only feel it with your tongue? A lot of times patients mistake sockets for being \" open \", because they can feel an indentation which they then mistake for an open hole. This is most likely because the socket has not been filled up with bone yet, although it is still actually closed with soft tissue and immature bone. For a socket to \"heal\" so that it \" feels \" closed or smooth, it can take up to 6 months for the process of bone formation and resorption to complete. By that stage the alveolar bone should be at a more or less horizontal level. holimolicanoli: Dr M said:\n\n\n\n\t\t\tGood day\n\nHow do you know there is still a hole? Can you see it or do you only feel it with your tongue? A lot of times patients mistake sockets for being \" open \", because they can feel an indentation which they then mistake for an open hole. This is most likely because the socket has not been filled up with bone yet, although it is still actually closed with soft tissue and immature bone. For a socket to \"heal\" so that it \" feels \" closed or smooth, it can take up to 6 months for the process of bone formation and resorption to complete. By that stage the alveolar bone should be at a more or less horizontal level.\n\t\t\nClick to expand...\n\nGood day. I thought there was a hole because there was a dark spot in there and I was able to place the syringe a bit deeper in that spot. Though maybe I was just pushing the syringe into the soft tissue. I just took a closer look by pulling my cheek to the side and it looks more like a slit now than a hole. I'm not sure if food can pass through there but I'll just keep cleaning the area with the saltwater syringe until it the soft tissue smoothens out. Thank you." }, { "id": 128, "title": "Dry Socket?", "dialogue": "Wilbo84: I had my lower back wisdom removed on Tuesday as it was giving me severe pain and it was really broken down. It's now Saturday and I have a really horrible taste in my mouth, there's a slight ache but nothing horrendous, does this look like dry socket and will it heal its self? honestdoc: No, dry socket is exposed bone inside. The discoloration is reparative epithelium and is normal. Lower molars can be more traumatic to remove and will need more time and more body's effort to heal." }, { "id": 129, "title": "Back lower molar extracted", "dialogue": "Linder: Hi,\nI had a bad tooth for awhile and when the lock downs hit, no one would deal with me. This caused massive infection to go through me, off and on. I would get antibiotics to kill most of it by presp. from dentist and that's all they would offer. In 2021 all I heard for the next year was we're backed up 9 months. So just recently since everything has calmed down, I had a miracle and got an appointment at my dentist, an xray showed my root fractured in an upside down V. I currently had a red eye and swelling, and was told to do eyedrops. Three days later the extraction was horrendous, as the surgeon pulled hard and caused a lot of trauma on me. He got the complete tooth out after 2 minutes. He was known as a good surgeon for the reason why my dentist sent me to him. I was given penicillin and sent home with instructions, which i followed. After a day, the bleeding stopped and I removed the gauze and did nothing. I had intense pain from shots. I ate soft foods and avoided the area, 1 day later started gently swishing with salt water. The thing ached a little. I had swelling for a week, and a black and blue mark on my chin. I recently went through all my antibiotics, I still have a red eye, and a little pain above eyebrow on head, feels like a headache. The swelling has gone down a lot, yet I have traces of light swelling. My question is what causes a dull pain now to be going through other teeth and every now and every now and then I get a small dull pain from extraction. I don't have bad breath, nor is the pain intense. My left eye burns and is red. It's been 12 days, should I get any more meds for my eye, do you think I have an infection in my head? I read on another forum that this dentist said in his 30 years he's never seen an infection in the brain. That your immunity kills most bacteria from abscesses. So does any of this sound normal as I have never had a tooth pulled. Is this normal healing for all the infection that I had over the years? \nI'm afraid to take a pic of it, or look at it. honestly honestdoc: Penicillin is a narrow spectrum antibiotic compared to Amoxicillin. I'm suspecting that your infection is not fully resolved. Go back to the surgeon for a follow up. It is impossible to diagnose you in this forum. Linder: The oral surgeon is 180 miles away, as I live in an area of only 4 dentist. I went to my dentist and he said the tooth is healing well. He gave me amoxicillin to take, I just don't understand the pain in my jaw as well as extracted area, which is now pain is going up to the teeth on upper area. The extraction looks solid white, and the dentist told me it's filling in, if he packed it, it would just go backwards. honestdoc: Wow, can you go to your physician to get your eye checked and make sure you don't have a fever and all your lymph nodes are ok. At this point, finish your Amoxicillin and hope it resolves. I understand it is very hard to travel that far. Linder: On the day I went to the dentist, which I don't believe he diagnosed it correctly, I went next door to my doctor about my eye. She said I had allergies, I do have symptoms of allergies. It is really bad this year, anyway the more I live with this pain, the more I realize this is a dry socket. I feel the dentist was wrong, the medical system here is terrible and very back woods. I myself feel its the bone that I see as at night the pain runs through that area and now going to the upper teeth. I have no fever-97, no bad taste, none of the symptoms that go with a dry socket. I have a sinus headache as I sneeze a lot and my head is stuffed. I also feel the amoxicillin isn't helping the pain and I read that dry sockets heal on their own in a week or two. I will continue to take the medz and see what happens, other than that I'm clueless of this pain. honestdoc: I'm sorry for your suffering. I'm working emergencies this morning and my assistant went home sick. According to a respected pharmacist who spoke at our conference. You can take a cocktail of ibuprofen 600 mg (3 caps) and eat because it tears up your stomach, Tylenol, and Benadryl at night. In the morning, switch Benadryl to caffeine. If those don't work, have your dentist prescribe you something stronger." }, { "id": 130, "title": "Did my tooth extraction fail?", "dialogue": "Barkermush: I recently (4 days ago) had a failed root canal tooth removed. Lower first molar I think. It was via an NHS emergency dentist. This is my first ever tooth extraction, so it's all new to me.\n\nAnyway the removal was horrendous, the lady really struggled with it. She was switching between so many tools and different angles, and applying so much pressure I thought my gum was going to pop. I finally felt and heard a crunch after about 10 minutes of severe pressure.\n\nShe said that's one part of the tooth out just one more part to go. Which she said she had lost, she could feel it with her tool but couldn't see it. So after some painful digging around.. she finally said she had it. Then after 5 more minutes of painful crunching/bending and pulling we were done. Both parts were out.\nThis experience was awful and painful throughout but I don't want to get into that. Afterwards she said 2 times unprompted, that all of the tooth is out and there is no need to worry.\n\n\nI've been in agony for the past 4 days, been taking amoxicillin (3 times a day for 5 days, 1 tablet left to take soon) and over the counter pain killers.\nBut it's still swollen and sore, I keep getting shooting pains down my neck and under my jaw. Short and infrequent but severe when they happen.\nAnyway the blood clot as started to fade color now and I can see the extraction area.. and to me it looks like there is still some tooth in there? But I'm no expert, got my wife to take a picture.. sorry it was hard to get a good shot.\n\nBut to me it looks like there is still some tooth in that extraction site.\nI'm worried this emergency dentist botched the extraction. She didn't x-ray it afterwards (or before) she never washed it out with saline etc after we were done. She just stuck a gauze in, got me straight up out of the chair (even though I was failing faint after all that) she said don't worry she won't let me leave till it's stopped bleeding.\n\nShe then got her assistant to get a prescription for the amoxicillin, did it on her computer..and then give me the prescription and sent me on my way. In the space of 2 minutes, she'd either forgot or didn't want to check if it was still bleeding.\nLike I said she didn't x-ray it before, but she was using an old x-ray of the tooth which was taken almost 2 years before by a previous emergency dentist.\n\nThat dentist who took the x-ray in the past.. said it was a failed root canal, and that it would be a really difficult tooth to pull. She was hesitant about pulling it, but she said it could be sorted with another root canal if I could get a permanent dentist. They couldn't do it because they are an emergency dentist, and told me I would need my own regular dentist to do it. So she cleaned the tooth, changed the filling and put in some anti-bac cream to appease the tooth until I could get a dentist to sort it.\n\nBut I never could get a dentist, due to Covid its been impossible to get a regular dentist in the UK. Anyway the clean out and anti-bac cream did put me on for some 18 months or so.\n\nTil it stared hurting again last weekend, and I got an abscess on the gum below it. Which is why I went back to an emergency dentist 4 days ago.\nThe dentist didn't seem too interested in the abscess or swelling on my cheek. She said it's due to that infected tooth and that we should remove the tooth.\nShe said we will just quickly 'wriggle' it out and call it a day. I said fine, as it does need to go.. it's been 2 years and still no dentists taking new patients on. But I found it strange that she said we will just quickly wriggle it out.. When the previous dentist had said it would be a nasty pull (she was right) There certainly no wriggle about it, felt like she was trying to snap my upper leg bone \nAfterwards she jokingly said it was a very naughty tooth.. I was in too much pain for any jokes.\n\nAnyway, so 4&half days later and I still have the abscess on my gum, the amoxicillin hasn't cleared it. It's actually worse after that extraction, along with the rest of the pain down that side.\n\n>>TO SUM IT UP <<\nSorry for the long drawn out post. Anyway to sum it up(too much for some to read) it's my first tooth extraction and I'm worried that the Dentist didn't do a good job. I got the feeling she was rushing it, and afterwards couldn't get me out of there quick enough. I noticed she had another patient in the waiting room on my way out.\n\nI felt it was strange the way she twice unprompted said don't worry, all of tooth is out (it seemed disingenuous) Felt like she was just trying to move me along, as she was only an emergency dentist to me and will never see me again.\n\nThen to top it all off, I googled reviews for the dentist.. I found this review posted 5 months before:\n\n\"Very bad experience, my whole face hurts. I've had 2 teeth removed in the past and neither of those were so painful as this one. I'm all bruised up still and I couldn't eat for 3 days straight now.\"\n\nThe fact that person has had 2 removed before, and they felt the one with this dentist was awful.. making me think it's not just me, and it's not normal for a tooth extraction to hurt that much. \n\nI just want to make sure I'm not just being paranoid, and get an opinion from other people in the know. If the extraction site looks as should be, I will leave it be and let heal. If not, I don't want it healing to have it cut open again down the line. Barkermush: Been to another Dentist this morning.\nI have a dry socket, even though I took every precaution not to get a dry socket.\n\nHe said sometimes with a traumatic tooth extraction, you get a dry socket no matter what.\n\nGood news that there was no tooth left behind though Apparently what I could see was the bone of the socket. Linder: Barkermush that sounds like what I have even though my dentist said it's healing well. I had a traumatic tooth extraction earlier this month and it aches around extraction, when you see the bone of the socket, does this look white where the tooth was extracted?\nI have solid white over area where tooth was pulled and wondered if this was bone." }, { "id": 131, "title": "Alveolar mucosal thickening at teeth 28", "dialogue": "nikassam: Hello\n\nI had a very complicated dental case due to some Extraction complications.\n\nFeb 2022 CBCT showed Periapical lesion at palatal root of teeth 28 . Than till June dentist ignored or i don't know why they never treated the condition. Than June 7 Extraction done , but i had 2 months of pain than on August 20 Cancer institute checked me and Ordered MDCT contrast enhanced and it shows ALVEOLAR MUCOSAL THICKENING AT REGION 28 . which feels like spongy , jelly like around teeth .\n\nIs it serious ? Cause It irritates me.\n\nP.s. My permanent dentist is about to reach home town after 6 months to home town but he ordered an MRI for me . honestdoc: Try to get an evaluation by an Oral and Maxillofacial surgeon. He/she will have the most experience in determining treatment options for your particular lesion. nikroute: Biggest issue is area which I belong to here it's very hard to convince them for any such diagnosis. As I said my CBCT of Feb 2022 shows the lesion which they kept ignoring . Now again I got reply ITS NOTHING.. what the hell . I am going to somewhere else for the treatment. I got hundreds of people responce about my area dental college and dentist mis diagnosis and wrong treatment complaint. Sadly I even talked personally with a man whom son who got wrong treatment at the place and died in just 7 days after so called ITS NOTHING Cause of death in PM report Brain infection . And same report says dental abscess at 18,17 region found.\n\nPatient can not go for legal action because these careless dentist in my area always do sign a paper by us prior to examination.\n\nI am off the place and going to some other place\n\n\nhonestdoc said:\n\n\n\n\t\t\tTry to get an evaluation by an Oral and Maxillofacial surgeon. He/she will have the most experience in determining treatment options for your particular lesion.\n\t\t\nClick to expand..." }, { "id": 132, "title": "Should i have my wisdom teeth removed", "dialogue": "Joro133: Hello, I have a question, is it necessary to extract the lower left and right wisdom teeth, because it is not known if it is a shadow from the x-ray or if it is eating away the tooth next to it. \n\nx-ray picture: https://prnt.sc/Hy8wxKMvSw66 Dr M: Good day\n\nI would recommend extraction. It seems like they are definitely partially impacted. If a portion of it is visible in the mouth, it can create an area where food gets trapped and also makes it difficult to clean. On the x-ray it seems that there might be some secondary decay due to possible food impaction in the area, especially on the right.\nBased on your PAN, I would suggest seeing an oral surgeon in order to take out the teeth, since their roots are in close proximity to the inferior alveolar nerve. To prevent future problems, we usually advise to take out all 4 wisdom teeth at the same time." }, { "id": 133, "title": "Does extraction of molars always lead to jaw shrinkage", "dialogue": "Annar19: Hi,\n\nI have had some bad news and I've been told they definitely need to take out one of my molars and maybe a second one both on the right hand side of my face. they said if they take out one it probably won't do anything with my jaw but if they take a second it will. However I was told by another dentist that from her experience that taking out molars doesn't do anything to the face. This is really stressing me out so I'm not sure what to expect, If it helps the molars are called 6 and 7 and I have one baby molar behind 7 for some reason.\n\nBy the way when I mean jaw shrinkage I mean will it affect my physical appearance. ann31: Annar19 said:\n\n\n\n\t\t\tHi,\n\nI have had some bad news and I've been told they definitely need to take out one of my molars and maybe a second one both on the right hand side of my face. they said if they take out one it probably won't do anything with my jaw but if they take a second it will. However I was told by another dentist that from her experience that taking out molars doesn't do anything to the face. This is really stressing me out so I'm not sure what to expect, If it helps the molars are called 6 and 7 and I have one baby molar behind 7 for some reason.\n\nBy the way when I mean jaw shrinkage I mean will it affect my physical appearance.\n\t\t\nClick to expand...\n\nI have the same question. Went to the dentist because my very back molar broke when brushing my teeth( a molar my dentist filled but apparently didn't do a very good job because it still decayed and had to be pulled) Plus, I found out that a tooth I had a root canal on has to be pulled as well! That one is in the front by my canine. They say i need implants for both but its so expensive that if I have to choose one to replace its obviously going to be the one in the front. \n\nMy sister and brother in law have had a tooth pulled in the back and have had no problems and its been 10 plus years. Now they say if you don't replace your lost tooth your other teeth will start erupting, your face will age from bone loss and more.\n\nSo stressed on making the right decision." }, { "id": 134, "title": "Two broken molars", "dialogue": "soulbee: Hi everyone. \n\nI broke my upper right molar two days ago. It all started with a crack down its middle, then the whole thing fell apart while I was eating cake. I have no idea how it happened, and there was no filling, no visible cavity, no physical trauma. I don't do chewing gum and don't drink sugary sodas at all, but occasionally I eat a few snacks or chocolates. I brush my teeth everyday before I sleep. I don't smoke or drink alcohol. I haven't had any root canals, or fillings done, or anything on my teeth in general, I do not visit the dentist unless a health issue comes up. I am generally physically healthy and cannot come to terms with this just happening out of nowhere. I went to the dentist yesterday and he said there is barely any tooth left so I need either extraction and/or implantation. I have another molar that also broke in the same spot, but upper left. I left it alone for a couple of years because my parents didn't want to deal with it (I'm pretty young and live with my parents). I am only 20. I just cannot deal with the fact that I have to implant two molars at this age, and the situation is only made worse by my mother, and dentist, who want to believe that I eat too much sugar and there is no other underlying issue. I heard from the dentist yesterday about having cavity on the tongue side of the tooth, even though I showed him the broken part of my tooth and it wasn't as decayed as he tried to convince me. He basically tried to convince me that the whole area was blackened with cavity before it broke, which it wasn't. I do not want to trust him, as he kept talking about irrelevant issues such as my overbite (which my orthodontist was okay with not fixing because of my mouth shape), my bite in general (he asked me to show my teeth then immediately said I was holding them down wrong and giving myself issues), my supposed last issue with lower left molar (he has it written down that I suffered a lower left issue last time I visited, which is a fabricated lie!), then he kept incessantly telling me off about me being stubborn (as if I was a child). I do not understand if this is some sort of joke he was playing that I didn't get, either way it was insensitive especially after I reacted with tears after he recommended an implantation (those are expensive, and I was expecting a filling).\n\nAnyway, I am grieving the loss of two teeth, too soon. I am still very confused and definitely suspicious of an underlying issue, such as my history with TMJ (temporomandibular joint) and grinding my teeth or a side effect of my braces (got them removed last August). Hopefulgirl: soulbee said:\n\n\n\n\t\t\tHi everyone.\n\nI broke my upper right molar two days ago. It all started with a crack down its middle, then the whole thing fell apart while I was eating cake. I have no idea how it happened, and there was no filling, no visible cavity, no physical trauma. I don't do chewing gum and don't drink sugary sodas at all, but occasionally I eat a few snacks or chocolates. I brush my teeth everyday before I sleep. I don't smoke or drink alcohol. I haven't had any root canals, or fillings done, or anything on my teeth in general, I do not visit the dentist unless a health issue comes up. I am generally physically healthy and cannot come to terms with this just happening out of nowhere. I went to the dentist yesterday and he said there is barely any tooth left so I need either extraction and/or implantation. I have another molar that also broke in the same spot, but upper left. I left it alone for a couple of years because my parents didn't want to deal with it (I'm pretty young and live with my parents). I am only 20. I just cannot deal with the fact that I have to implant two molars at this age, and the situation is only made worse by my mother, and dentist, who want to believe that I eat too much sugar and there is no other underlying issue. I heard from the dentist yesterday about having cavity on the tongue side of the tooth, even though I showed him the broken part of my tooth and it wasn't as decayed as he tried to convince me. He basically tried to convince me that the whole area was blackened with cavity before it broke, which it wasn't. I do not want to trust him, as he kept talking about irrelevant issues such as my overbite (which my orthodontist was okay with not fixing because of my mouth shape), my bite in general (he asked me to show my teeth then immediately said I was holding them down wrong and giving myself issues), my supposed last issue with lower left molar (he has it written down that I suffered a lower left issue last time I visited, which is a fabricated lie!), then he kept incessantly telling me off about me being stubborn (as if I was a child). I do not understand if this is some sort of joke he was playing that I didn't get, either way it was insensitive especially after I reacted with tears after he recommended an implantation (those are expensive, and I was expecting a filling).\n\nAnyway, I am grieving the loss of two teeth, too soon. I am still very confused and definitely suspicious of an underlying issue, such as my history with TMJ (temporomandibular joint) and grinding my teeth or a side effect of my braces (got them removed last August).\n\t\t\nClick to expand...\n\nHi, What did you get done since your incident,p? Did you get the implants? Who is the next two or more I can definitely be a traumatic experience trust me I know. Since you mentioned TMJ issues and grinding do you think that you grind it your teeth at night and that called the breakage? Hopefulgirl: soulbee said:\n\n\n\n\t\t\tClick to expand...\n\t\t\nClick to expand...\n\nsorry for the misspelling I didn’t realize, my microphone did that \nHi, What did you get done since your incident? Did you get the implants? TMJD can definitely be a traumatic experience trust me I know. Since you mentioned TMJ issues and grinding do you think that you grind your teeth at night and that caused the breakage? soulbee: Hopefulgirl said:\n\n\n\n\t\t\tsorry for the misspelling I didn’t realize, my microphone did that\nHi, What did you get done since your incident? Did you get the implants? TMJD can definitely be a traumatic experience trust me I know. Since you mentioned TMJ issues and grinding do you think that you grind your teeth at night and that caused the breakage?\n\t\t\nClick to expand...\n\nHi! \n\nI'm doing great. I went to a different dentist and he did a crown on my upper left, which I have had for two weeks now. Very happy that I can actually chew my food, as opposed to using my front teeth lol. \n\nThe other molar unfortunately still needs extraction, which might take a while for me to get to. \n\nAs for the underlying issue, I don't know. No one told me anything, and dentists mostly focus on fixing issues and don't like to explain causes (from my experience). I don't know how they teach them in school, and the ignorance is killing me (inside).\n\nI still grind my teeth though. I am scared of breaking my new crown. I try not to do that, at least when I'm awake, because my parents have not financially recovered yet from the crown.\n\nHope this helps somehow Hopefulgirl, whatever your issue. Hopefulgirl: Oh great that is good news because dental issues can be some of the hardest and most difficult to resolve especially to the point of being comfortable.\n\nIf you absolutely have to get an extraction, I strongly advise a replacement tooth in that spot especially if it’s a molar tooth because missing molars more than likely causes balance issues to the bite hence TMJD. If you are still grinding that sorta says something is still unbalanced as well in your bite since people grind when the muscles are trying to find the bite, but yes protect that new crown and your teeth at all cost. Use a thin night guard while sleeping, emphasis on thin lol.\n\nAs for me my issues is that a dentist misshaped my molar tooth so bad that it has thrown my bite off. I have balance issues and teeth that are hitting uncomfortably so I think my fix would be getting that molar built back up properly or a crown. And as far as how dentist are taught in school, it’s actually a lot they don’t know, never learn and have all wrong! I’ve read books and watched videos from other brave dentist that will admit that they have been doing a lot wrong and there’s a lot they just don’t know and have not learned about the bite! And I agree! I can tell because too many mess up time and time again. Hopefulgirl: soulbee said:\n\n\n\n\t\t\tHi!\n\nI'm doing great. I went to a different dentist and he did a crown on my upper left, which I have had for two weeks now. Very happy that I can actually chew my food, as opposed to using my front teeth lol.\n\nThe other molar unfortunately still needs extraction, which might take a while for me to get to.\n\nAs for the underlying issue, I don't know. No one told me anything, and dentists mostly focus on fixing issues and don't like to explain causes (from my experience). I don't know how they teach them in school, and the ignorance is killing me (inside).\n\nI still grind my teeth though. I am scared of breaking my new crown. I try not to do that, at least when I'm awake, because my parents have not financially recovered yet from the crown.\n\nHope this helps somehow Hopefulgirl, whatever your issue.\n\t\t\nClick to expand...\n\nok wait one sec lol, I had to read your original post again because I had actually forgot why I replied to your post. But omg I’m dealing with a liar dentist as well! I truly believe these dentist lie to us about the condition of things, they’ve also been known to destroy teeth for money. I wouldn’t be surprised if that dentist destroyed your teeth to make you get expensive implants. Did you see him in the past before the broken teeth? I had a dentist purposely destroy my tooth! I had no cavities. You should really try hard and think how did you get that crack in your teeth. soulbee: Thank you for your nice replies.\n\nAlso many thanks for your advice and the information about balance issues. I think I understand a lot now about why the dentist who did my crown was so annoyed with how I wasn't able to bite down. \n\nFor context, what he was doing was polishing the top of the crown so it fits neatly on my bottom teeth. He inserts a blue strip in between and asks me to bite down hard as if I were grinding on it, and now I understand from you that grinding is what folks do when their bite is unbalanced.\n\nAs for the reason my upper right broke, I am pretty sure I had that crack right after I took my braces off. Maybe the braces were holding the tooth together, and when they came out, it finally fell apart? At least I suspect so, and I had many times a thought that something was going on back there, but I wrongfully labelled my thoughts anxiety and moved on.\n\nI am glad you figured out your dentist is a liar. I can't imagine the trauma behind that, paying money expecting treatment and care and only getting worse. This is why I only go to the dentist for immediate issues. Reading online and researching is better to quell that fear of ignorance, and sometimes if it ain't broke don't fix it. I can't exactly say I recommend this philosophy, but what's the alternative? Humans are prone to error in many ways, and the nuances of who's right or wrong and whose opinion to take can be hard to resolve. I hope you got out of that awful dentist situation woth grace and resilience." }, { "id": 135, "title": "ORAL SURGERY - BROKEN TOOTH & ROOTS STILL IN GUMS", "dialogue": "MattTwinstar: I have a #2 molar in the upper right part of my mouth that was incorrectly extracted about 2-3 years ago. The dentist \"said\" it was out but come to find out as of a week ago when I experienced a weird popping sensation and sever excruciating pain that the dentist shattered my tooth and left both halves of my roots still in the gums. I am now informed that I have to go see an oral surgeon to have it surgically removed.\n\nI am incredibly PTSD and Anxiety struck over anything to do with the dentist let alone surgery. My past experiences with terrible and honestly not properly certified to work on patients teeth/mouth has caused me to have terrible fears and worries and always thinking the worst. (Because in the past the worst has happened)\n\nI am worried that im not going to be at ease or feel the pain. My last experience I had a dentist use the maximum amount of lidocane to numb me up and the legal dose he could give a human and I felt every minute of the pain. It was the longest 7 minutes of my life. Now then a surgery is taking place i just dont want to be in pain.\n\nCan anyone give me advice or experiences of similar surgical procedures to help me stop over thinking and giving myself panic attacks? I really am worried. Please. \nThank you to anyone who takes the time to respond.\n\nBest Regards Dr M: Good day\n\nSorry to hear about your bad experience. The dentist should have informed you of any fractured left behind. A lot of time teeth can fracture during an extraction process. There are a lot of factors that influence this. And a lot of time, tooth pieces can be left behind, if it is proximity to anatomical important structures, to prevent damage. But again, the dentist should have informed you of this. \nThere is a chance that the root pieces might be removed in theater under GA. If this is the case, there should be any discomfort during the process. If your surgeon does not advise GA, discuss your fears with your surgeon. There are other pre-medications that can be prescribed in order to reduce your anxiety." }, { "id": 136, "title": "Need help identifying this lump on lower lip. Is it a mucocele or muccous retential cyst? Maybe something else?", "dialogue": "HTX: Please help ! Need help identifying this lump on lower lip. Is it a mucocele or muccous retential cyst? Maybe something else? Please help!\n\nAbout two weeks ago I started feeling a small lump on my lower lip. The size and shape of the lump is a small, round dome and is very soft. I can push on it and flatten it out and when I let got it becomes the same round dome shape. The color is translucent around the outside and darker blueish inside. The lump has not grown and remains to look the same. Over the last couple of days, I have been rinsing with warm salt water a few times a day and also using Listerine mouthwash in the morning and at night but have not noticed any change.\n\nI have added a few pics for your vieing. My apologies, each pic was taken in a different light and why it looks a bit different.\n\nAny idea what this lump on lower right lip is? Dr M: Good day\nCould be a mucocele or retention cyst. For a definitive diagnoses, I would see a oral surgeon. Pigmentation in a lesion,especially on a sun exposed area, such as the lower lip, can be of some concern. The oral surgeon will excise the lesion if necessary and send for testing HTX: Thanks! I have an appointment for August 15th. The good news is that it has not grown. Might have even got a bit smaller (not much). \n\nNow I am not as concerned that it is something worse than a mucocele or retention cyst. \n\nDo you think that is a reasonable assumption? \n\nSorry, August 15th still seems far away. \n\nThanks again! Dr M: Yes I think it is a reasonable assumption, but I would still keep my appointment for 100% certainty." }, { "id": 137, "title": "Sharp Edged Bone Graft Cutting Into Gums", "dialogue": "Jedo: A few weeks ago I got a molar extracted and a bone graft placed. A couple days after I noticed that I could feel the bone graft pushing into my outer gums. The surgeon checked it 2 weeks later during follow up but said everything was fine. I saw my general dentist a few days later for another tooth and he checked the area and immediately noticed the problem. By this time the bone graft had cut through my gums and was exposed.\n\nIs this something that happens often? \nIs it a sign of shotty work or is there something I may have done to cause it?\nIs it normal for bone grafts to have such a sharp edge? nikassam: These are common complication . Few people do face them , most of people dont" }, { "id": 138, "title": "Tooth Issues Next to Extraction Site", "dialogue": "TeacherSpice: Hi,\n\nI am a 50-year-old woman. 7 weeks ago, I had all four wisdom teeth removed, along with the upper left molar directly next to my upper left wisdom tooth; therefore, 5 teeth in total.\n\nAside from two dry sockets in the lower sites, which healed fine, I’ve had no real issues with the extractions. Until now….\n\nAbout two weeks ago (5 weeks post extraction), I noticed that the upper molar next to the two upper extraction sites feels strange—almost like it’s being pressed on. I am constantly feeling this weirdness/pressure in the tooth all day and night. Even more concerning is the fact that, when I chew on that side of my mouth, the sharp pain in the molar is excruciating. \n\nI’ve consulted multiple times with my oral surgeon, his colleague, and my regular dentist. All seem to brush me off and nobody will tell me if this is normal, when it might resolve itself, or what I can do in the meantime.\n\nIs this something anyone else has experienced? I feel that 7 weeks post extraction should be enough time to begin feeling normal. I just want to be able to eat and to live normally without constant awareness of this tooth or the bad pain with shewing. Can anyone give me some information? I would so appreciate it. Thanks. Dr M: Good day\nDo you perhaps have any post-extraction x-rays that you could share? TeacherSpice: Dr M said:\n\n\n\n\t\t\tGood day\nDo you perhaps have any post-extraction x-rays that you could share?\n\t\t\nClick to expand...\n\nHi!\nNo, I don’t have any. I can ask my oral surgeon, then I can post here. Might be a day or two. Last time he x-rayed (one week ago), I was told all looked normal. Was given the brush off with no ideas on why this tooth feels so bad. \n\nAny ideas or thoughts you have even in lieu of the X-ray photos would be so welcomed!! Geparddent: TeacherSpice said:\n\n\n\n\t\t\tHi!\nNo, I don’t have any. I can ask my oral surgeon, then I can post here. Might be a day or two. Last time he x-rayed (one week ago), I was told all looked normal. Was given the brush off with no ideas on why this tooth feels so bad.\n\nAny ideas or thoughts you have even in lieu of the X-ray photos would be so welcomed!!\n\t\t\nClick to expand...\n\nx-ray would be most welcomed if you can get your hands on it. Might help in giving you more info from us TeacherSpice: Geparddent said:\n\n\n\n\t\t\tx-ray would be most welcomed if you can get your hands on it. Might help in giving you more info from us\n\t\t\nClick to expand...\n\nWill do! I will call tomorrow and see if they can email it. If not, I’ll see the surgeon Monday for a follow up and I’ll get it then! Thank you!!" }, { "id": 139, "title": "Bone graft insisted with extraction", "dialogue": "Thisbites: Hi\nIm trying to get some answers via google and other peoples experiences in regards to why bone grafting is such an automatic part of a reatment plan when there has been no pano taken.?\nI am in process of getting my #30 extracted. Deep decay under gumline (or so it says) But they want to do a bone graft when i have fresh bone still and enough of it. Cant surgeons just do the implant after the extraction? \n\nI understand when you have a single tooth missing for some time and your middle aged (as i am 57) Its undertandable that it would be prudent to bone graft with my #19 as it has been missing 9 yrs. \n\nBut for a new extraction, and im in good health with decent bone.. why wouldnt they do the implant without the grafting? Its like everyone now should have a bone graft with the plan regardless of if its needed or not?\nany answers or thoughts appreciated honestdoc: I don't place implants but I would recommend getting another opinion from an experienced Periodontist or Oral Surgeon. I would never have a general dentist place implants. Thisbites: It is odd because here many many dentists with their continuing education are placing successful implants right and left.\nHowever it makes more sense to have them done with a practice that does this all day long e.g. oral sx and periodontist honestdoc: Thisbites said:\n\n\n\n\t\t\tIt is odd because here many many dentists with their continuing education are placing successful implants right and left.\nHowever it makes more sense to have them done with a practice that does this all day long e.g. oral sx and periodontist\n\t\t\nClick to expand...\n\nI've seen too many implants fail. There are plenty of successful ones placed as well. I would go to an experience periodontist as first choice to place implants and the general dentist can predictably restore them. Thisbites: Thank you for the response. Unfortunately i had to have the tooth extracted. At that time the dentist put in bone graft and now i am \nnot healing too well. Bad taste in mouth, im ready for the sutures to come out. Pain at the extraction site. No bone graft fell out, no inflammation or swelling or leakage but certainly a bad taste all the time so i think its infected.\nIm going to see an oral surgeon/dentist/MD that works in a practice with a few other maxo facia surgeons. who does this all day long. Should have gone with him to begin with..could kick myself. I guess they have to dig it out and start over? Does not sound fun to me. Ill see what he says first before i assume the worst. My hunch tells me its not working out. honestdoc: Too often I see other general dentists try to make more money by pushing all this. I don't do implants because a lot of my patients cannot afford them and I don't do them enough to have solid experience. Implants needs to go to the surgeons for placement and to general dentists who have plenty of experience restoring them. Thisbites: honestdoc said:\n\n\n\n\t\t\tI've seen too many implants fail. There are plenty of successful ones placed as well. I would go to an experience periodontist as first \"choice to place implants and the general dentist can predictably restore them.\n\t\t\nClick to expand... Thisbites: honestdoc said:\n\n\n\n\t\t\tI've seen too many implants fail. There are plenty of successful ones placed as well. I would go to an experience periodontist as first choice to place implants and the general dentist can predictably restore them.\n\t\t\nClick to expand...\n\n\"would go to an experience periodontist as first\"\nIf I may ask so how does the periodontist distinguish from the oral surgeon? I would like to have the implants placed in the dentist that I have doesn't regularly and they seem to be pretty successful he likes to do crowns in plants and root canals so he knows what's going on but maybe that's also the dental industry just wanting money you know I don't know who to trust.\nHe charges less also, for example the oral surgeon charges and exorbent amount of money for one tooth $8,500 and this dentist I see is really reasonable both in plants about 9,000.\n\n\n(I guess I spoke too soon with my extraction infected there was no problem and it healed it just took a little while.) Thisbites: Thisbites said:\n\n\n\n\t\t\t\"would go to an experience periodontist as first\"\nIf I may ask so how does the periodontist distinguish from the oral surgeon? I would like to have the implants placed in the dentist that I have doesn't regularly and they seem to be pretty successful he likes to do crowns in plants and root canals so he knows what's going on but maybe that's also the dental industry just wanting money you know I don't know who to trust.\nHe charges less also, for example the oral surgeon charges and exorbent amount of money for one tooth $8,500 and this dentist I see is really reasonable both in plants about 9,000.\n\n\n(I guess I spoke too soon with my extraction infected there was no problem and it healed it just took a little while.)\n\t\t\nClick to expand...\n\nDoes them regularly, I type out and said 'doesn't regularly'" }, { "id": 140, "title": "Pain and asymmetrical nostrils after apicoectomy", "dialogue": "20something: I had an apicoectomy in September 2021 on one of my left upper incisors and root canal on the other left upper incisor. Since then, I had periods of toothache which was very different than every other toothache I've experienced. It would come and go and It would usually hurt when I drank water or ate some hard solids.\nIt doesn't hurt currently (it hasn't since April), but I still feel some small bump just above the gumline. Also, the nostril that's on the same side as those teeth doesn't move as much. My nose looks much more asymmetrical than it did before the surgery (the left nostril is much higher than the right one when I smile).\nMy dentist says there's nothing in the xray and that it's probably normal. Another dentist suggested tooth extraction, but he said he couldn't guarantee that the symptoms would go away.\n\nSo, my question is - what's the possible cause of this, should I see some other type of doctor? Could it be tumor?\n\nI am very sorry for such a long post, but I am getting a little paranoid and I feel very self conscious because I already have asymmetrical face and now it looks even worse. Dr M: Good day\nDo you perhaps have any post-op x-rays that you can share? The small bump that you feel, might be an area of hypertrophied tissue or scar tissue, in the area where the initial incision was made. MattKW: X-rays pre- and post-op please. Photo of the small bump too if possible. Having done many apicocectomies, and knowledge of the anatomy typically involved, I deeply doubt that your nostril position has changed. There is no anatomical or surgical basis for this to have occurred after an apico. Nearly EVERYONE has an asymmetrical face. Many movie stars and television presenters are often chosen because they have fairly symmetrical faces, so don't compare yourself to them - have a look at this site, or upload pictures of yourself and friends here." }, { "id": 141, "title": "Best Treatment Advice for a Recurrent Oral Mucocele", "dialogue": "RollingMenhir: I have been dealing with a recurrent oral mucocele in my lower right buccal mucosa for roughly half a year’s worth of time (it started occurring late November last year). The problem I am facing is that apparently, I can only have it excised when it is present (i.e., swollen), but the mucocele usually occurs at random intervals (between three to seven days) and at random times (sometimes in the late afternoon when most of the oral health surgeons near me are closing up for the day or on weekends) and I cannot do anything to make it occur manually. The reason why I assume it can only be excised when swollen is from my sole consultation with and later visit to a specific oral health surgeon (whom my dentist referred me to), who said in both instances that “I cannot do surgery if it’s not there”. Essentially, I would be forced to have to make an appointment on the same day the mucocele occurs to have it excised, and that is frustrating since not only can I not predict when the mucocele occurs, but some of the oral health surgeons around me will not accept same day appointments.\n\nIs there any other possible treatment I can undergo to have it excised? Can I have it excised even if it is not swollen? Or is it the norm for recurrent mucoceles in that they can only be excised when they are swollen rather than at any other time (in theory, since these are usually caused by a damaged salivary duct, would it still be possible to treat them just by fixing the duct)? I want to have this mucocele excised as soon as possible and I don’t want to be held down by whenever it shows up to schedule my appointment. nikroute: Your age , diet habbits with teeth edges needs to be checked . Reccurent situation handled by my dentist such way ,\n\nSurgery is not a solution for such condition .\n\nRecurrence , ductal damage is associated with mucocele surgical treatment .( as my dentist word MUCOCELE surgery is CHOICE OF TREATMENT but NOT THE TREATMENT )\n\nSo get a expert plan to manage the mucocele .\n\nidentify what triggers are behind it RollingMenhir: nikroute said:\n\n\n\n\t\t\tYour age , diet habbits with teeth edges needs to be checked . Reccurent situation handled by my dentist such way ,\n\nSurgery is not a solution for such condition .\n\nRecurrence , ductal damage is associated with mucocele surgical treatment .( as my dentist word MUCOCELE surgery is CHOICE OF TREATMENT but NOT THE TREATMENT )\n\nSo get a expert plan to manage the mucocele .\n\nidentify what triggers are behind it\n\t\t\nClick to expand...\n\nThis is the first time I’ve had a mucocele that reoccurs every week or so. If I’ve had lumps in my mouth in the past, they were either consistent yet temporary (I.E. swollen for a few days and then gone) or were just aphthous ulcers. I went to two different dentists and both said they could remove it but it would just come back so they deferred me to oral surgery for permanent removal.\n\nI’m not sure what triggers it. I tried to trigger it several times using spicy or acidic foods but it never seemed to work (neither would eating said foods while it was swollen prolong how long it was swollen). And foods that I had thought caused it would not work the second time around. As for my diet, my diet has been relatively consistent for the past few years so I don’t think that’s the cause (like I said, it only started late last year)." }, { "id": 142, "title": "40f, 31 extractions, 3 ankylosed teeth removed, jaw broke", "dialogue": "Mhunter: 40 f, had 31 extractions this past Wednesday. On my front lower jaw my oral surgeon said that 3 of my front teeth were fused to my jaw bone. This area is still extremely painful. I did have a check up and all he said was I might have to have another procedure in a few weeks but didn't say much else to me and acted as if he was in a hurry. I was also in a lot of pain and was not thinking clearly. \n\nOnly thing he told me when I woke up from surgery is that I have a very thick jaw bone and that 3 teeth were fused at the jaw bone and now jt looks as if part of my jaw bone is missing. He said he never seen anything like it. \n\nI really don't want to have to go through another surgery plus I don't have the money right now either. \n\nIs thus a common occurrence? Am I always going to have pain from this now? Any information you think would be helpful to me? Did this surgeon mess up and should I go to another one or was this just a weird occurrence? \n\nSorry if I'm rambling or not making sense. Been in severe pain and not slept much.\n\nIf you need any more info please ask. I also have a picture of my xray from before the surgery. Dr M: Good day\nAs I understand it, a part of your lower jaw fractured?\nThis can be a risk, especially when associated with a large number of extractions, and it also depends on the difficulty of the extractions.\nAs adjacent teeth are removed, the alveolar bone can weaken and then fracture.\nWhat is the plan for afterwards? \nThe second surgery might be necessary, because it might influence the restorability of the now edentulous jaw. \nI would discuss this with your oral surgeon, so that you can understand what the situation is now currently, and what the way is forward." }, { "id": 143, "title": "Oral Surgery or Braces", "dialogue": "arclaw: Hello I have been insecure all my life rregarding my gummy smile together with my side view that indicate I somewhat have a very protruded jaw.\nI visited some orthodontists a while ago and some suggested jaw surgery, some suggested braces and some said it's fine as it is. I'm still undecisive on which treatment i should undergo and I would really appreciate your opinions and suggestions. I have attached a couple of photos attesting to my condition. Feel free to take a look and writing a feedback. Any help would be appreciated. Sorry for the edits on my photos. Much thanks" }, { "id": 144, "title": "Implants", "dialogue": "profits: I'm have implants done on all 4's there removing 15 of my teeth. I'm about to cancel because the fear is killing me slowly. I'm having panic attacks, eating vallum & Xanax all day long.. ready to cancel my $55.000 appointment. Dr M: Good day\nIf you are scared or unsure about your procedure, arrange a sit down with your dentist/surgeon. Sometimes going through the procedure, step-by-step, can alleviate some of your concerns and make you more relaxed. There is also pre-medication that you can take, prior to the procedure, in order to put you in a more relaxed state. Ask your dentist/surgeon about your options." }, { "id": 145, "title": "How reliable would dental hygienistss word be on wisdom teeth being able to stay in?", "dialogue": "kttje: My dental hygienist told me that barring any complications like my wisdom teeth changing direction, I probably won’t have to get my top two taken out after she took a full x-ray to evaluate them (I don’t have the resulting X-ray on hand unfortunately). My dentist didn’t look at it because by then he had gone off to other patients, but would a dental hygienist know enough to confidently say this looking at an X-ray? She’s very competent, I’m just very worried about them getting taken out and the idea of it only being two puts me at ease more. honestdoc: They can't diagnose. Call the office and have the dentist look at the x-rays." }, { "id": 146, "title": "Can't decide between 3 unit bridge and bone graft with implant.", "dialogue": "C908: I was just told by my dentist my #3 tooth on top right needs to be removed. I was told I could do a 3 unit bridge or a bonegraft with an implant. I'm 67 with no dental insurance. As a child I was hurt by a dentist so this problem I have scares me. I told them I must be put under before this work can be done. My concerns with the bridge are weather or not the connecting teeth can hold up long term. My #2 tooth already has a crown. I don't like the idea of cutting off a perfectly good crown just to replace it with another crown. It seems to me this is just asking for trouble. My #4 tooth seems to be OK, I don't like the idea of filing it down to accommodate another crown.Another concern is the longevity of a bridge.Im reading 5 to 7 yrs is average, 10 years or more if your lucky.For approximately $3400.00 I feel it should last longer.Even though the expense is greater I guess I am slightly leaning towards the bone graft and implant. The bone graft scares me and the healing time concerns me. I'm looking at approximately $5500.00 for this procedure. This is a lot of money when your retired living on Social Security. I am shocked that it cost this much money to fix a problem caused by 1 tooth. I would have considered not replacing the extracted tooth if it wasn't for the fact the surrounding teeth will shift. My parents paid for me to have braces when I was a child. Because of this I have always tried to maintain my teeth the best I can. With the prices that are charged today I can understand why people are walking around with missing teeth. I would like to say thank you in advance for your comments. Thisbites: Hi\nI too have issues and concerns about how we are having to pay this kind of money for an implant. Im sorry noone has answered your question as mine was not answered either, even with several xrays. \nWonder why the site is up? Oh well. Good luck to you and hoping your tooth is replaced with a long lasting one.\nTake care" }, { "id": 147, "title": "Extraction #30 and the implants to follow", "dialogue": "Thisbites: So I have now a number 30 that shows i guess decay at the root and below the gumline that is not restorable?\nSo id like to do an implant but they insist on bone graft without seeing my imaging. It seems to be the MO like not even knowing.\nI have dull pain nothing crazy but yeah it feels like it wants to not be there anymore.\n\nSo my question is: Is a bone graft absolutely necessary?\n\n Ive seen 3 dentists so far to look at this number 30.\nThe pano is 2 1/2 yrs old. Oddly 30 looks like it has the same decay its had in 2019\n\n#19 extracted i 2013 due to failed root canal. I need my front bottom molars! I basically do soft foods because of it..\nany insight would be hugely appreciated. Thisbites: Thisbites said:\n\n\n\n\t\t\tSo I have now a number 30 that shows i guess decay at the root and below the gumline that is not restorable?\nSo id like to do an implant but they insist on bone graft without seeing my imaging. It seems to be the MO like not even knowing.\nI have dull pain nothing crazy but yeah it feels like it wants to not be there anymore.\n\nSo my question is: Is a bone graft absolutely necessary?\n\n Ive seen 3 dentists so far to look at this number 30.\nThe pano is 2 1/2 yrs old. Oddly 30 looks like it has the same decay its had in 2019\n\n#19 extracted i 2013 due to failed root canal. I need my front bottom molars! I basically do soft foods because of it..\nany insight would be hugely appreciated.\n\t\t\nClick to expand...\n\nSecond sentence meant to say \"It seems like their MO is to just automatically do a bone graft with out really needing it. I will not be able to do the implant until maybe August. I would do an implant right after extraction however if dentist allowed" }, { "id": 148, "title": "Wisdom teeth extraction progress?", "dialogue": "Lark: Hello, I got all wisdom teeth taken out on Monday (around 6 days ago) and I do not believe the stitches, which have dissolved, actually closed anything. I am worried the hole may still be open, I have attached a picture with the spot in question, which I'd the bottom left. Please let me know if its going in the right direction or if you need clearer images, it may be blurry MattKW: For a simple wound, stitches bring the edges closer together for faster healing (by primary intention) and also to help control bleeding. For extractions, resorbable stitches are nearly always used (plain catgut or chromic catgut). I can't tell from that photo much about the wound, but as long as you are controlling the apin or tenderness OK, and have little or none facial swelling, then any loose flaps will still heal across a gap (secondary intention) in the right circumstances. I wouldn't be worried. Lark: MattKW said:\n\n\n\n\t\t\tFor a simple wound, stitches bring the edges closer together for faster healing (by primary intention) and also to help control bleeding. For extractions, resorbable stitches are nearly always used (plain catgut or chromic catgut). I can't tell from that photo much about the wound, but as long as you are controlling the apin or tenderness OK, and have little or none facial swelling, then any loose flaps will still heal across a gap (secondary intention) in the right circumstances. I wouldn't be worried.\n\t\t\nClick to expand...\n\nThank you, it is day 7 and it turns out that inflamed tissue was inner cheek tissue. The swelling has gone down and the sockets are completely closed" }, { "id": 149, "title": "Tooth extraction doesn't look correctly finished", "dialogue": "pduffy4: Hello,\nMy first post.\nI recently had a wisdom tooth removed, lower left side. It was in a normal position, not a weird angle or anything. It had a temporary filling on it.\n\nI am very concerned that the dentist has not completed the work correctly. He put in stitches but only one stitch looks correct over a cut in my gum where an earlier extraction took place. The other stitches are just running up one side of the socket and not pulling the gums closed. So I am left with a painful gapping hole.\n\nCan a dentist give an opinion please. I am still getting pain in the area. I was given about 7 injections. One to the back of the jaw then about 5 injections around the tooth and another final one down one side of my jaw. Seems excessive for a tooth sitting normally. The dentist took the tooth out in pieces which I don't think was necessary. I am still in pain about 8 days after the extraction.\n\nLuckily I can include a photo of an x-ray of my tooth area (cropped) and I managed to get some photos done with my mobile phone, not an easy task.\n\nThank you for any replies.\n\nPeter Dr M: Good day\nStitches are not always placed to fully close a socket. If the tooth was erupted, such as in your case, the stitches are placed where incisions are made or where tissues were torn. Often there is still a hole left behind, to allow blood clot formation. \nThe fact that you have pain, might be an indication though that you have a dry socket. This happens when the blood clot is disturbed or if food gets into the socket. This is more common in bottom extractions and in some cases the stitches accidentally trap food particles, which if not rinsed out correctly, also leads to dry socket formation.\nI would arrange a follow up visit with your dentist/oral surgeon, to make sure that don't have a dry socket, and if you do, to treat it accordingly. pduffy4: Dr M said:\n\n\n\n\t\t\tGood day\nStitches are not always placed to fully close a socket. If the tooth was erupted, such as in your case, the stitches are placed where incisions are made or where tissues were torn. Often there is still a hole left behind, to allow blood clot formation.\nThe fact that you have pain, might be an indication though that you have a dry socket. This happens when the blood clot is disturbed or if food gets into the socket. This is more common in bottom extractions and in some cases the stitches accidentally trap food particles, which if not rinsed out correctly, also leads to dry socket formation.\nI would arrange a follow up visit with your dentist/oral surgeon, to make sure that don't have a dry socket, and if you do, to treat it accordingly.\n\t\t\nClick to expand...\n\nThank you for your reply. What I am concerned about it what appears to be left over roots that can be seen in picture DSC_0042, next to the x-ray picture. Thank you. Dr M: Impossible to say without a new x-ray, but it might only be the bone in between the roots of the molar that you are seeing here. This is normal and usually breaks down as healing progresses. You might even sometimes experience bone particles coming out through the gum at a later stage.\nIf you are scared that it is root pieces left in situ, you will have to take a new x-ray" }, { "id": 150, "title": "Pain in this weird shaped area", "dialogue": "nikassam: Hi ,\n\nI had a very surprising upper wisdom extraction ( surgical )\n\nAs my teeth had a very weird root position ( dentist found while looked in CBCT scan)\n\nBone loss and than while extraction required bone cut .\n\nAll done well , suture removed 9 days ago .\n\nIts been 2weeks+ of removal\n\nBut as shown in picture these weird shapes arised in the extracted teeth area and now it causing pain and pain radiates through my ear\n\nWhat it is ?? I wanted to know IS IT BONY THING or What ??? .. i will still wait next 3 weeks as dentist saaid DO NOT IRRITATE THE EXTEACTED AREA as well as DO NOT GO FOR ANY DENTAL PROCEDURE TILL THAN\nLater after 3 months Bone grafting is adviced by dentist ( i trust him as he is the only dentist who treat my entire family and me since my childhood )" }, { "id": 151, "title": "Does anyone know what these are?", "dialogue": "cfrost: First of all, I apologize if this isnt the right forum. Im lost and I dont know where else to ask, though i understand if you remove it. \n I had a panoramic xray a few weeks ago and it wasnt until now that I noticed these holes in my cheekbone and jaw area. What are they? Are they normal?\nThe oral surgeon didnt say anything about them (well... he just looked at my xray for like 3 seconds so I doubt he even saw them)\n\nAny ideas? It looks as if the bone is wearing down and im worried now..\n\nthank you" }, { "id": 152, "title": "Hardly any teeth, been terrified for years, previous work collapsed and now all need extraction. But no dentist,", "dialogue": "Mummylaura: After years of gum problems, work had done didn't last and just putting off dealing with it for years, I'm now in constant pain, can't eat properly, sore mouth, looking years older and no confidence at all . But now I can't find a nhs dentist, and scared will end up needing emergency surgery and being left looking even worse and no teeth at all. I'm 39 and it has taken over my life, I'm a shadow of who I used to be." }, { "id": 153, "title": "Impacted Wisdom tooth extraction", "dialogue": "GiGiGleeson: Hi. I had my upper right impacted wisdom tooth removed 4 weeks ago. My dentist at the time said that it had been a much trickier extraction than he originally realised and that my healing process would take longer than a \"regular\" extraction. I have been steadily getting better and had 2 courses of antibiotics But I still have some very minor swelling on my inner cheek and some slight throbbing now and again not enough to take any pain killers for but I just wanted to check that I'm on the right path. Do I need to book in to see my dentist again? Thank you in advance for any replies" }, { "id": 154, "title": "Is my tooth extraction healing correctly", "dialogue": "Cmattieg33: It’s day three of tooth extraction and was just wanting to know if it’s healing properly. I wasn’t given any antibiotics or pain killers, they said they weren’t necessary. The pain today is a very dull throbbing like a 1 out of 10. It looks like there’s a tiny hole in it, but I mean I did just get a tooth pulled three days ago but I didn’t notice it yesterday. I also woke up with really bad breath. Might just be normal bad breath and I’m just overthinking it because I am DEATHLY afraid of dry socket. I have been googling everything and looking at all kinds of pictures and of course it’s not helping. Dr M: Good day\nIt looks like it is healing normally. Typical dry socket signs would be severe pain after about 3 to 5 days. As well as a bad taste or smell. If your pain level is only a 1 out of 10, I would be patient, and just follow the post op instructions given to you by your dentist." }, { "id": 155, "title": "Wisdom tooth extraction methods and Dr Joel M Berns", "dialogue": "BTEpps: Hi there, \n\nI grew up in Stamford CT and in 1981 the most awesome dentist Dr Joel M Berns removed my wisdom teeth before I went to college. Dr Berns had a unique (at the time) technique, where he sectioned the tooth into 4 pieces and removed each piece individually. Many of my friends and family had their wisdom teeth removed with this process by Dr Berns and none of us had any issues or even needed serious pain meds to recover. \n\nIt is time for my kids to get their wisdom teeth done and of course Dr Berns is long since retired. Does anyone know. \n\n1) What this technique is called and if its still used?\n\n2) Any dentists in Pittsburgh PA who practice such a method?\n\nThanks,\nBruce AF05: BTE- I don't believe his method of treatment has a specific name; sectioning wisdom teeth is done when removing it in one piece will by difficult and/ or will cause damage to adjacent teeth and hard (bone) /soft (gum) tissue. Now, sectioning wisdom teeth is common when they are impacted. However, sectioning the wisdom tooth into 4 pieces is done in rare occasion for sure. AF05 BarbaraG: AF05 said:\n\n\n\n\t\t\tBTE- I don't believe his method of treatment has a specific name; sectioning wisdom teeth is done when removing it in one piece will by difficult and/ or will cause damage to adjacent teeth and hard (bone) /soft (gum) tissue. Now, sectioning wisdom teeth is common when they are impacted. However, sectioning the wisdom tooth into 4 pieces is done in rare occasion for sure. AF05\n\t\t\nClick to expand... BarbaraG: I had my impacted wisdom teeth treated by Dr. Joel Berns in 1982. As I recall, he pulverized the tooth and then removed the pieces. Never had any problem, although my current dentist says he can see scar tissue where the tooth must have been. But again 40 years later and it’s still fine!" }, { "id": 156, "title": "Redness on foliate papillae", "dialogue": "Shariar: I have redness on my foliate papilea with 2 little lumps over a year. it's smooth and soft." }, { "id": 157, "title": "Hospital Patients", "dialogue": "wmw313: Can someone please give me guidance on how I could get a medicare patient authorized in an outpatient facility for cyst and infection removal when the code 41899 is \"dental in nature\" and medicare doesn't cover dental procedures?\nThe codes that I am using are 21030,21040,21025,21026 - but the hospital says they have to add and bill 41899, so all of my claims are getting rejected." }, { "id": 158, "title": "Oral Surgery or Simple Extraction?", "dialogue": "strivingbowl: I have had one impacted molar since I was 17 (I am currently 31). About 2 years ago, the impacted tooth peeped out of the gums on the side, and since then about 1/4 of the tooth has become visible. The tooth is at a 45 degree angle underneath my second molar, and has dissolved half of the roots on the second molar. The same situation happened on the bottom wisdom tooth when I was 16, and the dentist just pulled the second molar and the wisdom tooth came in just fine (still 45 degree crooked but fully erupted, anyway). \nI went to an oral surgeon, and he said pulling the second molar this time would still not allow the tooth to fully erupt because I am 31 years old and teeth do not erupt anymore when you get that old. Then I read online about how supra-eruption occurs at any age, and I know the tooth has moved some recently because it sticks out farther now than when the gums still covered it.\nMy question is, is it true that pulling the second molar would not help because I am too old, and the wisdom tooth would just sit in its partially erupted state from now on? Or would it finish erupting after the second molar on top of it was removed? honestdoc: I believe the oral surgeon is partially correct in terms of eruption. Everyday your teeth will shift while the opposing and adjacent teeth will limit its extent. The wisdom teeth will shift less since your bone is much more dense at 31 than at 17. If the 2nd molar is damaged, it needs to be extracted. strivingbowl: Can teeth still erupt past 25-30 years old if they were blocked by another tooth prior? honestdoc: It is unpredictable and any eruption can be very slow due to more dense bone." }, { "id": 159, "title": "Nonsurgical cyst treatment", "dialogue": "Davada12: Hello,\nI'm hoping that someone is able to help with this. I have what seems to be a periapical cyst around the root of tooth 32, which had root canal done four years ago.\nFrom the research I could do online, it seems that conservative approaches are viable options and successful. I'm trying to find a doctor who might be open to the idea of trying a conservative treatment, before jumping into surgery. Any advice?\nI might be able to post some pictures of the 3d x-ray that I'll get tomorrow.\nThanks in advance." }, { "id": 160, "title": "Tooth implant - can I avoid sinus lift? (6.8mm bone, 10mm dental implant)", "dialogue": "avi321: Hi all,\n\n5 months ago, I had a tooth extracted (tooth #16) and now need to get a tooth implant.\n\nMy doctor wants to perform the implant without a sinus lift, but another doctor said I need a sinus lift/bone graft. My bone height is 6.8mm, and both doctors want to use a 10mm dental implant.\n\nMy dilemma:\n\nOne doctor wants to perform a sinus lift/bone graft because the 6.8 mm bone isn’t enough.\n\nThe other doctor also wants to use a 10mm implant, but without a sinus lift. He said a few millimeters of the implant will be in the sinus cavity, and that should be fine.\n\nWhat should I do?\n\nCT scan attached\n\n(Incase its relevant, I’m 33 years old) honestdoc: Nothing should penetrate the sinus. I would have an experienced periodontist or oral surgeon place implant with sinus lift. Don't cheap out." }, { "id": 161, "title": "Jaw necrosis?", "dialogue": "Deamo5339: Not sure if this is the right place to post. I have been on Bisphosphonates for bone cancer. I've noticed that I suddenly have a numb chin. It feels like when you get a shot before getting your teeth worked on. Is the from the Bisphosphonates? Kind of worried here. No other teeth/gum problems that I know of. Dr M: Good day\n\nThe best option would be for you to see your dentist as soon as possible with a possible referral to an oral surgeon. Deamo5339: Dr M said:\n\n\n\n\t\t\tGood day\n\nThe best option would be for you to see your dentist as soon as possible with a possible referral to an oral surgeon.\n\t\t\nClick to expand...\n\nThank you. I will." }, { "id": 162, "title": "Coming up on 6 Days Post Op Am I healing normally?", "dialogue": "Psypato: As a paranoid person who suffers from pretty severe dental phobia, I would like someone’s opinion on how my extraction is healing. I am coming up on the sixth day with no pain at all. Just a mild discomfort and occasional headache but no pain whatsoever in that region. I am also an athlete and I am wondering when I can go back to intense exercise. Thank you. Dr M: Good day\n\nIf there is no pain in the area, healing is progressing normally.\nAfter a week it should be fine to go back exercising. Psypato: Thank you Dr. M!" }, { "id": 163, "title": "Extraction and risk of sinus perforation", "dialogue": "ROverBoy83: I've had trouble with my second molar on the right side of my maxillary teeth on and off for a few years. To cut a long story short the decision has been made to extract the tooth next week to resolve all the issues with it, caused by my narrow jaw and not helped by the adjacent wsdom tooth. \n\nHowever the dentist has told me that the root of the tooth is very very close to touching the maxillary sinus and there is chance of a sinus perforation. He rates the risk at about 10% but says that he will do everything to prevent it from happening.\n\nNow I didn't know much about sinus perforation at time of being told about it and have read up on it and it sounds quite unpleasant and not something that you really want to experience.\n\nMy question is if it was to happen, I believe that it could well need an oral surgeon to fix it unless it's very minor? Apparently here in the UK waiting times for oral surgeons are very bad because of COVID, so makes me worry a bit. \n\nAny advice?" }, { "id": 164, "title": "Abscess (impacted 2nd bicuspid) - extraction needed?", "dialogue": "temple: Hello,\n\n60 year old male. My (new) dentist is recommending extraction of an impacted 2nd bicuspid following an abscess, which has now been cleared up by a course of anti-biotics.\n\nI've never had an issue with the tooth before, and am a little concerned due to the proximity of the tooth to the nerve (see attachment). A CT scan was taken and the justification was along the lines of general degradation and impact/damage to adjacent teeth. \n\nMy relationship with the dentist is new, and perhaps therefore I'm being overly cautious, but I'm curious if experts would suggest there are things that I should do to validate that extraction is the correct way forward?\n\nThanks in advance." }, { "id": 165, "title": "Tooth removed 3 days ago", "dialogue": "Adele93: I had my tooth removed 3 days ago now and no granulation tissue has started to form yet (at least I don’t think it has) with Christmas so close by I’d just like to know if this is dry socket or wether it’s just taking it’s time to slowly heal? Thank you Adele93: honestdoc: It looks good. The material you're seeing is epithelial repair tissue. Adele93: honestdoc said:\n\n\n\n\t\t\tIt looks good. The material you're seeing is epithelial repair tissue.\n\t\t\nClick to expand...\n\nThis is today (1 week 3 days since having the extraction) there isn’t much in the hole at all, I can certainly see the hole has decreased in size however the hole is pretty empty so am I still to be worried about the chances of dry socket or would I have had this by now? Thank you" }, { "id": 166, "title": "Tooth #30 extracted 11 days ago, healing normal?", "dialogue": "Vicky: It was a difficult extraction (for root resorption), dentist had to break up the tooth with a power tool (tooth had 3 separate roots). I was careful & followed instructions, but on Day 6 still had red, very sore gum. Dentist prescribed antibiotics over phone, which I take for 4 more days. The wound is covered over, but very deep and especially concave on the cheek side. I have periodic aching of my jaw, cheek, ear, or forehead (though pain is not severe). Gum is still tender on cheek side. Photo doesn't show how concave/deep the wound is. . . . Is it healing normally? Dentist doesn't want to see me for another 10 days. honestdoc: It appears to heal within normal limits. Make sure you are not experiencing any swelling. Vicky: Thanks very much! I ended up phoning the dentist again because of continuing earache, etc., but he said the pain would be concerning only if it got worse. He had me start on mouthwash rinses containing hydrogen peroxide. I see him in one more week. Vicky: Three weeks after the extraction, the gum is still somewhat reddish and sore, and now I'm wondering if the white areas are not the normal healing covering, but actually a bit of bone protruding? I gingerly touched a pointy white spot that juts up from the gum, and it is hard, like bone. Is this concerning? I finally get to see the dentist again this Thursday. Should I wait til I see him, or call in Wednesday about this hard, white pointy protrusion from the sore gum?" }, { "id": 167, "title": "Wisdom teeth removed 2 days ago, healing normal?", "dialogue": "Gannon369: Had three wisdom teeth removed 2days ago. The bottom tooth was impacted and had bacteria/infection in between molar and wisdom tooth. It was at a crazy sideways angle and was pushing the molar out and thus an infection. I've been taking antibiotics, and ibuprofen as prescribed. The bottom hole bled dark blood alot on day one. Eventually bleeding subsided. Have a bit of pink Saliva still, and am very gentle when brushing and rinsing with salt water. The two top extraction sites already seem normal, I can't even really feel any discomfort and look pretty normal to me. The extraction site on the bottom was definitely the problem area going into surgery. Now that heavy bleeding has subsided, the area is now looking dark, almost grayish fleshy in color. And am wondering what's normal two days after surgery." }, { "id": 168, "title": "How long is recovery after a premolar extraction?", "dialogue": "superpossible: A lot of the information online seems to be catered towards wisdom teeth extractions.\n\nI have had four premolars removed for my orthodontic treatment. MattKW: Assuming that you're fairly young, then it will heal very quickly, e.g. 1-2 weeks. Much easier than wisdom teeth. Nik Nik: superpossible said:\n\n\n\n\t\t\tA lot of the information online seems to be catered towards wisdom teeth extractions.\n\nI have had four premolars removed for my orthodontic treatment.\n\t\t\nClick to expand...\n\nI know this is an old post. I just got mine extracted ready for braces. How long did yours take to heal and did you get any tooth sensitivity ?" }, { "id": 169, "title": "Is this a Dry Socket PLZ ANSWER", "dialogue": "toothfairy1: I got my wisdom teeth removed 6 days ago and have been following all the rules very strictly but i’m paranoid this may be a dry socket or is it just holes? please let me know!" }, { "id": 170, "title": "Roof of mouth", "dialogue": "adamofatoms: Hey. So back in July I ate a really hot pizza and burned the roof of my mouth. I might have irritated the wound afterwards. Anyway, as it healed(?) A bump/lump formed. It doesn't really hurt or cause any pain when I run over it with my tongue. (I'm not a smoker or drinker. 25 yo. 248 lbs. 5'11. Medications: sertraline, bupropion, alprazolam, lisinopril, vitamin d, b12, CoQ10, atorvastatin). honestdoc: You must have burnt into the connective tissue. The bump/lump could be the scarring/healing response. I don't think it will be a problem unless you're having pain and or swelling or if the lesion is getting worse. adamofatoms: Thanks. That puts me more at ease. db1988: adamofatoms said:\n\n\n\n\t\t\tThanks. That puts me more at ease.\n\t\t\nClick to expand...\n\nso the lump is still there? adamofatoms: db1988 said:\n\n\n\n\t\t\tso the lump is still there?\n\t\t\nClick to expand...\n\nIt was, but I think it was from the agitation. I gargled with salt water the last couple nights and that's helped it heal a bit. I barely feel it now" }, { "id": 171, "title": "Could I be starting to have dry socket?", "dialogue": "Vlad797: I just had my bottom right wisdom tooth extracted at 17 about 18 hours ago, one of my stitches came lose and I'm scared that i might get dry socket, there is a visible hole with no blood clot, I'm also a smoker and I wanted to know what would be the safest time to start smoking again" }, { "id": 172, "title": "Full Mouth Extractions and Implants", "dialogue": "JJ_8613: Hi All.\n\nMy anxiety and stress levels are through the roof right now.\n\nMy two front lower teeth #s 24 and 25 have been having root canal symptoms recently. This all started in mid July 2021. My dentist was not able to get me in for an appointment until October 7, 2021. The left one #24 started first. The tooth became chipped when I was eating. The pain started gradually and intermittent at first and then became worse and worse and constant. Now both teeth have pain with hot and cold liquids and foods, sharp pain with hot and cold, the tooth throbs and pain lingers after hot and cold, a constant toothache and pain with biting and chewing.\n\nI saw my dentist three weeks ago. He examined these and the nearby teeth, took x-rays and testing the teeth with endo ice. Both #24 and #25 were positive testing to the endo ice and positive with the tapping on the teeth.\n\nHe said the x-rays look fine. No signs of disease or illness other than the one tooth being chipped. He referred me to the endodontist for a consultation and root canal treatment and sent the x-rays to them.\n\nI saw the endodontist for a consult yesterday Tuesday, November 2, 2021. I’ve seen this doctor before and he knows my history. I had a 3D cone beam CT scan performed at this appointment. I also had regular digital x-rays taken of the teeth in the area. He examined teeth numbers 22, 23, 24 and 25. Tooth #22 was normal to all testing. Tooth #23 actually surprised me and hurt the worst at this time. Tooth #23 the doctor told me had a previous root canal treatment, maybe 2-3 years ago. The tooth tested positive to all tests including tapping, gum probing, biting on cotton and cold testing. He showed me the digital x-ray that showed the tooth has extensive damage to the tooth and the surrounding gums. He diagnosed it with External Tooth Root Resorption. I’ve heard this diagnosis a few times before with different teeth. This is considered an auto-immune disease that only affects the teeth. It’s thought to be caused by trauma which in my case is likely the double jaw surgery I had in 2014 in addition to adult braces. He said the previous root canal treatment on #23 is breaking down and no longer helping the tooth. He said that normally he’d recommend a root canal re-treatment but that in this case it would be likely to fail. The tooth is too fragile and weak and he is also concerned about the surrounding gum tissue. This is why the re-treatment is not recommended. His recommendation is to extract this tooth and to replace it with an implant. The implant would be placed 2-3 months after the extraction giving the surgical site time to heal. I may need a bone graft but they won’t know until my dentist sees me.\n\nSo teeth #s 24 and 25 are also a possible cause for concern. These teeth did test positive to the tapping and biting on cotton. I did feel cold pain with these teeth also but he said they were within normal ranges at this time. This seemed odd to me because when my dentist tested those two teeth they hurt me a ton with the cold test. The endodontist said that this may be because tooth #23 is hurting me so bad. After #23 has healed from the extraction, about 2 weeks, he wants to see me again to re-test #24 and #25. These teeth may need root canal treatments but it’s hard to know at this time with #23 hurting so badly right next to the other suspect teeth.\n\nAs soon as I got all of this news my anxiety and stress levels got out of control. I felt like I wanted to cry in the dental chair. I think I was just in shock at the time.\n\nRight after the appointment I called my dentist and their next opening for an extraction appointment was a month and a half out. I took the appointment and then called around to a couple of Oral Surgeon offices to get their recommendations and appointment availability. The Oral Surgeon has an appointment on Thursday, November 11, 2021 in the afternoon. They said they could do a consult and treatment in the same day. They could also do my implant later on. I took this appointment and cancelled the other one. This tooth #23 is hurting me so bad that I just can’t wait any longer. The office does offer Nitrous Oxide which I told them I want to use for this appointment. It’s the only way I can get through dental treatment without having a panic attack.\n\nThe Endodontist is also very concerned about my gums around this tooth #23. He measured the pockets at the appointment and that really hurt. I had a bone and gum graft on my six lower front teeth about four years ago and this tooth was part of that. He wants me to see my Periodontist again to re-evaluate this tooth and the rest of the bone and gum graft. We’re hoping the grafts are not failing.\n\nI’ve been alternating taking OTC Tylenol and Aleeve. I was advised several years ago to try to avoid Ibuprofen due to a stomach condition called Gastritis. I was so stressed at the Endodontist appointment that I forgot to ask what to take for pain. I called the next day and they are calling in a prescription of Hydrocodone and Ibuprofen 800 mg. They are aware of the stomach issue and said that taking it short term should not cause any issues.\n\nThese teeth are just hurting a lot. The pain is keeping me up and waking me at night. During the day it hurts so bad that I'm distracted at work and during regular daily activities. I'm stressed and anxious not knowing what will happen. I still have these potential root canal treatments hanging over my head.\n\nI’m super anxious, stressed and nervous about meeting a new doctor the Oral Surgeon and of the procedure of the extraction and the future procedure of the implant. I’ve had extractions before but it was 8 teeth at once to prepare for my double jaw surgery so I had IV sedation at that time. I think in comparison the nitrous will work for just one tooth. The appointment is supposed to be 1 hour and 15 minutes for the consult and extraction at the same time.\n\nI’ve never had an implant before so the unknown of a new procedure is really freaking me out. I also plan to use the nitrous for this future procedure.\n\nI was told years ago when I had my first root canal treatment that being that I was so young that the root canals would likely have to be re-treated and the teeth would break down over time causing the need for extractions. I just hoped this wasn’t true and never expected it to happen so soon. I’m afraid this is just the beginning of more future extractions to come.\n\nThis auto-immune disorder External Tooth Root Resorption is a rare condition and in my case is very aggressive. This is at least my third diagnosis in 2-3 years.\n\nI've attached the x-ray is anyone is curious. If you look at the tooth #23 you can see the old root canal breaking down. Also if you look for the circle in the middle of the tooth that is the Resorption.\n\nI'm now 4 days post-op from #23 being extracted. I asked the Oral Surgeon about the External Resorption and it's likely progression and prognosis concerning my other teeth. He said that since this disease is very rare and aggressive it's hard to say. He thinks it will likely attack the rest of my teeth one by one leading to root canal treatments and eventually more extractions.\n\nI've already had 18 of my teeth root canaled in 10 years. A lot of these teeth the root canal treatments are begining to fail and causing me pain again.\n\nI have about 10 'healthy' teeth left and right now 7 of them are having pain and signs of illness. Three of them may need root canal treatments but I'm waiting to see the Endodontist this week.\n\nI was told a few years ago that my teeth are so fragile that they will all likely need to be extracted at some point and the root canals don't last forever.\n\nI'm seriously considering full mouth extractions right now. I'm sick and tired of having pain and anxiety about my teeth. If I did this I would have them all replaced with implants.\n\nHas anyone here had experience with full mouth extractions, implants and/or External Tooth Root Resorption?\n\nFeeling very lost, confused and anxious right now.\n\nI just need some support right now. Thank you for listening to me vent.\n\nJJ" }, { "id": 173, "title": "Instrument left on", "dialogue": "Kaya: I posted this on general forum but thought this forum is more appropriate\n\nHello\n\nLong time ago a file was left in the upper L-H side. I started to feel the pain now. My current dentist sent me to a very reputable oral specialist. He, however, for some reason doesn’t want to touch the area.; and didn’t explain why.\n\nWhat could be the problem? \n\nI would be grateful for advice\n\nKaya" }, { "id": 174, "title": "What to do post op after a Gingivectomy?", "dialogue": "Aurora: I had gingivectomy done between two molars where there was gum overgrowth, one of the molars has an rct done and is filled up but no crown yet. The bleeding from the gingivectomy has stopped but there is some gelatinous blood deposited between the gap of the 2 molars. I am 6 hours post op, should i brush the blood clean or wait for a few days? What are other post op measures i need to take?" }, { "id": 175, "title": "Tooth extraction with socket preservation recovery time", "dialogue": "exe8: I had a lower premolar extracted and bone graft placed 6 days ago. tooth was fractured and there was likely an infection already there. was put on antibiotics just before extraction. had considerable pain and swelling in the first few days, but pain and swelling remains. Seems to be subsiding day by day but slow. I'd like to ask what a realistic recovery time might be given I am already 6 days out? thank you pablomustangue: it depends on the surgery, and how you are treating it, better and go back to your dentist, so he can see if you need to continue with antibiotics for longer, meanwhile, make a warm water compress twice a day." }, { "id": 176, "title": "Bone around tooth root still not healing after 3 years - apicoectomy", "dialogue": "Kanti: Hello,\nI had an apicoectomy on a lower molar around 4 years ago. About a year ago I had a CBCT done and found out that the bone one of the root tips did not heal yet.\nCan someone please provide me with some explanation to why this could have happened? is it possible that there is an ongoing immune reaction to the synthetic membrane put inside to accelerate bone healing? or is this due to the bacteria?\nI have an unexplained jaw pressure and problems since 2 years. Could this be related to that non-healing bone?\n\nI had an another apicoectomy on the other side 2 years ago (where the extracted tooth location is), but had weird complications there and decided to get the tooth extracted 8 months after the operation. The extraction wound did not heal properly due to unknown reason. I had to go to a biological dentist who opened the wound again, scraped it properly and closed it back again. Now it is better.\n\nI have erupted wisdom teeth, however the lower ones are still pushed back into the jaw as there is not much space left for them.\nThe upper ones are a bit sideways and the is not much place for them either but all 4 are not \"severely\" impacted in that sense. I sometimes have soreness around the upper wisdom teeth. Could this jaw pressure be caused by them although they are not \"visually\" pressing towards nearby teeth? \n\nI attached a picture of the CBCT of the tooth in question (apicoectomy). Also an older panoramic picture where the wisdom teeth are visible (before getting the one tooth removed). honestdoc: I noticed 2 endodontic schools of thought about failing root canals. The older endodontists will do more apico surgeries while the younger ones will do root canal retreatments and less apicos. It makes sense because doing apicos without resolving internal disease will fail to heal. However, my observations are that teeth with multiple attempts at root canals are much more prone to root fracture. Many times the more predictable option for failing RCTs is to consider implants. \n\nAre your upper wisdom teeth tipped more towards your cheek? I see the lower right 3rd molar root apices are very close to a major nerve. If you're older than 25 years old, it can be more traumatic to remove your wisdom teeth since your bone is more dense and hard. Kanti: @honestdoc thank you for taking the time to answer me.\n\nSo if I understand you correctly, you cannot really tell me or know the reason why do I have such a relatively large unhealed chunk of bone after so many years? can the bacteria be so powerful that the body could not deal with it or does this suggest the existence of another accompanying condition?\n\nYes the upper wisdom teeth are slightly tilted towards the cheeks. The pressure feeling I have is in the upper jaw as well. And I have been having it for about 2 years so far. And no doctor is able to tell me what is causing it. Could those two wisdom teeth be the culprit?\nUnfortunately I am almost 30. I was thinking of getting all of my wisdom teeth out to see if this helps with my chronic severe tinnitus. I was scared of the complications, and you have confirmed them to me. But I assume that removing the upper wisdom teeth shall pose no problem still? honestdoc: There may be 2 possibilities for the radiolucency around the root apex. It could be a scar with no disease or there is still infection. Bacteria can get resistant (see Enterococcus Faecalis) but usually if the source of infection (internal root filling) is still there. Did you follow up with the specialist/surgeon who did the apico procedure?\n\nUpper wisdom teeth are less traumatic to remove. If you're having problems there, then it will be more predictable to remove them. Having an experienced surgeon can best manage any complications." }, { "id": 177, "title": "[X-ray included] Do I need to get my horizontal wisdom tooth removed ASAP?", "dialogue": "LadyinMid20s: 1. Do I need to get it removed as soon as possible, or can I wait one more year, for example? (I just don't know about getting a surgery during COVID). Can someone help me make this decision? honestdoc: The horizontally impacted 3rd molar on right side can potentially damage the tooth in front of it. However, the root tips are very close to a major nerve. I would find an experienced oral surgeon and get a CT scan to locate the proximity of that nerve. If you are concerned with Covid, make sure you vaccinated. You are less likely to get Covid in the dentist office but schedule soon because they will usually get booked out for many months." }, { "id": 178, "title": "Implants position 1.4 and 1.5", "dialogue": "Dr.A: Hei,i need some opinions about the restoration of these implants that i placed.I know that there is no 3 mm between implants but do you think it can be restorable?Thanks for help!" }, { "id": 179, "title": "Uncomfortable feeling 10 days after wisdom removal", "dialogue": "snojo: Today is 10 days after I had 3 wisdom teeth pulled (2 on top and 1 on the bottom) and I still have an uncomfortable feeling when I eat or talk. it’s not painful or anything but my mouth just doesn’t feel normal especially when I eat. It almost feels as if something more than just my 3 wisdom teeth are missing, Thats the best way I can think of to describe it. I don’t know if it feels that way because new gum tissue is forming/growing back or maybe they removed some of my gum before they could pull the wisdom tooth and that’s what’s giving me this sensation. anyway, is this normal 10 days after wisdom extraction? Has anyone else experienced this? Will that feeling go away? honestdoc: Every person will respond differently. What can be abnormal are swelling, intense pain, and more rare, numbness. snojo: Well It’s certainly not intense pain or numbness, but if it’s swelling then wouldn’t that be very noticeable when I look inside my mouth with a mirror. I say that because I don’t really notice anything different besides the slightly open holes where my wisdom teeth used to be.\n\nBy the way, since it’s not intense pain or numbness do you think my mouth will eventually feel the way it used to? Do you think the weird/unusual feeling could be due to new tissue forming? honestdoc: The unusual feeling could be from the healing process. You may eventually get used to the new conditions." }, { "id": 180, "title": "Remove implant crown", "dialogue": "Ann444: 18 months ago my general dentist advised that I have all my teeth extracted and have dentures made. She highly recommended snap on dentures on the bottom jaw which has been done. She is unable to do the upper denture for me because I have an implant to replace tooth #10. Besides this implant, I have only seven other teeth, most of my molars are already extracted, so I am not able to chew even with the snap on dentures. I have been looking for a dentist for over a year who can make an upper denture by first removing The implant crown. None of them want to remove the crown. I even waited two months to see the dentist who placed the implant, but then he refused to remove the crown saying that I need to save my teeth with root canal’s and crowns. He also insulted me by saying I would not have so much decay if I had been seeing a dentist. I had been seeing a dentist twice a month and as soon as a cavity was filled, another one appeared. My regular dentist says my teeth are so decayed and have been filled so many times, that they cannot be saved. I had three teeth crumble because they were filled so many times. I dread having dentures but fear I have no alternative, the decay is near the nerves and it’s urgent that something be done. When the molars were extracted, it showed bone destruction. I have been on many, many dental consultations regarding removing the implant crown in the last year. When I call an office they seem to understand and all insist that I come to the office where yet another x-ray is done, and I’m told this dentist can’t do it. My question is why are dentists who are inserting implants reluctant to remove a crown from an implant and, if it can’t be removed is it possible to make an upper denture around it? Surely with all the implants being done these days,I’m not the only one with this problem. Seeing all these dentists has become very expensive. I’m a senior citizen living only on social security. Ann444: Can anyone recommend a dentist who is willing and able to make an upper denture around my implant? honestdoc: You seem to have a complicated teeth conditions. If costs are burdensome, try going to dental school faculty (instructors) for their opinion." }, { "id": 181, "title": "Wisdom Headache", "dialogue": "PhilW: A month ago now I had a wisdom tooth extracted along with the two in front of that tooth...Sometime afterward I started having bone coming through the gum and ripping my tongue to hell..Well I went back and they nipped off the edge of the bone and called it good, and it was for about a week and it started ripping my tongue all to hell again! I paid cash up front cause I had no insurance so you can imagine they are in no hurry to help me the second time around!\n\nMy questions is will the gum ever grow over this damn thing? honestdoc: The gums should cover the extraction sites. Unfortunately you may be experiencing dead pieces of bone trying to flake off. Go back to that dentist to remove the bone." }, { "id": 182, "title": "Implant angle, material", "dialogue": "DF-Mark: I finally got my root canal tooth pulled at the start of the year.\nThe gum has healed very nicely, pink and smooth, no discomfort.\n\nI am ready for my first implant and have one main question right now.\n\nHow does a dentist determine/measure the angle of the implant and ensure\nit is correct?\nI am not talking about the angle left-to-right, but rather outward vs. inward.\nI hope I made myself clear. \n\nI'm sure they can't just eyeball this right?\n\nAs far as material is concerned, are there various options for both the base and the cover?\nIf so, briefly what are the pro's and con's of each? honestdoc: I would go to an experienced implant restorative dentist. He or she will coordinate treatment with an experienced surgeon (periodontist or oral surgeon) to place the implant. The restoring dentist may fabricate a surgical guide template to allow the surgeon to place the implant where the dentist will want it. Usually the surgeon will obtain CT scans to verify safe implant placement away from vital structures such as nerves or sinuses or if the bone is perforated. All your questions should be answered by the restoring dentist." }, { "id": 183, "title": "Have been recommended wisdom tooth removal but it has many complications, need help, idk what to do!", "dialogue": "mna: i've been having this pain in my last molar on the left lower side of the jaw. have been told it's because of an included molar (completely covered in the gum tissue, not exposed). i also had gum pain due to an abscess that formed on the last molar (the visible one). the abscess was drained but i had what i felt was a whole body infection from it - i took what antibiotics i had on hand (cefuroxime) but it didn't eliminate the pain completely, just diminished it. that was almost 2 months ago, now the pain is back along with an unbearable headache and a swollen behind the ear lymph node.\ni have been told i need surgery to remove my wisdom tooth but because of its positioning i have been made aware of many complications: the wisdom tooth touched the mandibular nerve and i have been told i can have permanent nerve damage to that part of the jaw. i also have been told the risk of dry socket and bone infection is higher. but i was told all this by dentists suggesting i get this operation at their practice at a very elevated price.\ni'm afraid to have this operation because of the possible complications and also because of the fact that i believe i have a general gum infection - as i feel pressure like pain in my upper jaw as well.\nshouldn't i take a round of antibiotics before the surgery anyway since - from what i understand - going into a surgery with an active infection is dangerous.\ni'm sitting here with a horrible headache that renders me useless and also nausea and an overall tired feeling in my body. i don't know what to do. the tooth itself doesn't hurt but i've been warned by the dentists it can get a bad infection further down the line.\ni don't even have a recourse here bc i live in a 3rd world country where there are few cabinets who do this procedure and i would have to go to the state operated dental hospital to get it done.\ni feel trapped, what should i do? i have a script for antibiotics (augmentin) form my GP. should i start taking those? i should add i suffer from liver inflammation and i'm afraid to add an known liver toxin like an antibiotic but idk what to do. the drs in my country are very incompetent and i'm afraid....\ni have an xray attached. Dr M: Good day\n\nUnfortunately the risk of nerve damage is always there with an impacted 3rd molar. It is therefore recommended to get the tooth removed by an experienced oral surgeon in order to limit complications.\nIt is also possible that the pain your are experiencing is from your lower left 2nd molar and not the wisdom tooth. On the x-ray provided it looks like you had root canal treatment done on this molar, but this treatment is incomplete, with the mesial root of the tooth completely untreated. This means you might have an infection in that tooth as well.\nToothache is best treated with anti-inflammatory medications, and if there is swelling or signs of infection, antibiotics. If you are worried about liver complications, you can ask for an antibiotic that is safe such as Amoxicillin or Azithromycin, and you should be fine if you follow the dentist/doctor's dosage instructions.\n\nHope this helps. mna: well thanks for the reply, it does help! i have been taking NSAIDS, mostly dexketoprofen.\ni actually have seen an endodontist today and she said to not get the second molar retreated. she said that to her it appears that there's no infection visible on the x-ray (but i know there can be a hidden infection). and she also said i should put a crown on the 2nd molar bc my gum is loose to fill the space, without retreating the tooth.\ni thought it quite odd that she didn't want to do the root canal.\ni have been to a surgeon - an oral surgeon - who was too afraid of the complications to pull out the wisdom molar. i have another appointment with another oral surgeon to get a second opinion." }, { "id": 184, "title": "Should I get my wisdoms removed?", "dialogue": "arence: Hello everyone!\n\nI went to get x-rays done the other day and the dentist said I should have my wisdom teeth removed. Attached is the x-ray.\n\nAs you can see, the bottom left has a molar that looks like it's going to move directly into my lower jaw. The orthodontic significance of this is that, if I do nothing and the tooth doesn't change direction, my bite will change. Also, there appears to be some sort of boney growth on the bottom left of the image, where my left lower jaw is. I don't know what to think about it.\n\nI really would like to get a second opinion on the doctor's verdict. I have only one mitigating factor and one concern that would make me cautious about getting surgery. Firstly, in my family, a similar situation has happened with mixed results. One of my relatives ignored the doctor's request to remove the wisdoms removed and turned out fine, however they dealt with crowding in their lower teeth and had to get braces. Secondly, I've heard but can not verify (please tell this is a myth) that losing your wisdom teeth could cause problems with sleep apnea.\n\nI'm scheduled to get the consultation/surgery on Thursday. I'd be very grateful to get a second opinion. Thank you!\n\nFor people who've had this type of surgery, did you do laughing gas or iv? Which do you prefer if you've done both before?" }, { "id": 185, "title": "Post OP of jawbone scrapping 10.months still tingle pain, burning pain", "dialogue": "degerardo: Hello guys, Im writing in regards of my wife's complex situation. Long story short is that \n1.tooth no7 extraction followed dry socket and infection due pieces of dental drills ledt in the wound.\n2.this followed with neuralgia\n3.she was having also a bit dislcated tmj disk due extraction and so she was wearing braces for 3.months, then they needed to be taken oit because pain of neuralgia.\nNo, last year 2020 November she was having surgery of scrapping out the wound in the jaw. But now a 10months later she is still having pain there and also like a vibrating feeling in the jawbone, but none of 10 XRays, 3D scans, MR or CT showed anything, no infection, nothing. All clear. \nAny of you had any such a experience of it? Or is it the healing of the jawbone after scrapping, even 10.months after? We went to many, many doctors, also neurologists, but noone coupd say anything. She is having an open bite a bit, maybe that is causing it, or muscles? \nAny answer, help, or experience from you I will really appreciate. \nThank you so much and sorry for typos. Im on my phone in the train \nGerardo honestdoc: Did she ever see a TMJ specialist? I believe she will need a team of specialists to manage her complicated conditions. Hopefully her neuralgia and TMJ dysfunction gets managed which will help her feel better." }, { "id": 186, "title": "Is this a dry socket", "dialogue": "Hahahah: I am currently day 4 after having all 4 wisdom teeth removed I have terrible pain on surrounding teeth no bad smell just terrible pain and sore jaw please help honestdoc: It's hard to see the socket from the image. Since lower wisdom teeth can be more traumatic to remove, your pain experience could just be from that. Make sure you have no swelling. MattKW: If painkillers are not controlling the pain, then I'd assume a dry socket and head back to the dentist for a review." }, { "id": 187, "title": "Rare Dental Implants", "dialogue": "GratefulGreg86: I received implants from an oral surgeon. These implants are apparently a rare brand and I have had trouble finding a dentist to put teeth on them. The two implants were for teeth that I genetically never had. The implants are located in my upper jaw where the lateral incisors should be. I recently found out the brand and type of implant I have but still can’t find a dentist familiar with my implants. The company is still in business so there has got to be someone out there that can help me. My implants are: “ Zimmer one piece screw vent implants.” I recently went to my 5th dentist and got sent to an oral surgeon who thought the implant was two pieces and tried to remove the lower half and put on a new abutment. This obviously didn’t work and then was told I needed them removed and it would be $7,000 plus for new ones. I already spent this much the first time to have them installed. There has gotta be a way to put teeth on my implants, that’s what they are made for right? Has anyone ever heard of this brand and style implant? Can someone please offer some help. Any help would be appreciated. The original oral surgeon who did the work is no longer in business. GratefulGreg86: My implant is actually called a Zimmer one piece tapered screw vent. It’s either 3.0mm or 3.7mm GratefulGreg86: This is what my implants looks like. Apparently the portion that sticks out of the gum is not something dentists are used to seeing. No dentist I’ve seen has any idea on how to put a tooth on it. MattKW: GratefulGreg86 said:\n\n\n\n\t\t\tThis is what my implants looks like. Apparently the portion that sticks out of the gum is not something dentists are used to seeing. No dentist I’ve seen has any idea on how to put a tooth on it.\n\t\t\nClick to expand...\n\nHave you tried contacting the parent company, Zimmer Biomet? They're not a small company. They might be able to give you address details of some of the dentists who buy and use their implants.Ususally the surgeon who places the implants would have some local dentists he works hand-in-hand with." }, { "id": 188, "title": "Advice after a tooth extraction, implant or leave a gap?", "dialogue": "alexfoxy: Hi,\n\nMy girlfriend (33, non smoker) has recently had two molars removed from her upper right set. The two which have been removed are the 1st and the 3rd, counting from the back, leaving the 2nd on its own.\n\nVisually like this: _T_TTTT\n\nThe dentist is advising to have an implant tooth where the 3rd tooth was, involving a sinus lift. Visually you can’t see the gap when she smiles but the dentist said there are lots of potential complications when leaving gaps in your teeth, such as:\n\nmovement of teeth\ntooth decay\nsuper eruption\nsunken face\nConsidering it is quite an invasive operation she is considering not having the implant, however she is worried about the potential complications. How likely are the side effects happening? Would it be foolish not to get it done? She’s very worried about both options so any advice would be greatly appreciated.\n\nThanks,\nAlex Dr M: Good day\n\nUsually when teeth are removed, some movement can take place since the lone standing molar will try and close the gap. This happens over years, and might involve tilting of that lone standing molar.\nTooth decay can be avoided with normal brushing and flossing and regular check-ups.\nSuper eruption usually only happens if she has a missing lower molar that was opposing the top missing molar.\nSunken face should not be an issue, unless she has several other missing teeth.\nIf she is worried about the consequences of having a missing tooth, she can always try alternative treatments that are cheaper, such as a partial denture. \nAlthough removable, this can be a good temporary option until she has discussed the benefits of an implant at a later stage, since the denture will act as a space maintainer. alexfoxy: Thanks for the response! We will consider the options with this new knowledge. honestdoc: I don't think that dentist is very trustworthy trying to sell her the implants. The only for certain outcome is minor tooth movement depending on the remaining opposing teeth as Dr M mentioned. jedapo: I got this implant three months after removing the second from back bottom left tooth. I went in one week later to get the stiches out...no problem...two weeks after that I noticed it starting to blister...started on antibiotics right away and today he said it looks much better. I go back in two weeks to see if improved. Doc said the dark area around the top of the implant is where the infection still is but might be improving... can someone in the know tell me what it looks like to them? Hate to go through the procedure again...\n\nThanks in advance! alexfoxy: honestdoc said:\n\n\n\n\t\t\tI don't think that dentist is very trustworthy trying to sell her the implants. The only for certain outcome is minor tooth movement depending on the remaining opposing teeth as Dr M mentioned.\n\t\t\nClick to expand...\n\n\nThanks for the response! I did wonder if the dentist was pushing his agenda. If money was no object, do the risks of having the procedure done (infection etc) outweigh the risks of leaving it? honestdoc: I'm very conservative (less drilling, less trauma, less complications). If your GF can function well, then it is prudent to leave it alone. If she has difficulty chewing, then implants can be beneficial. I would go to an experienced implant restorative dentist and that dentist would coordinate with the surgeon on implant placement and other necessary work such as sinus lift, bone grafting, etc. Otherwise like Dr. M mentioned, consider less expensive alternatives like partial dentures. I would stay away from bridges because it needs a lot of drilling on good teeth and once they get drilled, they are ruined forever.\n\nA lot of my patients cannot afford implants and they are doing fine without them. honestdoc: jedapo said:\n\n\n\n\t\t\tI got this implant three months after removing the second from back bottom left tooth. I went in one week later to get the stiches out...no problem...two weeks after that I noticed it starting to blister...started on antibiotics right away and today he said it looks much better. I go back in two weeks to see if improved. Doc said the dark area around the top of the implant is where the infection still is but might be improving... can someone in the know tell me what it looks like to them? Hate to go through the procedure again...\n\nThanks in advance!\n\t\t\nClick to expand...\n\nDid you get this implant from an experience surgeon or from your regular dentist? The x-ray shows some darkened bone around the implant possibly indicating poor integration. I would only have implants placed by experienced surgeons because that's all they do and they are very good at it. jedapo: honestdoc said:\n\n\n\n\t\t\tDid you get this implant from an experience surgeon or from your regular dentist? The x-ray shows some darkened bone around the implant possibly indicating poor integration. I would only have implants placed by experienced surgeons because that's all they do and they are very good at it.\n\t\t\nClick to expand...\n\nMy regular dentist and i have already paid. I have been using them for a very long time but don't think he is a surgeon. So you think I should get a second opinion?? honestdoc: jedapo said:\n\n\n\n\t\t\tMy regular dentist and i have already paid. I have been using them for a very long time but don't think he is a surgeon. So you think I should get a second opinion??\n\t\t\nClick to expand...\n\nI think that would be best. MattKW: jedapo said:\n\n\n\n\t\t\tI got this implant three months after removing the second from back bottom left tooth. I went in one week later to get the stiches out...no problem...two weeks after that I noticed it starting to blister...started on antibiotics right away and today he said it looks much better. I go back in two weeks to see if improved. Doc said the dark area around the top of the implant is where the infection still is but might be improving... can someone in the know tell me what it looks like to them? Hate to go through the procedure again...\n\nThanks in advance!\n\t\t\nClick to expand...\n\nThat's lost too much bone and the implant surface is certainly contaminated and infected. Unfortunately a lost cause, and antibiotics will do no good. Extract ASAP to minimise further bone loss." }, { "id": 189, "title": "Do I have dry socket?", "dialogue": "Elio: On Wednesday evening (6 or 7 days after the operation) the blood clot and the layer of granulation tissue fell out for some reason. The tooth socket hurts a bit. Will it resolve on its on or is there a risk of infection? Dr M: Good day\n\nIf you had a dry socket, you would have had severe pain with a bad taste and smell. Dry sockets are usually also only 3-4 days after an extraction. Any pain you are experiencing now, is most likely normal post op surgical pain that will resolve on its own." }, { "id": 190, "title": "Extraction wound", "dialogue": "Adele_Hedley: I am now awaiting an appointment to see a dentist regarding gum disease causing every tooth to become very loose\n\nI received an emergency tooth extraction by an NHS dentist \n\nEven though it’ was apparent to the dentist who removed a lower molar and a filling next to the extracted tooth, I am not entitled to preventative dental treatment on the NHS!\nIn the 18 months I spend on the waiting list the NHS are only able to extract & perform fillings should they cause pain! Gum disease treatment does not warrant treatment!\nI asked about going private, assessment, x rays, treatment plan starts at £160. I’m looking at £2500 for a hygienist even before I’ve had any surgery!\n\n My illness stole my career that I loved away from me! My marriage ended, I lost my flat, I became homeless, lost my car, my self respect, dignity, my mental health changed how people saw me!\n\nThen the icing on the cake is to loose my teeth at 47, the NHS does actually discriminate people who are struggling financially \n\nWould this happen to me if I had had my health and working in a job I loved.\nI wouldn’t be in a situation whereby I’m waiting 18 months to receive preventative treatment on my gum disease.\n\nI thought England had the finest health care system with the NHS, its an eye opener Googling the NHS dental health care sham." }, { "id": 191, "title": "Post op pain", "dialogue": "88dg11: hello, \ni had to have my upper first molar extracted because it was fractured. it has now been 80 hours and the pain has gone away from the extraction site thankfully. However, my jaw is stiff and my lower second molar has started to tingle and feel sensitive which is causing me discomfort is this a part of the post-op healing or could something be wrong with the bottom tooth because that's the only tooth that is causing pain alongside my jaw that feels like a magnet? also, my dentist has gone on vacation for a few weeks so i cant contact him for advice.\nThanks. Dr M: Good day\n\nDo you perhaps have any x-rays of your teeth? If there was a post op complication, you would most likely be in severe pain, with a bad taste or smell in your mouth. If this is not the case, it is normal surgical pain, and should subside over time 88dg11: No unfortunately I do not have any xrays but 3 weeks ago my mouth was xrayed and was told nothing was wrong with my bottom molar. Also, 3 weeks my upper molar was infected so it was root canaled which failed due to fracture that was not seen beforehand hence the extraction so my mouth has been through trauma the last 3 weeks. \nThis makes me think that my left side of my mouth is just tender from all the work done. \nHowever, the pain is not keeping me awake at night like before and there is no throbbing to indicate infection and painkillers seem to subside the pain.\nThanks for your reply Dr M: The pain at the bottom, might then just be normal referred pain from the top. Give it a few days still, and see if the pain gets better. 88dg11: day 6 update\nmy bottom teeth have stopped aching which is a good sign. However, my tooth next to the extraction site feels like there is so much pressure from that area in the next tooth, could this just be swelling from the gums from the extraction and will it settle down. besides, the extraction site is only mild pain which is easily controlled with pain meds. sorry for all the questions it is my first extraction and I'm freaking out a little and my dentist is on vacation. \nThanks. Dr M: Good day\n\nIf the pain is decreasing, it is a sign that it is healing. Post op surgical pain can sometimes take 2 weeks to disappear. If the pain is still there after about 2 weeks, go back to your dentist to make sure that the remaining molars adjacent to the socket don't have any problems as well." }, { "id": 192, "title": "Shooting pain 3 days after tooth extraction", "dialogue": "Aevansxx: I had a bottom molar extracted 3 days ago and the gum seems to be healing normally, however I do now have shooting pain in my cheek,jaw and ear. My jaw does feel as if its bruised could it be from that? I've never had a tooth extracted before so I don't know what's normal or not Dr M: Good day\n\nThe most common complication with the extraction of a bottom molar, is a dry socket. This usually happens 3-5 days after an extraction and is accompanied with severe pain, and a bad taste or smell in the area. If you don't have this, it is most likely normal surgical pain and will gradually get better." }, { "id": 193, "title": "Pain in one spot on gums", "dialogue": "Noaskiecards: I had multiple root canals on tooth 19. I have constant gum pain on the right side of the gum. I eventually got the tooth extracted and I still have the pain. It's a constant stabbing pain in this spot on the right side of where the tooth was. Sometimes the pain travels to the entire lower left side of my gums. I think it might be phantom tooth pain but does anyone have any other opinions on how to treat or what it might be? Thank you Dr M: Good day\n\nDo you have any recent photos or x-rays?" }, { "id": 194, "title": "Dry socket worries/help", "dialogue": "Helppp: Hello, I had my tooth extraction last Friday (it had a big infection) and I'm in my day 3 but I'm worried about a possible dry socket. I've been taking paracetamol/ibuprofen and amoxiciline for the pain and infection. I'm still taking ibuprofen and amoxiciline even if I don't really sure if I'm still in pain. Would you say this is normal healing process or I'm in risk of dry socket? Thanks MattKW: Normal healing. You don't form dry scabs in the mouth, you get whitish skin as in your photo. Dry sockets are characterised by very strong pain, bad breath, and bad taste at 3-4 days post-op. You're looking good. I would stop taking the antibiotics and only take painkillers if necessary (perhaps before bed)." }, { "id": 195, "title": "Teeth shifting after wisdom teeth removal", "dialogue": "Teresa1989: I got my wisdom teeth removed in may. Now i have noticed my teeth are shifting pretty bad like i can literally feel it almost like my front and button teeth feel loose but they don’t wiggle. But if i push my lips on them they feel weird almost like the bone is making a weird feeling. Is that normal I’m scared. I’ve been having so many dental issues since my last cleaning in may. Dr M: Good day\n\nOur teeth move constantly throughout our lifetime. Loose teeth could be an indication of underlying periodontal disease. Do you perhaps have any x-rays of your teeth? Recent x-rays? Teresa1989: I got x-rays done in may and i was told that i have bone loss and receding gums. Yet a peridontist didn’t want to treat me until i get invisaligns. I was told my bones are still very strong. Dr M: In my opinion is not a good idea to have orthodontic treatment done on if you have active periodontitis. This could worsen the situation and lead to tooth loss. I would get a second opinion. Teresa1989: Ok thank you. I will get a second opinion. MattKW: Get your periodontitis under control. And your wisdom teeth extractions are not related." }, { "id": 196, "title": "HELP NEEDED", "dialogue": "helphannah1992: Hi , i am 28 years old and currently have a top denture and 7 lower teeth that need removing as they are no good. I have searched everywhere for help thru the NHS and local charity's ect to try and help me. I am looking into getting implants of some sort as i haven't had confidence in years and have other health issues this doesn't help. I cannot get registered with an NHS dentist and cannot afford it , i am disabled with 2 young children. I have suffered with bad teeth since the age of 15, i also have learning difficulties which means understanding the in's and out of these things are not easy. I could contribute to the costs , just not a full ammount , it would also need to be on a monthly basis with bad credit.\nI'm trying to feel myself again, and my teeth are my biggest problem with my pain and self esteem. \nAny advice on this would be amazing \nThanks" }, { "id": 197, "title": "Wisdom tooth removal", "dialogue": "Shanmarie: Is this food stuck in my wisdom tooth hole, or normal healing? It'll be 2 weeks tomorrow since my surgery.\nIt had white stuff covering it just last week but that is gone now. Dr M: Good day\n\nIt might be some stitches that did not dissolve yet. If there is no pain, then healing is progressing normally." }, { "id": 198, "title": "Finding a Dentist to finish my Straumann Implant", "dialogue": "FJM: So I needed an implant and got one at the oral surgeon that my dentist referred me to. The abutment was installed. When I provided the information to my dentist, she said she does not have the equipment to finish the job! She works will a different kind of implant. So my question is this: is there an efficient way to find a dental professional to finish the job without calling multiple dental offices? Preferably one that takes my dental insurance. I live at the Maryland-Delaware border. Thanks. \n\nI saw that the Straumann website had a search tool for the UK, but did not find one in the USA. MattKW: Well, that's inconvenient. Most dentists work with OSs or periodontists that use the same sort of implant as them. That said, Straumann is the biggest brand, and I'd go back to the OS and ask him to suggest someone that he knows. That way you'll also get someone you can probably trust rather than simply ringing around. Failing that, riin Straumann USA and they may be able to give you the name of some of the dentists that order from them." }, { "id": 199, "title": "Side of tongue feels numb", "dialogue": "Lp8890: Hi All,\n\nHoping for some help and info. A few months ago i had a back tooth pulled. Every now and again the back of my tongue on my left side feels kind of numb/burnt and as if i have bits of something on my tongue but there is nothing there it also lasts for a few days sometimes weeks. I have tried different toothpaste and mouthwash but no luck. Does anybody have any ideas at all what it could be ? \n\nThank you honestdoc: Which tooth did you have pulled? If it is on the lower left, your tongue may be experiencing paresthesia. Usually that resolves within a few weeks. Lp8890: Hi honest doc. Thanks for the reply. It was a lower back left tooth. However this was pulled a couple of months ago ? Lp8890: Is there anything i can do to fix it ? honestdoc: Does your tongue feel numb all the time or sometimes? Does it seem to improve over time? I'm suspecting some swelling that may be placing pressure against the tongue (lingual) nerve. You should follow up with an oral surgeon and possibly consider corticosteroid therapy to reduce the pressure against that nerve. Lp8890: Only sometimes and yes it does get better over time Omi: Same here.... But my tongue is long as my dentist says. \nI am able to see that think..\nOn one side. This attached pic is taken on april 2020 and that time i also facing chronic tonsilitis same side.. (I am able to touch my tonsil by tongue also)\nStill i am facing this issue.. And that time ent advise me to pull out my last teeth but due to pendemic time i waited then i go to dentist he told me no need. And its a normal irritation.\nStill i am facing this issue.\nAnd using night gaurd. honestdoc: Omi said:\n\n\n\n\t\t\tSame here.... But my tongue is long as my dentist says.\nI am able to see that think..\nOn one side. This attached pic is taken on april 2020 and that time i also facing chronic tonsilitis same side.. (I am able to touch my tonsil by tongue also)\nStill i am facing this issue.. And that time ent advise me to pull out my last teeth but due to pendemic time i waited then i go to dentist he told me no need. And its a normal irritation.\nStill i am facing this issue.\nAnd using night gaurd.\n\t\t\nClick to expand...\n\n\nThe circled items on the image appears normal anatomy. Omi: honestdoc said:\n\n\n\n\t\t\tThe circled items on the image appears normal anatomy.\n\t\t\nClick to expand...\n\nYes.. But it irriited/inflamed/feel burning sensation sometimes. From last april.\nI.have little tonsil problem...\nWhat should i do.? aminakrati: HELLLO HOW ARE YOU NOW? i have the same thing, you have solved?" }, { "id": 200, "title": "Tooth fragment came out, one more is left after wisdom teeth removal", "dialogue": "Helpme??: There’s a big hole in my mouth it kind of felt like it popped open so I looked. I saw the hole I felt and it feels the same as the wisdom teeth holes when they were recovering, I also saw two whiteish things that were bone fragments that I’d felt in my mouth before but I thought they would just fall out. I pulled one fragment out because it was basically popping out. The other one is still in there it’s kinda stuck what should I do? And the holes really uncomfortable it’s not painful tho. MattKW: Probably more bone chips working their way out. If they really annoy you, contact your dentist." }, { "id": 201, "title": "Post surgical view of roof of mouth.", "dialogue": "mbasmith83: Had a left canine impacted tooth removed and the roof of my mouth hurts 5-7 days post op. Also noticing some speech differences. Is this hole normal? The white material is bone graft I'm assuming...?" }, { "id": 202, "title": "Wisdom teeth", "dialogue": "rosalync: Hi everyone so I just had my wisdom teeth pulled out all four of them and yesterday i noticed there’s white stuff around my gums and tongue. I’m worried if i might have a infection or if it’s just part of the process . Please let me know! honestdoc: Usually it is part of the process. The only concern is if you have increasing swelling which is a sign of infection (rare). The mouth has a great potential to heal." }, { "id": 203, "title": "Does a crown for an implant need to be removed to clean every 6 months?", "dialogue": "Rocca: I am having a crown placed on my new dental implant and was told by the Doctor that it will be fastened using temporary cement so that it can be easily removed every 6 months to clean and maintain the implant. I am concerned to hear this and a bit confused. Previously I had an implant that had failed (same tooth), but that implant did not need maintenance like that. The implant was treated like a regular, permanent tooth. Is anyone else having their implant crown taken out every 6 months? If any dentists read this, is it normal that this is how an implant should be treated? Thx MattKW: Nope. The crown should either be permanently cemented, or more commonly screwed on permanently. The implant should be almost self-cleansing with your own efforts. Is it too late to get 2nd opinion? Rocca: MattKW said:\n\n\n\n\t\t\tNope. The crown should either be permanently cemented, or more commonly screwed on permanently. The implant should be almost self-cleansing with your own efforts. Is it too late to get 2nd opinion?\n\t\t\nClick to expand...\n\nHi - thanks for your reply. Your answer was helpful. I called the Dr. and received more clarification. The implant will be finished by being screwed in and then also using temporary cement so that it can be removed without damaging the crown if needed in case there is an issue. Maybe I misunderstood what the doctor was explaining originally but there will only be removal of the crown if there is some sort of problem. I guess that makes sense. I hope that does not occur and that this implant is permanent. Thanks again!" }, { "id": 204, "title": "Wisdom tooth removal", "dialogue": "Jade Bug: Hi, so I got my tooth removed on may 25 and it is now may 31 and I looked in my mouth to see that one of my wisdom tooth wholes looks completely different from the other I have some very very mild pain in the tooth next to the extraction site that’s more open but other than that I do not feel much discomfort. I wanted to show a picture and see if the site looks ok or if I should be worried of dry socket or infections? Dr M: Good day\n\nUsually a dry socket is accompanied by severe pain in the first 3 to 5 days after the extraction. If the pain is only mild, most likely it is only post-op surgical pain, which is normal. Follow the instructions gave to you by your dentist/oral surgeon and healing should progress normally." }, { "id": 205, "title": "Normal?", "dialogue": "Itsjustmeee: I had some teeth cut out on the 17th. Yesterday some stitches came out(dissolvable) and now it looks like this. It’s my lower right molar. I’ve been dealing with dry sockets where wisdom teeth were. My oral surgeon said this is all normal but maybe I can other’s opinions? Dr M: Good day\nIf you have no severe pain, then this is normal. MattKW: All normal. Dry sockets occur 3-4 days post-op. After teeth are removed, the bony walls rarely allow the skin to be fully closed even with sutures. However, over several weeks the bone and gum reshpaes (remodels) and close up. It wouldn't be harmful if some food got in this hole occasionally; it will simply work its way out." }, { "id": 206, "title": "9 teeth extracted 2 weeks ago, inquiry about unknown problem (Picture)", "dialogue": "Bimpy: So as stated i have no idea what this is, it is non responsive to hot or cold, but when any pressure is applied its a very sharp sore pain, similar to when a tooth becomes loose. Ill be going to my dentist tomorrow morning but just curious to see what it might be ahead of time, I'm very impatient with unknowns. (This is my lower front gums from canine to canine)\n\n (The red dot/bump) Dipsey: Looks like a blood blister to me they hurt a bit if you press it but best leave it alone it will heal up in a week or so. Du92979: I have the same thing now next to a extraction site on both sides. What did the dentist say? MattKW: Looks like satisfactory granulation tissue healing; nothing out of the ordinary. It's not a blood blister." }, { "id": 207, "title": "Wisdom tooth extraction", "dialogue": "Nilo: I had my wisdom tooth removed as well as had a first molar cavity refilled on the same side, and it's now day 9. I still have earache and TMJ pain and my extraction site still looks like a hole. Yesterday I thought I had some debris stuck and it wasn't going and thought it was granulation tissue but today while rinsing it got cleared out. Whole right jaw and earache has been there since day 1 and gets aggravated at night. My bite was off for the first week and was corrected but the pain is persistent, usually comes back after sleeping. Could you please tell if this is normal or I need to get it checked again? Dr M: Good day\n\nDo you have any x-rays of your teeth? Nilo: Dr M said:\n\n\n\n\t\t\tGood day\n\nDo you have any x-rays of your teeth?\n\t\t\nClick to expand...\n\nNo, haven't taken one. But the base of my molars feel swollen and painful. Earache and TMJ pain has reduced but is still there. It became 14 days since procedure yesterday. Dr M: 2 weeks is a long time for that area to heal. I would consider arranging a follow up visit with the dentist and maybe consider seeing a TMJ specialist.\nX-rays would be helpful, so that we can evaluate the other teeth in the area." }, { "id": 208, "title": "Dental Abscess", "dialogue": "boymom21: This is kind of a long story:\n\nI have a tooth that needs to be extracted and have already seen a Periodontist for a consult on an implant. During that appointment, the doctor (thank god) found a cyst at the roof of my mouth and I was told to see an oral surgeon immediately. The next day I saw the oral surgeon who told me it's a benign cyst that needs to be removed. That has been scheduled for May 21 and now I have to wait until after this surgery for the implant. I have been in pain for almost two weeks due to the abscess, was given Amoxicillin which did not take and then prescribed Amox-Clav and Metronidazole. I am about 4 days away from finishing my prescription and I have noticed a difference but not totally and I am worried I am going to have to live like this for the next 2 months. Is there anything that can be done for me? I am worried that when I finish the antibiotics my pain will still be there and come back full force. Needless to say I am desperate and I have a 1 year old at home and it's hard to be a mom when I am in pain. Any advice? Dr M: Good day\n\nMy advice would be to finish this last course of antibiotics and then see how the pain is. If there is no relief, contact the oral surgeon and explain to him the situation. He might be able to see you earlier or provide other pain meds that might assist you" }, { "id": 209, "title": "Third moral gum light pain", "dialogue": "Aja: Hello dr. \n\nI am facing tonsilitis from last one year.. Ent dr. Advise me to extract your 3rd moral when get time after covid lockdown.\n\n\nAfter that i didnt get relief and reach dentist.. He told me no. Need for extract your teeth is healthy... He also took xray.... But still i am suffring from 3rd moral gum on off pain.... \nWhat i do now.\n\nPlease advise!!! Dr M: Hi\n\nWhat you have is pericoronitis. This is usually due to a partially erupted 3rd molar. If there is not enough space for the third molar to fully erupt into the mouth, it is best to have it extracted. Aja: But sir ... Dentist told me wait for like you feel more pain or uncomfortable... Otherwise its okay.. Its a on off pain.. But it is from last long time... And if i extract 3rd moral. Then procissure is cut bone then extrct my teeth... Doing daily 2 time brush and warm salty but not help. Dr M: If the pain does not subside, you will need to have the teeth removed. Try taking anti-inflammatory medication if you have at home" }, { "id": 210, "title": "Swollen gums", "dialogue": "Dental Shy: I had #15 extracted 8 days ago because of abscess. About 3 days after extraction, the gum around the site became swollen and distracting to my tongue and cheek. It seems to be the gum area next to adjacent tooth. Day 8 and swelling has not gone down. It seems less distracting at times and more so at other times. Is this normal or could infection be involved? I have been on Amoxicillin since extraction. Dr M: Good day\n\nIt is very difficult to give an opinion without any photos or xrays. It could be related to another tooth that was actually contributing to the initial abscess or could be a possible gum infection due to poor oral hygiene in that area. It is best to arrange a follow-up visit with your treating dentist, so that the area can be evaluated." }, { "id": 211, "title": "(Pic included) do I have a dry socket", "dialogue": "Jake58156: My wisdom teeth got take. Out 4 days ago and there’s a foul stench in my mouth and kinda taste like a liquid or something that makes it smell like that I saw some brown stuff and some whiteish around it and with the syringe they gave me I cleaned it off and seems like little pieces were coming off then a flake of brown went into my sink and I can see the blood clot but there’s a little white surrounding the hole I also had some other teeth pulled for braces for specification I’m talking about the one in back\npicture is a bad sorry but it’s a decent size hole do I need to see a dentist or will I be fine MattKW: If you are able to manage any pain, then there is no need to go back to the dentist for a dressing or similar. Dry sockets represent a delayed healing. They will heal with time, but most people need some pain relief in the manner of a sedative dressing just to get them through the rough patch. Jake58156: MattKW said:\n\n\n\n\t\t\tIf you are able to manage any pain, then there is no need to go back to the dentist for a dressing or similar. Dry sockets represent a delayed healing. They will heal with time, but most people need some pain relief in the manner of a sedative dressing just to get them through the rough patch.\n\t\t\nClick to expand...\n\nOkay thanks it’s been 5 days am I allowed with the dry socket to have pocky or reese's peanut butter cups? I got told I could but that’s not a medical opinion so I would like to check please look pocky up if you do not know what it is MattKW: Eat whatever you like." }, { "id": 212, "title": "Wisdom Teeth Post-Op, Hole in Gum, No Pain?", "dialogue": "Johnathan: I got my wisdom teeth pulled on the third. They've been healing fine and I've been eating normal foods and feeling no pain ever since the 12th. In the last couple of days a bunch of white stuff has been getting dislodged (from the googling I've done, it's just dead tissue on top of the healing site and is normal). Well, today a huge white thing got loose in the site and I dislodged it with my tongue semi-accidentally (it got loose and I thought it was food stuck). And then I checked in the mirror and there's a small hole in the gum. This is worrying me a lot. I really don't want to go to the dentist to get a dry socket filled, but I don't think it is one. There's been no pain since I've opened the hole (though I am only writing 15 minutes after) and I didn't feel pain or discomfort in that area before either. I drank a little water to see if that would give me a shock of pain and it didn't. Is it a dry socket? Do I need to go to the dentist to get it filled? Is it normal? If I don't go there will it eventually close on it's own? Thank you so much!!!! Genesis41026: I would gargle with some salt water to draw out any possible infection if any and keep it clean and do a checkup with your dentist as soon as possible\n\n\n\nBacteria is everywhere and a little hole like that will be a new home to some if u do not keep it clean do your best dsakxi: Johnathan said:\n\n\n\n\t\t\tI got my wisdom teeth pulled on the third. They've been healing fine and I've been eating normal foods and feeling no pain ever since the 12th. In the last couple of days a bunch of white stuff has been getting dislodged (from the googling I've done, it's just dead tissue on top of the healing site and is normal). Well, today a huge white thing got loose in the site and I dislodged it with my tongue semi-accidentally (it got loose and I thought it was food stuck). And then I checked in the mirror and there's a small hole in the gum. This is worrying me a lot. I really don't want to go to the dentist to get a dry socket filled, but I don't think it is one. There's been no pain since I've opened the hole (though I am only writing 15 minutes after) and I didn't feel pain or discomfort in that area before either. I drank a little water to see if that would give me a shock of pain and it didn't. Is it a dry socket? Do I need to go to the dentist to get it filled? Is it normal? If I don't go there will it eventually close on it's own? Thank you so much!!!!\n\t\t\nClick to expand...\n\n\nhi johnathan. i just recently got my wisdom teeth out and am having the same problem as well. did you ever end up going to see the doctor? if so what did they say. my mom doesn’t think i need to see them but i’m concerned about the hole gettinf bigger MattKW: The white stuff is the top layer of skin sloughing off. Think of it as a wet scab. Perfectly OK and requires no intervention.\nDry sockets will occur 3-4 days post-op and will be one of the worst pains in your life. So, you're well past that date. No need to worry.\nThe hole will gradually fill in with new bone over the next few MONTHS. It won't matter if a bit of food gets occasionally jammed in the healing wound - it will work its way out without your intervention.\nSounds like all is going well!" }, { "id": 213, "title": "Name of a good oral surgeon in the southeast", "dialogue": "oceansmith: I had a tooth extracted a couple years ago and I now need to get an implant for it. The oral surgeon I went to here who extracted the tooth cut out part of the surrounding bone (around tooth). I will probably/maybe need a bone graft. I am looking for a good oral surgeon that i can trust. \n\nI saw that dr carlo litano has pretty good feedback and is also on the ball for keeping up with new technologies while also being \"holistic\". That is quite a ways away from me and I would like to have an oral surgeon relatively close in case there are complications. \n\nAnyone able to suggest anyone else?\nthanks" }, { "id": 214, "title": "Dislodged blood clot", "dialogue": "Blue Mermaid: Hi, I had a tooth extracted on Wednesday. The dentist could not save it, as it was severely infected, with a large abscess at the root (I have advanced gum disease). During the night, I felt something on my tongue. On a tissue, it looked like a lump of red jelly. I suspected it was the blood clot and looked online to confirm, where I read about dry sockets. I took a picture of the blood clot on the tissue and sent it to the dentist for advice. The next day, he confirmed it was the blood clot but just said, it was normal and not to touch it. I didn't feel reassured, having read that the socket would now be unprotected. So, I asked my dentist for further advice, explaining that I was still concerned after reading about dry sockets. He didn't like me questioning further and sent a very curt and what I consider a rude reply, repeating that it was normal and to stop contacting him with questions, with immediate effect. He said I was not in pain (which wasn't true, I had been in severe pain that night following the extraction but painkillers had helped and I appreciate that this was just post extraction pain) and he suggested I refrain from searching on the internet for issues that I do not have, or will not have. He himself, confirmed the picture I had sent him was the blood clot, so I don't know why he was saying I do not have the issue. I appreciate that not everything you read on the internet is true but I was looking at official sites (such as NHS sites) and when they are all stating the same things, then I believe them to be correct. So, I am left without any further advice from the dentist himself. Could a professional here be kind enough to explain to me, whether I should be concerned that my socket is now left without the protection of a blood clot? Do I now have a dry socket? Should it be cleaned and covered by a gauze or whatever a dentist uses to protect the open socket? Or, is this only if I start to experience new or worse pain? If my dentist had given me a full explanation, as to why he was saying this was normal, then I wouldn't have to look on the internet for advice! Dr M: Good day\n\nIf you disturb the socket, even unknowingly in your sleep, the blood clot can be dislodged yes. The blood clot is part of the normal healing process. This being said, this doesn't mean that the socket will turn into a dry socket. \nA dry socket usually appears after about 3 to 4 days, and is accompanied by a severe pain, sometimes difficulty in opening, and a bad smell.\nMy advice would be to leave the socket alone. Don't brush over the socket to clean it. And then follow the post-op instructions which should have been given to you by your dentist. Keep the area clean, by rinsing with some luke-warm saltwater ( very gently ) about 3 times a day. Keep to a soft diet for the first few days and chew mostly on the opposite side as much as possible.\nThe socket will gradually be filled with granulation tissue as healing progresses and then close normally. MattKW: Loss of a blood clot per se does not cause a dry socket. Rather, the release of chemicals during an extraction can cause early breakdown of the clot by fibrinolysis. Dry sockets occur most often in lower extractions, in difficult or surgical extraction, and in patients who smoke. If it’s going to happen, then it’s already too late to prevent it. The only technique that has been shown to make a small reduction in the risk of developing a d.s. is to start rinsing pre- and post-opratively with a chlorhex mouthwash, Blue Mermaid: Thanks so much to both of you for your replies and for reassuring me. \nIt is good to learn that losing the blood clot does not automatically mean you have a dry socket. Now, I won't worry in the future, if the same thing happens again.\nAll I have left now is some soreness, so I am still eating on the other side and not brushing over the socket. I stopped the salt water rinse after 7 days, as per the instruction leaflet from dentist but I am being meticulous with keeping whole mouth as clean as possible.\nMany thanks again for your kind help and advice." }, { "id": 215, "title": "Does implant look ok?", "dialogue": "Patsyp: Hi I had this implant placed before getting braces and How does it look does it look good.? The cover screw seems close to the premolar is that how it’s supposed to look.? My dentist said it looks fine and I just need more space to open the second molar which I’m already in the process of it. honestdoc: What the dentist will look for are if the implant healed in the bone properly on x-ray and there are minimal gum inflammation around the implant. The lighter pink and tighter the gums look the better. It's difficult to assess based on the given image. Patsyp: honestdoc said:\n\n\n\n\t\t\tWhat the dentist will look for are if the implant healed in the bone properly on x-ray and there are minimal gum inflammation around the implant. The lighter pink and tighter the gums look the better. It's difficult to assess based on the given image.\n\t\t\nClick to expand...\n\nYeah he said it everything looked good just needed a bit more space for crown to fit once braces are off. I was just worried about how the flat screw or abutment looked since it covers the whole gum." }, { "id": 216, "title": "White spot after Wisdom teeth removal", "dialogue": "Jae: I got all 4 of my wisdom teeth out 7 day ago, my left side of my jaw feels fine and I can eat normally. However, my right side is still in pain, sometimes I can still taste blood but my sister said I wasn’t bleeding when she looked. I am still swollen on the lower right. I shined a flashlight in my mouth and saw a white spot back behind my molars. My mom is convinced it’s normal but I am not. The pain reaches down past all my molars. Dr M: Good day\n\nIt might be that you have a dry socket. This is when the socket becomes infected. It is best that you go back to your dentist, so that the area can be evaluated. The socket will have to be cleaned out, rinsed and then additional medication will be prescribed if required. MattKW: Not a dry socket, and dry sockets are NOT an infection, so are not prescribed antibiotics. Dry sockets occur 3-4 days post-op and are characterised by severe pain, bad taste, and foetid breath. What you are looking at is eith a bit of food sitting there (it'lll do no harm and work its own way out), or some sloughing scar tissue (also no worry). You look like you're going well - listen to Mum." }, { "id": 217, "title": "All on 4", "dialogue": "Richard1372: I recently received my snap on denture (top), I have 4 full size implants...my question is, if I decided to “upgrade” to all on 4’s, how much would it be. I assume my existing implants would work to attach the the all on 4 set? MattKW: If All-on-4 was in your mind before receiving your current implants, then this is a discussion that should have occurred earlier. It is not possible in this forum to determine if your implants will allow \"upgrading\". Similarly, estimating costs are not possible for that kind of treatment in this forum; there are just so many variables. You may not even have the type of jaw that would allow All-on-4. Go back to your dentist and discuss, or seek a referral to a prosthodontist. Sorry..." }, { "id": 218, "title": "Implant hidden cost", "dialogue": "GoofyMan: Hi,\n\nI had two implants placed last week (brand: Noble).\n\nThe oral surgeon office required me to pay extra for a bag they will give me after the follow up and will contain \"components\".\n\nI asked them, what are these components for?\n\nThey said - it is something you give your dentist that will guide him when placing the abutment. \n\nI called the dentist who said: i don't need this, don't bring it.\n\nDoes anyone know what are these components for and how can I refuse to buy something that neither I, nor the dentist will use and will go directly into the trash?\n\nThanks! Dr M: Good day\n\nJust make sure that the oral surgeon did not mean impression copings. This is a necessary component that is needed in order to guide the technician in order to make sure that the implant crown's path of placement is correct. You can't guess this.\nA lot of times the oral surgeon sends this with the patient to the dentist. It might be that your dentists has his own components that he uses. Just make sure that if that is the case, that the components are sterile MattKW: Probably not necessary if your general dentist already has the components. These are usually transfer copings etc. Abutment copings are usually bought by the general dentist when the crown is being made by the lab, and may already have been factored into the cost by the general dentist. I'd say, \"Thanks, but no thanks.\"" }, { "id": 219, "title": "Black spot around distal impacted wisdom tooth", "dialogue": "Jayne40: I went to the dentist for cavity on my lower back molar and my dentist found and impacted wisdom tooth. He's sending me to an oral surgeon but I cannot get in for over 6 weeks. I'm concerned because the x-rays of impacted wisdom teeth I'm seeing on google don't show this large black spot around the tooth. Is this something dark area something I should be concerned about ? Dr M: Good day\n\nAn impacted wisdom tooth can sometimes cause a dentigerous cyst formation around the crown of the tooth and then bone loss. This leads to the area that you are seeing on the x-ray. When the oral surgeon removes the wisdom tooth, this area will be scraped clean, and then new bone formation will hopefully occur in the area as normal healing takes place." }, { "id": 220, "title": "Lingual vertical release", "dialogue": "ToothFixerUpper: This is a question I have asked many surgeons and no one gives me the same answer, except to say, be careful down there..... So the lingual nerve traverses coronally in contact effectively with the mandible around the 3rd molar, to the 2nd molar, but then quickly falls apically and medially. The question I have is in regards to dropping a lingual vertical incision to assist in lingual flap reflection. \nFor example, doing a crown lengthening on the 2nd lower molar, and trying to remove bone at the disto-lingual position, means the lingual flap has to be stretched quite a bit to allow access. This stretching is one of the most common causes of lingual nerve injury. So to avoid this, why wouldn't we drop a slight vertical incision say at the mesial of the second premolar (not deep, just beyond the keratinized attached gingiva) that would allow much more movement of the flap but without risk of stretching it?\n\nAm I missing something here?\n\nThanks honestdoc: Since Periodontists do a lot of crown lengthening procedures, they may provide more insights. Anecdotally, lingual nerve may situated really close to the coronal aspect and can be risky to flap near it. Risk vs benefit of your crown lengthening case may not be worth the trouble. Any alternative treatment options such as extraction, implant, etc. that may be more predictable? ToothFixerUpper: I would agree but I am suggesting a vertical release at the lower premolars which seems to be well clear of the lingual nerve. Like, not even remotely close. I just wanted opinions and to see if anyone does this because it isn't discussed in any of the textbooks I have ever read.\n\nThanks\n\n\nhonestdoc said:\n\n\n\n\t\t\tSince Periodontists do a lot of crown lengthening procedures, they may provide more insights. Anecdotally, lingual nerve may situated really close to the coronal aspect and can be risky to flap near it. Risk vs benefit of your crown lengthening case may not be worth the trouble. Any alternative treatment options such as extraction, implant, etc. that may be more predictable?\n\t\t\nClick to expand..." }, { "id": 221, "title": "Failed dental implants", "dialogue": "CraigPhillips: Approximately three years ago I had dental implants installed. I first had bone graphs with no problem, then eight months later the dental surgeon drilled to place the post on the left side. While he was drilling, the shooting pain started and was immediately a ten (despite 10 to 15 shots of Novocain). It felt like my head was in a vice, almost unbearable. There was no pain at all, during or since, for the two posts on the right. While working on my right side, his assistant called his attention back to the left side, and he returned to my left side shoving the post so hard he almost shoved me out of my chair. When finished, he stitched both sides and didn’t request a return visit.\n\n\n\nSince that day the excruciating pain has only slightly diminished on the left side. Occasionally it will ease for a few minutes, or if I apply slight pressure with my finger on my left nostril the pain subsides, sometimes immediately. OTC painkillers dull pain temporarily; prescription painkillers make me feel unwell.\n\n\n\nThe pain is dramatically affecting my life. Typically a high-energy person, I now feel chronically tired. At night I press on my nose to go to sleep, but when I rise from a lying position, it comes right back and is constant throughout the day.\n\n\n\nCan the dental implant surgery be reversed? Left-side post removed and the jaw allowed to heal? Is there any procedure that can relieve this pain? Dr M: Good day\n\nIt is very strange that the dentist didn't arrange a follow-up visit. Was this someone who was experienced with the placement of implants?\nImplant surgery should only be done with proper planning and training, since a lot can go wrong.\nThere are important anatomical structures such as maxillary sinuses, as well as nerves, that could get damaged with implant placement. It could be that he accidentally damaged a nerve during the surgery.\nI would arrange a follow-up visit with him or an oral surgeon, so that this pain can be evaluated. The oral surgeon will then decide if it is necessary to remove the implant screw.\nThis can be done, and the jaw can be allowed to heal, but if there was any nerve damage, this could be transient or permanent and if you wish to place another implant at a later stage, additional bone grafting might be required. CraigPhillips: I did return to the dental surgeon who performed my surgery and he informed me that he had performed something like 1,700 dental implant surgeries prior to mine, and there had not been a single complaint. Dr M: I would then seek a second opinion from another oral surgeon. 1700 implant placements without any complaints, seems unlikely. You will always run in to complications sooner or later, no matter how experienced you are." }, { "id": 222, "title": "Allergy or hypersensitivity to debatable implant", "dialogue": "Cathy Ha: Hi I had a titanium dental implant placed 1.5 years ago. Due to Covid and my dentist being on vacation quite a bit I have finally had the tooth put on. Even prior to the crown being placed I had a very irritated mouth all around the entire time. i have cried about it many times. I was hoping that my symptoms would disappear with crown Placement. But it has not worked. I have burning in my mouth, kind of itchiness in mouth • a bad taste, severe tongue reaction next to the implant. The tongue is red, many white inflamed taste buds and is very painful. The piece of gum behind my implant which is number 31 all the way back is red and inflamed compared to the other side.\n\nIs my only option to remove the implant? Has anyone ever heard of this allergy or sensitivity? How bad will it be to take the implant out? Dr M: Good day\n\nIs this implant screw retained or cement retained? Have you spoken to the dentist/oral surgeon that placed the implant regarding the reaction? Inflammation around an implant is never a good thing, since it can eventually lead to peri-implantitis, bone loss and implant loss. Cathy Ha: Dr M said:\n\n\n\n\t\t\tGood day\n\nIs this implant screw retained or cement retained? Have you spoken to the dentist/oral surgeon that placed the implant regarding the reaction? Inflammation around an implant is never a good thing, since it can eventually lead to peri-implantitis, bone loss and implant loss.\n\t\t\nClick to expand...\n\nYes, I have notified the dentist and the oral surgeon. They said it is placed normally, not infected and is osseointegrated. \n\nHas anyone else had a bad reaction like mine? The implant has been shaved down at the lab to keep away from my tongue. But my tongue looks red, like ground hamburger on that side. Very different from the other side. Also always hava a bad taste, uncomfortable irritated mouth all around. Makes me want to chew gum all the time. I am not a gum chewer.\n\nIt is screw retained. Dr M: Do you perhaps have any photos of the area? In the rare case that you have a contact dermatitis or allergy to the metals used, it is something that you will have to get tested for.\nBut it is also important to make sure this pain, redness and irritation is not due to another underlying condition, that happened to coincide with the implant placement.\nIt is best in such a case to see the oral surgeon in his office for a consultation." }, { "id": 223, "title": "Dental implant, periodontist or oral surgeon?", "dialogue": "Pumpkin2128: Hi ,\nHi, so im considering getting implant on my lateral incisor, i lost tht tooth back when i was in middle school n now i’m 32yro.i’ve been wearing bridge ever since then. About 7 yrs ago i did try to get implant, my periodontist performed bonegraft n 1 yr later when i was supposed to get implant, she found out my body didn’t take in all the bonegraft n not enough bone to put the implant so she did another bonegraft, which 2-3 months later after my second bonegraft, it got infected so i had to remove the bonegraft, then I decided to just get Maryland bridge instead of trying to get another bonegraft. \n\nBut now my Maryland bridge started to get lose so i’m considering to get an implant again. Recently, I went to 2 diff dentists for consultation, both are well respected dentist around my area. 1st i went to oral surgeon, he took 3d scan, ct scan after he looked at them he think implant is not an option considering how much bone i had lost, n the area where the implant supposed to go is really narrow, hard to do bonegraft , he told me to stick with Maryland bridge\n\nThen i Went to get second opinion from a periodontist, after reviewing the ct scan taken from previous oral surgeon office, he told me , there’s a lot of bone lost but he sure he can do the implant but he has to open up the area to decide whether to do implant n bond graft at the same time or do bonegraft first then after it heal, do the implant. When i asked him, What happened if it failed agaim. But he is very confident it won’t. \n\nBtw my first n second bonegraft was using xenograft . This time the perio will use allograft. I wonder if my body rejected xenografts, will it likely to reject allograft? \n\nI’m really bummed about it. I dont know what to think. Considering what i went through before. Should i get third opinion? But should i go to\nOral surgeon or periodontist.\n\nThank you for reading this long pathetic dental story of mine. Dr M: Good day\n\nFirstly both specialists deal with the placement of implants. Periodontist are however more specialized with regards to peri-implant tissues, such as gum level, emergence profile, grafting etc.\nTo understand rejection, you have to understand the definition of the previous graft you received.\nXenograft-usually from a different species, such as bovine or porcine.\nAllograft-bone from a deceased donor or cadaver that has been cleaned and stored\n\nIt is possible to rather reject xenografts than allografts, although the success of the grafting procedure is dependant on a host of factors, including patient immune status, medication use, oral hygiene, home-care, clinician skill and surgical technique.\nThat being said, it is not say the second grafting procedure won't be successful. \nAs long as you understand all procedures have their risks." }, { "id": 224, "title": "Ankylos Implants in North West UK", "dialogue": "Briggs60: Are there any Dentists in the north west using the Ankylos system?" }, { "id": 225, "title": "Post implant failure", "dialogue": "petek: Had a total of eight upper dental implants fail all within a year. (extraction of real teeth, bone grafting and sinus lift a year prior implant placement)) All implants have been removed one by one(no bone grafting at time of removals) After removal of implants my denture was still causing pain... My dentist told me to go back to the oral surgeon for alveoloplasty surgery to smooth the gums for denture because of bone protrusion, so I did. I have had severe pain for the past three months since alveoloplasty(Dec. 1st). Cant wear denture and i am in severe chronic pain. what is wrong and what can i do? honestdoc: I'm sorry I can't answer you question with just the above information. Is this Oral Surgeon Board Certified in the US or certified in your country? What did he/she say about your condition?" }, { "id": 226, "title": "Curretage after extraction?", "dialogue": "mrjohnson: Hi,\n\ndo you always curettage the bottom of the alveola after a tooth extraction?\nor only when there is an apical infection?\n\nand if you do; aren't you afraid to damage either the mandibular nerve or perforate into the sinus? Dr M: Good day\n\nUsually the pre-op radiographs will give you an idea of where important anatomical landmarks are situated, so that you can keep this in mind when you are considering curettage.\nI usually only consider curettage of the area when there was obvious infection, cystic tissue or granulation tissue that needs removal" }, { "id": 227, "title": "Dental implant next to a root canal is it safe?", "dialogue": "Achygirl1: I had heard on other forums and through a few dental professionals that placing an implant next to a root canal tooth will result in failure of the implant. Is this accurate information and what is the likely hood of failure if placed next to a neighboring root canal tooth?\n\nI also read that there are zirconia implants. Are these safer then Titanium? Dr M: Good day\n\nI have seen a lot of successful implants next to root canal treated teeth. As long as the minimum space requirement between the implant and the natural tooth is met , i.e 1.5 - 2.0 mm, then there should not be any issue.\nKeep in mind the root canal treated tooth should be healthy, without any issues, to prevent spread of infection to the adjacent implant.\nZirconia implants is an alternative to titanium implants, although there is insufficient data as yet, to confirm the long term success rates of zirconia implants compared to titanium implants." }, { "id": 228, "title": "Been 11 days since wisdom tooth removal does this look normal?", "dialogue": "Shawn987: In some pain but it’s not excruciating at all just very uncomfortable. I’m an anxious person so I’m worried something is terrible wrong. Isn’t it too late to develop dry socket? I had pain for a couple of days afterwards but then it came back after I ate pizza, cookies and Reece’s cup. (Yeah I know I’m dumb and shouldn’t of eat them but I was freaking starving) I also grind my teeth at night so i dont know if that has anything to do with anything. honestdoc: It seemed that the area is closing and healing nicely. It is not a dry socket or you will have excruciating pain. You don't appear to have swelling so all is well. Grinding and clenching can cause a lot of problems so talk to your dentist on options to manage that. Shawn987: Thank you so much! Could I still get dry socket? It’s 13 days now since I had the surgery. \n\n\nhonestdoc said:\n\n\n\n\t\t\tIt seemed that the area is closing and healing nicely. It is not a dry socket or you will have excruciating pain. You don't appear to have swelling so all is well. Grinding and clenching can cause a lot of problems so talk to your dentist on options to manage that.\n\t\t\nClick to expand... honestdoc: No, unless you intentionally disturb the healing site. Shawn987: honestdoc said:\n\n\n\n\t\t\tNo, unless you intentionally disturb the healing site.\n\t\t\nClick to expand...\n\nOk sweet! I did end up sneezing and started to hurt a bit more am I good? honestdoc: Yes, just be aware of any swelling and increasing pain." }, { "id": 229, "title": "Has anyone gotten or know of anyone that's gotten a ceramic implant?", "dialogue": "troubledsoul: I've discussed this with my dentist and she said people get metal for the most part because they've been around longer, they're stronger and overall more reliable. But having metal in my mouth is just something I cannot digest.. getting metal drilled into me. I thought I'd come here for potential success stories of what I want to get done. Thank you in advance.\n\n\n\n\n\n\t\t\t\t\t\tWhat are the benefits of ceramic vs titanium implants?\n\t\t\t\t\t\n\nCeramic implants are a growing market in dentistry. But what are the benefits of ceramic vs titanium implants? Here are some key points to consider.\n\n\n\n\n\t\t\t\t\twww.nobelbiocare.com Dr M: Good day\n\nRecent studies has shown that Zirconia implants ( a type of ceramic implant ) has been successful in certain cases, however there is still insufficient data to show long term outcomes of Zirconia implants." }, { "id": 230, "title": "Tooth fragment after extraction?", "dialogue": "RobLCook: A week ago today I had an extraction done on my #30 molar. I had a root channel done on it around 20 years ago but needed to be pulled due to infection. The procedure itself was horrendous. I can only remember one other thing in my life that was more painful. He pulled it out in pieces. I will never be awake for anything like that again. Anyway everything seems to be healing fine except for one spot that feels like a cut. Could this be a tooth fragment? It's hard, sharp and wiggles. The gum is also a little red and sore around the location. honestdoc: Most likely it is a piece of dead bone (partial bony sequestrum). Bone needs blood supply to stay viable and any area of bone that does not receive adequate amounts will separate and exfoliate. It can happen during traumatic extractions. Your mouth is very efficient at healing and will expel any dead and or contaminated particles." }, { "id": 231, "title": "Is this normal? (4 days after extraction)", "dialogue": "Yeahidkdudebro: I had a first molar extraction last Saturday, and the dentist told me all the basic stuff to prevent dry socket, at first I had my gum hole filled with blood and then the clot formed but the last two days I've seen it get smaller and also the color changes.\n\nI don't have pain except that I sometimes feel it throbbing (blood pressure changes maybe?) honestdoc: It looks good. The color changes indicate reparative epithelial tissue forming. The only signs to watch is pain and swelling. Lukey17: This is also 4 days extraction, does this all look ok? Really been worried about dry socket honestdoc: With a dry socket, you will be very miserable. As long as the hole is covered and you have no swelling, you are fine." }, { "id": 232, "title": "Extraction of first molar insight pls", "dialogue": "troubledsoul: Hello I extracted my first lower left molar a couple years ago back in 2017. I am now 27 years old and I'm noticing a drastic change in my left facial profile in comparison to my right. There is a dent at the sight of extraction as well as a droopy look relative to the strong, bold and defined right side. This is really depressing me. I did a bridge with a bone graft. Inside my mouth I can see gum recession in that area. I am thinking of getting an implant because I'm worried this will just keep getting worse. Is it typical for exterior facial profile to change after such a procedure? Is there anything I can do about it? I'm willing to do anything to get my face back :/ honestdoc: First molars are very traumatic to remove because of their size and anatomically flared roots. Once it is removed, the area loses a lot of bone and will continue to lose bone through time. Implants are a better option because it helps retain bone. Keeping bone will help with facial profile. troubledsoul: Hello and thank you\nWhat did you mean by anatomically flared roots?\nAlso what is ridge augmentation? honestdoc: troubledsoul said:\n\n\n\n\t\t\tHello and thank you\nWhat did you mean by anatomically flared roots?\nAlso what is ridge augmentation?\n\t\t\nClick to expand...\n\nFlared roots means the molar roots are more angled at different directions. Ridge augmentation is to rebuild the bone with bone grafting material." }, { "id": 233, "title": "Extraction", "dialogue": "Teenbean27: I had a tooth extracted 3 days ago. I just want to see if this is what it’s suppose to look like after the 3rd day of healing. I feel a throbbing pressure in the tooth in front of it and a little pain. Is this normal? honestdoc: Normal. If you notice any swelling, get follow up visit." }, { "id": 234, "title": "Extraction, should I be concerned?", "dialogue": "DF-Mark: I am in a situation where I am pretty much forced to have a tooth extracted.\nThe tooth (36 Canadian) had a root canal more than 20 years ago.\n\nI pulled the crown off the tooth a little more than a year ago while flossing.\nIt was the second time the crown had come off and this time my dentist\ntold me he couldn't replace it.\n\nFrom the start (when the root canal was done) the endodontist had filed the tooth way down to little\nmore than a tiny stump, just coming above the gum line.\nNow with all the time that has gone by the tooth has decayed to where it is barely visible and sits below \nthe gum line.\n\nI have an appointment with my dentist to extract the tooth on Tuesday but am a little concerned as\na layman. I have two concerns.\nThe tooth cannot be gripped unless some digging is done between the tooth and the gums.\nSince the tooth has been without a nerve for such a long time I'm, concerned that it may break\nduring the extraction. I believe there are four chambers.\n\nMy dentist tried to re-assure me last visit by saying all should be OK and even if it were to break\nhe could leave the piece there if it was small and couldn't be accessed!\n\nA year ago, when I first started getting opinions on this tooth, another dentist was also prepared to\nextract it and had no concerns about doing the work.\n\nShould I have concerns, or should this be routine? Any advice? honestdoc: I will agree with your dentist. The body has great potential to heal and to exfoliate unwanted material (leftover teeth). Your dentist will use a small dental surgical elevator and gently ease the pieces out. I am also concerned with the deteriorated tooth in front. That tooth has poor prognosis for restoration (crown). Make sure you get regular dental visits and minimize teeth deterioration through good oral hygiene, decreased sugary/acidic/creamy beverages like soda, Starbucks, Energy drinks, etc. and good Fluoride therapy. DF-Mark: Thanks for your reply honestdoc!\n\nI have one more question. The plan for this tooth is to extract it and then wait a couple of months before an implant is done.\nIs this standard dental procedure?\n\nI ask because I have a Russian friend who knows many people there who get there teeth removed and then have an\nimplant done in the same session, same day!\n\nWhat are the pros/cons of each method? MattKW: Agree with honestdoc. The extraction shouldn't be too hard, and I would have that out within a 30min appt. If you are thinking of implants, then I would advise you extract the one in front as well - it has a poor risk of lasting too long even with a crown. Then you would get 2 implants. \nImmediate implants are possible in carefully considered cases. Usually for front teeth where appearances are more concerning. It is less risky to do it over a period of time: extract, allow healing, then place implants, allow healing, then crown. DF-Mark: MattKW said:\n\n\n\n\t\t\tAgree with honestdoc. The extraction shouldn't be too hard, and I would have that out within a 30min appt. If you are thinking of implants, then I would advise you extract the one in front as well - it has a poor risk of lasting too long even with a crown. Then you would get 2 implants.\nImmediate implants are possible in carefully considered cases. Usually for front teeth where appearances are more concerning. It is less risky to do it over a period of time: extract, allow healing, then place implants, allow healing, then crown.\n\t\t\nClick to expand...\n\n\n Thanks Matt for your reply!\nI visited my dentist on Jan 5th and the plan was to fill a cavity and then extract 36.\n\nI told him I have a few questions about the extraction before he went ahead with it.\nJust before my dentist started his work he said there are a few fillings he'd be doing!\nThis came as a big surprise and I don't like surprises when I visit a dentist.\n\nI asked him how many fillings he did when he was finished and he said \"three\".\nThen I explained to him why I was not too thrilled with the way he proceeded with his work.\n\n... Around ten years ago I visited another dentist and had fillings done on around five teeth.\nThe next day (for the first time in my life) I slept almost non-stop for 30 hours !!!\nI just got up to go to the bathroom and then went back to sleep!\n\nNothing else had occurred at the time. I wasn't sick. I wasn't taking any drugs or alcohol etc., no food poisoning, no stress\nor other extraneous factors....\n\nWhen my dentist was finished with the three fillings I asked him some questions about the extraction.\nThen came the second big surprise of the day. He said he'd probably need to do a bone graft and started\ntalking about possibly using pig bone! He said he could use grafts from other animals or possibly a synthetic graft.\n\nAt the end of the day, it was clear that he wouldn't be doing the extraction that day! Third surprise! \nHe said he needed to get the graft material before the extraction was done.\nSo an appointment was booked for two weeks later (Jan. 20).\n\nWell I am putting the brakes on until I am fully briefed about everything, all possibilities etc.\nMy dentist first started talking about this extraction more than a year ago. He never talked about a bone graft until\nlast visit.\n\nI hope you folks can give me a quick course on extractions and implants.\n\nHere are my main questions right now:\n\n1. Why are these two procedures (extraction/implant) included in your Oral Surgery section, when there are two dentists \n I visited (who are not surgeons) who are prepared to do the work?\n\n2. How often are bone grafts done for an extraction/implant? My mother has had five or so dental implants and never had \n a bone graft done.\n\n3. What is the purpose for the grafts and what material is usually used? Do they remain in the gums?\n\n Thanks in advance! MattKW: 1. Implant surgery can be legally done by a general dentist, oral surgeon, or periodontist. Altho I've had training in a number of implant courses, I prefer to let my periodontist do the surgery because often the patient needs some touch-up periodontal therapy on the side. Also, a peridontist is better in my opinion than an oral surgeon to handle bone and gum grafting if required. A competent general dentist can do implant surgery and grafting if they have the experience.\n2. and 3. Grafting might be actual harvested bone, synthetic or bovine bone, or GTR (guided tissue regeneration. For places where there is either not enough bone for the implant to take hold (or needs supplementation), or for front implants to plump out the gum. Most grafting if for front teeth and upper molar teeth (sinus lifting). It becomes part of your body. See part 2. here.\nSometimes the decision for grafting is made before extractions and done at the same time; sometimes it is done after the extraction wound has healed. DF-Mark: MattKW said:\n\n\n\n\t\t\t1. Implant surgery can be legally done by a general dentist, oral surgeon, or periodontist. Altho I've had training in a number of implant courses, I prefer to let my periodontist do the surgery because often the patient needs some touch-up periodontal therapy on the side. Also, a peridontist is better in my opinion than an oral surgeon to handle bone and gum grafting if required. A competent general dentist can do implant surgery and grafting if they have the experience.\n2. and 3. Grafting might be actual harvested bone, synthetic or bovine bone,...\n\t\t\nClick to expand...\n\n\nThanks very much Matt for your helpful reply.\nI really appreciate it!" }, { "id": 235, "title": "Hard palate still has redness", "dialogue": "aqz: Hi so this is a question about my hard palate. I first noticed this around three years ago but was told by docs etc its nothing to worry about etc. It causes me no pain and never has done apart from giving me anxiety.\nHowever i have forgotten about it for the last three years and decided to check after such a long time and its still there! I have got no where with the nhs. Your opinions will be much appreciated. I would like to add in the morning the lesion is always less pronounced and covered in a white coating which just scrapes off with this redness. The first pic is how it looked 3 years ago and others are now. honestdoc: I can't diagnose it only from the image. I can't explain why you had it for 3 years. It appears like an autoimmune response where your body is attacking itself. If it is, the lesion will respond to corticosteroids. Related to it is a response to medication/substance such as new toothpaste, mouth rinse, herbal supplements, cinnamon products, etc. Very rare could it be a sinister lesion such as cancer. The only way to diagnose it is to obtain a tissue sample and examine it under a microscope (biopsy). Is it worth undergoing such an invasive procedure? If any images such as CT scan shows any expansion of the lesion, then it is definitely needed ASAP. If you can identify source(s) of autoimmune responses then you save yourself a lot of trouble and trauma." }, { "id": 236, "title": "My dentist won't pull my wisdom teeth", "dialogue": "Faraway11: I went to the dentist today because my bottom wisdom teeth are coming through. The left one has made my gum very sore and is only just starting to get better although it's still tender and painful sometimes. The right side is partially through but looks as if it's coming in at a slight angle towards the other tooth. They're not very painful now at all and the only difficult thing at the moment is cleaning them. I just hope I'm doing a well enough job. I've managed this far with no infection fingers crossed. My dentist said they don't remove them unless I've had 2 infections which I'm pretty annoyed about. Is it possible that they'll be okay and the right side will straighten up abit? She said there isn't enough room for them and they might misalign my bottom teeth a bit but I can get retainers if so. I don't know what to do, I can't live off mashed potato all my life and I can't live in fear waiting for an infection. honestdoc: Get another opinion and a referral to an Oral Surgeon. MattKW: Are you in the UK? They follow the NICE Guidelines there which are IMHO too conservative about wisdom teeth. They won't misalign your lower front teeth (a myth), so no need to get retainers. Get them out if you can somewhere else." }, { "id": 237, "title": "Post lingual Frenectomy exercise!", "dialogue": "robnav: I had the procedure done yesterday at 2:45PM. Yesterday was ruff, I was in severe pain. I have a very low pain tolerance. I’m feeling a little better today but not great. Still hurts to talk and regular movement. My oral surgeon said after this I will show you some exercises to do but after the procedure I was so happy it was done and the nurses dismissed me that I just bailed. At night I remembered wait he said something about tongue exercises and I looked them up. \n\nPretty much they were all the same. Just general tongue movements. My question is when do I start doing these? Today or when the stitches fall, which one fell yesterday by the way. \n\nI had a tooth pulled a while back and remember that the dentist told water and Salt promote faster healing. Is the case with a frenectomy as well? Dr M: Good day\n\nYou can start rinsing with salt water. This will help the area to heal. Start with the exercises as soon as possible. Don't wait for the stitches to fall out. Dr M: Keep the movements gentle for the first few days. You don't want to be too rough, so that you cause the stitches to tear open. robnav: Thank you for your response. I have been doing the exercises. When I do the one that you pull your tongue to the wall of your upper mouth I get this really bad pain in my right ear. I’m assuming this is not normal. Sometimes I feel a discomfort in the left ear but it’s actual pain in the right ear.\n\nI know you can’t tell me without an examination but could a frenectomy cause an ear infection? Dr M: It might just be referred pain. Should clear up when the area heals. If it doesn't, go and see your oral surgeon again." }, { "id": 238, "title": "Infection and/or dry socket? Pics", "dialogue": "Annie2020: Hello!\nI had tooth #18 extracted on Wednesday (today is Saturday). It’s been quite painful since the extraction, but pain and swelling are worse as of last night (a 6-7 on pain scale). There is pain in my jaw, radiating towards the front of my mouth along the jaw bone and up in to my ear on the same side.\nDoes this look like possible infection and/or dry socket? Dr M: Good day\n\nYes this seems like a possible dry socket. Go back to your dentist for a follow up. He can clean out the area and prescribe additional medication as required." }, { "id": 239, "title": "Should i be concerned this is dry socket ?", "dialogue": "Lp8890: Hi all,\n\nI had a tooth removed 4 days ago on the 29th of september. The photos are what the socket look like today. Should i be concerned ? I brush twice a day and salt water rinse a minimum 3 times but it is usually more. All i am eating is soup , mashed potatoes and gravy. I do have a funny taste in my mouth but have just put this down to the surgery. Please help as i am a bit worried. I would also like advice on when i can eat solid foods again. I am stressing over this to be honest.\n\nThank you all. Emmab: Can I ask if this turned into dry socket. This is what mine looks like now Dr M: Good day\n\nThe area doesn't seem very inflamed. If you don't have any severe pain, the area is most likely healing normally. Leave as is and allow healing to take place. Can take 2-3 weeks." }, { "id": 240, "title": "Implant front tooth", "dialogue": "sueanne21: Hoping for some help and guidance please\nNearly 30 years ago I had 2 front teeth caps.\n3 weeks ago, just out of the blue and after a little\nniggling, my front tooth just completely sheared off.\nOf course I was pretty upset, I looked like Nanny McPhee!\nWith the help of my daughter in law, I found a dentist and\ncontacted them. They gave me a price to have a new screw\nin tooth fitted after the old roots were taken out of the gum.\nThe appt was booked for 1 1/2 hours and my son dropped me\noff. I was in the dental surgery from sitting in the chair to paying\nthe receptionist 19minutes, he just didn't seem to care.\nThe temp replacement tooth he put in was shorter then my other\nfront tooth but as the numbing wore off my gum seemed sore. My son\nlooked at it and the tooth was absolutely terrible, all glue around my\ngums and 3 big hard rough bits. Also in 2 days it fell out.\nI went back to the dentist (personality of a slug) he redone it. Honestly,\nit looked even more of a mess than the first one, and once again it has\nfallen out in just over a week. You can see by the picture that it\nlooks like a lump of popcorn. I know he was peed off with me going back\nto about the 'first' replacement. Before doing a second replacement, he put some\nacid stuff in my mouth and for days the acid burnt my lips and my tongue and was really sore.\nI have paid him good money and still have more to pay in 3months when the\nproper tooth is fitted. I feel really down and fed up, tearful and STILL with a gap honestdoc: How did you find this dentist? Where are you located? In the US, there are no excuses for such poor service since there are too many better dentists down the street. sueanne21: honestdoc said:\n\n\n\n\t\t\tHow did you find this dentist? Where are you located? In the US, there are no excuses for such poor service since there are too many better dentists down the street.\n\t\t\nClick to expand...\n\nHi there,\nNo I live in the UK honest Doc. honestdoc: I'm sorry for your poor experience. In the US, we are required to wear masks during this Covid pandemic. Usually, no one will notice your less than perfect temporary restoration." }, { "id": 241, "title": "Comparison between basal and Conventional Implants", "dialogue": "fungame: I know conventional implants (3 pieces) are the standard way in the USA (takes 8-12 months to finish).\n\nBasal implants work very well on every type of bone (no need of bone graft). In the USA it is not very popular or used by dentists (my search).\n\nAnyone here like to share more info on basal (if you have received it)" }, { "id": 242, "title": "Single mini implant cost for upper & lower teeth", "dialogue": "fungame: I have to extract one lower ( retreated) and upper (done once) tooth due to root canal failure. \n\nAny idea how much a single mini-implant cost in california or anywhere in US? I understand many dentists will say the mini-implant fail rate is higher but regular is not 100% assurance either. It will all depend on dentist practice. fungame: extracting #19 & #13....any suggestion I go with min-implant (abutment attached to implant) on both (molar tooth so don't know single piece implant will work)" }, { "id": 243, "title": "Is it impacted wisdom teeth", "dialogue": "fungame: I am getting mixed responses about upper wisdom teeth. Do the upper two wisdom teeth impacted? (left in particular looks impacted). One dentist said wait and watch while other said left is severely impacted and oral surgeon should remove it. I think both should be removed. any inputs Dr M: Good day\n\nI would watch and wait. Your 2nd molars are still not fully developed, when looking at the root apex closure, and your third molars or wisdoms are also still developing.\nI would wait to see what happens.\nIn a lot of cases, impacted but unerupted and asymptomatic wisdoms can be be left alone without any intervention. Especially if they pose no risk to the adjacent teeth.\nIf they do seem impacted and pose a risk to adjacent teeth, a good age to remove them is between 16-18 years, when the roots aren't fully developed yet. fungame: Thanks for the quick response.\n\nOrthodontist mentioned removal of wisdom teeth before starting braces. I think he said crowded teeth and wisdom doesn't go well and removing them will help in straightening the teeth.\n\nThank you Dr M: If this was the recommendation of the orthodontist, then it is a good idea to remove them." }, { "id": 244, "title": "11y child, fallen out tooth placed back in(2y ago) but now due for surgery to be cut and put a flipper instead", "dialogue": "Mae: Needing a second opinion:\n\nAbout 2 years ago my 11 year old daughter had an accident and her front top tooth fell out.\n\nThe dentist managed to put it back in and overall its been fine since.\n\nBut because the nerves on the root were dead and they cleaned them off that means that basically the tooth is dead and won't grow with the rest of the teeth and jaw.\n\nBecause of that the dentist advised that now they cut her tooth all the way up to the gum (while leaving the root inside) and have my daughter wear a flipper tooth instead until she is old enough to have an implant.\n\nThey said that if we leave this tooth as it is now, if we leave it like this until she is old enough for an implant then while the rest of her teeth and jaw grows, this dead tooth including its gum will stay up and will look very disproportionate from the rest of her teeth and then when it's time for an implant it will be a very complicated and dangerous process.\n\nLast week we had the impressions done and next week she is due for the surgery to have her tooth cut while leaving her dead root in and she will have her first encounter with her flipper tooth that she will have to wear until she is old enough for an implant.\n\nI would like to know if there is another option for her? I am very relactant of her having this surgery as well having her wear a flipper for the next 10 years at least.\n\nAlso I don't understand how leaving the whole tooth on as is now until old enough for an implant will be very complicated and dangerous then but that won't be the case if they cut the tooth now while leaving the dead root in now and having a flipper in as they plan to do?\n\nAlso how cutting the tooth now while leaving the dead root in won't have the consequences of it and it's gum being disproportionate with the growth as it would apparently be if they leave the tooth in? honestdoc: This doesn't make sense that the dentist has to cut the tooth. Was there a fracture that separated the tooth (crown) from the root? Of course the tooth will be dead because the nerve lost its blood supply. Here in the US, we will do the root canal to clean all the dead nerves and seal it from getting any infection. We try to preserve the tooth as long as possible since the child is still developing and removing the tooth will collapse the developing bone causing some malformation of the facial profile. We would splint the tooth to allow for bone to tighten around the root. Cutting the tooth would be the last resort if there was too much damage. Once the bone is fully developed around 19 years or older, implant would be more predictable. Mae: Honestdoc, thank you so much for your reply.\n\nThere was no fracture that seperated the tooth(crown) from the root. \n\nAnd just to add it is the top central incisor tooth.\n\nThe trauma and replantation of the tooth happened 2 years ago. The trauma occured in the evening and the replantation the following morning. At the time I believe the dentist did a root canal to clean all the dead nerves and seal it from getting any infection, trying to perserve the tooth for as long as possible. Also about few days later or so, the dentist put a metal splint which my daughter wore for about a week which was a but painful.\n\nAt the beginning of this year the little filling at the back of the tooth fell out and she developed an infection which was treated. The dentist cleaned it up inside with a thin tube and sealed the tooth again.\n\n\nBut even when they replanted the tooth at the time 2 years ago they said that at one point the tooth(crown) would need to be cut all the way to the gumline, while leaving the root inside and a flipper will need to be worn until later when my daughter is in her 20's when she would be able to get an implant. \n\nThe main reason from what I understood that that needs to happen is to make sure that there is enough bone for the future implant. Otherwise if the tooth is left as is apparently the tooth will become smaller then the rest of the teeth, the gum would pull back in developing an uneven gumline and bone loss will occur which all will be a problem for a future implant. That os what I understood from what the dentist explained. I remember the dentist saying that in that case the future implant would be more complicated as they would have to build on more bone so that the future implant can take hold. Also I was told that the reason this tooth will remain smaller then the rest and the gumline would be pulled in is because the remaining of the teeth and gum would grow as she grows while that tooth will stay the same size which would result in a uneven tooth line and gumline.\n\nWhat I don't understand is how now cutting the crown from the root and leaving the root inside helps no bone to be lost and that can't be the case leaving the crown to the root as it is now.\n\nAnd just wanted to find out if there was another option so she doesn't have to go through this surgery and loose the crown which all seems good like this and to have to wear a flipper for at least 10 years which is a very long time for a annoying temporary solution that would also need adjustments along the way. MattKW: replanted teeth have a poor success rate by 5 years. Often the root becomes eaten away (like a baby tooth) and replaced by bone. So, unless your child is having pain or infection, I'd suggest leaving it alone and simply X-raying it annually." }, { "id": 245, "title": "Impacted Wisdom Teeth", "dialogue": "Mike09: I had a panoramic X-ray done a week ago.\n\n\n\n\nAs you can see, the two lower wisdom teeth are problematic. They sometimes cause bleeding.\nThe dentist who took the photo said that I don't need to get them removed as long as I clean them properly and that there is a high risk of alveolar nerve damage from the extraction. She offered treatment for periodontal disease instead, and it includes root scaling, laser sessions, and injectable stem cells. \n\nSince then I asked a few dentists online and they all said that the teeth should be removed. One of them explained that the lower wisdom tooth on the left (right on the picture) has already caused significant bone loss and its roots are not close to the alveolar nerve so it should be extracted as soon as possible. The right one (left on the picture) on the other hand, might be risky to extract and the surgeon might want to take CBCT to see where the nerve passes.\n\nI have an appointment with another dentist tomorrow and she will probably recommend an oral surgeon.\nI am worried that the surgeon might suggest extraction regardless of how risky it might be.\n\nSo here are my questions:\n1) Do you think that both teeth should be extracted or do you think that both (or one of them) could be left and it/they wouldn't cause serious issues in the future?\n2) How risky is the extraction of each one of them, in your opinion?\n3) Is the extraction currently more urgent than the periodontal disease treatment offered by my dentist?\n4) How much can the extractions and the periodontal disease treatment be postponed without developing serious problems? Both procedures are very expensive and I will have to choose one of them and put off the other one.\n5) What could happen if the wisdom teeth are not extracted? Could this lead to a jaw infection? How would it be treated?\n6) What would happen if the alveolar nerve is damaged during the surgery? And would it require expensive treatment afterwards (which I probably wouldn't be able to afford)? Dr M: Good day\n\n1) Yes both teeth needs removal, since the bone loss can affect the teeth adjacent to them and lead to further problems. Impacted 3rd molars can also lead to dentigerous cysts and then this can also affect the adjacent teeth. If they are partially erupted in the mouth, they can lead to continuous episodes of pericoronitis, which is very painful and also lead to abscesses.\n\n2) Both of the teeth appear to be in close proximity to the nerve. This is a 2 dimensional image however. An oral surgeon can take a 3 dimensional scan that can give a better evaluation.\n\n3) I would prioritize the extractions and then continue with periodontal treatment afterwards.\n\n4) It all depends. Everyone is different and an exact timeline can't be given. Based on the amount of bone loss, I would not wait too long and definitely would prioritize the extractions.\n\n5) If the teeth are not extracted, it could lead to cyst formation or additional bone loss, affecting the adjacent teeth, which might be lost as well, with or without additional bone loss of the cysts have to undergo additional debridement. Abscess formation is also a possibility and this infection could spread to additional spaces in the face, and can become life threatening if left untreated.\n\n6) If the nerve gets damaged, it all depends on the type of damage. If the nerve is completely severed, you could lose all sensation on the affected lower side from the back up until the front, with possible neuropathic pain. If the nerve is only bruised, the numbing sensation could be prolonged for a period from a few days up until a few months/years and then gradually return to normal. This can also be accompanied by neuropathic pain such as a burning or tingling pain.\nUsually the symptoms area treated with medications, and there have been some new studies done on laser therapies and Vitamins that can speed along nerve regeneration, but in my experience thus far, the main thing is to watch and wait and be patient.\n\nHope this answers some questions. Mike09: Dr M said:\n\n\n\n\t\t\tGood day\n\n1) Yes both teeth needs removal, since the bone loss can affect the teeth adjacent to them and lead to further problems. Impacted 3rd molars can also lead to dentigerous cysts and then this can also affect the adjacent teeth. If they are partially erupted in the mouth, they can lead to continuous episodes of pericoronitis, which is very painful and also lead to abscesses.\n\n2) Both of the teeth appear to be in close proximity to the nerve. This is a 2 dimensional image however. An oral surgeon can take a 3 dimensional scan that can give a better evaluation.\n\n3) I would prioritize the extractions and then continue with periodontal treatment afterwards.\n\n4) It all depends. Everyone is different and an exact timeline can't be given. Based on the amount of bone loss, I would not wait too long and definitely would prioritize the extractions.\n\n5) If the teeth are not extracted, it could lead to cyst formation or additional bone loss, affecting the adjacent teeth, which might be lost as well, with or without additional bone loss of the cysts have to undergo additional debridement. Abscess formation is also a possibility and this infection could spread to additional spaces in the face, and can become life threatening if left untreated.\n\n6) If the nerve gets damaged, it all depends on the type of damage. If the nerve is completely severed, you could lose all sensation on the affected lower side from the back up until the front, with possible neuropathic pain. If the nerve is only bruised, the numbing sensation could be prolonged for a period from a few days up until a few months/years and then gradually return to normal. This can also be accompanied by neuropathic pain such as a burning or tingling pain.\nUsually the symptoms area treated with medications, and there have been some new studies done on laser therapies and Vitamins that can speed along nerve regeneration, but in my experience thus far, the main thing is to watch and wait and be patient.\n\nHope this answers some questions.\n\t\t\nClick to expand...\n\nThanks for the thorough response, Dr M. I really appreciate it.\nI have another question. What if the molars next to the wisdom teeth are extracted instead? That would allow me and my dental hygienist to clean the wisdom teeth properly, right? Would this be less risky? Does that even make any sense? No dentist has suggested that, I just came up with it the other day, so it's probably nonsense.\n\nAlso, how common is it for the wisdom teeth to be in close proximity to the nerve? And how common is it for such nerve damage to occur during extraction in cases similar to mine? I would like to have a better idea of the risk of removing the teeth vs. the risk of not removing them. Does the risk-reward ratio in a case like mine seem like a no brainer to a dentist like you? I am somewhat worried that when I go to an oral surgeon he will suggest extraction anyway, since it's his job and he will get very good money for it (especially considering the crisis that we are living in right now). So I'm not sure how objective his/her opinion would be in this case. I hope you don't find this offensive as a dental professional. Dr M: An oral surgeon will definitely suggest extraction. An experienced oral surgeon can remove these teeth without any complications. I have seen a lot worse impacted molars than the ones you have. 90% of them were removed without any complications, and permanent nerve damage is rare.\nAlso remember that the image you have is 2 dimensional. In reality there might not be any nerve involvement. There are certain signs that we look for when evaluating risk of nerve involvement on a panoramic x-ray. And it doesn't look like you have many, so it might be that the nerve is not involved, in my opinion.\nIt would also be best to keep the adjacent teeth and remove the wisdoms. You will have to have some sort of periodontal treatment afterwards, to attend to the bone loss surrounding the adjacent molars, but this can be postponed for a while if money is an issue. Mike09: Dr M said:\n\n\n\n\t\t\tAn oral surgeon will definitely suggest extraction. An experienced oral surgeon can remove these teeth without any complications. I have seen a lot worse impacted molars than the ones you have. 90% of them were removed without any complications, and permanent nerve damage is rare.\nAlso remember that the image you have is 2 dimensional. In reality there might not be any nerve involvement. There are certain signs that we look for when evaluating risk of nerve involvement on a panoramic x-ray. And it doesn't look like you have many, so it might be that the nerve is not involved, in my opinion.\nIt would also be best to keep the adjacent teeth and remove the wisdoms. You will have to have some sort of periodontal treatment afterwards, to attend to the bone loss surrounding the adjacent molars, but this can be postponed for a while if money is an issue.\n\t\t\nClick to expand...\n\nThanks for the quick response." }, { "id": 246, "title": "Shaving off bone fragments after wisdom tooth removal", "dialogue": "Du_deleted: Hii,\nI have extracted right upper wisdom tooth in July. No stitches done. Went back for follow-up and it was healing properly. I saw some 2 hard bump on the gum of the extraction site in August and it was so tiny and hard. I went back and asked the surgeon. He said it will absorb on it's own and it will take time. Told me to come back after 2 weeks. I didn't go back and was waiting to see if t goes away on its own. It started giving me sharp pain and pinching like pain for last 2 weeks. Went back today and he shaved it off. He said it's a bone and it was a bone that emerges like 2 bump. He put anesthesia and shaved it off and dod stitches. I didn't have stitches for the tooth extraction. I had stitches today and he said it will dissolve on it's own. How to know if it will dissolve? I never had stitches before. Whether will I be able to see the area and identify if stiches present or not. How to know that if stich dissolve on it's own . Can I eat normally? How long does it take to heal from that?will stich go on it's own?\nDo we need to follow the same post op instructions as wisdom tooth removal? Anyone did this bone shaving earlier?\nEven though they numbed me during the procedure, I could feel the pressure they used to shave it down. It was so hard and pressurized. He did stiches after that. When can I eat normally?\n\nI wanted to ask these questions to the surgeon. He did the stiches and told me to take motrin OTC and left the room. I felt so bad and came out of the office.\n\nIt's been 2hours and I still bleed. I am using the gauze and changing it every 45 minutes. Is this normal? How to stop bleeding? Any inputs please. Du_deleted: @honestdoc ,@Dr M any inputs please." }, { "id": 247, "title": "PLEASE HELP AND ADVISE", "dialogue": "Lp8890: I had a tooth extraction 8 days ago. It all seemed to be healing ok with a greyish layer in the socket but now the grey seems to have gone and theres like a white and yellow bit in the extraction. I have included before and after photos. Somebody please help as i am freaking out that i have some how dislodged the blood clot and will end up with dry socket. Dr M: This is part of the normal healing process. Granulation tussue is white and yellow. This will eventually turn pink." }, { "id": 248, "title": "Sinus problem after tooth removal.", "dialogue": "CheyanneWinter: I recently had a top wisdom tooth removed (almost 2 weeks ago) and had issues with slight dry socket. My dentist used something to plug the hole to help with healing and ease the pain I was having. It's been 3 days since then and now I'm having sinus effects. The stuff he used tasted/smelled gross but I worked though it but now it seems to be in my sinus?? I blew my nose and the stuff that came out smelled bad as well. Did I unintentionally suck the stuff he used into my sinuses? Is that possible?\n\nI'm attaching my xray of tooth prior to removal because the root seems to go beyond the bone and they didn't seem to do anything special when taking it out (I wasn't even put under, just had laughing gas). I'm probably being paranoid but I'd really like what another dentist may think. Thanks for listening. honestdoc: The top right wisdom tooth was very close to the sinus. The membrane separating the sinus is very thin and could easily be perforated. If the socket is closed, there is good chance the membrane will close up. Get a follow up to check for closure and avoid blowing your nose to minimize disturbing the healing process." }, { "id": 249, "title": "Wisdom tooth advice", "dialogue": "Alina D: Hi\n\nI have a wisdom tooth under the gum, which once in a while causes mild pain and tension for shorts amount of time. I have been advised to have it removed asap, but I would like to do so back home and therefore to wait for at least a month since I cannot fly anytime soon because of work commitments. Pain is not an issue so far, I'm just wondering whether there may be other complications if I choose to wait. What would you advise? \nPS: The treated molar close-by has a temporary crown, and I am planning to replace that with a permanent one pretty much at the same time. You can advise me whether that's a good idea or not. Thank you. honestdoc: This wisdom tooth is a high risk for injury case. The tooth is distally impacted (tipped away from the midline) which the path of exit is towards your throat where there is no space. The most scary is the close proximity to the Inferior Alveolar (IA) nerve which if damaged, could make your Lower Right lip numb (maybe permanently). What can make it easier is the fused root anatomy which can help roll the tooth out in one piece. I would only have the Oral Surgeon evaluate it. In the mean time, have the dentist prescribe you Peridex 0.12% (non-alcohol base to minimize chemical irritation) and rinse for 2 to 4 weeks (not longer because you risk darkening your teeth) and get the temp crown taken care of. Alina D: Thank you so much for your reply. I will follow your advice and go to an oral surgeon to evaluate it. \nIf I'll there will be pain, I will not wait 4 more weeks and I'll get it removed as soon as possible. Have a great day." }, { "id": 250, "title": "Can I just have a tooth extracted and delay insertion of a post for later implant? How long could I wait?", "dialogue": "Bill54: I have an upper tooth (Number 5?) with an old metallic filling on the bite surface. The tooth has cracked around the filling and it has been torturing me. I have seen two dentists; one told me that if I have it pulled, the other teeth will start coming out. The second told me that if I have it pulled, then a post will need to be inserted immediately (at great expense) if I want an implant later. He wants to do a root canal instead. I am on antibiotics now, awaiting next appointment.\n\nQuestion: If the tooth is pulled, can’t I have the post and implant inserted later? If so, how long could I wait? It is a problem of expense, and I want immediate relief. Dr M: Good day\n\nAn implant can be placed at a later stage depending on the bone quality and space between planned implant and adjacent structures. Some specialists advise to wait 3 to 6 months to allow bone healing to take place. If there was infection, then you have to wait a bit longer. Bill54: Thank you for your reply, Dr. M. May I ask one more question?\nA dentist told me I would need a guided tissue regeneration and bone graft after extraction (immediately, I gather) to preserve the bone structure. This would be quite expensive. Is an immediate bone graft, etc. really necessary? I just want to have the tooth pulled; it is slow torture. Dr M: Good day\n\nIt all depends on the extraction procedure. If it is a difficult extraction with more than normal bone loss, and there was not much bone to begin with, then this might be necessary." }, { "id": 251, "title": "Post extraction post healing pain.", "dialogue": "KM01: Hi I had first upper molar extraction after root canal failed to stop pain and made it worse. \nIn the extraction the tooth was sawn in half , it was quite a surgical type extraction and took a while to heal over. I went in for dry socket and dentist applied get which helped. \nWeek 3 after extraction I no longer needed any pain killers. \nWeek 4 slowly some pain returning and treatable with paracetamol. By end of week getting worse. \nVisit dentist week 5\nHe says extraction site gum has healed over so it can't be dry socket. \nHe prescribed me course of clindamycin and that if that doesn't work he will refer me to the dental hospital. \nI'm worried that I've got some infected bone or something wrong with my nerve that was caused by root canal treatment. \nThe pain is getting worse even with the antibiotics although I'm only 1.5 days into the course. Ibuprofen doesn't help much I have to take the one with codeine to sleep. \nI'm just a bit worried about what is going on. I thought tooth extraction would solve my problems. \nI don't have a swollen cheek or throbbing pain it is more constant dull/burning ache from a general area. \nThanks for your replies. Dr M: Good day\n\nDo you perhaps have any x-rays? Need a bit more information" }, { "id": 252, "title": "Is this an infection? 5 Days Post Wisdom Teeth Removal", "dialogue": "jisoon: Regarding the first photo, is that thing in the back normal? I have no pain on the other side (second pic) but still have pain on the side with that thing...does anyone know what it is? \n\nI wasn't given any advice related to cleaning the extraction areas except for a mouth rinse. honestdoc: That \"thing\" is normal epithelial repair tissue. I would stop using any rinses especially mouth rinse. Mouth rinse can chemically irritate and you shouldn't agitate the healing area for now. Just avoid having any debris in that area and it should close up in a few days. jisoon: Thank you for the helpful words!!" }, { "id": 253, "title": "My all on 8 implants was on one arch", "dialogue": "thetiggler: I wanted to get the all on four fitted. I was told by the dentist all on 8 would be better so I went with that.\n\nNow the lockdown has finished I recently able to get the all on 8 fitted. I had them fitted in both the upper and lower jaw.\n\nI assumed the all on 8 meant my upper jaw teeth/implants would be fitted in 8 individual pieces and the same for my lower jaw in that it would also be 8 individual pieces in my lower jaw.\n\nWhen it came to having my implants fitted. I didn't get 16 individual pieces. All my implanted teeth for my upper jaw came as one set. It was the same for my lower teeth. All my lower teeth came as one set. I have 4 screws in my lower jaw that the teeth are screwed into and I have 4 screws in my upper jaw that the teeth are screwed into.\n\nDid I get what I paid for? Why do they call it the all on 4 or all on 8 when it comes as one piece?" }, { "id": 254, "title": "Stent overload?", "dialogue": "Henry O: I have a concern.\nMy upper yaw teeth have been extracted in preparation for implants.\nDentist wanted to support new dentures with only two stents.\nI suggested at least four implants. Dentist agreed but then she drilled three holes.\nAll three holes are in front close to each other, none in the back.\nBesides the limited load distribution problem, my main concern is the torque on the stents.\nIf my molars bite on something hard, cantilever action with about 30 to 40 mm lever arm causes high torque at the point of the stents. I am afraid, this could break the yaw bone. \nIs there a reason not to put two stents in the back close to the molars to eliminate the problem?\nPlease advise - Thanks Dr M: Good day\n\nIs there enough bone present posteriorly? Sometimes the availability of sound bone as well as the proximity to other vital structures can influence the decision to position implants. Henry O: Dentist mentioned something about not enough bone. \nBut, will it break??? honestdoc: Where did you get the implants placed? Did a surgeon or general dentist place it? The upper posterior bone usually is thinner under the sinus cavity. Usually the surgeon may recommend lifting the sinus to allow more bone grafting to place implants. Without posterior implants, your denture may not be as stable and retentive.\n\nWith the cantilever action, most likely your bone won't break but it won't osteointegrate (heal) around the implants causing the implants to be loose and fail. I always recommend an experienced surgical team as well as restorative team for implants. Henry O: It was a general Dentist. So far, only holes are drilled, no implants yet.\nHealing ... that's another point, the bone integration might suffer due to constant wiggle. Dr M: I agree with honestdoc. \nUsually a surgical team with proper planning is needed.\nIt is also strange that the dentist only drilled holes without at least placing the implant screws. Usually this is done and then they are covered by healing abutments if immediate loading was not planned, in order to allow osseo-intergration to take place. \nThis does sound like a strange protocol to me.\nAs honestdoc said, if the implants aren't positioned properly to allow for the various forces that are going to influence them, the implants will ultimately become loose and then fail.\nIt sounds like the general dentist might have realised that the positioning was not planned properly and then aborted placing the implants.\nI would consider getting the procedure done by someone that is experienced in implant placement as well as the subsequent restoration. \nAfter all-you are paying a lot of $. Henry O: I could be wrong about the sockets. Maybe they have been placed. But they are not visible. \nIn the lower yaw I got two implants at the same time, there the metal (stents) is visible.\n\nI was thinking, if the denture would be on a ball joint or stents that are slightly flexible in the \nforward-backward plane, the problem might be reduced or eliminated. Henry O: Update:\n\nThe sockets were placed. They were not visible in the mouth with a mirror, but X-ray showed them.\nDentist acknowledged my concern with cantilever torque but showed 3D X-ray that there is very little bone under a big sinus cavity.\n\nCan the bone mass be increased? honestdoc: Sinus lift surgery usually done by oral surgeon or periodontist. Dr M: Yes, sinus lift surgery with or without additional bone augmentation, but this does increase the overall treatment time." }, { "id": 255, "title": "6th day after extraction pain. Am I healing okay?", "dialogue": "KM01: Thanks for your attention.\nOn the third day after upper molar extraction I started feeling a kind of burning pain in the socket. Not severe or constant that I cannot sleep but strong enough that I have to continue using painkillers a few times a day.\nOn the fourth day my gums swelled up. Not my cheek just the gums.\nAnyhow it's now 6 days after with the same symptoms. Before I go and bother the dentist with my worries can you tell me if you think I'm healing okay? I've attached two photos. It was quite a tough extraction where the tooth had to be bisected and the gum needed a stitch afterwards.\nMany thanks for your help. honestdoc: Upper first molar is very difficult to extract because it has 3 roots usually very flared and anchored into the bone. Make sure you don't have any nasal or sinus problems because the root tips situate very close to the thin sinus membrane. Your healing in the pictures look good. Have the dentist check on the swelling. It could be minor inflammatory healing process and not a rare post-op infection or debris accumulation." }, { "id": 256, "title": "Swelling of gums 4th day after molar extraction.", "dialogue": "KM01: Good evening.\nI had my first upper molar extracted on 21st August. \nIt was quite a long procedure as the tooth needed surgical bisecting to remove it plus gum required cutting and a dissolvable stitch put in. \nThis evening on 25th August I've noticed a feeling of swelling in the gum above the extraction site and the teeth in front and behind it. The gum that sits over the jawbone area. It feels like it is pressing a bit against the inside of my cheek. \nIs this to be expected? I didn't get any noticeable swelling until now. \nMany thanks. Dr M: Good day\n\nUsually a bit of swelling can be expected after a surgical extraction. If there is no severe pain, just keep the area clean and undisturbed, and allow for normal healing to take place. KM01: Dr M said:\n\n\n\n\t\t\tGood day\n\nUsually a bit of swelling can be expected after a surgical extraction. If there is no severe pain, just keep the area clean and undisturbed, and allow for normal healing to take place.\n\t\t\nClick to expand...\n\nThanks for your reply." }, { "id": 257, "title": "8 days post op...gaping hole", "dialogue": "Valibrae: Hi, was wondering if the following is normal? I have a really deep wisdom tooth socket after an impacted tooth in my lower left side. My suture fell out day 5. I am 8 days post op and can still barely eat and sleep due to some pain. It's so deep I cannot even see inside to see if there is debris/dry socket. Will this heal correctly? I see my dentist tomorrow but wanted some opinions. Is there any way this could be re sutured? Thanks Dr M: Good day,\n\nThe area looks inflamed and based on the pain that you are experiencing i.e can't eat and sleep, it might be an indication that you have a dry socket. If you have any anti-inflammatory medication, take it and let the dentist evaluate if the socket needs to be rinsed out, to allow a new blood clot to form. Valibrae: Dr M said:\n\n\n\n\t\t\tGood day,\n\nThe area looks inflamed and based on the pain that you are experiencing i.e can't eat and sleep, it might be an indication that you have a dry socket. If you have any anti-inflammatory medication, take it and let the dentist evaluate if the socket needs to be rinsed out, to allow a new blood clot to form.\n\t\t\nClick to expand...\n\nThanks so much. Pain has receded to ear and temple so i'm sure thats what it is. Post op is tomorrow, so I'll see what they say." }, { "id": 258, "title": "How long does it take to heal after the wisdom tooth removal?", "dialogue": "Du_deleted: I have extracted the upper right wisdom tooth on July 2nd. It's been a month and a half. I didn't have any stitches. \nI went for a follow-up after 2 weeks and OS said it's looking good and taken a xray to check.\n\nI feel some sharp and sore pain whenever I eat some hot food on the extraction site since last week. I couldn't see the site in the mirror.its too far. \n\nI ran over my tongue over the extraction site and it looks closed and I feel some gap between the second molar and the third molar gap which is very hard. But the gap between two feels not hard and feels like a gap in between. Is this normal? How long does it take to close completely? All the area should feel hard when we run over the tongue? \nI also see a white pimple like boil blister on the gum of the extraction site. Its been there for past 2 weeks. I have some lower jaw pain under the earlobe for 3.months and I extracted the upper wisdom tooth as dentist said that could be the reason. But my symptoms got worse after the extraction.\nI still have the lower jaw pain. \nIs the gap between the molars take time to get hard? \nI couldn't differentiate if I get any pain from the extraction site now since I have TMJ issue and pain in the lower jaw and in front of the ear. It's so painful. \nDo I need to go back to dentist to check this or is this normal?" }, { "id": 259, "title": "Day 6 of extraction", "dialogue": "Kae Jae: Hello. 6 days ago i went in to get a molar removed because of a bad cavity. I’m still having some throbbing pains (not unbearable) and my extraction site is greenish/blackish/yellowish . Is this normal? Dr M: Good day\n\nThis might be an indication of a dry socket. This is common in bottom extractions, since food and other particles can get stuck in the socket easily.\nI would make a follow up visit with my dentist, so that he can wash out the socket and allow a new blood clot to form, in order to facilitate healing.\nHe will also give antibiotics if he hasn't done so already.\n\nHope this helps Kae Jae: Hello, yesterday I spoke to a nurse over the phone and ate her the same pic I did here . She said everything looks normal and it may be that color because of the granulation tissue is forming and also from the blood . However, it still throbs on and off . He prescribed me 800mg ibuprofen. Do you think I should still go get it checked out? This is how it looks today .... MattKW: If the pain is bearable and manageable, then you're going to be OK. Don't bother with antibiotics - not required. Dr M: Agree with MattKW. Usually a dry socket would be unbearable pain. Continue with the anti-inflammatory meds and monitor the area. Kae Jae: Ok . But since it’s been a week since I’ve had it removed is it normal to still have a throbbing & sharp pain sensation on and off ? Dr M: Surgical pain can sometimes gradually decrease over 2 weeks." }, { "id": 260, "title": "Perforated sinus how long to heal", "dialogue": "MCH2012: I recently had 3 teeth pulled, on day 7 I started getting liquid that came out of the nose when gargling. And since then, I feel air rushing through, and liquid still comes out. The dentist said it’s a perforated sinus and will close on its own. It’s been 4 days with this going on. Is this true?? Will it close on its own?? Dr M: Good day\n\nDepending on the size of the sinus perforation, it might be necessary to have surgery done to close the opening. If this is not done, it could cause chronic sinus problems and/or infection. It might be a good idea to have an oral surgeon look at this problem, and then he can determine if it needs to be closed or left as is.\n\nHope this helps MCH2012: The water stopped coming out 3 days ago and I don’t feel air rushing in or out anymore. Do you know if this means it closed and if I go to an oral surgeon how do they determine if it closed? I’m two weeks post extraction and I would hate for them to cut me open just to see if the perforation closed or can he see through a CT scan? MattKW: Be careful not to break it open again while still healing. Don't blow your nose, and don't hold back sneezes. Most perforations of 5mm or less will close up if you allow for healing. Dr M: Usually they can determine through a scan if the perforation is closed. It all just depends on the size of the perforation, if it would close naturally or not. Dr M: New studies show that perforations of 2mm or less heal spontaneously and if larger than that, you are at higher risks of complications. \nIt is normal for a small amount of fluid or blood to drain through the opening, but it is a good sign that it stopped. If you develop any sinus problems related to the affected side, please go and see a oral surgeon. This happens after about 2 weeks." }, { "id": 261, "title": "Do I need more imaging?", "dialogue": "Du_deleted: Hello,\nI did see a TMJ specialist and he did a pan xray. He told me that my bones are scratching each other and that cause the pain. He told me to do physical therapy first.\nHistory:\nhave been dealing with lower jaw pain under right ear with swelling since 3rd week of may.It started after I chew some food more than usual and next day I heard a pop in the jaw,pain and swelling started the same day.went to ENT to check sinus as I had facial pain.he did an Endo,no infection in ear,sinus.Pain radiates to side of the neck in June&swollen a little.Went to the dentist,he told me to extract upper wisdom tooth&removed it.\n\nEven after that,symptoms persist.he referred me to tmj specialist. I saw the tmj specialist and he prescribed me PT for my symptoms. He said he will give splint after PT.\n\nI have ear pain,jaw pain under ear where the lower jaw ends, pain on top side of the head above the ear, neck pain(only right side and it's very painful). My Dr did see a small lump on side of the neck and my neck is swollen a little.\nI have continuous sore pain. It's like sore scratching/burning pain on side of the neck, lower jaw under the ear, inside the ear and top right of the head(one spot above the ear).I hear some soft music pitch, ringing in my ear at times during the day and while lying down.\nIt hurts to touch spots under the ear, side of the neck and on one spot on top right side of the head. Neck and jaw are mildly swollen. Severe pain in the lower jaw under ear and side of the neck. It hurts to touch. I feel like something stuck in the throat constantly. I see in Google that something stuck in the throat symptoms comes under TMJD too. So, I am not sure if the neck pain and swelling(lump) comes under TMJD.\n\nI have started PT for tmjd. My symptoms have become severe and the pain is worse. PT did say that pain will become worse before getting better. What are those spots or lumps which I feel on the jaw under ear, side of the neck and top right side of the head. \nAny thoughts?\n I feel those spots when I run my finger over those spots and it hurts to touch. What are those spots which are bulgy and hurts to touch? I have a lump under the ear in the lower jaw since end of may when this issue started. It's still the same. How to know what are those? Do tmjd diagnosis require further imaging? The specialist didn't say anything about further imaging. Why those spots hurts to touch and what helps to get relief from those? Any thoughts doctor(s) here?" }, { "id": 262, "title": "Dry socket?", "dialogue": "MCH2012: Hi I just got 3 teeth pulled on Monday. I’m still having bad pain in one of the teeth and to me it looks a little more sunken in then the others. Is this dry socket? Dr M: Good day\n\nUsually a dry socket is pain that presents 3 or 4 days after an extraction. \nDo you have any photos of the area? MCH2012: Still having pain. MCH2012: .. Dr M: If you still have pain, it is most likely that the sockets are infected. Make a follow-up visit with your dentist, so that he can clean out the socket, to facilitate a new blood clot forming. He will also give you some antibiotics to drink. MCH2012: I have been on antibiotics this whole time and before though. Dr M: It might be that the socket needs to be rinsed out. There might be food particles or tooth/ bone pieces left over that cause a chronic irritation. Sometimes it needs to be rinsed out more than once before the infection clears up-even with antibiotics. If you rinsed too violently, the blood clot could also have become dislodged, which could lead to this problem, i.e dry socket.\nArrange a follow-up visit with your dentist.\n During this follow-up visit, the dentist can also take x-rays of the adjacent teeth, to examine their status." }, { "id": 263, "title": "Help!", "dialogue": "MCH2012: Hi! I had 3 teeth pulled on Monday I’m on antibiotics and it’s day 6 and I’m still in a lot of pain! And two hours before pain meds wear off I have pain bad pain! Anyone had teeth pulled and had this happen? Is this dry socket? Can I get sepsis?? The pain hasn’t subsided. honestdoc: You have some choices. Being the weekend, you can wait until Monday morning to see your dentist for followup. If you have access to your dentist's emergency phone consult, you can give them a call. If you can't wait and must be seen, you can find an emergency dental clinic. In the US, it can be very costly and if they accept your dental insurance, it can help with the high fees. Last resort especially if you have swelling with difficulty breathing and or pressure in the eyes is to go to the Hospital Emergency. Ashtek: MCH2012 said:\n\n\n\n\t\t\tHi! I had 3 teeth pulled on Monday I’m on antibiotics and it’s day 6 and I’m still in a lot of pain! And two hours before pain meds wear off I have pain bad pain! Anyone had teeth pulled and had this happen? Is this dry socket? Can I get sepsis?? The pain hasn’t subsided.\n\t\t\nClick to expand...\n\nHope you are eating semi solid foods and avoiding a hard rinse in your mouth . Avoid smoking and alcohol \nI had wisdom tooth removed on Monday but the pain eventually went away on Friday. My doctor fucked up by leaving a bur inside my jaw.\nWhat I did was cold compress with ice packs and after eating meal gently rinse my mouth with Luke warm salt water \n\nIf the pain is very bad it could be dry socket so best get it checked ASAP on Monday" }, { "id": 264, "title": "During wisdom tooth extraction bur got broken and stuck", "dialogue": "Ashtek: Had my lower wisdom teeth extracted yesterday , problem arose when the steel drill tip(bur) got stuck inside the jaw bone. Dentist tried to remove but was unable to do so\nDoctor says to let it keep that way, if he tries to extract can lead to perm nerve damage\n\n\n\nWill there be any complication in future due to the foreign body being stuck ? Any infections ?\n\nReally scared \n\nAlso they showed me the xray but didnt hand them over , said will be handed on next visit Dr M: Good day\n\nUsually if there was a complication with a wisdom tooth extraction, and the extraction was initially performed by a normal general dentist, it is advisable to refer to an oral surgeon, which will then advise on how to proceed. \nBecause there is a foreign body left over, the body might \" push it out \" naturally after a few months, if healing proceeded normally. There is always a risk that it might not heal and lead to a post-op infection.\nI assume the doctor prescribed you antibiotics?\nIf the drill-bit becomes dislodged, there is always a risk that you can swallow it as well and then it can perforated important anatomical structures, since it is sharp.\nMy advice would be to seek the advice of a specialist such as a maxillo-facial surgeon, since there are some risks which could lead to severe complications if not taken into account. The specialist will give better advice on what steps need to be followed. Ashtek: Dr M said:\n\n\n\n\t\t\tGood day\n\nUsually if there was a complication with a wisdom tooth extraction, and the extraction was initially performed by a normal general dentist, it is advisable to refer to an oral surgeon, which will then advise on how to proceed.\nBecause there is a foreign body left over, the body might \" push it out \" naturally after a few months, if healing proceeded normally. There is always a risk that it might not heal and lead to a post-op infection.\nI assume the doctor prescribed you antibiotics?\nIf the drill-bit becomes dislodged, there is always a risk that you can swallow it as well and then it can perforated important anatomical structures, since it is sharp.\nMy advice would be to seek the advice of a specialist such as a maxillo-facial surgeon, since there are some risks which could lead to severe complications if not taken into account. The specialist will give better advice on what steps need to be followed.\n\t\t\nClick to expand...\n\n\nThanks Dr M the doctor who treated me is indeed a oral and maxillofacial surgeon .Yes antibiotics painkillers nerve soothing medicine was provided \n\nNow my issue the bur is tuck in jaw while the extraction took place and the doctor tried to take it out but said could do damage to the nerve hence stopped\n\nThis is the lower right molar , I have attached a xray (Not mine but looks exactly the same where the bur is stuck\n\nMy question is can it lead to a infection after few years ? Dr M: Good day\n\nThe bur that is used, is a sterile bur. So in theory it should be clean, and if it remains in the position, and healing is normal, it could stay there without any problems. Or push itself out.\nFollow the advice of the specialist, and go for your regular check-ups, where the position of the bur can be determined with a x-ray.\nIf you feel any pain in the area, or notice any swelling, it is important to go back to the specialist.\nSometimes the bur moves over a period of years, to such a position where it can be safely removed, without nerve damage. Dr M: The foreign body i.e bur could be enclosed by a capsule of granulation tissue, and be left for years. There has been minimal reported cases like this. The important thing is regular follow-up, to observe the fragment and to prevent it from moving into other anatomical spaces. Ashtek: Dr M said:\n\n\n\n\t\t\tThe foreign body i.e bur could be enclosed by a capsule of granulation tissue, and be left for years. There has been minimal reported cases like this. The important thing is regular follow-up, to observe the fragment and to prevent it from moving into other anatomical spaces.\n\t\t\nClick to expand...\n\nThanks will keep this is mind honestdoc: It is hard to judge an image that is not yours. Could you provide your true pano? Where are you located? I find it strange that a board certified oral maxillofacial surgeon in the US would have difficulty with this. The surgical bur in the x-ray is too big and wide to use for teeth extraction. Most likely the area will not get infected like Dr. M mentioned as well as formation of granulation (scar) tissue. If it does get infected, the bone and tissue will get softer and make retrieving the object more predictable. Ashtek: honestdoc said:\n\n\n\n\t\t\tIt is hard to judge an image that is not yours. Could you provide your true pano? Where are you located? I find it strange that a board certified oral maxillofacial surgeon in the US would have difficulty with this. The surgical bur in the x-ray is too big and wide to use for teeth extraction. Most likely the area will not get infected like Dr. M mentioned as well as formation of granulation (scar) tissue. If it does get infected, the bone and tissue will get softer and make retrieving the object more predictable.\n\t\t\nClick to expand...\n\n\nHey my xray comes next week when I visit the dentist again for stitch removal .\nBtw any idea when the infection can occur ? I mean within a year or after 7-10 years ?\nThank you very much\n\nEdit : - I am a US citizen on my assignment to India. The surgery was performed in India as I had a severe chance of infection . I will be stuck here till 2022. Ashtek: Also as the stainless steel bur contains nickel can it lead to metal poisoning ? honestdoc: Are you an engineer? You ask very good questions. When nickel is used in metal mixture, the irritating potential is usually gone. How you know you have an infection is swelling. If the infection has matured, the x-rays may show dark areas around the metal object. That dark area indicates softer/destroyed bone. The longer the object has been in the mouth, the less likely it will get infected. Ashtek: Thanks doc will\n\n\nhonestdoc said:\n\n\n\n\t\t\tAre you an engineer? You ask very good questions. When nickel is used in metal mixture, the irritating potential is usually gone. How you know you have an infection is swelling. If the infection has matured, the x-rays may show dark areas around the metal object. That dark area indicates softer/destroyed bone. The longer the object has been in the mouth, the less likely it will get infected.\n\t\t\nClick to expand...\n\n\nThank you very much for the detailed answer , will post the xray when I rec it .\nNo I am not a engineer I work as a analyst" }, { "id": 265, "title": "Upper teeth extraction with implants", "dialogue": "Suzieq: Getting ready for all upper teeth removal plus two implants and implant supported denture on Wednesday! Will I be eating? Will there be a lot of bleeding? How long to recover? Need to know what to expect!! Thanks for any info! Dr M: Good day,\n\nWhen a full upper dentectomy is done, there will be some bleeding obviously. The bleeding should become less and less during the day, with minimal if no bleeding the next day. The pressure of the denture on the sockets helps to facilitate the bleeding to stop. I would advise to stick to a soft diet for the first 2 weeks. Thereafter gradually build up to a more normal diet. And follow the post op instructions given by the surgeon.\nRecovery depends on the patient as well as the operator. This is influenced by various factors such as number and difficulty of extractions, surgical or normal extractions, size of wound areas, post operative care by the patient according to the instructions given by the surgeon etc.\nUsually after about 2 weeks, healing should have progressed quite nicely and after 1 month, you should be feeling a lot better. Bone can take from 6 months until 1 year to fully stabilize.\n\nHope this helps. Suzieq: Dr M said:\n\n\n\n\t\t\tGood day,\n\nWhen a full upper dentectomy is done, there will be some bleeding obviously. The bleeding should become less and less during the day, with minimal if no bleeding the next day. The pressure of the denture on the sockets helps to facilitate the bleeding to stop. I would advise to stick to a soft diet for the first 2 weeks. Thereafter gradually build up to a more normal diet. And follow the post op instructions given by the surgeon.\nRecovery depends on the patient as well as the operator. This is influenced by various factors such as number and difficulty of extractions, surgical or normal extractions, size of wound areas, post operative care by the patient according to the instructions given by the surgeon etc.\nUsually after about 2 weeks, healing should have progressed quite nicely and after 1 month, you should be feeling a lot better. Bone can take from 6 months until 1 year to fully stabilize.\n\nHope this helps.\n\t\t\nClick to expand...\n\nIt's a big help! Thank you so much for the reply. My dentist has been working diligently for many years to avoid this result, but with years of dental issues and in the past several years fighting against auto-immune dry mouth we have lost the battle. I am of course very anxious about the unknown. Thank you again." }, { "id": 266, "title": "Molar Extraction healing?", "dialogue": "Tk19: Hi,\n\nSo basically i had my molar removed on the 4th of August 2020, it is now only the 7th of August and i just wondered is anyone can tell me if it is healing as it should be? Started as a white covering that has slowly turned to greenish colour and has now gone a dark colour. Its smooth and a jelly like substance but i really don't want to risk infection.\nI know mild pain is expected but i have mainly had pain when moving my mouth too quick or when i open it over half way. Also noticed it can be hard to swallow and an excess of saliva but apparently that is to be expected.\nThanks in advance. honestdoc: Fortunately your extraction site looks good. I'm not seeing much swelling. The color changes are normal. It represents the formation of epithelial repair tissue and will soon close up. Lower 2nd molars can be difficult to remove due to the thick, dense jaw bone locking in the varying root anatomies (multiple divergent and curved roots). The mouth has good healing potential so it is fairly rare to experience complications unless you smoke and or have medical conditions like diabetes. Tk19: honestdoc said:\n\n\n\n\t\t\tFortunately your extraction site looks good. I'm not seeing much swelling. The color changes are normal. It represents the formation of epithelial repair tissue and will soon close up. Lower 2nd molars can be difficult to remove due to the thick, dense jaw bone locking in the varying root anatomies (multiple divergent and curved roots). The mouth has good healing potential so it is fairly rare to experience complications unless you smoke and or have medical conditions like diabetes.\n\t\t\nClick to expand...\n\nThat is really helpful, thank you!" }, { "id": 267, "title": "Apicoectomy teeth #s 23, 24, 25, 26 with bone graft", "dialogue": "Gental: Hello, (see before and after images)\n\nI had apicoectomys (apicoectomies?) done on my front 4 bottom teeth. I was under the impression that only the bottom 2 to 3mms of my teeth were going to be removed. I asked to see the after x-ray and I was surprised at how much tooth looks like was removed. Is it me or was a lot of tooth removed? Could someone explain if this just looks like a lot or hopefully there is some kind of reason this much had to be removed due to infection? I thought that the teeth were exposed, the very tips of the teeth were removed, and then as much infected bone and tissue needed to be removed would be removed, just a little surprised at how much actual tooth was removed.\n\nI am a little concerned about if what is left of the teeth go down far enough to be sturdy long term? If my bone graft turns to real solid bone well, should they be strong? Hopefully my bone graft heals well, I did have a bit of a set back with wound dehiscence unfortunately, which is now healing through secondary intention. Right now the hole is just 2mm I think and is healing. The dentists/students? that have seen me on follow ups think that the bone graft should be fine and I am staying on the chlorhexidine until it fully closes.\n\nI am reaching out on this forum because I have some questions but it is really hard to get questions answered at this residency clinic. They didn't really tell me all the info I should have known beforehand and I haven't seen the doctor who actually did my work after the surgery. Thanks for your time everyone, appreciate it. Dr M: Good day\n\nFirstly, it is important to note that this x-ray is 2 dimensional. Usually a tooth is also sectioned at the tip at an angle, so this x-ray might give you a misinterpretation of how much tooth was actually removed.\nSecondly, as much tooth, bone and granulation tissue needs to be removed in order to facilitate healing. The ideal crown ( top part of tooth ) and root ratio is 1/3 to 2/3's. Or at the very least 50/50. \nJudging from your x-ray and counting in the fact that you have a graft, the stability should be fine.\nThe tooth with the post and crown is a bit more of a worry, since the seal on the root end part might not be that good and could lead to failure.\nIt is also important to keep in mind that root canal treated teeth, with apicetomies, is no guarantee that the teeth will be fine in the long term.\nThere is always a chance that this could also fail, and then you will end up loosing the teeth, which would lead to either a partial denture, or implants as solutions.\n\nHope this helps. Gental: Hi, yes that all makes sense, thanks for your reply. I agree about the crowned tooth, it was done by my hometown dentist and he did a great job so we have to just hope. And for the longevity of the apicoectomy as well, just hope I am a long term outcome, there must be some cases where they last impressively long.\n\nAbout the wound dehiscence, it was not across the entire length of the opening and is now down to 2mm or less. Basically my question is can you have dehiscence in part of the wound and it not affect the bone graft? I am not showing any signs of infection. Just a little worried that maybe the wound closes but somehow the bone graft was compromised while the dehiscenced part was closing up.\n\nThanks again Dr M: There is a risk, but it may be relatively small, depending on if the area was treated appropriately. My advice would be to watch and wait and to go for your scheduled follow up visits to confirm new bone formation in the graft area.\nIt is a good sign that everything is healing. Gental: Great, will do. Thanks for your time. Gental: Hi Again. I was wondering as well. Could you tell from the X-ray if the surgeon put a root end filling at the bottoms of the teeth? I am curious if this was done and I can not tell from the image and I asked the helpers to ask the surgeon and they said they’d get back to me but no one has told me. MattKW: Sorry, but those are pretty rough apicos which I would expect to fail within 12-18 moths, either from reinfection or fractures. They appear to have been done by an oral surgeon and not an endodontist. There has not been much regard for the quality of the underlying RCTs which are of so-so quality. Normally an endodontist would try redoing the RCTs, and use apicos as a secondary intervention. Gental: I would have rather had the roots retreated. When I went to the clinic I purposefully went on the one day a week that the endodontist is in. At first she said to try a root canal re-treatment of 2 of the teeth but then looked over it all for awhile and said that with the bone loss in the jaw that it is better to get in there and remove it all along with a bone graft. They made it seem that just root canal re-treatment would not completely solve the jaw bone infection, could re-treatments have cleared all the infection away?\n\nHonestly I would have gotten a second opinion if I was aware of how significant apicoectomies are, they really made them seem like a very minor thing where the very very tip of the root is taken, and when I looked them up a bit on the web, everywhere seems to also make it look like this tiny bit of the apex is taken. But after having them and I watched an actual surgery video, it really is not that small of a thing.\n\nAs for the original root canals, I got them done in 2004/2005 when I was 17/18 after a basketball injury sent all 4 of them straight backwards from an elbow. I had no problems with them until around 2015 when I got a basketball shoulder that shattered the one that then got a crown. I never had any issues with those root canals until that second injury.\n\nWhen you say fracture, do you say this because of how much tooth was taken and lack of stability will lead to them fracturing with normal use? I am a pretty healthy person, if the bone graft takes well is there a chance they can become pretty strong? Also what is your fear of reinfection, because of not all the infection being cleared when the apicos and bone graft were done, or the wound opening? The wound opening is nearly shut now. Dr M: Good day\n\nI agree with MattKw, that apicoectomies are usually done as second line treatment. A retreatment would have been first choice. It is possible that unfortunetly the infection was to severe, for only a retreatment to have cleared it up, and therefore apicoectomies might have been needed. Even with a retreatment, there is a chance that all the granulation tissue and infected bone, could result in the retreatment failing, or the teeth that are being retreated could end up fracturing during the retreatment process or the end result could have been similar with similar quality root canals. There are unfortunately a lot of possible outcomes, but at this stage it is too late to reminisce over what could have been done. The infection should have been picked up initially during check-up visits, before it got to such a severe stage.\nLike I explained in my previous post, the root-crown ratio is a bit compromised now, and since these teeth are root canal treated, they might end up fracturing at a later stage. \nIn my personal experience it won't last you the rest of your life. You can consider crowning the remaining teeth, in order to prevent them from fracturing, but this should only be consider once the apicoectomies and bone graft have been deemed successful and there is no longer residual infection at the site. Crowns might increase the strength of the teeth.\nIf the roots fracture, because of weakened structural stability after the apicoectomies, then unfortunately they will have to be removed. Gental: Thanks for both your time. Yes I wish I had at least once paid out of pocket to see my hometown dentist during this span of not having insurance/funds. I went to a few dentists that took my crappy insurance and asked them about the teeth and they were not concerned but my gut said that the darkness there was not normal. But you are right, you can't go back in time...\n\nJust hope these last long enough for me to move up in my career and them not be so daunting to address financially, because everything is times 4. If/when... they fail, I hope that at least I can get an implant supported bridge, but would rather 4 implants. Though one dentist seemed like I could get 4 implants and another acted like there was not enough space. Would 4 implants be an option and if I got another bone graft and they were done by a good dentist could those last a real long time?\n\nThanks for the advice on maybe getting crowns for them, part of me feels like maybe just saving up for implants in the future. One dentist said that after the apicos I could get a special bridge made for support which confused me. I said I thought bridges are for missing teeth and that I was confused and he did not explain further. I am guessing like some kind of cap thing that would span the 4 hurt teeth and 2 neighboring teeth, which I don't really want to bother the neighboring teeth that are healthy.\n\nThanks again, appreciate the responses MattKW: Once the integrity of the tips are removed like yours have been, then the root as a whole is weakened, and that leads to fractures. I would not advise crowns; it would be a waste of money. You would be better saving up for implants. You don't need an implant for each lost tooth; 2 implants would suffice to hold up a 4-unit bridge. Dr M: Agree with MattKW. In terms of a long term solution, implants will be the best option. Gental: I understand what you both are saying, though I still do not get why so much of the root tips were removed by the oral surgeon. If you have the window open why couldn't you scrape away the infected jaw bone and you should have visibility to take a smaller amount of the tips. Especially hearing that this is pretty important to long term outcome.\n\nAs for the implants, why is it not more advisable to get 4 implants? From everything I hear it seems like implants can last a really long time with proper care, they take up the socket space and keep the gums and bone from shrinking etc. The process of cleaning them is more straight forward and like regular teeth. Then you have the bridge, sure it is in implants so not affecting the natural teeth, but from what I have gathered, the bridge part needs to be replaced on average sooner than an individual implant would, there can be bone/gum loss going on underneath the bridge, and cleaning under them seems a bit less straightforward with possible issues arising. Not to mention maybe getting something stuck under by accident and pulling on the unit.\n\nSo why do dentists say a bridge. Is it that there is legit not enough space there? I don't care if it is a bit more expensive with more steps, is it just easier? Dr M: Usually price is an issue. Most people can't afford 4 implants. There is also the issue of the amount of space needed between implants. Usually about 2.5-3mm of bone needs to be present between implants. In such as a case it is possible that 4 implants will not fit in the available space.\nWith good maintenance it is possible that the bridge components could also last a very long time before they need replacement. \n\nWith regards to the apicoectomies that were done...without seeing how much of infected bone was present or what the condition of the root apices were, it is difficult to say if he took too much off. Gental: I see, thanks a lot for expounding. Thank you both for your time. Maybe I can hold out long enough for new advances in smaller but stable screws or something. Dental needs to be part of health insurance always and not this side thing, I guess too many people are lucky and don't get elbows to the face in high school and are just ignorant to the need. Dr M: Good luck and all the best! Gental: Thank you!" }, { "id": 268, "title": "Do I need an oral surgeon rather than a dentist?", "dialogue": "nobodyspecial1981: This is embarassing but it is what it is. I suffer from anxiety and have only been to the dentist 2x in my whole life. I had a very bad experience. It isnt the pain that concerns me. I just dont like having things in my mouth especially metal. Is my condition so bad that I am probably going to need an oral surgeon rather than a dentist? I know you can only tell so much from pictures but thought I would ask. Dr M: Good day\n\nIt is difficult to say without an examination and some x-rays, since some of your top teeth for example, might be located close to important anatomical structures, such as your maxillary sinuses. If this is the case, the consultation of an oral surgeon might be required. Your bottom wisdom teeth also look impacted, and if close your inferior alveolar nerve, will also require an oral surgeon to continue management.\nMy advice would be to go and see a dentist, who will then take some x-rays and refer you to the relevant specialists if required. nobodyspecial1981: Dr M said:\n\n\n\n\t\t\tGood day\n\nIt is difficult to say without an examination and some x-rays, since some of your top teeth for example, might be located close to important anatomical structures, such as your maxillary sinuses. If this is the case, the consultation of an oral surgeon might be required. Your bottom wisdom teeth also look impacted, and if close your inferior alveolar nerve, will also require an oral surgeon to continue management.\nMy advice would be to go and see a dentist, who will then take some x-rays and refer you to the relevant specialists if required.\n\t\t\nClick to expand...\n\n\nOk yhank you so much for the reply. I have been trying to find a dentist that offers general anesthesia but havent been able to locate one. I will contact my PCP and maybe he can refer me to someone. MattKW: The upper scraps of teeth should be relatively easy to remove. The lower wisdoms will be more difficult, but are probably achievable by a good general dentist. Since you have anxiety issues, you primarily need to talk about this with your general dentist. Perhaps you will find benefit with some nitrous oxide (laughing gas), or even supplement it with a short-acting benzodiazepine, e.g. triazolam (\"Halcion\").\nI'd suggest you try some of the easier extractions with these supplements, and you may build up your confidence. You shouldn't need to go to an oral surgeon every time you have a dental problem." }, { "id": 269, "title": "Implants in back teeth", "dialogue": "veohstew112: Is it possible to get implants near my back teeth. Dr M: Good day,\n\nIt is possible to get implants near your back teeth, as long as their is sufficient bone and sufficient space between the implant ( usually about 1.5- 2mm ) and the adjacent teeth/implant. This is evaluated with radio-graphs and/or CBCT scans.\n\nHope this answers your question." }, { "id": 270, "title": "Beginner upper dentures over top of dental implants", "dialogue": "John B: I am 64. After a lot of years of difficulty, my dentist has talked me into upper dentures. I have 2 upper dental implants, prior to remaining extractions. My dentist put screws, or covers in the 2 remaining implants, while he extracted all upper teeth. He said that I could decide if I want snap in upper dentures, and the 2 implants would be enough to hold them. He said I could let my gums heal for at least 6 months while I decided whether to go with 2 implants that are already there for $2000 or use suction to hold the denture, without implants for additional $1000. Wearing the upper denture over top of the upper gums with old implants that have screws in them has been painful, and I think that the implant screw keeps the denture from seating. One implant seems quit irritated. I need to go forward with my permanent upper dentures. My beginner dentures do not fit and fall out without adhesive. I am uncomfortable at this point with the dentures in or out. I need advise as to get permanent upper dentures using my 2 current implants or hope for a good fit and not use the implants. Can you give me advise on this irritating issue? Dr M: Good day\n\nThe beginnner dentures that you are talking about, is what we refer to as immediate dentures. They are usually placed directly after extractions. They begin to lose retention after a period of 6 months to a year, because the areas where your teeth used to be, changes shape as the bone changes dimensions.\nSometimes a reline is done, to improve the fit, but usually a new denture needs to be made ultimately.\nWithout any pictures, it is difficult to give an exact opinion, but it can be possible that the existing implants can prevent the denture from seating as it should.\nIf there is too much pressure on the implants, and one already \" looks irritated \" , I would get this looked at, because chronic inflammation can result in a condition called peri-implantitis or peri-implant mucotitis, which could ultimately lead to implant failure and loss.\n\nSince you already have 2 implants, I would suggest going for an implanted supported denture, where the denture is attached to the implants. It might be necessary for an additional implant to be placed, in order to prevent too much strain on the other implants, especially if they aren't 100%.\nYou can maybe have a consultation with a prosthodontist, in order to make sure if 2 implants are enough and if the 2 that are there, are still stable enough to support a denture?\nUltimately an implant supported denture is a lot more comfortable, since they don't \" feel loose \" in your mouth. John B: Dr M said:\n\n\n\n\t\t\tGood day\n\nThe beginnner dentures that you are talking about, is what we refer to as immediate dentures. They are usually placed directly after extractions. They begin to lose retention after a period of 6 months to a year, because the areas where your teeth used to be, changes shape as the bone changes dimensions.\nSometimes a reline is done, to improve the fit, but usually a new denture needs to be made ultimately.\nWithout any pictures, it is difficult to give an exact opinion, but it can be possible that the existing implants can prevent the denture from seating as it should.\nIf there is too much pressure on the implants, and one already \" looks irritated \" , I would get this looked at, because chronic inflammation can result in a condition called peri-implantitis or peri-implant mucotitis, which could ultimately lead to implant failure and loss.\n\nSince you already have 2 implants, I would suggest going for an implanted supported denture, where the denture is attached to the implants. It might be necessary for an additional implant to be placed, in order to prevent too much strain on the other implants, especially if they aren't 100%.\nYou can maybe have a consultation with a prosthodontist, in order to make sure if 2 implants are enough and if the 2 that are there, are still stable enough to support a denture?\nUltimately an implant supported denture is a lot more comfortable, since they don't \" feel loose \" in your mouth.\n\t\t\nClick to expand...\n\nI have pointed out to my dentist about crooked implants information that I have read. He agrees after 6 months that mine are crooked and will not work. Therefore I have dentures over top of 2 unused implants. They make the implants sore and uncomfortable. Is this a common practice? They cannot be removed easily? Dr M: Good day,\n\nThe implants can be removed. If the implants stay painful and sore, this could be that the pressure of the denture is causing some inflammation around the implants. Chronic inflammation is never a good thing, since this might actually lead to soft and hard tissue damage.\nIt might be a good idea to get a second opinion. John B: Dr M said:\n\n\n\n\t\t\tGood day,\n\nThe implants can be removed. If the implants stay painful and sore, this could be that the pressure of the denture is causing some inflammation around the implants. Chronic inflammation is never a good thing, since this might actually lead to soft and hard tissue damage.\nIt might be a good idea to get a second opinion.\n\t\t\nClick to expand...\n\nIs removing the implants a complicated procedure, or is is similar to a tooth extraction? Dr M: Good day,\n\nIt depends on the amount and condition of the bone surrounding the implant. Sometimes a similar instrument that was used to \" screw the implant into the bone \" is used to \" unscrew it \". This should be done by dentist or oral surgeon that is trained in the placement of implants." }, { "id": 271, "title": "Feel mild sharp pain after 17 days of wisdom tooth removal and hurts to open the jaw wider. Is this normal?", "dialogue": "Du_deleted: Hi,\nI had lower jaw pain, ear pain with mild swelling over the jaw line for 2 months. Been to many dentist and no definite answer. Told me to try removing the upper wisdom tooth and extracted it 2 weeks back. I still have the same lower jaw pain, continuous ear sore pain and neck pain. My neck is so sore and tender to touch. Under the ear was sore to touch.\nI didn't feel much pain on the extraction site as I was having more pain on the lower jaw and ear, neck.\nFor last 2 days, I feel sharp pain on the extraction site. I am still using peridex rinse and salt water rinse. I haven't used that side to chew at all till yesterday. Only yesterday I chewed little food on that side and after that I felt sharp pain on and off.\n\nThen I stopped chewing that side.\nI am not able to open the jaw wider and it does hurt on the site when I open the jaw. When can we start chewing food on that side? And paining while opening jaw is normal?" }, { "id": 272, "title": "Wisdom Tooth and Bite Change", "dialogue": "thatman: So I went to an orthodontist and he told me that my bite isn't correct to due to me wisdom teeth. I have known my bite isn't right as I don't end touch my left hand sided teeth together when I bite and on the right hand side then aren't even aligned. So now I am getting an extraction of them this week. Will this fix the problem or not? honestdoc: Without xrays and images, we don't know how your teeth and bite are aligned. If it is only slightly off and you don't have crowding and lack of space, your cheek and tongue may help align your teeth (more so when your teeth are erupting). Most likely your orthodontists will answer your question after taking records and images." }, { "id": 273, "title": "Post wisdom tooth removal. Is this normal?", "dialogue": "Du_deleted: I had upper right wisdom tooth removal last week. Following post op instructions. I feel the first and second molar very tight and stiff since day 2 after extraction. It's hitting hard and tight while closing the mouth. I couldn't chew anything even on the opposite site because of this. I am eating only soft foods which are easy to swallow. Is this normal to have tight and hard molars? How to get back to normal? \nAnyone had this experience? Please share your inputs." }, { "id": 274, "title": "Post extraction", "dialogue": "gmock94: Bone graft seems to be getting smaller every day and there are very random, small shocks of pain that dont last more than a second. I've been good about brushing and flossing and rinsing with salt water. Do I have an reason to be concerned? I also smoke but rinse after every smoke. Dr M: Good day,\n\nSmoking is never a good idea in cases where bone grafting was done, since this can influence the outcome. From the picture alone, it is difficult to see if everything is okay. If you are concerned, book a follow up visit with your dentist." }, { "id": 275, "title": "Molars feel tight after WT extraction.", "dialogue": "Du_deleted: Is this normal?\nI am on day 3 after WT extraction. My upper right WT. \nToday I feel so tight in first and second molars upper and lower while closing the mouth. Is this normal?\n\nAlso , I don't see any swelling in the cheeks. But see some swelling in the gums on extraction site. I feel more pain in the ear. Inside the ear. Is it normal ? I get constant pain in the ear and in front of the ear. \n\nWhy the bite is so hard and stiff on that side? The molars hit so hard and my ear hurts. It's like burning, sore scratching pain in the ear. Du_deleted: Any inputs anyone?" }, { "id": 276, "title": "Whether upper wisdom tooth removal doesn't require stitches?", "dialogue": "Du_deleted: Hi,\nI had my upper wisdom tooth extraction. I did it with numb shots. Didn't go for sleep sedation. The procedure was very quick and I felt some pressure while pulling out. Then he immediately said it's done. I was shocked. It literally took 2 to 3 minutes I immediately asked him (thank God. I was awake and know what's happening). I asked why no stitches? He said no stitches required for upper wisdom tooth and only lower ones will have stitches. Is that so? Anyone had stitches for your upper wisdom tooth removal? How will the hole wound get better and sealed??\n\nAnd , I am bleeding for more than 5 hours and keep changing my gauzes. How long will the bleeding continue? Is it normal? How to stop bleeding? I am feeling so sleepy and I couldn't sleep because I keep checking on gauzes and changing it every 30 to 45 minutes. \n\nHow long bleeding will continue? Dr M: It is normal for the bleeding to continue for a few hours. If it is still bleeding after 24 hours, go back to your dentist. It isn't always necessary to place sutures. A blood clot forms in the socket, that will eventually turn into tissue. This can take a few weeks. Don't disturb the blood clot in the mean time with excessive forceful rinsing, placing your finger or tongue into the socket as well as any other foreign objects. Du_deleted: Dr M said:\n\n\n\n\t\t\tIt is normal for the bleeding to continue for a few hours. If it is still bleeding after 24 hours, go back to your dentist. It isn't always necessary to place sutures. A blood clot forms in the socket, that will eventually turn into tissue. This can take a few weeks. Don't disturb the blood clot in the mean time with excessive forceful rinsing, placing your finger or tongue into the socket as well as any other foreign objects.\n\t\t\nClick to expand...\n\nThank you doctor @Dr M. Appreciate it.\n\nWhen can I start rinsing? I got a prescription for mouth rinse. It's been 24 hours after the extraction now. Can I rinse with mouth rinse or salt water rinse now or tomorrow? \n\nI didn't brush yet after the extraction. Can I rinse today? And what should be the diet like?\n\nI am eating only jell-o, pudding, yogurt and water. I am worried about dry socket. How to avoid it? What to do to avoid it? Please share your inputs. \n\nWhen should I rinse?" }, { "id": 277, "title": "What sedation should I choose for WT removal?", "dialogue": "Du_deleted: Hi all,\nI am dealing with some tooth issues. Jaw pain and swelling under the ear for more than a month. Had sinus Infection and I got antibiotics for that. I thought this jaw pain and swelling is because of the sinus infection.\nThen waited for a couple of weeks and went to dentist to check that out. My regular dentist is not available and went to a new dentist. He checked the x-rays and said no infection seen on any tooth. He said, since I have taken antibiotics already, if at all any infection was there and it would have cleared up.\nHe did bite test and I felt so discomfort on one spot on lower first molar. So he told me that this tooth is causing the jaw pain and swelling under the ear. It might have a fracture. So told me to extract it as RCT will not be successful. He told me to take cbct scan and told me that he couldn't tell for sure there is a fracture. It's not visible on the scan and it is unpredictable. I was totally shocked and I didn't have any pain on that tooth before the visit.\nThough I didn't chew much on that side, I feel so tight on all the molars that side.\n\nI went to an Endo to evaluate it. He checked through microscope and said no fracture seen. He didn't either take or see my cbct scan images. During cold spray test, I felt very sensitive on that tooth than other ones. And felt pain and sensitivity to bite on one spot on that tooth during bite test. So, he said might be minor crack and I can get a crown. I told them it's throbbing pain in the jaw while lying down and during the day. He was not sure if the jaw pain and swelling is because of the minor crack and told me to RCT if I cannot bare the pain. I don't know if I can go for RCT for the jaw pain.\n\nAgain not a definitive answer and clueless. Been through the same pain and swelling for more than a month. My quality of life is gone really bad. Went to an oral surgeon to check my upper wisdom tooth. I have removed my lower wisdom tooth 19yrs back.\n\nI went to the Oral surgeon on Friday and he said my jaw pain and swelling is because of the erupted upper wisdom tooth and told me to extract it. Prescribed robaxin, valium, ibprufen 800 for jaw pain and inflammation.\n\nI wanted to remove it asap. Before that I am also planning to see another Endo to see if any issue on #30 tooth and that is given a first priority treatment or the upper wisdom tooth.thats really frustrating for me to not get a definitive answer been to many dental office. If that tooth need RCT or extraction, implant and I have to do that too.\n\nComing to the original query, my lower wisdom tooth has been removed with a numb shot only. Not anesthesia stuff.\n\nHave you used general or local anesthesia for your wisdom tooth removal? If so, how many tooth removal in a visit? All 4? I have 2 upper wisdom tooth left. The oral surgeon if I have to be awake or sleep for the surgery? I said I have to be awake since it's pandemic time. To be honest, I don't know the difference between the 2 anesthesia for wisdom tooth removal.\n\nIf I planned to remove those 2 WT in the same spot, do I need general anesthesia? As if now, I want to remove only one on right side as that s causing the pain and swelling for more than a month. Nothing helps to reduce the swelling and pain. It's still the same.\n\nDo I need to wait to go for extraction until the swelling and pain subsides??\n\nWhich anesthesia do you recommend? I am nervous about dental procedures. So, what should I chose?\n\nHow about the post op for you? How many days does it take for you to recover?\n\nThanks for reading this here. Thank you!! MattKW: Usually upper wisdoms are easily done under local anaesthetic. Du_deleted: MattKW said:\n\n\n\n\t\t\tUsually upper wisdoms are easily done under local anaesthetic.\n\t\t\nClick to expand...\n\nThank you doctor. I was very nervous and thought I should go for full sedation. I am planning to take out only one upper WT now." }, { "id": 278, "title": "Implants", "dialogue": "tazmaniandevil36@hotmail.: Good Morning \nI need Implants on upper and lower jaw, I have asked my dentist if he can refer me to a dental training hospital but he will not he said he could do implants for £14000,I have been to a private dentist and they say that this is what I need but the cost is up to £30000.\n Due to my teeth being so bad and painful and a badly fitted denture on the upper jaw that falls down at least 3 times in a day, even with Fixodent, it has been realigned and teeth added to it over 5 years because of my gums shrinking,and teeth coming out, it has lead me to having low self-esteem and no confidence and I'm embarrassed, my marriage is falling apart, I don't have a job, and I have no money, I cannot get finance, and do not know what to do.\nIf you can help or point me in the direction of someone who could, I would be extremely grateful. This is what has been proposed \n\n\nThank You honestdoc: Since you have no money and no job, you may need to consider not having implants and get a new denture made at a teaching facility like Dental Schools. I am not sure about the NHS in England. Implants are elective and usually you need to pay out-of-pocket." }, { "id": 279, "title": "Dry socket?", "dialogue": "Koolkid150: I had a tooth extraction 4 days ago my jaw is sore/swollen and am in pain. This can most definitely be from the canker sore that have been formed around the tooth extraction site. I wasn’t scheduled a post op appointment, so before doing so I was seeing if anyone has advice. I’m so sorry for the unpleasant picture Dr M: Good day,\n\nUsually a dry socket appears +- 3-5 days after an extraction. Bottom sockets are more commonly affected, because food and other particles are more likely to get stuck, because of gravity as well as other factors that play a role\nAlthough a dry socket is usually self limiting, it can be extremely painful and can also lead to infection spreading to adjacent areas.\nIt is my recommendation to rather schedule a follow-up visit with your dentist, so that the socket can be cleaned out, and most likely your dentist will then prescribe a short course of antibiotics. You can take anti-inflammatory medication in the mean time to help with the pain." }, { "id": 280, "title": "Pls help. advice needed.", "dialogue": "Du_deleted: I have right lower jaw pain with swelling for past one month. It started after I did lots of chewing one day. Next day ear pain, jaw pain exactly under the ear started. Its very tender and pain to touch under the ear. No redness. I went to Dr and got antibiotics for sinus,ear infection. I thought the swelling is because of that. Sinus cleared up. Still there ear, jaw pain with swelling was there. Went to an ENT, he said no infection in sinus/ear. Went to dentist last week, took x-rays and said might be a crack/fracture in one tooth. Went to Endo, he confirmed no fracture, might be minor crack in 1st molar. More sensitivity in first low molar, so said RCT, crown. Endo said this crack or sensitivity will not give jaw swelling and he said not sure why. I have pain continuously under the ear in the jaw. Pain inside ear too. Is like scratchy sore pain in the low jaw where jaw ends on top of the neck under the ear. Tender to touch. I hear snapping sound from the jaw when I open mouth.\nI feel some throbbing pain in the upper and lower jaw. It's exactly under the ear and in front of the ear. What could be the reason?\nIs it something related to my 1st molar crack or sensitivity? My Endo said I might have a minor crack and more sensitivity in that tooth#30. But he said that will not give any swelling in the jaw.\n\nWhat could be the issue. I am taking ibprufen for pain and swelling. I was taking indomethacin for a week earlier which was prescribed by urgent care.\n\nBut the pain and swelling didn't reduce at all. It's constant from day 1. Any thoughts anyone? Please help. MattKW: If the endodontist checked the vitality of your teeth with a cold spray, and they all reacted within normal limits, then it's not a dental infection. Du_deleted: MattKW said:\n\n\n\n\t\t\tIf the endodontist checked the vitality of your teeth with a cold spray, and they all reacted within normal limits, then it's not a dental infection.\n\t\t\nClick to expand...\n\nThank you doctor.\nThen it could be my sinus issue or any other glands issue or jaw issue?\nHow do I proceed further for diagnosis? I have upper and lower jaw pain and swelling. I see little swelling in the upper jaw today. Do I need to see my GP again?" }, { "id": 281, "title": "Implants at 30 outlook", "dialogue": "Mobile: I don't have the best understanding of how implants work;\n\n1. If a dental implant fails, can it be replaced? \n\nIf I'm going to be having dental implants at 30, ideally id be doing it because I don't want a gap. However, I've read that they can last up to 20 years.\n\nWhat happens after that 20 years, and theoretically they have failed. Can I get them replaced by doing another surgery, maybe with a bone/gum graft if required? \n\nI'd be only 50 at the expected lifetime of a implant and it worries that I'll either be forced to wear dentures at 50 or have no teeth there at all. Dr M: Good day,\n\nThe technology and techniques with the placement of dental implants has improved greatly over the last few years and it is still improving today.\nIt is not to say 100% that an implant only lasts you +- 20 years. There are a lot of factors that play a role, including your own personal oral hygiene, the skill level of the surgeon that placed the implant as well as the quality of the final restoration method, to name a few.\nIt is also important to note, that the implant screw can fail over time, or the implant crown or both, so it depends on the scenario.\nOnce an implant fails, there is also a lot of treatments that can be done to try and save the implant first.\nIf it needs removal, it is also possible to replace it with another implant.\nIf additional implant surgery is required, depends on the reason for failure, the bone quality and quantity that is left, as well as other factors.\nIt is important to remember that once a implant is placed, it doesn't mean you should neglect your regular dental check-ups. Success is also up to the patient" }, { "id": 282, "title": "Think I ripped my stitches! Large hole next to back molar after wisdom teeth extraction...", "dialogue": "Cali.T: I had all four wisdom teeth extracted last Thursday and I was unlucky enough to get dry socket. I was so focused on that I didn’t notice the growing hole on the other side. I sneezed today and felt something rip open, and found this gaping hole in a strange place. You can see there’s a hole, a weird piece of skin in the middle, and you can’t quite see the rest of the hole right at the front. It hurts quite a bit and I’m worried about how it will heal. I’d contact my dentist but they are closed for the next three days... should I be worried? \nI’m now experiencing pain underneath my ear. honestdoc: I don't think you have a dry socket. As another dentist mentioned in another post, you mouth has a strong tendency to heal. How you know you must get seen is if you have swelling and/or unbearable pain. Cali.T: honestdoc said:\n\n\n\n\t\t\tI don't think you have a dry socket. As another dentist mentioned in another post, you mouth has a strong tendency to heal. How you know you must get seen is if you have swelling and/or unbearable pain.\n\t\t\nClick to expand...\n\n\nThe dry socket is on the other side and has already been packed, but I really just want to know about the stitches. I’ve woken up today in even more pain and it is oozing yellow pus. MattKW: Cali.T said:\n\n\n\n\t\t\tI had all four wisdom teeth extracted last Thursday and I was unlucky enough to get dry socket. I was so focused on that I didn’t notice the growing hole on the other side. I sneezed today and felt something rip open, and found this gaping hole in a strange place. You can see there’s a hole, a weird piece of skin in the middle, and you can’t quite see the rest of the hole right at the front. It hurts quite a bit and I’m worried about how it will heal. I’d contact my dentist but they are closed for the next three days... should I be worried?\nI’m now experiencing pain underneath my ear.\n\t\t\nClick to expand...\n\nSutures help the healing by bringing the skin edges together; this is called primary intention. It's not always terribly important, because in the mouth there's often a hole left after the extraction, so healing by primary intention is not always possible. Therefore, healing where the edges can't be brought together and healing by secondary intention is quite common. As honestdoc says, thankfully the mouth usually heals quite well. Cambridge: I had my wisdom teeth removed Wednesday so this is the 5th day and my pain seems to have gotten worse today and my pain is radiating from my ear to my chin and my tooth extraction site itself feels like it’s throbbing. Cambridge: This is what it looks like best picture I could get honestdoc: Hopefully you can see your dentist soon. It's hard to spot all the details but if appropriate, the dentist can apply some medicament into the socket to relieve your pain. Lower wisdom teeth are more traumatic to remove because your lower jaw has denser bone to contend with." }, { "id": 283, "title": "I have a big crown problem!", "dialogue": "ghoul31: My teeth naturally only hit on the right side\nBut I didn't remember that when i got my crown fitted\nSo they said your right and left side need to be touching\nSo I had them keep cutting down the back right crown until it was super low\nSo then the crown didn't hit at all, only one right side tooth was hitting\nSo they had to cut down the right side teeth so the crown would hit\n\nNow my teeth are even and they hit on both left and right sides\nOne big problem though is I can't comfortably close my mouth now\nI have have to stretch my jaw to close it and its uncomfortable so I never can close my teeth together. But leaving my teeth open is not as comfortable as letting them rest on each other closed\n\nI could get a new crown made and let it be higher this time, but then my other right side teeth wouldn't hit because they were cut down\nWhat do I do? MattKW: With such limited information, your situation is too hard to understand in this forum. Maybe go to another real dentist for a 2nd opinion before you have any further treatment." }, { "id": 284, "title": "Wisdom tooth extraction pain/healing", "dialogue": "Faithb777: Hello, I had my wisdom teeth extracted around 4 days ago. I am still experiencing pain and a tiny bit of swelling but it has improved. I am worried that my bottom tooth suture may be infected as there is a white past near the suture that stings when I swish with salt water. I have read on certain websites that it’s normal and others that it’s an infection. I can’t see my dentist until Friday so I would really appreciate anyone’s help! I have been ensuring to do all that the dentist instructed btw. honestdoc: The extraction site appears healing normal. Be aware of any swelling which could be a sign of infection. The white area is normal repair epithelial tissue. I detected a canker sore (apthous ulceration) to side of the area which will heal in about 7 days. You can use Over the Counter numbing gels or try to find Colgate Orabase to relieve the area. Faithb777: Thank you so much! This really cleared up my worries! I appreciate you taking the time to reply" }, { "id": 285, "title": "Can I get tooth extraction even if it still hurts a bit and has a pus?", "dialogue": "storm: My concern is I need to get my two left molars extracted as they have been pestering me for a very long time now. I just found out that dental abscess can cause some serious problems like brain abscess if not treated. It's getting me all anxious. I went to a small dental clinic nearby and had my teeth checked last week. And just when I thought they could be yanked as soon as anesthesia kicked in, the dentist had to stop the procedure because I could still feel the pain when she was trying to move my molar which shouldn’t hurt considering that she'd already injected anesthesia in my gums thrice to numb them. I had also finished taking amoxicillin for 8 days but I feel like they're gonna hurt again anytime soon because of the pulse I feel. I've never had extraction before because I'm too scared so Its gonna be my first time.\n\nCould you evaluate what happened? Should I take amoxicillin for another 7 days? Or can I just proceed with the extraction even if it still hurts a bit? She suspected that it still has pus inside my gum that's why one molar was still hurting so she prescribed another amoxicillin but I no longer want to take any antibiotics as I might get resistant. I'm planning to have an appointment again after my period. I appreciate your help. Dr M: Good day\nSometimes the bacteria that causes the pain and infection is resistant to Amoxicillin if used alone. Some bacteria are anaerobic i.e requires a different antibiotic in combination with Amoxicillin. I usually give a dose of Flagyl or Metranidizole. You can also try this now instead of another course of Amoxicillin, since the Amoxicillin stays in your system for up to 2 weeks till a month. \nThere are some side effects with this antibiotic, such as some GI issues, which you can combat with a pro-biotic.\nSometimes the abscess can also prevent the local anaesthetic to reach maximum effectiveness, which might result in a small amount of pain.\nMy advice would be to rather remove the tooth. Without the source of infection, no further antibiotics will be needed." }, { "id": 286, "title": "Is this normal pricing?", "dialogue": "Batkraft: This is a treatment plan from a business who claims they are trying to help people who cannot afford dental work, to obtain a cosmetic dentistry grant and only pay for their general dentistry needs prior to any cosmetic work being fully covered. I need advice. Can someone please help advise me? Thanks. MattKW: That's expensive. They're not saving you any money there. Go elsewhere for a 2nd opinion and treatment plan." }, { "id": 287, "title": "Is this normal after a tooth extraction?", "dialogue": "Jhonny287: I had my lower right second molar removed 3 days ago and I keep having this feeling that something is off with the extraction site. There is little to moderate pain. But I'm concerned. Please help. honestdoc: It seems like normal healing. Keep track if any swelling occurs. Lower molars can be very traumatic to remove due to thick dense lower jaw bone and multiple molar roots." }, { "id": 288, "title": "Implant thoughts on immediate vs delayed?", "dialogue": "j4kskateboarding: Just wanted to get thoughts on the subject. Is it best to extract, heal, and implant or straight to implant? Ive heard a mix of different opinions what are yours? I will be faced with this decision very soon any insight is appreciated, thanks in advance. honestdoc: I'm sorry I don't place or restore many implants. My advice is to go to a dentist experienced with implants. Usually the restorative dentist decides on the proper course of action and has a referring surgeon to place the implant and followup on bone healing. MattKW: Generally extract, heal, then re-evaluate in case of need for bone or gingival grafting. Immediate placement only saves the patient some time (supposedly) but introduces other risks, e.g. what if the tooth fractures during extraction, is the position of the tooth root ideal for the same position of an implant, what retention will the implant have if it isn't fully surrounded by bone?" }, { "id": 289, "title": "White tiny pimples at extraction site?", "dialogue": "Mima: I had a tooth infection (tooth number 3 upper right) and they did a root canal. The root canal failed, I had lots of pain and swelling. Oral surgeon said the tooth is cracked. He removed it and put bone graft. I still had pain, and found out a little pus on the gum above the extracted tooth. He removed the bone graft and placed fresh bone graft. And also did a biopsy with result “ chronic inflammation reaction”. I was ok for a while, now again cheek and inside at the extraction site feels stiff and pain. I noticed little tiny white pimples. What could they be? Picture attached. ( ps I’ve been on antibiotics for a week because I’ve been sick)." }, { "id": 290, "title": "Wisdom tooth dry socket or normal?", "dialogue": "Julsnb: Hello, today is day 3 of my wisdom tooth removal recovery I had both of my lowers removed. and the pain has nearly almost went away on its own but on my left side I feel a slight pain and I’m not sure whether or not it looks like dry socket and was wondering if I could have some opinions. The first picture is my left side and the second picture is my right side. \nthank you! Sorry for the gross pics MattKW: Dry sockets are defined not by the appearance, but by deep and unrelenting pain, a foul taste, and halitosis. By tomorrow afternoon, if you';re still going tolerably, then you will be past the risk time for dry sockets." }, { "id": 291, "title": "4 separate implants or 4 unit implant bridge (on 2 implants @ top front)?", "dialogue": "Bob59: I'll be getting implant's over the next couple of months. I need the front 4 teeth replaced with either 4 separate implants of a 4 unit bridge on 2 implants. I'm very excited, but I'm frightened of peri-implantitis! I figure that if I go the 4 unit bridge on only 2 implants and gum disease strikes. then it'll spare half the area, thus leaving it to use later, especially if I require gum grafts? Could someone please give me their opinion? MattKW: A 4 unit bridge on 2 implants should be quite adequate. 4 separate implants is unnecessary and may be a bit cramped. Bob59: Many thanks MattKW. j4kskateboarding: I am faced with the same decision. What did you end up going with?" }, { "id": 292, "title": "Tooth abscess and awaiting extraction", "dialogue": "Craig: I have had an periapical abscess under my wisdom tooth for two months and am on the waiting list for extraction at the local oral surgery department. The infection improves sometimes and flares up at others and I have had a few antibiotic courses. I now have pain when the tooth is pressed and what is probably a sinus to the gum (some swelling near that tooth). When the tooth is extracted, will the surgeon drain the abscess under the root or will that clear by itself once the extraction is done? MattKW: By removing the tooth, the abscess is automatically drained, and it will clear up by itself and without antibiotics. It's like taking out an infected splinter of wood. Craig: But, I have seen others comment that it is possible for the infection to spread when the tooth is extracted. What is the likelihood of that? MattKW: An abscess is a collection of bacteria (alive/dead), and dead white blood cells that have been trying to fight the infection. Once you get rid of the source of infection, the body defenses will nearly always win. \nThe more often you take antibiotics while waiting for an extraction, then the more likely the bacteria will become resistant. Maybe once every 3-5 years I have sent people to hospital because the infection was too well established by the time they finally had an extraction, and they needed IV antibiotics to help. Every year, 1 person will die per population of 2 million people in a 1st World country from an uncontrollable infection, usually because they kept throwing antibiotics at it rather than get it extracted." }, { "id": 293, "title": "Complicated wisdom tooth problem", "dialogue": "gradym: I’m in my late sixties. Upper right wisdom tooth was extracted approximately 27 years ago. The lower right wisdom tooth has migrated upwards about 4 millimeters because of lack of an opposing tooth.\n\nThat lower right wisdom tooth has had a series of big fillings, and they always fall out after six months to 1 year. The last time the filling fell out, I had pain and the dentist suggested extraction, but I am nervous about extraction and the possibility of permanent nerve damage, so I asked her to just fill it again. She did so, although she warned that the filling probably would not last long.\n\nThat filling has now fallen out, but there’s no pain. Maybe the nerve has died?\n\nThe dentist suggested that, if I didn’t want to extract it, the next best thing was to crown it, and also crown the tooth next to it, and then attach the crowns together. She said this attachment would prevent the 3rd molar from migrating further.\n\nI don’t really like the idea of crowning both teeth if it’s not necessary, and a few questions occur to me:\n\nAt my age, is this lower wisdom tooth really going to keep migrating if it only migrated a few millimeters in 27 years?\n\nIs it possible the wisdom tooth will migrate to the point that it self-extracts itself safely? Is it migrating away from the root, or just growing longer?\n\nWhat if I asked her to just crown the wisdom tooth and not its neighbor?\n\nWhat if I do nothing?\n\nFor the record, the 2nd molar also has a fair amount of decay.\n\nI haven’t had panoramic x-rays, but a regular x-ray did show that the 3rd molar roots are pretty close to the nerve and I don’t want to risk having permanent nerve damage even if it’s unlikely. The x-ray also showed that the wisdom tooth is not straight, it’s angled away from the second molar.\n\nI would like to be able to chew hard food on that side again, instead of always chewing on the left side (I did that to avoid disturbing the fragile filling on the right side). Now that the filling has fallen out, I’m chewing soft foods on the right side with no pain.\n\nI’d greatly appreciate some opinions so I can make a decision.\n\nThank you. MattKW: The risk of nerve damage from that extraction is about as likely as getting hit by lightning on a clear day. Any competent dentist or oral surgeon would not have a problem with that.\nThe idea of crowning it and joining to the adjacent tooth is absolutely bonkers, and is much more high-risk than the extraction. \nThere's the risk of damaging the nerve in either tooth (5-10%) then needing an RCT.\nThere's bad angulation that would increase that risk dramatically.\nThere would be a big problem trying to keep the gap between your teeth clean.\nI would have the wisdom removed, and THEN crown the 2nd molar. No other sensible option. gradym: Thanks for the reply, MattKW. \n\nI have read that the risk of having nerve damage that affects the lip, chin and gum is not insignificant. The following is from Coronectomy – oral surgery's answer to modern day conservative dentistry (https://www.nature.com/articles/sj.bdj.2010.673):\n\n\"Mandibular third molar surgery\nOral surgery procedures commonly involve the removal of MTMs. A significant risk associated with this procedure is temporary or permanent altered sensation to the lower lip, skin of the chin, teeth and gingivae on the operated side caused by iatrogenic injury to the IDN. The incidence of injury to the IDN when removing MTMs varies from 0.41% to 8.1% for temporary lack of sensation and 0.014% to 3.6% for prolonged signs and symptoms.1 In 'high risk' teeth this may reach 20%.\"\n\nAlso see \"Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review\" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306319/\n\n0.014% to 20% (in high risk teeth) does not seem to me to be comparable to the odds of getting struck by lightning on a sunny day. Did you look at my x-ray? The dentist did say that my roots were curved and long, and that made it more risky.\n\nYou think my x-ray does not look risky for damage to the inferior alveolar nerve?\n\nWhen I was searching for a dentist in the Asian city where I am retired, I settled on two finalists. Then I googled these dentists and found Google Reviews for each of them.\n\nBOTH dentists had one review in which the person said he had suffered altered sensation to the lip, chin, gums after a wisdom tooth extraction, which appeared to be permanent. One person said they have pain and involuntary drooling from the corner of their mouth, almost a year later. They were full of regret for having extracted the wisdom tooth.\n\nThese were reviews of the clinic, so not necessarily of the dentist that I see at that clinic.\n\nBased on what I’ve read about coronectomy (a procedure that seems to avoid the nerve damage), it’s contraindicated in teeth with a lot of decay, which my tooth has. (Although I found another article that said maybe it can be done on a decayed tooth.) Anyway, it’s quite difficult to find any oral surgeon here who is experienced in coronectomy.\n\nI also googled my dentist’s suggestion of placing two adjacent crowns and connecting them to prevent any further lengthening of the wisdom tooth due to lack of an opposing tooth. I could find no reference to that procedure. I wonder if that’s a standard procedure or an original idea of my dentist with no precedent.\n\nI guess I have to go to another dentist and get another opinion. Maybe more than one other dentist.\n\nThanks again for your reply. gradym: I just want to add: my dentist isn’t 3rd World trained -- she graduated from a highly regarded dental school in the US and was recommended by local expats.\n\nI do appreciate your opinion. You might be correct. I am very risk-averse on matters like this, and just want to find the best solution.\n\nPlacing two crowns on the 2nd and 3rd molars and joining them seems dubious to me, too.\n\nI still wonder what would happen if I just did nothing. The filling has fallen out and there is no pain. Is it possible the wisdom tooth can eventually come out safely by itself? MattKW: The literature you cite covers all cases of wisdom surgery and all skill levels. I certainly wouldn't let an inexperienced person attempt this extraction. So a good surgeon would have very little risk.\nThe biggest hurdle to removing that tooth is not the root shape or proximity to the IAN. It is the way that the tooth points slightly backwards (disto-angular). Like removing a tree, the direction of the roots determine the direction to apply the forces, so this tooth will come out in a backwards direction, into the bone behind it. This makes it the most difficult factor in your case.\nThe roots of wisdom teeth usually lie to the inner side of the IAN. You are looking at a 2D image so it can look like overlap. In the \"old\" days, we only had 2D images, and this is where a lot of those unfavourable statistics in the reports were developed. Nowadays, a prudent oral surgeon will arrange a 3D image and make plans accordingly.\nIf you wait for pain, then you will have less opportunity to have a well-planned extraction done carefully. And you are not getting younger, so older patients have more medical issues, more medications, and heal more slowly. You don't want to have an emergency at 85 years old when you're in a nursing home. gradym: Thanks Matt for the reply. Sorry it took so long for me to respond. \n\nWell, I went to another dentist and he had different ideas.\n\nFirst of all, I was wrong -- the filling in the 3rd molar did not come out. What came out when I was flossing must have been a piece of the filling from the 2nd molar.\n\nHe said that the 3rd molar did not look like a risky extraction. When I said I was still reluctant to extract it, he suggested I could leave it alone as long as the filling was intact. And he said I could either crown the 2nd molar, or put an overlay on it.\n\nThen I went back to the original dentist and she said an overlay is not strong enough for the biting forces that I would get on the 2nd molar. She also said that if the big filling on the 3rd molar eventually comes out, the filling could still be replaced.\n\nHer suggestion of placing 2 crowns on 3nd and 2nd molars and connecting them -- I think she means “splinting” them.\n\nShe said if I crown both 2nd and 3rd molars and don’t splint them, it will be impossible to prevent food from getting between them, and I won’t be able to keep it clean even with daily flossing. And this will lead to decay and loss of both teeth eventually.\n\nI’m a good flosser so I am skeptical about this. Unless there is something about the angle of the proposed (unsplinted) crowns that will make it impossible to get the floss between them completely.\n\nI see from the x-ray that the 2nd molar’s roots are partially exposed above the gumline. I guess this means it really should be crowned?\n\nThe main thing to me is that I want to be able to bite hard foods on that side, instead of always biting on the other side for fear of dislodging the big filling on the 3rd molar.\n\nI also read somewhere that lower 3rd molars do not generally get longer due to lack of an opposing tooth, this problem is mostly with upper molars. Also, even if the 3rd molar HAS lengthened, it is not getting in the way of my bite on that side. I can still close the bite fully. gradym: Matt, you are talking about getting a CT scan on the wisdom tooth, right? But my risk aversion also applies to radiation -- and isn’t a CT scan a LOT of radiation? MattKW: Where do I begin???\n\nSplinting is the same as connecting or joining them. Still a stupid idea and highly risky, but what would I know? Me and honestdoc probably have 60-70 years of experience clocked up between us.\nGet rid of the wisdom tooth, repeat ad nauseam.\nAll radiation carries risk. You are exposed to background radiation minute of every day. That Xray you have put up above is equivalent to about 8 hours background radiation. A cone beam CT is about 8X that of background, a transatlantic airflight is about 16X that of background. Think about what the crew are exposed to during their working career. gradym: Thanks Matt. I appreciate your opinion and will seek out a really good oral surgeon." }, { "id": 294, "title": "Is my extraction site healing properly?", "dialogue": "bgtipton1896: Hi, a week ago today I had my bottom right wisdom tooth extracted (they had to cut into my gums, I don’t know if that’s always the case). This is the only tooth I’ve ever had pulled so I don’t know what it’s supposed to look like when healing. It’s not hurting very bad, it’s mostly just sore.. The stitches have already dissolved and the swelling is gone as far as I can tell. But I notice this little opening and I don’t know if that’s just the skin growing back together or if I have dry socket. Any advice or reassurance is greatly welcomed and appreciated. MattKW: That's fine." }, { "id": 295, "title": "Dry socket? With pic", "dialogue": "Lmoon304: Is this dry socket?? I am day 5 since extraction and have had pain and discomfort for the past couple of days. The pain is a constant throbbing and almost pulsating sensation. It isn’t unbearable but very frustrating and it is helped with ibuprofen. I haven’t noticed any bad taste or bad odour.\n\nMy extraction took 15 minutes and the tooth didn’t want to come out and instead needed to be broken off bit by bit. I know it takes time to adjust to the sensation of a missing tooth but I’m really just wanting it to feel better already. MattKW: If the pain is bearable at Day 5, then you are past the risk for dry socket. Occasional painkillers is fine." }, { "id": 296, "title": "Is this dry socket? (image included) Pls help :(", "dialogue": "petrav: I extracted a lower molar 3 days ago and so far recovery has been going great. However, this morning I noticed something like a seed surrounded with coagulated blood come out of my extraction site. I am terrified that I have lost my blood clot and will develop dry socket. Currently I am in no pain, but it happened about half an hour ago so I guess it wouldn't start yet. How long after tha blood clot comes out do you start to feel pain (I'm not talking after extraction, I'm talking after the blood clot comes out). Anyway, here is an image, I hope you can see the extraction site well. Toothless: YEAH THATS DRY SOCKET MattKW: Don't worry about how it looks. A dry socket is primarily diagnosed by the immense pain, foul odour, and bad taste. Starts 3-4 days post-op. If you get to day 5 with only minor symptoms, then you're in the clear." }, { "id": 297, "title": "Extraction and implant...", "dialogue": "DF-Mark: I had a root canal done on a tooth more than 20 years ago and a gold crown placed on it.\nThe tooth was filed down so much that there was just a tiny stump remaining.\n\nThe crown came off a couple of years ago and was re-glued.\n\nWhile flossing a couple of months ago I was careless and let the floss catch a side of the crown\nand I pulled off the crown.\n\nI had hoped the crown could be re-glued again but two dentists say it can't be done now.\nThey are now recommending extracting the tooth and going either for an implant or a bridge.\n\nI guess I am going to have to bite the bullet and have the tooth extracted.\nI would like to know how the procedure is done?\n\nI wasn't aware that a tooth extraction was considered oral surgery until I saw this forum.\nThere is so little tooth showing above the gum that I wonder what the procedure is exactly to get it out\nwithout complications?\n\nThe two dentists mentioned above are prepared to do the extraction, one is prepared to also do an implant.\nIf extracting a tooth is considered surgery, would it make sense to have an oral surgeon do the procedure?\n\nThanks! MattKW: Which tooth? If you don't know the ID, then count from the front (or back). DF-Mark: MattKW said:\n\n\n\n\t\t\tWhich tooth? If you don't know the ID, then count from the front (or back).\n\t\t\nClick to expand...\n\nI am pretty sure it is 36, third tooth from the back, lower left side.\nHere is an X-ray of the tooth from December 2019.\nAs you can see there is very little tooth remaining above the gum line.\nThere are four roots altogether. MattKW: No hope for that tooth (36) and I would also suggest you extract the 35 as well. A bridge will not be suitable for a lower gap that wide. You would be better off with 2 implants eventually. If finances are an issue, do the 36 implant first.\nTo extract either tooth, it is quite possible they may turn into a surgical procedure. The gum would be incised with a scalpel, then pushed back, and some bone removed around the teeth so that an extraction instrument can get some grip. DF-Mark: MattKW said:\n\n\n\n\t\t\tNo hope for that tooth (36) and I would also suggest you extract the 35 as well. A bridge will not be suitable for a lower gap that wide. You would be better off with 2 implants eventually. If finances are an issue, do the 36 implant first.\nTo extract either tooth, it is quite possible they may turn into a surgical procedure. The gum would be incised with a scalpel, then pushed back, and some bone removed around the teeth so that an extraction instrument can get some grip.\n\t\t\nClick to expand...\n\n\nThanks again Matt for your help!\nI'm glad you mentioned how the tooth would be extracted, because that's what I expected would have to be done.\nI couldn't see any other way to grip the tooth to remove it.\n\nIn terms of surgery or not...\nWhen I asked the last dentist I visited for an opinion on the tooth and how it would be removed, he said he would go in between the tooth and the gum (below the gum line) to get at the tooth.\nI don't believe this dentist is an oral surgeon.\n\nWould you recommend having an oral surgeon extract the tooth or a dentist? He was prepared to do it and the implant, following healing. MattKW: Oral surgeon is not necessary for this sort of extraction - it's fairly commonplace for a general dentist to perform. For the implant, I prefer to have a periodontist perform the surgery as they can also deal with any other gum or bone issues that arise. Oral surgeons can also do implant surgery. Some general dentists can also do implant surgery but need a lot of experience to handle all the eventual issues that might arise. Steve123: I figured this is a good post to show what im dealing with. Im 36 just had this guy taken out. My question is. Did the Doctor cause these bubbles from stitches? They were x figured ontop of guns. Does it look like too much pressure trauma from stitches being too tight. Will the bubble looking balloon effect. Go down? Ive had my wisdom teeth taken out ay before this and i dont recall how the gums looked after surgery. Socket is 1 week old" }, { "id": 298, "title": "Biopsy result Chronic Inflamation Reaction", "dialogue": "Mima: I had a tooth infection (tooth number 3 upper right) and they did a root canal. The root canal failed, I had lots of pain and swelling. Oral surgeon said the tooth is cracked. He removed it and put bone graft so I can do my implant later. I still had pain, and found out a little pus on the gum above the extracted tooth. He removed the bone graft and placed fresh bone graft. And also did a biopsy with result “ chronic inflammation reaction”. He doesn’t know why I still get stiff/puffy cheek but said to let it heal. The biopsy reads “ Multiple sections show fragments of fibrocollageneous tissue containing lymphocytes, plasma cells, and neutrophilis. Viable bone trabeculae are also seen” and diagnosis is “chronic inflamation reaction”. Can someone please tell me what does this mean? Thank you so much! MattKW: Simply means healing wound tissue with the usual body defenses coming in to tidy up." }, { "id": 299, "title": "Implant surgery healing - Is it ok to talk?", "dialogue": "Ooppss: Hi,\n\nI had an implant surgery 4 days ago. My question is probably dumb, but is it ok if I talk and laugh (which I do a lot), or will it compromise the healing and the osseointegration? The screw is under the gum. Thanks a lot, I have to admit that I'm worried... MattKW: No. honestdoc: What may compromise the healing of the implant should have been discussed prior to placement such as conditions like diabetes, or habits like smoking. The surgical team should have full information and scheduled followups." }, { "id": 300, "title": "Periodontal Flap Surgery Question", "dialogue": "madelenegail: Hi everyone,\n\nMy last trip to the dentist resulted in a discussion of flap surgery for periodontitis. I'm a little nervous about scheduling it because after a lot of googling (I know, I know) and research I struggled to understand, I'm worried about recovery from having incisions inside my mouth. I'm in my 30s and I just don't heal as fast as I used to. \nI sort of inadvertently came across the concept of \"soft-brushing\" (https://www.pstshop.com/dr-choukroun-soft-brushing-kit/) for this type of surgery but I was confused about how that works. If my dentist uses this method or tools like this, do they still have to make an incision? Or does using a soft-brushing technique just reduce the inflammation and recovery from work done post-incision?\n\nLike everyone, I guess I'm just trying to figure out the most painless way to take care of the problem.\n\nAny reassurances or explanations in layman's terms would be greatly appreciated!" }, { "id": 301, "title": "Which is the better option ?", "dialogue": "Grinwald: I have been advised that I should consider a fixed form of denture for my upper jaw. At present I have just two natural teeth left one of which is a molar soon expected to fail - and this molar is used to anchor my present denture. I have been offered two solutions after extraction - The first is to have four implants installed with healing caps left in place for a number of months to allow bone to settle, and during this time to wear a loose temporary plastic denture. The second option is to have the final metal arch fitted on the same day that the implants are installed - I think this is called \" Smile in a day \". It seems the cost of both are similar at about £12,000. My questions are - What is the professional view of these two options, the pros and cons - and what alternative procedures might be available. MattKW: Option 1. Allow the implants to establish integration with the bone before placing any loading forces on them. Then check for stability and osseointegration before proceeding to the bridgework." }, { "id": 302, "title": "Treatment suggestions for tooth #36", "dialogue": "Christopher Morgan: Hello, hope you are well.\n\nI am a 46 year old male. I have seen 2 dentists in the past week for pain issues with molar #36. (I wanted a second opinion). \n\nDentist one found no issues on x-ray. Dentist 2 said the tooth is dead. (The same x-rays were taken exactly 7 days apart). I am trying to use my best judgment to decide on a plan.\n\nI am already missing Tooth #46 and #27.\n\nMy question is: Will I be able to chew if I extract #36? I would only be able to do my chewing on #34 and #35, on the left side. Tooth #26 will have no opposing bottom tooth if I extract #36. In addition, Tooth #37 will have no opposing top tooth as #27 is gone. (please see attachment from my dentist). \n\nLastly, I need to have extensive sinus polyp surgery in 3 months. Should that have an impact on my decision? Thank you for reading my post. MattKW: If you take out the 36, it will become annoying to eat. If the tooth is indeed dead, then an RCT and crown is preferable, and that seems to be a good price (depending upon where you are).\nYou haven't put up any Xrays to view. Christopher Morgan: Thank you for your response. It's helpful. I am in Canada, just outside of Toronto, so it's in Canadian dollars. I suspected it was a good price because I do reasonably trust the guy. \n\nI'll try to obtain both Xrays and post them side by side. My reticence comes from dentists here becoming a little defensive when you question their evaluations. But, it's a health issue at the end of the day.\n\nI appreciate it, MattKW. Cheers. MattKW: And that's why it's using FDI notation for your charting. I tutor at Sydney Uni once a week and see quite a lot of your Canadian compatriots here. I'll await the Xrays - get them in digital form, usually JPG or TIF." }, { "id": 303, "title": "Surgery Options", "dialogue": "Nuluvius: I have lost:\n\nUR 4, 5 & 6\nUL 5 (which has recently sheared off post xray) & 6\nLL 6 (root remnant left behind)\n\n\n\n\n\n\nI have a number of treatment options to choose from. I would appreciate some help in deciding which option to go with:\n\nDentist A (qualified with a diploma in implant dentistry):\nAlpha Bio X3 implant supported pink porcelain bridge of X3 crowns on the upper right with a sinus tent\nAlpha Bio X2 implant supported pink porcelain bridge of X2 crowns on the upper left with a full sinus lift\n\nDentist B (foreign qualifications):\nX3 implant supported bridge of X3 crowns on the upper right with a sinus tent (note no pink porcelain - just the crowns)\nX2 (linked) implant supported bridge of X2 crowns on the left with a sinus tent (also just the crowns)\n\nDentist C (masters in implant dentistry):\nBredent X2 implant supported bridge of X3 crowns on the upper right with a sinus tent (just crowns and only 2 implants - gum would be 'crafted' around middle crown)\nBredent X2 implant supported bridge of X2 crowns on the upper left with a sinus tent (just crowns)\nDisplacement drilling techniques used meaning no need for large bone grafting MattKW: That implant system is unknown to me. It's not one of the larger players.\nI don't know what \"displacement drilling\" means.\nThe use of pink porcelain suggests you will have a large gap to fill - this might make it harder to keep clean.\nDentist C appears to be the most qualified. Nuluvius: MattKW said:\n\n\n\n\nThat implant system is unknown to me. It's not one of the larger players.\nI don't know what \"displacement drilling\" means.\nThe use of pink porcelain suggests you will have a large gap to fill - this might make it harder to keep clean.\nDentist C appears to be the most qualified.\n\n\nClick to expand...\n\nI was concerned that with only 2 implants that bone atrophy would occur in the space between them (underneath the 3rd mid crown). What do you think? MattKW: No. It won't happen like that. Bone resorbs from direct pressure, so once you cover it up with a bridge, then it will not change. Nuluvius: MattKW said:\n\n\n\n\t\t\tNo. It won't happen like that. Bone resorbs from direct pressure, so once you cover it up with a bridge, then it will not change.\n\t\t\nClick to expand...\n\nInteresting. I thought that bone atrophy was a function of preasure as well as the loss of mechanical stimulation at the site i.e. tooth loss. MattKW: Teeth exert a pulling force through the periodontal ligament, thus preserving bone. Applying widespread and significant pressure by dentures causes bone to resorb. You won't cause significant pressure by eating with only your gums because you don't apply the same amount of force as dentures. It's not strictly bone atrophy as in osteoporosis. Nuluvius: MattKW said:\n\n\n\n\t\t\tTeeth exert a pulling force through the periodontal ligament, thus preserving bone. Applying widespread and significant pressure by dentures causes bone to resorb. You won't cause significant pressure by eating with only your gums because you don't apply the same amount of force as dentures. It's not strictly bone atrophy as in osteoporosis.\n\t\t\nClick to expand...\n\nOn further conversations with that dentist, they clarify: There is 19 mm of space on the right. Given 2 planned implants there should be 5-6 mm of space between them and the recommended minimum space is 3 mm. They think that the implants will transmit forces over most of the area to help maintain the bone. Moreover the bridge will also cover it providing further protection. Nuluvius: Update: Dentist A has dropped out of the running, it's now between Dentist B and C. I am having a really hard time choosing..." }, { "id": 304, "title": "Molar extraction blood clot", "dialogue": "Chloance: Hello.\nI had a molar removed yesterday (lower left) and I’m a bit concerned about the clot. It is quite thick and is above the gun line. I had another molar removed 2 weeks ago and the clot didn’t look like this... \nsorry for the picture I can’t get a very good one on my own! Any advice? My dentist surgery isn’t open on weekends. Thank you MattKW: There is no urgency. Nothing unusual here to worry about." }, { "id": 305, "title": "Is my implant positioned right ?", "dialogue": "Chegels: Hello experts, \n\nI am looking for an opinion on the positioning of my implant which i have for around 3 months now. The gap between 3 and 5 was a bit too big so we decided to go closer to the 3, what i am concern is I would think that the implant should be parallel with tooth 3 and it seems it is parallel with tooth 5. what do you guys think ?\n\n\n\n\n\nAlso a possible question, what should i do next for the missing 6 next ? is a super short implant possible ? or sinus lift or my doctor even mentioned some IHDE implants that go directly into the sinus and stay there, is that a good idea ? it sounds scary to me \n\nThank you ! MattKW: That implant is not parallel to either the 3 or the 5. This can sometimes mean that the abutment comes too close to the 3. I think you will have enough room, so don't be too worried.\nYou won't need a big crown to fill the small gap between the 5 and the 7, so a short implant might be possible. At most you would also consider a sinus lift. I looked up IHDE implants and they seem to be making implants similar in size and shape to other implant manufacturers. I would stick to major implant manufacturers like Straumann, Nobel, BioHorizons where the quality is more assured and the availability of components will always be there. Chegels: MattKW said:\n\n\n\n\nThat implant is not parallel to either the 3 or the 5. This can sometimes mean that the abutment comes too close to the 3. I think you will have enough room, so don't be too worried.\nYou won't need a big crown to fill the small gap between the 5 and the 7, so a short implant might be possible. At most you would also consider a sinus lift. I looked up IHDE implants and they seem to be making implants similar in size and shape to other implant manufacturers. I would stick to major implant manufacturers like Straumann, Nobel, BioHorizons where the quality is more assured and the availability of components will always be there.\n\n\nClick to expand...\n\n\nThank you for your replay, regarding point 2, i think IHDE are suggested in this case because they have some model that is designed to penetrate the sinus and stay there, i researched as much as i could online and i didnt found anything like that but im presuming the doctor knows more then me and such thing exists. But my question is, even if there is an implant designed for that purpose, is that a good idea ? or some other option is still a better choice. For example one doctor suggested pulling the 5 to the place of the 6 and planting regular implant in the place where the 5 is now. MattKW: I can't think of any reason why an implant sticking into the sinus like that would be a good idea. Absolute lunacy to extract the 5 and planting an implant there!" }, { "id": 306, "title": "Is this normal?", "dialogue": "Elenaelena: Hello. I had an abscessed tooth extracted 3 days ago.\nI'm on antibiotics for 2 more days and all the swelling is gone at this point. I don't have much pain but today my wound from red turned white/yellow?! Is it infected? Is it a dry socket?\nShould I visit my dentist?? Thank you in advance!!! Elenaelena: It has changed into this in an hour! Please im so scared Anon1234: Are you constantly touching it with your tongue or finger? honestdoc: Leave it alone. The whitish color is normal epithelial repair tissue. Elenaelena: Anon1234 said:\n\n\n\n\t\t\tAre you constantly touching it with your tongue or finger?\n\t\t\nClick to expand...\n\nNo I'm trying not to touch it at all!!! Elenaelena: honestdoc said:\n\n\n\n\t\t\tLeave it alone. The whitish color is normal epithelial repair tissue.\n\t\t\nClick to expand...\n\nOkay thank you very much!!" }, { "id": 307, "title": "Dental implants and extraction question", "dialogue": "Achygirl1: I think i'll look into removing this painful root canal tooth. My question is: When you have a tooth that has undergone a root canal (#12) in my case, would I need to be put fully under for the procedure? Also when I get the implant installed will I need to be put under? Lastly and sorry for all the questions but can the implant and extraction be done in the same sitting and is there a temp tooth or way to cover the missing area while waiting on the healing process? honestdoc: Putting you fully under is very risky. You may never wake up. If you need sedation, consider milder forms such as conscious sedation or IV sedation. There are different schools of thought for different scenarios on same day extraction and implant placement. Discuss all of these questions with an experienced restorative dentist as well as an experienced surgeon. MattKW: Very rare to put you under just for a single tooth. The relative risk is not worth it. Placing implants is less traumatic than an extraction, altho a light sedative might calm you a bit, Achygirl1: Thank you both Doctors for your reply. It is much appreciated. If one is relatively healthy with good bone and takes good care of their teeth any thoughts as to how long the implants can last? Again thank you for your time. MattKW: Implants, like real teeth, can last indefinitely if you're a bit lucky and do your best to maintain them. Nothing in life is guaranteed." }, { "id": 308, "title": "Did I get dry socket?", "dialogue": "jjjy: Hi! I got my wisdom teeth extracted 2 days ago. This is the 3rd day and I noticed that the dark blood clot that I had yesterday is no longer there. I'm feeling significantly more pain than yesterday and I'm wondering if I got dry socket. The first picture is taken today and the second one was taken yesterday. Please let me know, thanks!! MattKW: Dry socket is diagnosed primarily from the severe pain that accompanies it, usually 3-4 days post-op. Also bad taste and horrid smell. Photos don't mean anything." }, { "id": 309, "title": "Is this Dry Socket?", "dialogue": "a.c.111: I had my wisdom teeth removed 9 days ago. I have healed for the most part. I forgot I am not supposed to be using straws and accidentally used one at lunch today. I have noticed a sour taste in my mouth and saw this little hole in the bottom left area. Is this a dry socket?! It doesn’t hurt but I am unsure of what else it could be. I chew on this side and don’t want to get an infection. I know the pictures aren’t the best but it was hard to get a good picture. Please help, thank you! DocT: It looks like healing site to me, everything is within expected normal healing process. You can’t completely close extraction socket within 9 days and tissues are not fully formed yet, but you definitely can use straw now without causing any harm." }, { "id": 310, "title": "Grayish, Greenish Thing in Mouth After No. 17 Extracted", "dialogue": "johnthomas: I had my number 17 wisdom tooth/third molar out 11 days ago. There was a biopsy due to a cyst and a bone graft involved. \n\nAbout 7 days after surgery, the swelling had gone down enough that I could see this. It looks to me a bit like a leach or like the intestine of a nightcrawler that comes out when you’re baiting a hook. It seems to be attached somewhere at the gum, but I can’t see it’s origin.\n\nSomeone suggested that it could be a suture, but it doesn’t look like the other sutures I can see that look like other sutures I’ve gotten. That is to say, they look like a thick, white thread. This looks organic. \n\nSomeone else suggested that it could be a vein that will shrivel and fall off on its own eventually.\n\nI’ve got an appointment to see the oral surgeon again for a followup, but I can’t wait for an answer. This is too bizarre for me to wait.\n\nAny ideas what this could be? honestdoc: It looks like a suture. The surgeon had to flap back the gums extending toward that particular location and close it in that fashion to access tooth #17. The suture appears resorbable and will naturally fall off. As long as you are not in intense pain and no swelling, the healing looks good." }, { "id": 311, "title": "Got my second molar extracted. What is this white thing inside my gum?", "dialogue": "sugarush: Inside my gum, there is this white thing inside. I dont know what it is. I thought it was rice that got inside my gum, so I took some out. But then i saw a larger size, so I stop pulling it out. And dont think it's no longer rice.\n\nIs it infected? Should I go see my dentist? MattKW: Wounds in the mouth don't form hard, dry scabs like you get on outside skin. You get soft, whitish waterlogged skin as you see. This is part of normal healing and requires no intervention. sugarush: MattKW said:\n\n\n\n\t\t\tWounds in the mouth don't form hard, dry scabs like you get on outside skin. You get soft, whitish waterlogged skin as you see. This is part of normal healing and requires no intervention.\n\t\t\nClick to expand...\n\n\nThank you very much!\nWhen I rinse with salt and water earlier today, some part came off by itself, is that normal as well? (I'm not sure how long the white part is supposed to stay) It has been about 6 days since I got my tooth extracted. And I am terrified for dry socket when I'll be abroad for almost a month in a week. sugarush: MattKW: You won't get a dry socket now; you are past the danger period. Don't worry about anything. A socket takes 3 months to fully close up." }, { "id": 312, "title": "Dental sinus lift anf flying", "dialogue": "ennogs: I am going to have a dental bone graft in my upper jaw. I am flying to Budapest to get the treatment. The dental bone graft involves a sinus lift. \n\nI have been told after having a sinus lift you shouldn't do anything that will rapidly raise or lower pressure in your sinuses such as flying.\n\nThe problem I am having is the conflicting advice on the number of days I have to wait before flying back home.\n\nAfter having my dental bone graft and sinus lift how many days should I wait before flying back home? MattKW: There shouldn't be a problem unless they accidentally break the sinus lining. Also make sure your sinuses are unclogged before flying by using a nasal spray." }, { "id": 313, "title": "Is my extraction site going to dry socket?", "dialogue": "WisdomTeethPain96: Hi all\nIt is day 4 after my wisdom tooth surgery (got 4 removed) and my right side has been absolutely killing me. Pain wakes me up at night and can flare up during the day. It’s a dull, throbbing pain, which is why I’m worried it may be dry socket under my sutures. \n\n Pain medicine does relieve the pain, but only for about 5 hours. I’ve attached a photo of what it looks like. Any ideas? MattKW: If painkillers relieve it, then it's not a dry socket. You would also have a really bad taste and foul breath. Once you get past Day 4 or 5 and the pain is manageable with painkillers, then you'll continue to improve." }, { "id": 314, "title": "Jaw/bite issues post wisdom tooth extraction", "dialogue": "Harling78: I had a number of procedures done last week. I had my upper right and lower right wisdom teeth removed, two fillings on the left side of the mouth and a root canal and crown done on the left side of my mouth. I have yet to remove the wisdom teeth on the left side and plan to do so separately. I had this done all within a week's time.\n\nThe heeling of the wisdom teeth extraction seems to be going fine but my jaw and overall bite feels quite odd. When I close my mouth my bite feels slightly different but the main thing is my jaw feels like it doesn't want to close, my teeth don't want to rest closed and when I try to close my teeth and mouth there is almost like a slight jitter in the upper and bottom teeth. I don't know if this is just post dealing with keeping my mouth open for hours at a time the last week or if it is something different. My jaw just feels like it wants to shut but can't naturally leading to a overall fatigue feeling in the mouth and head.\n\nMy overall bite does feel somewhat different and I don't know if this is due to the crown or wisdom tooth extraction. Prior to extraction the wisdom teeth were not touching each other so I can't see that influencing things.\n\nWhat input or wisdom can anyone experiences provide regarding this?\n\nThank you! MattKW: I would guess it's more likely the crown and maybe the fillings. Delay the nexxt stage of treatment until this has resolved. If no better in another week, go see the dentist." }, { "id": 315, "title": "Possible dry socket?", "dialogue": "Faye98: I had my two lower wisdom teeth removed yesterday under general anaesthetic with stitches as they were quite severely impacted. after waking up, drinking a glass of water, I said to the nurse that I could feel as if the clot had dislodged a bit and she said it has a little bit but it should be fine and settle down in the night. I have only drank water and eaten luke-warm broth and will swill with salt water later tonight. I think I’m being paranoid but can anyone say if this looks like a dry socket? I’m so scared of getting one!\n\nI am in pain now but I know it’s just post-surgical pain and normal swelling." }, { "id": 316, "title": "How to best inquire about implant prices", "dialogue": "saminsanjose: Hi,\n\nI live in the San Jose Bay Area and need a dental implant. My understanding is that the price differences are enormous. I gathered a list of oral surgeons that are highly recommended, but I'd like to get a general idea of their price structure without having to be examined by each one of them. I don't really need an accurate estimate to my particular procedure, I just like to get a general feel where there are in the scale from low to high priced. \nIs it appropriate to ask them for a list of standard prices? Any other way to get a feel of their priciness?\n\nThanks,\nSam" }, { "id": 317, "title": "Should I save this implant? (bone loss + peri-implantitis)", "dialogue": "implant-man: I have a 10-year old implant in my #11 tooth, which has now suffered a significant amount of bone loss, along with a diagnosed peri-implantitis. I have visited a couple of dentists and they differ on whether the implant is worth saving. Also, there are competing opinions on whether to use autograft vs bovine-based graft, but this, I think, is the less relevant issue.\n\nSaving the implant was argued compellingly, as the least invasive course of action. The implant itself isn't moving. Of course, the price is also compelling, vs the alternative.\n\nThe alternative is to remove the implant altogether, which is almost 3-fold more expensive, but was argued that it is the safest, most prudent bet... while at the same time, this dentist was a bit pessimistic about the possible success of the new (auto) graft, adapting... saying that my case has a high risk of failure.\n\nSo I'm confounded as to whether the first is overly-optimistic, or is the second just covering for himself, or non of the above (I appreciate the notion that, in healthcare, there are no guarantees).\n\n\n\nAny opinions? Here is an image of the implant. MattKW: Other Xrays taken over time would help us gauge how active this problem is. But even using that single Xray and a history of peri-implantitis, I'd suggest you have it removed ASAP. The longer it stays there, the more bone you will lose, and the more difficult it will be to make ANY type of replacement, be it an implant, bridge, or denture.\nI don't like your chances of a new implant at all. You might want to look at the possibility of a simple cantilever Marylands bridge off the canine after you've healed up. implant-man: Thanks for your input.\n\nSi you don’t think it’s even worth at least trying to graft it and see if it keeps?\n\nWhen you say there’s a risk I won’t be able to make any type of replacement... is there’s a scenario where only a prosthesis will do? \n\nThanks again? MattKW: Totally agree with 2nd dentist. Poor chance of keeping this implant; poor chance of grafting and new implant working. Time to cut your losses rather than throwing more money at this situation, sorry. implant-man: I appreciate your honesty. I'm probably going to go for a bridge. The main challenge at this point seems to be saving my gum line.\n\nThanks again." }, { "id": 318, "title": "Wisdom teeth and a broken molar removal", "dialogue": "Apl: I’m having my wisdom teeth removed and a broken molar removed I think it’s #2. The oral surgeon told me one of my wisdom teeth is actually 2 fused together and that there’s a 80% chance that he will have to do an additional surgery to the sinus cavity floor because the tooth is protruding into it. I’m terrified. Is it really that bad? And he also mentioned he bottom right wisdom tooth is impacted and on the nerve or something like that." }, { "id": 319, "title": "Strange suturing?", "dialogue": "tati17: I had a tooth extracted on Monday with bone graft. Today, Thursday i had some concerns about a strange taste so i returned to the dentist. after examining me he said that he needed to re-suture the area, this evening i just realized that the lower part of cheek seems to have been sutured into the extraction site. the dentist did say on Monday that i did not have a lot of tissue to work with, I don't feel comfortable going to my dentist with this question in case it is not normal, is this typical in cases where there is limited tissue? MattKW: Unfortunately some people have very little gum tissue to work with, or it is so fragile it tears easily. Then we have to resort to less desirable measures to get tissue there, sometimes by simply pulling it in from the cheek, or sometimes by dissecting the skin and repositioning it to cover the defect. Repositioning skin takes skill and is usually done by specialists (periodontist, oral surgeon). I doubt that the dentist would be worried about answering your questions." }, { "id": 320, "title": "Slow healing after wisdom teeth removal", "dialogue": "juliemra: I am 16 days past my wisdom teeth extraction surgery. I have had excruciating pain since the 3rd day after surgery. The holes are close to being covered but are not quite there and I am still in a lot of pain. I went by the dentist's office yesterday and the nurse irrigated the holes. She said they are healing and it's normal to take 6-8 weeks to heal. They told me before the surgery it would take a few days until I felt good again. They say what feels like nerve pain to me is just jaw pain. When I mentioned that the pain has been worse than child labor she said that is normal and I am in my 40's and this is to be expected. I've had numerous surgeries in my life along with complications and none have taken this long to heal. I just got a message that they want me to come in for an X-ray in a week. I'm not sure why since they say everything is normal. I am considering getting a 2nd opinion from another dentist or going to a MD for the pain. I'm a diabetic so i am worried about the slow healing and infection. MattKW: Sounds like you had a dry socket - they usually start 3-4 days post-op. By now it is probably too close to healing over and so placement of a sedative dressing may not be possible. The good news is that even dry sockets heal without dressings. If you have no swelling, temperature, then it is probably not infected. Well-controlled diabetes (are you Type 1 or 2?) does not pose an added risk." }, { "id": 321, "title": "Surgeon says this is not dry socket, but I have excruciating pain for days. See pic.", "dialogue": "juliemra: Everything seemed normal until post surgery day 3 and I woke up with horrible pain in my lower extractions. I called the doc and he said it was muscle pain. I'm 47 with a long medical history so this isn't my first rodeo and I know the difference between muscle and nerve pain. I sent this pic to him and he said he couldn't tell from the pic. I went in today after being in terrible pain for 48 hours and he didn't see me. Instead an assistant told me all about jaw pain and how that is what they think I have. Of course the terrible pain is coming from the lower extraction sites. No one looked at my teeth. They originally told me I would start feeling better a few days after surgery and the pain would basically be gone. Now they say it is normal to have this kind of pain and it may take weeks. I feel like I'm losing my mind and I really just want relief. Opinions? \nNote: I've been putting cotton pellets soaked in honey in the sockets after I numb them. I take Hydrocodone every 3-4 hours and 4 Ibuprophen in between doses. It doesn't take away the pain but it does help a little. I also use heat and cold compresses. I am taking an antibiotic and rinsing with salt water through the day. honestdoc: Are you having any swelling? No swelling means no antibiotics. It is hard to know if you have dry socket from the image. Next time you see the assistant, ask for 2 things...gentle irrigation with Peridex 0.12% Chlorhexidine rinse and Dry Socket Paste. juliemra: So seeing a bone is not necessarily a bad thing? What would cause such tremendous pain if it's not dry socket. I don't have swelling now. I am a diabetic so an antibiotic is probably a good thing. MattKW: Dry sockets are typically diagnosed from : pain starting 3-4 days post-op, unbearable pain that doesn't respond to painkillers, foul taste and breath. There is no point taking antibiotics as this is not an infection but a breakdown in the normal healing pathway. The wound should be gently flushed out (I prefer CHX), and dressed with either a proprietory substance like \"Alveogyl\" or a zinc oxide/eugenol dressing until the healing catches up (usu ~ another 3 days). The dentist may need to give you some anaesthetic just in order to achieve these steps. He didn't even see you? - don't take No for an answer, threaten to call the ADA. That's very unprofessional and neglecting his \"Duty of Care\". juliemra: Thank you for your helpful response. It is now 11 days past the surgery and I am still in horrible pain. My condition fits the dry socket pattern and symptoms. I am taking care of it by flushing with saltwater and using Sockit! or cloves with cotton pellets. I take Hydrocodone and 4 Ibuprofen every 4 hours and they barely touch the pain. The holes do seem to be getting narrower but I wonder if my diabetes is slowing down the healing. I don't know what else I can do for the pain and I do not want to miss more work. I haven't reached out to the dentist again simply because he was so dismissive and insisted it was normal jaw pain after surgery. I don't understand why he wouldn't look at my sites or consider the pain that I described. I am assuming that once the holes close the pain will cease? Is this correct?" }, { "id": 322, "title": "Is a bone graft needed in this case", "dialogue": "oceansmith: Hey, \n\nI had a tooth removed it was number 19 -- my molar. When the surgeon removed it he cut our the outer buckle wall. So What i have left is some bone or the inside buckle wall. The same surgeon says that an implant can be placed on this remain bone but I was under the impression that I would need a bone graft to replace that outer buckle wall. Anyone have any opinions on this? \n\nThanks MattKW: It depends upon how well the bone heals. The loss of a buccal )outer) wall of bone would be a problem for front teeth where the appearance of the gumline is very important, but it's not so much of an issue for a molar. Have it assessed 3 months after the extraction. oceansmith: Ok thanks. Like I said the oral surgeon that cut the buckle wall out said that there would be enough bone for the implant but its hard to know who to trust now when doctors and surgeons tell you something. And Iwanted to check with some others first.\nWhen my tooth was cut out i didnt know the buckle or the side wall would be cut out as well.\n\nBut thanks for the reply\n\nEdit: So if the bone has healed well then that is enough bone to place the implant on? There is no chance of that buckle not being strong enough even if it healed back ok? MattKW: Buccal walls are often removed for difficult extractions. Whether you have enough bone for an implant will have to be reviewed a few months after the extraction - I can't advise any more from this position." }, { "id": 323, "title": "Palate area", "dialogue": "aqz: Hi ive had this red area on palate just behind front teeth for about 18 months it does not bother me apart from my anxiety. Been to docs and dentists but they think its nothing. If i dont touch or rub with tongue it gets a white coating which rubs off. Is this something to worry about or just thrush. Baring in mind its been well over a year and has not got worse or progressed so could it be cancerous? I have left it and my anxiety has been better however i have checked again recently advice will be much appreciated. Thanks aqz: These pics are before and after i rub off white coating." }, { "id": 324, "title": "Under tongue", "dialogue": "aqz: Hi all, \n\nIve pulled on this skin tag under tongue and now its painful and tender. Just wondering what is this? I assumed its the plica as its a dangling skin ‍\n\nThanks aqz: @MattKW @honestdoc hi i would appreciate some advice please.\n\nThanks honestdoc: You have a very good chance of it healing because the tongue has very good blood supply for tissue repair. You may request your dentist or doctor to prescribe you some Kenalog in Dental Paste for more intense sores. aqz: Is it a skin tag? @honestdoc aqz: It has healed more today and not as painful but is stil there honestdoc: Looks like a canker sore. It should heal fairly soon. aqz: @honestdoc ok thanks, but its a tiny skin tag that ive always had in that area that became irritated. Hence i dont think its a canker sore? honestdoc: You CANNOT substitute blurry image exam over the forum with a full clinical exam. So instead of asking us a lot of questions to escape a real dental visit, GET A REAL DENTAL VISIT! aqz: @honestdoc ok there is no need to be rude and abrupt with your response." }, { "id": 325, "title": "Gums", "dialogue": "aqz: Hi \n\nIs this just pigmentation spots on my gum? The otherside does not have this. Its not raised or painful. Bear in mind ive always had dark gums runs in my genes. \n\nThanks MattKW: Natural pigmentation. aqz: So this is not white specs" }, { "id": 326, "title": "Teeth in one day", "dialogue": "VeeDubz: Hi all\nim looking to have the procedure \"teeth in one day\" on both jaws. i have been having free tests and checks at a local dental academy and they have come back with a price of £40000. i really want this procedure doing but i cant justify that cost. £20000 per jaw seems really extortionate to me. i understand the procedure is costly and im prepared to pay, just not that much. anyone out there had the procedure done, or any dentists on here who do the procedure. i know i could go abroad fir this but id rather use a reputable uk dentist\nkind regards MattKW: Is this local dental \"academy\" a private business, i.e. a dental surgery? Academy makes it sound like a government institution.\nWhy do you think this is the only option for you? \n\nHave you received 2nd or 3rd opinions?\nDo you have Xrays (including an OPG) to show us? Zuri Barniv: I have done a few dozen of these cases, they are challenging and require many appointments, thus the high cost. In the USA-California it is much more expensive. We charge about $30k (US Dollars) per arch, but that includes everything from a temporary denture affixed on the implant and the final denture with a titanium milled bar. Our lab bill alone is a ton on these cases. As Matt says, there are alternatives, but none are as effective and loved by patients like implant supported fixed dentures (hybrid denture)." }, { "id": 327, "title": "Ongoing pain after wisdom tooth extraction", "dialogue": "Kittykebab: Hello all,\n\nApologies for long winded post! \n\nJust wondering if anyone else had their wisdom teeth removed as an adult and suffered with ongoing pain after?\n\nHad 3 wisdom teeth taken out 2 weeks ago under general anesthetic in hospital. After surgery, the consultant told me that one of the lower ones had double the amount of root /nerves as normal and they had to cut away some bone and break it into pieces to get it out, then stitch me back up and to expect bad pain and swelling, but that it should start to get better by about 72 hours later. Pain was so bad on the weekend that I would literally just rock and cry whilst dosing up on paracetamol and ibuprofen. But after 72 hours the swelling had gone down a bit and the bruising came up so I was hopeful it was healing even though I was still in constant pain 24/7 (but not enough to bring me to tears!) and pain relief just didn't touch it. The other two wisdom teeth (or what were) have caused me no pain at all. \n\nDue to continued pain I went to see my dentist to rule out dry socket or any sort of infection. They said it was healing well and no infection, just keep salt water 'swilling'. Went to GP who prescribed codeine and naprofen (which both have their own negative side effects on me) and suggested i adjust doses to suit pain level and signed me off work for a week. To be honest this pain relief hasn't once stopped the pain, occasionally it might just take the edge off, or at least make me drowsy enough to sleep for a few hours at night and keep me sane.\n\nSo now 2 weeks on from surgery and the pain hasn't reduced at all (except after the initial few days when the swelling went down). Still constant, spread from ear to jaw to teeth/gum, localised on the side of my face that the problem tooth was removed from.\n\nIf its a case of 'just deal with it', healing takes longer the older you are, etc. I guess I'm just hoping someone has experience of this and how long it took them to recover roughly. I don't want to just keep moaning and being off work if there's anything else I can do, or that might be the problem. My face isn't numb at all, which seems to be an issue with nerve damage, dentist has said no infection so it's not dry socket. I can still semi-function, but when I take codeine I get drowsy and feel dizzy and also due to pain I'm just not sleeping more than a couple of hours a night, if that, so going to work isn't a great option, especially when I have to drive there. But I do hate having time off work. \n\nAnyone had any similar problems? \n\nThanks in advance. MattKW: How serious is the pain now? Like, what would be a record of your painkillers intake over the course of 24 hours? Kittykebab: Hi, \n\nPain is difficult to describe, but I guess nearest I can describe is a constant dull throbbing ache, with the feeling like someone also has a knife to the gum and is poking it with every throb. This radiates across my jaw up to inside my ear. Scale of 1 to 10, probably a 7, but enough to stop sleep.\n\nCurrent painkillers on average are paracetamol x2 and codeine 15mg x2 every 4 hours (up to max suggested amount), then additional ibuprofen inbetween. I was on a heavier dose of codeine but this made me really nauseous and 'out of it', so dropped down. MattKW: That's not good for you, but you're doing everything possible. \nIt may be too late, but maybe a dry socket dressing if they can get it into the wound. I prefer ZnO/eugenol mixed with Vaseline and impregnated into a large (sterile) cotton pellet packed up to the brim of the wound. You might need some LA to get it in - ask for some long-lasting stuff like bupivacaine or ropivacaine so you can have a bit of a rest too." }, { "id": 328, "title": "What is the best type of dentist to remove a route canal tooth?", "dialogue": "Charlieboy: Hi all, \n\nI have a route canaled tooth upper 6 that has broken leaving little above the gum perhaps 3mm to 4mm. I think I may be best to get the tooth out as I have two route canal teeth and am not happy with either of them. My concern is getting the tooth out and some or the route or debris being left behind.\n\n1, Would I be best to go to a experienced yet general dentist or would I be better going to an endodontist who's surgery has a camera device that goes in the mouth and bring up the image on screen? \n\n2. What check should be made and how to make sure there is nothing left behind when the tooth has been removed?\n\n3. Will where the routes and so were fill up and heal over, if so how long may that take?\n\nAny help will be much appreciated \n\nThanks in advance\n\nCharlieboy Dr M: Good day,\n\nA general dentist should be able to remove the tooth, but it always important to be careful when extracting a root canal treated tooth, since they can end up being very brittle.\nIt is also important to take note of other important anatomical structures in the area, such as your maxillary sinus floor.\nAny upper molar tooth can have roots that extend into the sinus and then lead to a sinus floor opening.\nIf there is not a lot of bone between the roots and the sinus floor, it might be best to go to a oral surgeon or a maxillofacial and oral surgeon, to remove the tooth and take care eof any possible complications.\nYour dentist should refer you anyway if this is the case.\nTo make sure that all roots are removed, you are more than welcome to ask the dentist also to show you the tooth afterwards, so that you can see for yourself or insist on a post-op radiograph to confirm.\nUnfortunately a lot of the post-op wound care responsibility also rests on the shoulders of the patient.\nYou have to follow the instructions given to you by the dentist.\nIf there is also some post-op infection, it is also best to return to the same dentist, since he is familiar with the case and will be able to treat it or refer accordingly. Charlieboy: Dr M said:\n\n\n\n\t\t\tGood day,\n\nA general dentist should be able to remove the tooth, but it always important to be careful when extracting a root canal treated tooth, since they can end up being very brittle.\nIt is also important to take note of other important anatomical structures in the area, such as your maxillary sinus floor.\nAny upper molar tooth can have roots that extend into the sinus and then lead to a sinus floor opening.\nIf there is not a lot of bone between the roots and the sinus floor, it might be best to go to a oral surgeon or a maxillofacial and oral surgeon, to remove the tooth and take care eof any possible complications.\nYour dentist should refer you anyway if this is the case.\nTo make sure that all roots are removed, you are more than welcome to ask the dentist also to show you the tooth afterwards, so that you can see for yourself or insist on a post-op radiograph to confirm.\nUnfortunately a lot of the post-op wound care responsibility also rests on the shoulders of the patient.\nYou have to follow the instructions given to you by the dentist.\nIf there is also some post-op infection, it is also best to return to the same dentist, since he is familiar with the case and will be able to treat it or refer accordingly.\n\t\t\nClick to expand...\n\n\nHi Dr M, \n\nMany thanks for your reply and you thoughts which make sence and are useful \n\nCharlieboy" }, { "id": 329, "title": "Is general anesthetic really necessary?", "dialogue": "losing #14: I just finished a consultation regarding the extraction of a split # 14 molar. It is broken six mm above the gum line.\n\nIt is broken near the sinuses, so the surgeon said in might leave a hole that an EN and T surgeon would need to fix later.\n\nI have an HMO that will not put a dent in the cost.\n\nThe tooth extraction is only $110, but the general anesthesia in a whopping $252 for each 15 minute interval for a total of $756 for just anesthesia. Total cost is $866. \n\nMy pathetic insurance will only pay $40 total.\n\nThis surgeon only gives general anesthesia, so I would like to know if this is really necessary, or would a local anesthesia suffice?\nThis surgeon only provides general anesthesia for all patients.. MattKW: Can't be sure without Xrays, but a general dentist competent in surgical extractions might be able to get it out. I'm surprised that the surgeon won't do it under LA. Get another opinion. Fauchard: Yes get a 2nd opinion, GA seems like overkill. Busybee: I haven't had an extraction since I was a child but the last time it was with a local anaesthetic and despite the injection it really hurt (I can still remember the intense pain and I was 11!). That was just a simple premolar which was not broken. So perhaps the surgeon realises it's complex and does not want you to be distressed or in pain. \n\nWhy don't you ask whether you can be sedated instead of put right under. MattKW: Some surgeons simply prefer to do work under GA. They line up a day of patients and go through them very quickly. I wish I could do a lot of my work on people under GA too. \n6mm under the gum just turns it into a surgical extraction of a 1st molar that many general dentists encounter frequently. They are nearly always near the sinuses, but as a general dentist I've only punctured the sinus once in 37 years, and it was also the only time I had to refer a surgical 1st molar to a surgeon for repair.\nUpper teeth are easy to effectively numb with local anaesthetic, but a surgical can be a bit stressful given the greater time and difficulty. losing #14: I had my 14 molar extracted one week ago.\nThe procedure was done under local anesthetic and took about 30 minutes.\n\nThe actual surgery only produced minimal discomfort. but the primary source of discomfort was having my mouth forced to stay open with a block.\n\nI was disappointed to discover I needed to pay an extra $450 for a bone graft. I was not told this until the day of the surgery. In fact, I was told virtually nothing until the day of the surgery. The oral surgeon did not even look in my mouth during the initial consultation, which really was not even a consultation. He just read the dentists referral out loud to himself, and then I was sent on my way.\nThis lack of information seemed strange, but i guess it worked out fine. I will have my stitches removed in five days.\nI imagine the bone graft is a simple procedure since the entire operation took about 30 minutes.\nThe surgeon was carrying on a conversation about vacations with the receptionist as he was applying the stitches, so i suppose this did not require much concentration on his part.\nI hope the bone graft was necessary. I hate to think this is a money grab." }, { "id": 330, "title": "Tender jaw after infection scraped out of extraction", "dialogue": "Tiffany: Three weeks after I had a lower molar extracted, I went back to the dentist who confirmed it was infected. It was filled with very red gum tissue, which after a couple days developed into a round lump in the extraction site. He made an incision and essentially scraped everything out (I could literally hear him scraping against the bone in my socket the whole time. Initially I could feel it too so he gave me more of the numbing shot!). So, I was back to square one like I just had the extraction done again (gauze, clotting, etc). This time, the hole was actually stitched closed to promote healing, since it wasn't healing well before (even before signs of infection). I THINK it's healing better than it was initially (although hard to tell since it was stitched closed this second time & not the first).\n\nHOWEVER my jaw is fairly tender still (week later). It's NOT a stiff muscle feeling, & it's only tender when pressed on the side of my face. I'm not even really sure it's it's the jaw itself, more like if I were to try to poke the extraction area from my cheek. That's the area that still feels sore. However, if I touch the extraction site with my tongue (I don't do this on purpose, but it's happened on accident a time or two!) that doesn't hurt. Just poking from the outside hurts. \n\nIs this soreness just from him scraping so much to get the infected tissue out? & If so, how long can I expect this tenderness? I'm just trying to confirm if it's normal or if the infection went deeper (I'm a worry wart, to be fair, but still lol). I have my follow up in a little over a week (next Friday). The soreness hasn't gotten worse. If anything it has gotten a TAD better since the first day he scraped the socket out, but not much..\n\nThanks! MattKW: Sounds fine and healing better than first time." }, { "id": 331, "title": "Is this a dry socket?", "dialogue": "wisdomteethquestions: I had my 4 wisdom teeth removed and I’ve been trying to figure out what that thing is in the back row of my teeth. I’m day 4 post surgery and have had no severe pain so far. just saw this today. honestdoc: The white areas are epithelial repair tissue. The gums should even out over time." }, { "id": 332, "title": "Immediate implant placement and delay implement placements", "dialogue": "Freefrompain: My lower right first molar needed to be extracted due to the fracture. \nI am thinking to replace it with the implant after extraction. \nThe surrounded bone of the tooth has melted due to the infection. \nI had visited few dentists.\nOne of them suggested to extract it, replace it with temporary tooth and wait 3 months to allow healing then do the implant placement.\n\nAnother dentist suggested to do the immediate implant placement after the extraction and if it doesn't hold then leave it 3-4 months to heal with bone grafting.\n\nIs it possible to do the immediate implant placement (with bone grafting) after extraction with my tooth since the surrounded bone has melted? MattKW: Extract, allow healing for 3 months, assess for grafting. If necessary then graft, wait further 3 months and reassess.\nImmediate implant into a fresh extraction wound rarely has the right bone contours." }, { "id": 333, "title": "Tooth piece left in wound after wisdom tooth removal?", "dialogue": "Epicly: Hello!\n\nI just got two wisdom teeth removed, but noticed there are something white \"sharp\" sticking out from the hole itself, they put in stiches, seems weird that they might have left out some tooth, should i be worried?\n\nalso my dentist said that the stitches need to sit in for 1 month, that seems like an awful long time doesnt it? \n\nThanks for help in advance ! honestdoc: Maybe your dentist meant 1 week? The stitches should be either resolvable or nonresolvable meaning you need to return for removal. The \"sharp\" debris usually are \"bone spurs\" or bony sequestrum that usually exfoliates naturally. As long as your are not experiencing swelling and or pain, you should be fine. Epicly: honestdoc said:\n\n\n\n\t\t\tMaybe your dentist meant 1 week? The stitches should be either resolvable or nonresolvable meaning you need to return for removal. The \"sharp\" debris usually are \"bone spurs\" or bony sequestrum that usually exfoliates naturally. As long as your are not experiencing swelling and or pain, you should be fine.\n\t\t\nClick to expand...\n\n\n\nThanks for the answer, puts my mind to rest for abit.. Never tried to have a oral surgery before, so i dont know what common haha.." }, { "id": 334, "title": "Wisdom Tooth Removal", "dialogue": "Jonathan Phelan: I had my lower right wisdom tooth removed in 2007, I was given the option of local or general anesthetic, I opted for local, I had the gel applied before the injection, it was pain free and straight forward\nThis year the dentist recommended having the remaining 3 removed\nYesterday I had the upper right removed under local anesthetic, leaving the left 2 to remove in 6 weeks time, The dental surgeon refused the gel, gave me a local anaesthetic, which I don't think kicked in, and after a lot of pulling ripped out the tooth !!!!!!!!\nWhat I would like to know is ......... Do I have the right to insist on a general anesthetic ? As there are 2 more to remove and I don't want to go through that again twice over\nWhy are they not applying the gel first ? I doubt it's expensive\nDo I need to find the local drug dealer and be so high they could do an amputation without me noticing ? !!!!! MattKW: A different dentist, I assume?\nsure, ask for gel; I don't know why he didn't use it. \nDifferent teeth can present different levels of difficulty to remove, so hard to comment on that. You can ask for IV sedation or GA and see what they say. You might require a referral to an oral surgeon for that. Jonathan Phelan: Yes, different dentist from 12 years ago, I did ask for the gel, I think her reply was \"You don't need it\" Maybe I need to get in touch, sadly there probably wasn't a lot of tooth to get hold of, maybe that was a factor ? GA probably costs the NHS a lot more, with anaesthatista and all that business\nCan I insist on a General Anesthetic, can they refuse ? MattKW: I don't know how it works under the NHS. But they do have restrictive rules for removing wisdom teeth that would be considered very conservative in Australia and USA. You'll have to ask." }, { "id": 335, "title": "Multiple extractions.", "dialogue": "Andy1408: Hello - \n\nI’ve finally decided I want my whole top deck removed. After I had the ‘fang’ removed as a child my teeth have moved way over to one side. I hate my teeth and have been told I’m unable to have them corrected with a brace due to back teeth already gone. \n\nIs it possible to have 9 teeth removed and dentures applied. ‘Straight ones’....\n\nThank you. MattKW: Sure, happens all the time. But that's a discussion you have to have with your dentist as there are pros and cons of which you may not be aware." }, { "id": 336, "title": "Chronic Pain 12 days post molar extraction and immediate implant post proceedure", "dialogue": "Iuanduofm: Tooth 30 was extracted 12 days ago and an implant screw was placed same day. I have chronic pain due to what I think are 2 issues. #1 - there is a small dry-socket hole next to implant screw that catch food particles that I have to clear after each meal. The tissue inside that space is very tender and causes pain after I flush it out. #2 - there is an exposed bone ridge on the tongue side next to the healing cap - it is hard - and painful to the touch.\n\nI have been on two round of steroids and one round of antibiotics. I see the surgeon next week (out of town now). What should I expect to have done - the pain is getting slowly worse each day, and I am running low on pain meds. I don’t really want to hear to just wait it out - that’s why I am posting - should I expect them to address both the socket and the bone when I see them?\n\nThank you." }, { "id": 337, "title": "Can anyone recommend a dentist that does bone grafting, gum", "dialogue": "Rachel Thomson 83: Can anyone recommend a reputable dentist that does bone grafting, gum grafting and implants or veneers. Ian: Please remember, this is a global site and you've not mentioned where you are based. Without more information on where you are located, we can't give any useful advice.\n\nUnfortunately, we're not really the place for recommending specific dentists - as we get a lot of spam attempts each week trying to promote this sort of thing. I think you're best bet may be to have a Google search of your local dental practices and then read some reviews and make an appointment to discuss things." }, { "id": 338, "title": "Does my wisdom tooth extraction area look infected???", "dialogue": "Aschwane: It’s been 4 days since I got all 4 impacted wisdom teeth taken out. Last night this one bled for the first time, and I couldn’t get it to stop after 2 hours so I just went to sleep. It’s still slightly bleeding this morning, but looks horrible. The stitch also kind of looks like it’s coming loose. Does it look infected? The red spot isn’t blood I can wipe away, it stays there. MattKW: It's rare to have infections after healthy wisdom teeth extractions. Can't think of the last occasion for me. Infection would be diagnosed by facial swelling, pain, and possible fever. \nYou just appear to be healing normally - it will take 2 weeks for the wound to finish initial healing, and 3 months for the bone to reshape. Aschwane: MattKW said:\n\n\n\n\t\t\tIt's rare to have infections after healthy wisdom teeth extractions. Can't think of the last occasion for me. Infection would be diagnosed by facial swelling, pain, and possible fever.\nYou just appear to be healing normally - it will take 2 weeks for the wound to finish initial healing, and 3 months for the bone to reshape.\n\t\t\nClick to expand...\n\nThank you!! Im hoping it doesn’t get infected since I’m not on antibiotics. My face did get more swollen today which worries me. Does it look swollen from this picture? There’s white surrounding it. MattKW: Too hard to say. I haven't had to give antibiotics in my memory, unless there was already significant infection present. They shouldn't be given routinely post-op for uninfected extractions." }, { "id": 339, "title": "Does this extraction look infected?", "dialogue": "Aschwane: Today is day 5 since the surgery. My facial swelling went down from day 3 to 4, but increased today. The right bottom side of my face is in more pain than yesterday, but not bad enough to need pain medicine. Last night when I pushed around in the area (I know, big mistake) it looked like a white-ish ooze or puss came out. Today there is a white/ yellow/ gray slimy cover sitting over the extraction site (see picture). Is this normal or does this look infected?" }, { "id": 340, "title": "Worried about dry socket", "dialogue": "plasmapancakes: I got my wisdom teeth removed 8 days ago and one extraction site appears to have formed dry socket but I am unsure. I am not experiencing pain in the socket yet asides from general discomfort." }, { "id": 341, "title": "Skin flap growing over 2nd molar after wisdom teeth extraction?", "dialogue": "Aschwane: I had 4 impacted wisdom teeth removed yesterday with IV sedation and local anesthesia. After the local wore off I noticed there was a piece of skin covering my bottom left 2nd molar that prevents me from closing my mouth. Today the skin looks/ feels bigger, and it’s even harder to close my mouth. I also keep accidentally biting it in my sleep and randomly throughout the day. My oral surgeon said this is normal swelling and should go down by Sunday, but I haven’t been able to find anything like this online. The side of my face the skin flap is on is also muuuuchh more swollen than the other side. \n\n\nIs this skin flap normal? Dr M: Firstly swelling is normal when a surgical extraction of a wisdom tooth was done.\nThe swelling will definitely go down as your oral surgeon suggested, if the wound area is kept clean and you follow the post op instructions.\nWith tegards to the swollen piece of flesh.\nA lot of changes will occur in your mouth now since a tooth in that area is missing.\nThere will be changes to the bone and to the soft tissue.\nGive it some time for healing to set in first, and observe the changes that occur in that area. Most likely the problem will dissappear on it's own after a week or two, but if not, the oral surgeon can just remove the excessive tissue if it irritates you" }, { "id": 342, "title": "Implant fallen out??", "dialogue": "evan thompson 3535: Hi \nI had implant surgery 4 weeks ago and a metal screw came out of my mouth last night.\nIs it the implant itself or just a healing screw/cap, please?\nMy dentist is closed over the weekend!\nCheers MattKW: Implant come out with healing cap attached. That's the end of that - can't be re-used, sorry. evan thompson 3535: I suspected that thanks how the hell did it literally \nfall out after 4 weeks!!!! MattKW: evan thompson 3535 said:\n\n\n\n\t\t\tI suspected that thanks how the hell did it literally\nfall out after 4 weeks!!!!\n\t\t\nClick to expand...\n\nCan't tell. Go back to whoever implanted it." }, { "id": 343, "title": "Wisdom tooth removal", "dialogue": "Nu222: I have a pain in my lower jaw right side wisdom tooth. So I decided to remove it finally. But I'm afraid of complications. As I found out.\n\nThere are some nerves down the tooth there. If any of them damaged during the extraction, chin or tongue can go permanently numb.\nI also took an x-ray which is shown below,\n\n\n \n\nDoes it look worse (orientation of the tooth makes hard to remove)?\nDoes it need complicated surgery?\nWill it take too much time to heal? (I'm having my wedding ceremony next week. So if it heals within about 4-5 days it is okay)\nI greatly appreciate if anyone can give me some helpful advice on this. Thank you. MattKW: You've put yourself in a difficult position by leaving it so long. The tooth badly decayed, it is distally impacted (difficult) with very curved roots that come close to the major dental nerve (IAN). You need to have this removed by a competent specialist oral surgeon. He may require a CBCT to make a full assessment.\nWith a wedding next week there is no time to arrange removal plus healing time. The best you might be able to accomplish is either minimal removal of decay and placement of a sedative temporary filling, or partial removal of the nerve and placement of a temporary filling. Nu222: Thank you very much for the lengthy explanation. I found it is very helpful. Thank you again." }, { "id": 344, "title": "Bruising after extractions", "dialogue": "darkmom: View attachment 2581 I had multiple tooth extractions yesterday, and swelling beginning last night which has gotten worse today. I had a short appointment with my primary dentist today. He commented on the swelling on the left side. When I got home, I put an ice gel pack on both sides. When done, I saw an ugly bright purplish bruise like a line, running along the fold on my left cheek, which wasn't there previously. Was i caused by the ice? What can I do? How can I make it go away? How long will it last? Dr M: Hey there,\n\nBruising is quite common sometimes especially when multiple extractions are performed and it depends on the level of difficulty of the extractions. \nSometimes the dentist has to stretch your cheek etc to gain access to the tooth.\nSome people also bruise easier than others.\nSince the extractions were performed quite recently, I would not worry at the moment.\nHealing can sometimes take a long while, depending on home wound care, so give it at least a week or so to start the healing process .\nFollow the post operative instructions that your primary dentist gave you, and keep the wound as clean as possible to prevent any infection from setting in.\nIf pain persists after a week, and the bruising has not subsided, visit your dentist again for a follow-up examination.\nIce packs on the affected side, usually helps to reduce any swelling and to help speed up the healing process.\nHope this helps a little" }, { "id": 345, "title": "Hooked roots", "dialogue": "Hayden5073: So, went to the dentist to have a simple tooth extraction.. got the x rat done to find out that what was causing most of my complications was a horizontally growing wisdom tooth, not only that but my left rear bottom tooth has a curved root that’s shaped almost like a fishing hook going up and underneath the wisdom tooth. Is this common? honestdoc: It's a variation of people's anatomy...not common, not rare." }, { "id": 346, "title": "Four Failed Implants", "dialogue": "dentamax: My dentist placed 2 implants on the right bottom 2 years ago and they both failed – he added the healing cap on one of them last year too loose and the cap fell out in a couple of days and then he tightened it too tight (that twisted the implant inside the bone and gave me pain for 5 days) and later this April, he could not unscrew the healing cap to place the crown on it. So, he just removed the whole implant (that was integrated very well with my bone for 2 years) without even telling me. Later I found that it could have been unscrewed by placing an ice cube on it for a minute but he did not do any research or discuss it with me - he just pulled it out!\n\nThe other implant on the right bottom – he removed the crown after placing it this April at the same time saying that it did not go deep enough. He grinded the crown on the sides saying the surrounding teeth were blocking it from going deeper and tightened it too tight (that twisted the implant inside the bone and gave me pain for 5 days) but it did not go any deeper than it did before other than DAMAGING the implant that was well integrated with my bone for 2 years. After he placed the crown, it was fine but when he removed the crown to re-screw it (screwed it too tight), it became loose and painful. He doesn't answer why it did not go any deeper \"vertically\" even after grinding the crown on its sides. Even after a similar disaster with the other implant, he did the same mistake again of tightening it too tight instead of finger tight and I can feel the implant is damaged as it is painful to touch and loose on feeling it with the tongue - I can feel it is moving inside when I push it with my tongue. Is this going to heal after some time and re-integrate with the bone? Or should I have it pulled out and restart with bone grafting?\n\nHe extracted my 2 front bottom teeth and did 4 bone grafting procedures over a 1 year period. He placed 2 implants in the front bottom in Sep last year that failed due to using short implants (8 mm and 10 mm) and they are loose and just sitting on the top of the gums. Later he placed healing caps on them and noticed the implants were short and loose from the X-Ray \"after\" the procedure. That was a waste of time and money! He ordered longer implants (11 mm and 13 mm) and they are sitting in his office for the last 4 months. He says there is not enough bone and gum on the front bottom to place the implants (in spite of doing 4 bone graftings). What is the solution? If they don't have enough gum/bone, why did he extract them instead of doing root canals?\n\nCan I ask him for for a refund for the failed implants and healing caps as they failed due to his experiments on me using me as his lab animal to learn dentistry?\n\nDo I have a case to sue him for damages?\n\nTIA MattKW: \"So, he just removed the whole implant (that was integrated very well with my bone for 2 years) without even telling me.\" A well-integrated implant won't come out that easily. If you have any Xrays we might be able to opine more. Or, get copies of all records and go to another dentist or specialist (like a prosthodontist) for a 2nd opinion." }, { "id": 347, "title": "Nightmare...Pain? Numbness?", "dialogue": "comiceye: Hello! \nI’m here looking for help/ advice about my past and present situation.\n\nOn the 9th of May (6 days ago) I had my lower left wisdom tooth extracted. I had local anesthetic applied, yet the pain was absolutely awful! I have never had any issues at the dentist, although I’ve had plenty of procedures, I’ve never physically started shaking, sweating and almost pass out from the pain..so it came to me as quite the surprise. The reason I think it hurt so bad is that it took more than an hour and my tooth had a hook like appearance (and also the assistant was quite aggressive, my mouth is tiny and he tried his best to widen it, basically rupturing open the side of my mouth.) They stitched me up and told me to come back in 10 days to remove the stitches. They also advised me not to drink anything hot, not to drink from a straw and not consume any dairy products either.\n\nThe next few days (days 1,2,3) were great, I had minimum swelling, the bleeding stopped after day 1 completely and I was prescribed to take antibiotics and ibuprofen. I felt little to no pain at all up until day 4.\n\nDay 4 comes along and I start feeling sharp pain that is consistent, pretty high on a 1-10 scale (6-7) but not as painful as people describe dry socket. It’s more on my cheekbone area at the moment. It is now day 6 and the pain is still consistent. I don’t see any “blood clot” but I’m not sure what I’m looking for, most of the sites about information on these issues are either blocked in my country or strange natural remedies that don’t really have anything to do with my situation anyway.\n\n*** I also can not feel my lower left lip and chin, and the numbness is becoming tender and sore as well?? I thought it was the anesthetic initially but I’m pretty sure it’s nerve damage at this point... \nI’ve posted images of my extraction site below, I hope someone here will be able to tell wether I may have an infected area, dry socket or (hopefully) am healing correctly. \n\nThanks in advance!! honestdoc: Can you feel your lower left lip at all. Do you still feel \"tingly\" on the lips? If your lip is partially numb while still have some sensation, your nerve should recover. If you feel the lip is totally numb, return to the surgeon for a full evaluation. You may be experiencing a milder form of dry socket that hopefully should resolve on its own as long as you are not experiencing swelling. comiceye: honestdoc said:\n\n\n\n\t\t\tCan you feel your lower left lip at all. Do you still feel \"tingly\" on the lips? If your lip is partially numb while still have some sensation, your nerve should recover. If you feel the lip is totally numb, return to the surgeon for a full evaluation. You may be experiencing a milder form of dry socket that hopefully should resolve on its own as long as you are not experiencing swelling.\n\t\t\nClick to expand...\n\n\nI can’t feel half of my lower left lip and neither half of my chin, to the extent that if something touches that region I couldn’t tell if I had my eyes closed. There isn’t really any tingly sensation although in the first few days I would feel as if the numb part was itchy and of course, I couldn’t feel the scratch. honestdoc: Have your surgeon evaluate you for possible nerve damage as soon as possible. comiceye: honestdoc said:\n\n\n\n\t\t\tHave your surgeon evaluate you for possible nerve damage as soon as possible.\n\t\t\nClick to expand...\n\nOof.... doesn’t sound good. I have an appointment to remove my stitches tomorrow and I’ll update this thread to see what my surgeon says as well. Thank you for the feedback! comiceye: UPDATE:\nI went back to my surgeon, she told me everything was looking good, (no sign of dry socket).\nAbout the numbness she told me that it’ll take months to regain feeling in my lower left lip only because my wisdom tooth was positioned in a very complicated manner, so not damaging the nerve was unlikely. \nFortunately she said that I’ll gradually regain feeling in my lip/chin and that the damage is not permanent. honestdoc: Where are you located? We take nerve damage seriously in the Pacific NW. You said your lip feels totally numb. If it feels partially numb, then I would understand. Also, if you feel totally numb, you shouldn't feel extreme pain in the extraction site. I must be missing something. MattKW: That's a strong statement from a surgeon; no-one can be that confident at this stage.\nI would expect that if after 2 weeks you still have full anaesthesia (i.e. no improvement), then the surgeon should start evaluating your numbness as per this excellent article. Print it out and make a time to see the surgeon with this as a discussion paper; it'll at least make them take proper notice of you.\nFull numbness may indicate that the nerve has been severed, and surgical repair is suggested by some as required within 3 months. comiceye: honestdoc said:\n\n\n\n\t\t\tWhere are you located? We take nerve damage seriously in the Pacific NW. You said your lip feels totally numb. If it feels partially numb, then I would understand. Also, if you feel totally numb, you shouldn't feel extreme pain in the extraction site. I must be missing something.\n\t\t\nClick to expand...\n\nI might’ve not described what I feel correctly; Half of my lip and chin feels totally numb (the left side, the side of my extraction) I’ve also discovered that my gums and teeth (from my central incisor to my premolar) are also numb. My tongue, molars and extraction site do not feel numb. \nTo describe this numbness, I do not feel cold things such as ice on my lip, nor would I realise if I had my eyes closed if something was touching any part of that numb area.\nWhen I firmly press on my numb area (lip and chin), paradoxically, I feel a dull soreness(???). I am located in Europe. comiceye: MattKW said:\n\n\n\n\nThat's a strong statement from a surgeon; no-one can be that confident at this stage.\nI would expect that if after 2 weeks you still have full anaesthesia (i.e. no improvement), then the surgeon should start evaluating your numbness as per this excellent article. Print it out and make a time to see the surgeon with this as a discussion paper; it'll at least make them take proper notice of you.\nFull numbness may indicate that the nerve has been severed, and surgical repair is suggested by some as required within 3 months.\n\n\nClick to expand...\n\nI might go to another surgeon since I feel as if this current surgeon isn’t handling this issue properly. She did not mention any check-ups after she took out my stitches and I don’t really want to go back there anyways. \n\nThank you for the article, I will read it, since I live in a country where english isn’t the first language I couldn’t show it to the surgeon, but I can very well educate myself and discuss further on with a different surgeon and see what has to be done.\n\nCan complications appear if I leave the numbness untreated? As bad as it sounds since I’m a 22 y/o female student, I much prefer living with (metaphorically speaking) half a lip than paying God knows how much for surgery. \nThanks! honestdoc: You may be permanently numb without treatment. Since you are young, you have potential for healing. You need to have surgeon evaluate you for nerve repair surgery." }, { "id": 348, "title": "Is this dry socket or infected?", "dialogue": "Kendrick Burrell: I had my wisdom tooth removed 4 days ago it doesn’t hurt at all But this looks infected I’m not sure" }, { "id": 349, "title": "White thing on my widsom tooth hole", "dialogue": "Celine: Hello! I removed my widsom tooth 2.5 weeks ago and the dentist removed the stitches and told me to be carefull to not let any food in the hole. I am eating on the other side and rinsing my mouth with salt water after every meal. But recently there is a white thing on the side of the hole and i cam't decide if it's food or something normal. I have tried rinsing it but it wouldn't come out , i'm scared it will be infected if it's food. Please help!" }, { "id": 350, "title": "Is this normal? 2 weeks post wisdom teeth removal", "dialogue": "c.robertts: Someone help! It doesn’t hurt. Just a little lump near my sutures." }, { "id": 351, "title": "Tooth taken out but does this look normal?", "dialogue": "macc2019: Had a tooth out last Wednesday and 5 days after i am still getting some pain where the socket is.\n\nso i asked my wife to take a photo of it and can see some yellow/white on it as in the photo i have added to this post.\n\nso does it look ok or do i need to go back to my dentist? Kathe1994: I had my tooth taken out Thursday and now mine looks like yours. Worried it's an infection. Still in some pain aswell and now its monday. U had any replys on it? macc2019: Kathe1994 said:\n\n\n\n\t\t\tI had my tooth taken out Thursday and now mine looks like yours. Worried it's an infection. Still in some pain aswell and now its monday. U had any replys on it?\n\t\t\nClick to expand...\n\n\nHi i went back to see my dentist and it was dry socket so he put some meds into the socket and it cleared up after a couple of days.\n\nso i would get back to your dentist and tell him or her that you think its dry socket and they will sort it out for you. Kathe1994: Ok thanks I'll ring them tomorrow. It's sore but not really pain Full macc2019: Kathe1994 said:\n\n\n\n\t\t\tOk thanks I'll ring them tomorrow. It's sore but not really pain Full\n\t\t\nClick to expand...\n\n\nLet us know how you get on.\n\ndont forget to wash your month out with Warm salt water a few times a day and after food as that will help as well." }, { "id": 352, "title": "Infection after wisdom tooth removal", "dialogue": "mhkillam: hey all,\nso i had my wisdom teeth (4) taken out last wednesday, april 24th. the top two were not impacted and very easy to remove, as well as the healing process was very quick and easy.\n\nthe bottom two, however, were impacted and have been giving me so much trouble. when my dentist went to remove the bottom right (i was awake the entire procedure), i guess he cut my cheek pretty bad and i ended up with an infection. i didn’t realize it was infected until about 48 hours later when it sunk in and i knew something was wrong. i went to a different dentist as mine didn’t seem to think it was infected when i called, and when my husband went to call back, he didn’t answer. i was SO swollen and badly bruised (still slightly 9 days post op). the second dentist started me on clindamycin, and referred me to an oral surgeon to see this past tuesday, may 1st, as my post op with my original dentist didn’t go the way i hoped. he assured me i was healing just fine, and “it was my body’s way of healing” - wrong.\n\nwell, here i am 9 days post op, still can’t really eat solid food, and taking the antibiotics 4x a day. i still have an AWFUL taste in my mouth. am i at risk of sepsis? i have another appointment next thursday to see the oral surgeon to see if i need to have another surgery (the dentist left roots in both lower sockets). she said also concerned about osteomyelitis. how long before i see any kind of change in the infection and can eat semi-solid food? (ive been living off of yogurt, mashed potatoes, and ice cream and i’m dying)." }, { "id": 353, "title": "Failed implant. Is it worth trying again?", "dialogue": "barona: I am a 59 years old female; a non-smoker, with no health issues and not on any medication.\nI had an upper L-H side molar pulled out 18 years ago.\nTwo years ago I had a sinus lift done and an implant placed.\nThe implant failed after a month.\n\nMy surgeon said we can try again, but that the implant may fail again.\n(He did not say why it may fail ?)\nSo we tried again.\nWhile accessing the area, he said he can't proceed, as the sinus membrane is too thin\nand that possibly it was caused by graft.\nHe said if we go ahead my implant will fail for sure.\n\nI was told not to blow my nose for two weeks and to take Augmentin for two weeks.\nThen I will have to take antibiotics for four more weeks (= 6 weeks of antibiotics in total). \nSo after 6 weeks a new implant will be placed.\n(In the meantime I feel like maybe I developed sinusitis?)\nI am so disappointed and am not sure if it's worth it doing it again. My hopes will go up and it may happen again.\nI would be thankful for your advice. honestdoc: Is your surgeon a general dentist or a board certified oral surgeon or periodontist? If he/she is a general dentist, you may consider seeing a specialist. barona: my surgeon is a Maxillofacial and Oral Surgeon." }, { "id": 354, "title": "had tooth extracted on wednesday and it’s now saturday and looks like this —— is it dry socket??", "dialogue": "eviegrace: i had my 2 teeth removed on wednesday, it’s now saturday and the bottom one looks like this. Is it dry socket??" }, { "id": 355, "title": "Lower left extraction, dry socket", "dialogue": "Neonmime: i got the last tooth on the bottom back removed on Sunday last and within 24 hours the blood clot was removed leaving me with an infected dry socket. Already on antibiotics (cefaclor due to the fact I’m pretty much allergic to everything else) I went straight into the dentists and got it scraped out and they filled it with an antibiotic fake clot material (or whatever it is - they said they were trying to recreate the clot). They then also put me on Metronidazole to cover all infections. That night my whole face swelled up and down to my neck with so much pain and dizziness that I ended up going to the ER where they gave me two kinds of iv antibiotics and sent me home. I went back to the dentist the next day and once again they cleared it out and repacked it. That night - once again - I ended up in hospital (last night) with severe vomiting and fever. This time they just kept an eye on me and you can guess, sent me home. Today is been okay, the taste is still pretty bad but I do worry as that side of my face is still pretty warm despite the lack of pain. Should I go back and get it cleaned out again? Pictures for reference are attached.\n\nAgain I’m. It having a ton of pain anymore and the swelling is definitely going down, but I don’t want it to go bad again. Also I’m still on antibiotics an, though I’m struggling taking the metronidazole as it’s making me pretty ill to the stomach and giving me the runs quite a bit.\n\nSorry for the tmi." }, { "id": 356, "title": "In a Lot of Pain no Dentist Action", "dialogue": "grease: Two and a half weeks ago I got my wisdom teeth out. A few days after the surgery I noticed an area of exposed bone underneath the two molars that are in front of my bottom left extraction site. It’s been 2 weeks since I first noticed this area and it has grown in size. I have been seeing my dentist every other day since the operation, but he seems to think nothing is wrong. This is not a dry socket as this area of exposed bone is more forward in my mouth than where the extraction site is, although I’m being treated for a dry socket in this area as well. I have been on 2 different courses of antibiotics - a Z Pack and Amoxicillin and they have not done anything. My dentist has confirmed that this area is exposed bone, but is writing me off as melodramatic. He is not taking any action or telling me what I should do. I am in increasing pain every day, and today has been the worst pain I’ve experienced yet. Should I be concerned or see a new dentist? What should I do? honestdoc: Can you take more images, I can't see as well as I like. It looks like a large sore with the potential to heal on its own. If it's exposed bone, it is not normal and you may need to see an oral surgeon. Normal exposed bone are usually small around the area of the extraction site." }, { "id": 357, "title": "Bone fragment after wisdome removal", "dialogue": "mrzipper: Over a month ago I had my last impacted wisdome removed and I now have a piece of bone fragment sticking out tounge side. I saw the dentist surgeon today and he says he doesnt see an issue even thought I am now on antibiotics for the 3rd time for infection. What should I do? MattKW: What infection? That is a bit of lingual plate sticking through and will not resolve with antibiotics - who's giving you the antibiotics? \nIt's not a big issue unless it annoys you. Eventually that bone will break off or skin will cover it. mrzipper: There is an infection that in in the gum under the molar and on the cheek side. It is swollen a bit and there is pressure and pain when I bite down. This is the 3rd time since the wisdome was removed. And the xray shows the molar is fine." }, { "id": 358, "title": "Bone sticking out of gum", "dialogue": "fapers: Hello,\n\nI quite worried and confused about what has been happening recently. Well, abt. 6 weeks ago I had my (bottom-right) wisedom tooth removed. After few days I \"digged out\" with a toothpick two peces of bone (which looked simillar to a cut nail). After that I starded feeling onother hard stuff that seemed to be pushing in the gum to get it's way out (everything happening on on the tongue side of jaw). This time however it was by the tooth before wisedom tooth (7th). I thought it must be one of these chips I got out before and tried to pull it out as well. In the effect a piece of bone (looks like a bone or a tooth) showed up. And it was much harder and much more \"fixed\" inside the gum (a photo enclosed). On the side of throat is feels sharp. It also hurts a lot when I push or put pressure on it. I went to my dentist yesterday and first of all he was convincing me that I has got nothing to do with the extraction (I'm not claiming that it's not truth as I'm not a specialist in this subject). When he looked at it he said that is is not a chip but it looks like a regular bone (maybe piece of jaw bone) or a tooth. He said however that he doesn't know and that he hasn't seen anything alike before. He also made an RTG which didn't show anything left in the gum after wisdom tooth axtraction - however as I mentioned that sticking out bone is by the tooth before wisdom and it's roots covered the spot so it was not possible to see what it is. He advised me to wait some time and if nothing gets better I should return to get a CT done to see what that is and how it could be removed.\n\nI decided to ask here, since I'm a bit concerned that the dentist may not be 100% honest with me and he may be saying so so I dont blame him for anything (I wouldn't do it anyway, since I'm aware that somethimes things go wrong, but I would just like to know what is going on there and what should be done now). \n\nI will be very gratefull for your sugestions and advices.\n\nThank you. mrzipper: I have the same issue. Did you find a solution? MattKW: Looks like bone, although a bit forward of where I would expect to see after wisdom tooth extraction. Unlike mrzipper's situation, this is larger and more nasty-looking. If the general dentist took out the wisdom tooth, then ask for referral to OS for opinion. That photo is not enough to judge better on a forum." }, { "id": 359, "title": "Gum around tooth next to extraction is red and inflamed", "dialogue": "oceansmith: I had a tooth extracted back in feb, it was a molar. Since then the gums around the tooth next to it has been red and inflamed and it seems as if the gum is receding on the side of the tooth facing the extraction site. \n\nI have done everything to fix this. I swish with salt water multiple times a day. I have tried oil pulling. I am flossing twice a day and brushing 2 to 3 times a day. \n\nI have seen the oral surgeon 3 times over this and he says its nothing to be concerned with. That sometimes the gums of the teeth around extraction sites will have the gums recede and can be inflamed for some time. This doesnt sound right. \n\nAnyone know anything about this? MattKW: Some recession is to be expected. Can't comment on inflammation without at least a photo of site." }, { "id": 360, "title": "Do I have a post wisdom tooth infection?", "dialogue": "Kevyrivas: Help my wisdom tooth was removed on Thursday and it’s currently a Sunday. I’ve been taking the antibiotics I was given but I’m afraid I have an infection. MattKW: If you filed this y'day, that would've been a Saturday for you. It's now Wednesday going on Thursday. You're fine. God knows why surgeons prescribe antibiotics in the absence of infection - oh that's right, to cover their a***." }, { "id": 361, "title": "Is this dry socket? Did my wisdom tooth surgery gone wrong?", "dialogue": "Dinvincible: Hello. I recently had my wisdom tooth extraction. These pictures were taken 4 day post op. I don't know if my socket( pink arrow first pic) hurts or not because the two molars next to extraction site are in pain. I could not tell. It is throbbing pain. I already visited my dentist for my concern. My dentist irrigated the sides ( pink and green 2nd pic) of my two molars. He then placed this medicated gauze. I don't know if it looks normal or infected. Can you tell?\n\nMy other questions based on the photos:\n1. Do I have dry socket? It is not visible in the photos because it is hard to take a photo of it. but if I self check in the mirror, I can see an open deep hole. I can visibly see a bone on the side. I could not see the bottom properly to indicate if there is an exposed bone as well. I could not either tell if it is in also in pain because the neighboring two molars and its gum are in pain. All I can feel right now is throbbing pain, I have a headache, I feel dizzy. Tho I don't have halitosis or my mouth doesn't taste bad. The surrounding tissue around extraction site is still visibly inflammed/swelling.( I don't know if it's part of healing process) I have taken a stronger pain med( arcoxia ) prescribed by my dentist since mefenamic isn't working. It isn't working! My pain is getting worse.\n\n2. Am I infected?\n\n3. Is this the dry socket, my nerves got injured, or what? My pain is 9 over 10 now.\n\n3. What should I do? I'm getting really drained( mentally, emotionally, also money) from this thing. Stressed AF\n\nThank you for those who will give their expert opinions about my case." }, { "id": 362, "title": "Extract 2 molars together or one at a time ?", "dialogue": "decal: I have 2 lower right jaw adjacent molars 31 & 32 which I am advised need extracting based on a 3D scan (one is crowned) and after pain and a course of antibiotics.\nIs it best to have them both extracted at the same time or one after the other with a short interval to allow the first extraction site to heal a little and also to still be able to chew on the remaining tooth during the initial healing process for the first extraction socket ? honestdoc: It would be less traumatic to get both teeth out the same time." }, { "id": 363, "title": "Dental Implant (Possible Sinus Lift)", "dialogue": "fredo_corleone: Would appreciate your advice on how I should proceed with a dental implant. So I had a failed root canal (infection and root fractures) and needed a tooth extraction and bone grafting on tooth 14. I went ahead with it late last June (2018) and ended up moving to another city for work so I couldn't complete the procedure with my original oral surgeon. I waited till January so that I could reload my FSA and immediately went to an oral surgeon in my new city who suggested I wait another 3 months (despite it already being 6 months since my extraction) since the bone hadn't ossified (according to the pano x-ray) and also gave me a treatment plan with a mandatory IV sedation (which would have been an additional 1600 out of pocket). I decided not to proceed since I didn't feel like I needed the IV sedation but did wait till early March for another consultation.\n\nI then saw a periodontist recently who said that I only had 6mm of bone (when in actuality I had somewhere between 8-9mm) and gave me a treatment plan for a sinus lift/bone graft to go along with an implant. He said that for tooth 14, I should get a big sturdy implant and that he would use a 10x5mm implant and that he wouldn't go ahead with the procedure without a sinus lift. I sent my x-rays over to the oral surgeon who carried out my original extraction/bone graft and she said that she didn't think a sinus lift was necessary.\n\nI then went to another oral surgeon for a second opinion and he told me that he would use a smaller implant (8mm) to avoid a sinus lift as best as he could, but that he may have to still carry out a sinus lift/bone graft on my plan in case it were necessary the day of surgery. (He won't know till he ends up taking a look.)\n\nI know that it is hard to make any suggestions without an x-ray, but I'm getting mixed messages and I'm frankly confused and frustrated. I'm leaning towards the periodontist since he seems to have better reviews and would most likely not end up puncturing my sinus - although I may have to have a sinus lift unnecessarily. Having said that, I think the oral surgeon would most likely take a more conservative approach (even though he did say the sinus may be breached by 1-2mm) but at the same time, I may end up with a sinus lift if needed on the day of surgery - which would ned up costing the same.\n\nWould appreciate your thoughts and input.\n\nI have been advised from another dentist that I should opt for the oral surgeon (second opinion) since i have 8-9mm of bone height and since he would take a more conservative approach." }, { "id": 364, "title": "root in sinus cavity", "dialogue": "maryjoh1952: What happens when you pull a tooth when the root is in the sinus cavity?It has to be pulled but not sure what to expect. Can someone please tell me. Really worried about it." }, { "id": 365, "title": "I had my wisdom tooth pulled do I have dry socket?", "dialogue": "Ashlyxx4: Does it look like u have dry socket? I’m scared and trying to prevent it, I did slip up and drink out of a straw a couple times but would catch my self doing it and stopped, this morning I woke up and had a little more pain pressure then I usually do. Can someone please lmk so I can go in!! Thank you in advance" }, { "id": 366, "title": "all on 4 or snap on denture", "dialogue": "deansreef: Hello All, I am new to the forum. I have questions, I need 12 teeth on bottom removed ( all that is left) and wanted to get either 4 implants and a snap on denture and was quoted all in cost with extractions, implants and denture ( $14,500) or all on 4 ( not sure the cost), can anyone tell me if they have had either done and what it cost? Oceansightdental: Hi Dean,\nThe most important question you need to answer is \"what do you have on the top?\" If you have natural teeth or crowns & bridges on the top, then you're going to be miserable with a lower denture. Considering going for all-on-4 teeth if this is the case. On the other hand, if you already have an upper denture, then going for a lower denture is not a bad idea. Typically, all-on-4 teeth is more than double the cost of dentures. In my practice I charge 15k for an all-on-4, but based on your dentist's pricing, I'm guessing he charges around 25-35k. If you'd like to learn more about what exactly all-on-4 teeth are, you can read my article on is all-on-four the right choice for me? Hope this helps and best of luck.\nAli Jazayeri DDS Janiceg63: deansreef said:\n\n\n\n\t\t\tHello All, I am new to the forum. I have questions, I need 12 teeth on bottom removed ( all that is left) and wanted to get either 4 implants and a snap on denture and was quoted all in cost with extractions, implants and denture ( $14,500) or all on 4 ( not sure the cost), can anyone tell me if they have had either done and what it cost?\n\t\t\nClick to expand...\n\nHello Dean, I just completed the all on four snap on dentures procedure.Im 69 years old in good health. Cost of dental procedures vary depending on where you live. Depending on what shape your mouth is in when you start this project. Every person has different needs so to compare costs is difficult. You can break it down to individual things like my quote was 135 per extraction and 1,500 per implant. Then there is the cost of the actual dentures. Here you have choices in material with variable pricing. I had all my teeth capped 17 years previous so to start the procedure my dentist had to cut out the caps and then extract my roots. I had no periodontal disease. He said I had 13 extractions total. Then 2 bone grafts in the front of my lower jaw, to build up my jaw bone Then he gave me 7 implants. 4 on top 3 on bottom. He couldn’t do four on bottom due to not enough jaw bone. Total cost for all was $12,800. This was a complete set of snap ons. I feel I received an excellent deal. This dentist was 100 miles away from my residence in Phoenix Az. It took him 2 years and 3 months. 36 appointments. My husband and I drove approximately 7,200 miles spent easily $1,600 on meals. He just finished this January 2019. I still need to go back for adjustments as my bottom plate doesn’t want to stay stable. . Dentists can change the snaps in the dentures to be a smaller size to hold in place but you have to be able to take it out yourself to clean and to sleep. The secret to getting them out yourself is get your mouth rinsed out so it’s wet and using both hands gently rock the plate back and forth and it will eventually come out. Line your thumbs up to where you know the implants are. All in all I like them the whole concept is much better than just regular dentures. I would shop around. If I would have used a dentist in Phoenix it would have, I think been double. Look for a dentist in a smaller town that owns their own practice. I wouldn’t go to a chain dentistry outfit if I could avoid that. The reviews are not so good on those. \nLastly and very important is when they have you try on the wax replica for your approval, DON’T FEEL RUSHED. This moment is your last chance to change anything. Look in a two sided mirror so you can see your profile. My lower jaw ended up jutting out so I looked like a barracuda. They had to fix that as it wasn’t right. Make sure you can smile without effort. My top lip was resting so to speak on my lower lip cause the top plate wasn’t curved out enough. Don’t approve unless you have both plates in. They need to work together. I found a website that explains what my dentist did. You should lead the article they have on this procedure. Colgate.com . Good luck to you. \nP.s. the worst part is when you get your teeth extracted. They give you a temporary plate to wear. I couldn’t understand how I could put this plate over my bloody gums but it’s necessary to wear to keep the swelling down. I was only uncomfortable for a few days to a week. Buy a food chopper! There is no such thing as one day implants. The implanted posts have to heal for 4 months to grow around your bone before they finish the posts. The rest is not bad. There are no nerve endings in your jaw. Read that article! Colgate.com" }, { "id": 367, "title": "Impacted wisdom tooth worth extracting?", "dialogue": "Dudeman74: My impacted tooth is at the bottom right of the picture. One dentist said it was too risky so he wasn't willing to remove it, and he recommended to leave it there because it is too close too nerve. I may get another opinion from an oral surgeon but does anyone have any opinions? thanks. Gadsie: Both my bottom teeth were that close to the nerve and they came out fine. Don't have it done by a dentist who is too afraid, go to an oral surgeon." }, { "id": 368, "title": "My wisdom tooth extraction was an absolute disaster (took 7 hours total)", "dialogue": "Gadsie: Friday morning I left for my second set of wisdom teeth removal. The teeth were positioned exactly like the other set so I expected no problems. The bottom one (most difficult) came out fine. The top one didn’t. After an hour of trying there was a pool of blood on the floor. The dentist took an X ray and it revealed that my wisdom tooth was pushed into my nasal cavity, lying horizontally on top of the roots of the M2 and M1. I was panicking hard.\n\nWas sent to the hospital immediately. Waited for 3 hours there in panic and with the biggest swelling you’ve ever seen until a surgeon saw me. This surgery took about 2 hours. The surgeons constantly told each other they couldn't get it out etc so I was very afraid. Eventually they had to make the hole in my jaw bigger to get it out. It was done under local anaesthesia because it has the least risks. It were the worst 2 hours of my life. By the time they pulled the tooth out my local anaesthesia was about 3 hours ago and I felt pain, but I was euphoric that they even managed to get it out. Afterwards they sutured the hole(s) between my mouth and nasal cavity.\n\nMy cheek was and is insanely swollen, insanely. My entire mouth is crooked. I got preventative antibiotics and I just have to hope and pray it doesn’t get infected and that it heals.\n\nI'm 22 years old, I think my dentist should've waited with the top teeth, they didn't look problematic and perhaps they would've come down more, oh well." }, { "id": 369, "title": "Dry socket??", "dialogue": "Jkoch3: Last Thursday I had three wisdom teeth removed. I looked in my mouth and saw this. \nIs this dry socket? There isn’t really any pain. Just sore from Novacaine shots. MattKW: Dry socket is judged from the symptoms and timing. If it occurs, it will be 3-4 days post-op, with great pain, bad taste, and foul breath. You're past it now." }, { "id": 370, "title": "How common is it to cut away bone from jaw during tooth extraction?", "dialogue": "oceansmith: I had to have a tooth extraction last week on one of my molars. It was the large second to last molar on the left side. It had a crack or two in the tooth and it had become abscessed. Also one of the roots were curved to the outside. That being said I went in to a oral surgeon to have it pulled. \nWhen I got out and looked at the area where the tooth was cut out or removed from it looked really low to the jaw line on the outside/cheek side. So i went back to the oral surgeon and I find out that he cut away some of the bone in the jaw to get the tooth out. \n\nHe said he did this because I had really long roots and that he had to \"drill it out in there\". \nIs it common to have to cut away the bone from around the tooth so you can get a tooth out? If I want to get a dental implant I will probably have to get a bone graft now. \nI also had the doctor use PRP and I suppose he put the PRP in the root cavity but if he removed part of the bone would he have still been able to use the PRP correctly? \n\nThanks for anyone who can comment on this. MattKW: Unfortunately we usually have to extract crappy teeth that are at risk of fracturing. This increases the risk of having to remove bone in order to get hold of the roots. Quite common. I'd prob do one a week. Not that I want to because it takes up more time, but because there's no other way to get it out. oceansmith: well, when you have to remove \"crappy\" teeth from a patients mouth by cutting away part of the jaw bone do you inform the patient? Isnt that part of informed consent? \nI thought most teeth were split anyways to allow for the tooth to be pulled at an angle out of the socket. \nI had called another dentist who does implants and I asked them about the same procedure that I had and they told me that they tried everything to make sure they preserved the bone. \nMaybe not all dentist have such a cavalier attitude about their patients. MattKW: Yes, it's informed consent and I always warn patients if I think there's the least chance of it becoming difficult and surgical. Unfortunately, it doesn't mean that there's always an easier way to take out some of these teeth; you make it sound as if there is always a choice. \nTeeth are not always split to be removed - that only applies for certain teeth in specific situations; I'd much rather get it all out in one piece. \nI certainly don't go looking to make it harder for me or the patient. I'm all for preserving bone WHERE POSSIBLE. And you misunderstand me, I'm not being cavalier, just practical, and endeavouring to answer your question. oceansmith: Well its good that you inform the patient. I wasnt informed. I was just put to sleep and it was cut out with some of my bone. \nMaybe the question should have been \"how many dentist dont tell their patients they are going to remove bone during a procedure?\" \nI didnt know that a dentist could not remove a tooth without having to cut out bone from my jaw. Makes you wonder how people have done it for eons before. MattKW: The mere fact you had to go to an oral surgeon is never a good sign; usually means it's likely to be a tough extraction.And \"in the good old days\", people simply suffered or died from infections." }, { "id": 371, "title": "Is this normal healing or should I be worried?", "dialogue": "ScottMalgieri: Hey all,\n\nI just got my wisdom teeth out 2/19/19 and I just want to make sure this is normal healing or know if I should be worried?" }, { "id": 372, "title": "Is it necessary to extract all 4 wisdom teeth?", "dialogue": "larryy: Hi Everyone. I recently went for a clean/check up and the dentist advised me that I should get all 4 wisdom teeth extracted. I had an X-ray scan done and would just like to hear some other opinions. The wisdom teeth are not causing me any pain or discomfort. Any advice would be greatly appreciated regarding the wisdom teeth and other teeth in general. Thank you all for reading. honestdoc: I always favor conservative, less traumatic options. As long as you aren't having pain and have no bone disease, gum disease, cavities, etc, and you are keeping them clean, I would leave them. Other dentists may choose to extract them to prevent future problems which maybe more popular. Keep in mind that any extraction/surgery run the risk of injury and trauma. Does the benefits outweigh the risks? MattKW: I would advise you to remove them, and if you look closely you'll also see a 5th wisdom tooth in the upper right corner of the Xray (upper left in your mouth). These teeth are never go to be of significant use, and it appears as if the lowers are partially covered by gum.\nHow can you maintain these plaque traps for the next 50 years? You don't want to be an elderly person with other health problems that make extractions difficult, e.g. osteoporosis, blood thinners, poor healing, ... Busybee: I can see the logic in wanting to do this when someone is young but I also had a school friend who died having their wisdom teeth out as a teen. Every surgical procedure carries a risk, leaving the teeth in the mouth also carries a risk. MattKW: Yes, logic drives the decision, and the logical decision points towards doing when younger. If we're trading anecdotes, I had a personal friend whose unerupted wisdom tooth developed a huge cyst and he had to have his right jaw resected at age 62. I have the Xrays. The risks are much, much less when you're younger. Busybee: I've been told by a dentist that there is greater risk of facial nerve damage if you have the extractions after the age of 30. Is that true and if so why? MattKW: Busybee said:\n\n\n\n\t\t\tI've been told by a dentist that there is greater risk of facial nerve damage if you have the extractions after the age of 30. Is that true and if so why?\n\t\t\nClick to expand...\n\n.\nThe factors that have been suggested to explain this situation are increased bone density, surgical difficulty, complete formation of the root and reduced capacity for subsequent healing. It's not just the paraesthesia but complications generally. Busybee: The NHS only removes them routinely if they are impacted or infected. A private dentist offered to remove mine at 25 but I was horrified. I only found out when it was too late that there are risks in extraction as you get older. They did cause problems with my bite and one is really difficult to clean because it's at an angle. I did have them sealed which has really helped. But it's a shame the NHS are not more open about the long term problems you can get by leaving them intact. By the time they grow people stop going to the dentist regularly as it's no longer free. MattKW: As I understand it, the NHS follows the NICE Guidelines which are quite conservative. It's also convenient for the NHS as it saves money (cynical). I have seen some literature which is wondering if there should be a rethink about the Guidelines. Oceansightdental: I agree with Dr. Matt. You absolutely need all of your wisdom teeth removed (all 5). The lower right one has a cyst. The lower left one has created substantial crowding issues. Once you remove the bottom two wisdom teeth, your upper wisdom will move downwards and create issues. The sooner you remove these problematic teeth, the easier it is to treat them. They'll start getting painful and infected within the next few years, but removing them when you're in pain is more challenging and not the correct approach. Any dentist that would advise you NOT to remove your wisdom teeth has not had enough experience with wisdom teeth and the consequence of ignoring them. Best of luck!\nAli Jazayeri DDS" }, { "id": 373, "title": "Extractions", "dialogue": "Zaia: Is it true that if a tooth that needs to be extracted was infected, the healing process from getting it pulled will be harder? There is barely any swelling and little to no pus MattKW: Not really. In most circumstances healing will be about the same. TALDDS: Depends on overall health status, in a healthy person the healing times will be the same. Add lets say, uncontrolled Diabetes the healing times will change dramatically MattKW: I haven't encountered anyone with uncontrolled diabetes. Certainly something to ask about, but most people are well aware of the importance of good control. TALDDS: Then you are lucky, I have had several with a sugar range from 6-700. Got them to them to the ER. I take blood sugar on certain patients prior to extractions. It has saved me from some bad potential outcomes" }, { "id": 374, "title": "Post Bone Graft Inner Lip Discoloration", "dialogue": "dianawayen: I'm getting ready to get an implant in the near future and a couple of days ago I had bone grafting done in one of the front teeth on the side and today I noticed my inner lip being way darker than the normal pink. Is this normal will it go away? I'm scared its something dangerous but then again maybe its normal after bone grafting? It's like dark red almost black color and it's only in the center of the inner lip on the top lip and it goes all the way to my gum area. Does anyone know what this is? Maybe it's stained blood but I don't think blood can stain that area TALDDS: Go in to your dentist, explain concerns, if he has any immediate thoughts they will photo document and compare over time. If No improvement presents then it will be biopsied. Nothing to be concerned with off the cuff." }, { "id": 375, "title": "Dry Socket?", "dialogue": "Doggydoo22: Hi everyone! First time poster. \n8 days ago I had all four wisdom teeth extracted. \nTeeth were feeling great, medication made me ill and I delt with a lot of stomach sickness and vomiting. Finally feeling better on Day 8 But i am checking after a gentle brush and I notice my gums look a bit strange.\nDoes this look like Dry Socket on one side? Or the beginning of it? Included both sides of my gums. \nThanks Doggy MattKW: Dry socket risk peaks at day 3 after extractions. You've got past that date OK, so now it's just slow, normal healing. You don't have to do anything special, just clean the area as best you can with toothbrush as per normal." }, { "id": 376, "title": "Behind gums", "dialogue": "aqz: Hi doc hope all is well just a quick question, this area on floor of mouth behind gums has felt slightly irritated for last few days. Ive noticed a tiny white spot is this something to be concerned about? honestdoc: It may be an accumulation of mucous in the saliva duct. Usually the floor of the mouth heals quickly after mild trauma and irritation. aqz: So is that an ulcer? Should it have healed by now? What should i do in meantime? \n\nThanks aqz: @honestdoc honestdoc: aqz said:\n\n\n\n\t\t\tSo is that an ulcer? Should it have healed by now? What should i do in meantime?\n\nThanks\n\t\t\nClick to expand...\n\nNo, it is not an ulcer. From this vantage point, I don't see anything unusual. Look and feel for any swelling. If no swelling, you are in the clear. aqz: Ok, it just feels slightly irritated but not really swollen as such. When i rub tongue in that area feels slightly more raised then other side is that a concern? Is it cancerous? aqz: @honestdoc i have been using difflam spray on a ulcer not far from this area could that be the cause? honestdoc: I don't know the answer to the difflam spray and the reason you feel raised in the area. You shouldn't be feeling much now. The floor of the mouth heals quickly. Don't irritate it." }, { "id": 377, "title": "Dry socket?", "dialogue": "thekermo: Hi all, my wife had a tooth removed yesterday and we are just coming up to the 24 hour mark .Pain is better today but she's terrified of developing dry socket. Try as we might we can't really see what the socket is supposed to look like at this stage of healing but it does look like all the images you can find of dry socket. Was just hoping for someone else's opinion. Thank you .\n\nPs, sorry for the quality of the image. Best I could do MattKW: That looks very good for 24 hours. A dry socket will not usually create problems until 72-96 hours post-op. You would develop severe pain, a nasty taste, and foul breath. It is rare to develop a dry socket for an upper extraction. thekermo: That's great, thank you so much" }, { "id": 378, "title": "Radiopacity in the left mandible", "dialogue": "Drmario240: Patient presents to office one year after third molar extractions. Patient presented for oral hygiene visit and bite wing x-rays. The bitewing X-rays reveal a radiopacity in area of 17. Looks fully integrated. How do you address situation. honestdoc: I may take a periapical image. If I'm sure it is fully integrated to bone (not in soft tissue) I would monitor it for any pathology. On this image, I'm not noticing any bone pathology so monitoring it would be the least traumatic. If I absolutely need to remove it, I may take a 3D CT image to gauge the proximity.\n\nI would inform the patient of this object in the bone and discuss treatment options such as monitoring it or removing it with the 3D CT imaging aid. MattKW: Yep, just locate it and monitor. From the radio-opacity and size, it's not metallic. I wonder if it was a DO composite from the 2nd molar that came free during the extraction? maybe we'll never know... Oceansightdental: It appears to be a broken extraction equipment, like an elevator tip, my guess is a broken root tip elevator. The OS should've discussed this with the patient. So long as it's not infected, it should qualify as a watch. Unlikely it ever will become infected since it's metallic object." }, { "id": 379, "title": "Seniors with Implants", "dialogue": "A FIELDS: I have upper dentures which fit horribly and I wear as little as possible. However, my concern now is my bottom front teeth which I know are going to have to be pulled. My question: What is the cost of dental implants. I was told that implants come in \"quarters\" and I was quoted $20K for (I guess) my whole mouth. I do want implants but at almost 77 years young, I don't want to empty my bank account for them. So, can you implant one or two teeth, or was I misinformed? Oceansightdental: Unfortunately, one or two implants can not handle your entire bite forces. If you want permanent teeth, a minimum of 4 dental implants is needed. This is called an all-on-4, and the cost is around 20k as you had mentioned. Less expensive options are overdentures, where your denture locks onto 2 or 4 implants. Now this is a removable option, but much more comfortable than dentures alone. Plus, overdentures are typically far less expensive, costing around 5 to 10k. Don't forget, 77 is the new 57, and investing a bit into more comfortable teeth is certainly worth it for most!" }, { "id": 380, "title": "misplaced implants?", "dialogue": "RebeccaNYC: I had two implants done (tooth no. 3 and 4) on 1/6/18, with sinus lift and bone grafting. Before the implants were put in, I had one tooth (no. 4, only the root remaining at the time) extracted in the same session. The other tooth had been missing for 3 or 4 years. The oral surgeon had one post in the hole where the root of no. 4 just came out. No. 4 was angled. The end result is the two posts are close to each other and close to the neighboring molar, but further from the much smaller premolar. The two posts are straight, parallel to each other. My concern is if the crowns are put on (if there's a way to make that happen), they won't be centered on the posts. Also note that no. 3 is much larger than no. 4. So even if they manage to put the crowns on, it won't last (I assume), because the crowns would be imbalanced on the posts. I'm attaching the x-ray here (showing teeth no.2 to no. 5 from left to right). It doesn't seem there's enough space for the crown for no. 3, and the post for no. 4 would be outside of its crown area. Is this a bad enough job that needs to be undone, or should I go ahead with the abutments and crowns? I will greatly appreciate your thoughts and insights. Thanks a lot! Oceansightdental: Your implants look very nice, don't be worried. The fact that the implants aren't perfectly centered is not an issue and corrected at the time of restoration. Generally, 1-2 mm deviation is not an issue and your restorative dentist will correct this deviation later. Your crowns will work out just fine and last a long time. So long as the implants are not moving or infected, you should be in good shape!" }, { "id": 381, "title": "Is this dry socket?", "dialogue": "meepermeep: The stitch from one of my wisom teeth came out yesterday and now this is here. It does hurts a little but it's not bad enough for me to need pain meds and there's no bad breath or bad taste in my mouth. Is it dry socket? honestdoc: No, dry socket would become very painful for the bone underneath is exposed. Minimize disturbance in the area and allow it to heal. If pain worsens and or you experience swelling, get followup evaluation. Oceansightdental: Dry socket means very slow healing. If your pain is minimal and the area is filling up with bone/gums, etc. then you are good and don't suffer from dry socket. Rinse, keep the area clean and follow your PO instructions and you'll heal in no time." }, { "id": 382, "title": "Is it necessary to extract my tooth and get an implant?", "dialogue": "larryy: Good afternoon everyone,\n\nAbout 10 years ago, I had a large cavity on my upper left 6th tooth. I got treatment on one of the roots and had a silver crown inserted. For the last few months, I've had a bit of pus discharge from the gum above the upper left 6th tooth. I went to the dentist recently and was prescribed antibiotics for the infection. I also had scans taken and the dentist advised me that the upper left 6th tooth and roots need to be completely extracted and that I need an implant. I have no pain in the tooth and I am scared of having this procedure done.\n\nCould you please kindly have a look at the attached x-ray scans and provide your independent opinion on this matter.\n\nThank you very much. honestdoc: UL 6th tooth (in the US, the tooth is labeled #14) does have extensive damage and missed 2 (Mesial buccal and MB2) canals. The tooth does need to be extracted because it is a source for infection and contamination.\n\nThe extraction process for this case is not bad. Since there is already an infection, the bone around is softer and less prohibitive to remove the tooth (the body wants to get rid of any infected material). The tooth will come out in pieces so don't let that scare you. \n\nYou may not need an implant. Implants are expensive and are just elective. I think leaving the space is realistic. Back teeth will shift (tip) forward and the opposing tooth will erupt up. However, judging from the upside down bitewing x-ray, your bottom opposing tooth will not hyper-erupt due to opposing the tooth in front and the upper back tooth should minimally tip. As long as you are functioning without difficulties, you may not need an implant.\n\nIf you desire an implant for certain, I recommend placing bone graft immediately after tooth extraction to strengthen and prepare for future implant. You may also need sinus lift surgery to accommodate an implant. MattKW: Extract it because even though the RCT could be redone, it has a poor crown on it that would need replacement too. Have to disagree about leaving a gap. Tilted teeth create cleaning problems. If you want to leave the gap, then I would suggest extracting the wisdom tooth to minimise risk of 2nd molar tilting over. Aim for implant in long term, but don't let whoever did the RCT or crown anywhere near this. honestdoc: Leaving a gap is what most of my patients could only afford. I live in an expensive state and most of my patients are poor and put almost all of their money into housing/rent much less into dental prosthetics like implants. I have no opinion with removing the wisdom tooth to minimize #15 tipping. However I always prefer the least traumatic plan. I do agree that tipped molars create undercuts for food trap but I observe many patients adapt...they don't have much choice. MattKW: True enough, we don't all have choices we'd like. Oceansightdental: That tooth is very infected and needs to be removed ASAP. Additionally, the tooth is right on the sinus so most likely it is draining into your sinus cavity and causing a widespread infection. Start off by taking a few days of antibiotics, Augmentin or at least Amoxicillin, and remove the tooth and place bone graft to close the space. If you can afford an implant great, but at a minimum you should remove the infected tooth to prevent infection from spreading to the rest of your body." }, { "id": 383, "title": "I am so worried about this implant", "dialogue": "pava: It was placed next to my natural tooth but seems so close. I can barely fit my fingernail between them.\nI wonder how will it be possible to place a crown on it? And wouldn't the implanting dentist see straight away that it's too close? The procedure was done three weeks ago. \n\n I am attaching a photo. It shows the implant in my right side of the upper jaw. (The photo is not very good as it looks like there IS a small gap, which is not the case)\n\nMay I please get some information. Thank you honestdoc: It is hard to give you a definitive answer but the healing cap is covering the implant leading you to think that it is so close to the adjacent tooth. The implant crown will be made by expert technicians who will accommodate the minimal space. pava: Thank you so much Honestdoc. I read your response straight away because I was so anxious but didn't have time to thank you. I am so grateful to you, you saved me from sleepless nights. jc1199: pava said:\n\n\n\n\t\t\tThank you so much Honestdoc. I read your response straight away because I was so anxious but didn't have time to thank you. I am so grateful to you, you saved me from sleepless nights.\n\t\t\nClick to expand...\n\nPava, How much did the implant cost? pava: jc1199 said:\n\n\n\n\t\t\tPava, How much did the implant cost?\n\t\t\nClick to expand...\n\nMy apologies, just noticed this message.\nI am not sure as a family member paid. Oceansightdental: Your implant looks good. What you are seeing is the healing cap not the dental implant. Plus, a dental implant needs to be only 1.5 mm away from a natural tooth for it to succeed. If you are not having pain or feeling looseness, you are good my friend. Your dentist and lab technician will address the spacing and give you a beautiful crown once the implant has healed." }, { "id": 384, "title": "Found a white spot on xray", "dialogue": "cyman26: I'm 35 decently healthy. Went in for a filling and dentist found a white spot in my lower jaw with a grey ring around it. Not going to lie I'm pretty freaked it is cancer bc I have four kids. Anyone know the statistics of it actually being cancer? Doesn't hurt at all nor can you see it without an xray.\n\nThank you! honestdoc: Please provide an image. Cancer in the mouth statistically are low compared to benign lesions. \"When you hear hoof beats, think horses not zebras.\" Zebras would be more like cancer and horses are more common and benign. White spots in the jaws are usually not as scary as black spots. White spots depict denser mineral aggregates where black spots are typically hollow, infection, loss of bone material. My differential guesses (without an image) are odontoma, saliva duct stone, retained root from baby tooth, sclerotic bone, normal bone trabeculae, or restoration debris. Do you use tobacco, drink heavily, or have family history? The only way to know if it is cancer is to remove it (biopsy) and check it under a microscope. Removing it can be traumatic so only the high risk lesions should be considered. cyman26: I didn't get a copy of X-ray unfortunately. I have never smoked a day in my life and rarely drink.thank you for your input!" }, { "id": 385, "title": "Dry Socket?", "dialogue": "Solidworks400: Had a front canine pulled two and a half days ago. Extraction site looks kind of funny. Is this a developing dry socket? Very minimal pain in that area. Any thoughts on this photo? MattKW: Looks good. If you get a dry socket, it will occur 3-4 days post-op with really bad pain. You're almost past that point. It is rare to get dry sockets in upper extractions." }, { "id": 386, "title": "Lingual alveolar fracture", "dialogue": "AndrewMr: Can anyone tell me about these? Symptoms ? Diagnosing ? Treatment ? Potential problems and symptoms if left untreated and anything else that might have relevance? MattKW: Insufficient information about the procedure etc. AndrewMr: MattKW said:\n\n\n\n\t\t\tInsufficient information about the procedure etc.\n\t\t\nClick to expand...\n\nI started having problems last winter with my #10 tooth. It was causing me incredible pain in turn causing me to seek treatment. I went to a local dentist who told me that it was fine and looked good, after a few additional visits for some other work I decided to get a root canal treatment done. After successfully completing the procedure the pain from my tooth had not subsided. I finished my remaining treatments and sought a 2nd opinion. New Dr. gives me the same prognosis, and over the course of a few more visits I was provided with a nighttime mouth guard and advised that if it wasn't from grinding then it was neuropathic and not much can be done if that was the case. Well I wore the guard that night, woke up and took it off and my teeth were in even more pain than pre-mouthguard days. A couple days later the pain in my mouth had only gotten worse so I got in my car and drove to the dentist's office where upon examining my xrays he concluded I have a \" possible lingual alveolar fracture.\" I'm curious as to why that wasn't ruled out based on my initial complaint. Were they being negligent or ?... MattKW: Tooth #10 is the upper left lateral incisor (2nd from front); please correct me if I'm wrong.\nA lingual alveolar fracture means that the bone on the inner side has broken, and you'd need a good blow for that to happen; your tooth would be at the back of your throat. \nCan you get a copy of the finished Xray of this tooth to put up here?" }, { "id": 387, "title": "tooth extraction", "dialogue": "user1515: hi, my local dentist has taken out two teeth , on my top row , one on each side , tooth 5 to be exact , so i can have space for my braces but i its been 32 hours since the extraction and the area of the missing teeth is a very dark colour . almost black ? is this normal? advice ? honestdoc: This looks normal. It is good to have blood clotting which seals and reforms the extraction site. If you have dry socket (exposed bony socket) and or swelling around the area then get followup by your dentist." }, { "id": 388, "title": "Lingual Gum Graft--How to do it right", "dialogue": "dtatum: How to Get Your Periodontist to do a Successful Behind the Teeth (lingual) Gum Graft\n\n\n\n Gum grafts done on your interior gums (lingual) are notoriously difficult to do, primarily due to the motion of the tongue dislodging the delicate gum graft. Having had two relatively unsuccessful lingual gum grafts done just behind by lower front teeth (lateral incisors), I wanted to try something different. At $2,000 per attempt paid out of pocket, I had strong motivation to try something new. \n\nMy periodontist (Dr. Soolari) had previously done four different totally successful gum grafts on my exterior gums demonstrating a high level of skill and a mastery of his profession; although he did say numerous times that I was an excellent patient (excellent I guess means strictly adhering to the post-surgery protocol). Since I knew Dr. Soolari was properly doing the lingual gum graft surgeries correctly, and I knew that I was a good patient, I thought an idea that I had just might work.\n\n In January of 2017 I proposed to my periodontist that he make a relative cheap plastic night guard that would firmly attach to the teeth but would deliberately leave space to completely cover my next lingual gum graft. My thought was that despite very careful daytime management of my tongue while awake (no talking, liquid diet) my tongue was dislodging the graft at night while I was asleep. He agreed to try it.\n\n Making the custom post-surgery night guard was clearly a first time thing for his office. After making a mold of my lower jaw and despite my repeated instructions for a specialized post-surgical night guard, the office staff produced a rugged rigid standard night guard that only fit on the tops of the teeth to prevent teeth grinding at night (I already had one of those). With the surgery only days away, my periodontist managed to make a cheap plastic flexible night guard that covered the lower interior teeth, and some of the gum. When I saw it, it didn’t look like it would cover all of the upcoming surgical area but Dr. Soolari assured me that it would. Otherwise, the thin, flexible, lightweight, clear plastic night guard was just what I had envisioned.\n\n On the day of the surgery (April 22, 2017), after the procedure, he carefully put on the custom night guard and it covered most of the surgical area but not all, which turned out to be good enough much to my relief two weeks later when the night guard came off and the numerous stitches came out.\n\n The results were, quantity wise, absolutely stunning. The amount of new gum was between 10 and 15 times greater than what had adhered on either of the prior two largely unsuccessful lingual grafts. The night guard seemed to both protect the surgical site AND gently apply pressure to the gum graft itself which no doubt helped more of the rather large piece of tissue ‘stick’ to the target site.\n\n So if you have an upcoming gum graft on your interior gums, insist on an inexpensive custom night guard to totally cover the surgical area in order to protect the site from the tongue’s movements while you are asleep. To be extra safe (as I did), wear the night guard 24 hours a day (except for cleaning) and go to a liquid diet only for the first seven days, then only very soft food for day 8-14. The less you talk the better. Finding a periodontist as good as Dr. Soolari won’t hurt either!\n\n Having done some research on the use of antibiotics, infection, and dental surgery, I decided to go against doctor’s orders and not take an antibiotic during or after my surgery. I had, as usual, no swelling at all and very little post-surgical pain and absolutely no infection. Antibiotics kill off most of the beneficial bacteria in your body, and more diseases are being traced to inadequate gut bacteria, so using antibiotics is something I don’t like to do unless there is no other alternative.\n\n If the custom night guard covers too much of your exterior lower gums, it may produce uncomfortable pressure. The solution is to take a sharp knife or scissors and make a small cut in the center where it covers the exterior gums; that will significantly relieve the pressure on your gums.\n\n\n\nKey Search Terms: gum graft, lingual, interior gums, custom night guard, antibiotics, gut bacteria, dental surgery." }, { "id": 389, "title": "5. If a patient has a perceived or overtly shared drug abuse problem then how do you manage this si", "dialogue": "ngheibid: I'm in dental school and need to complete an assignment by interviewing a dentist. \nAnyone interesting in answering 5 questions about their personal practice?\n\nIt would be greatly appreciated!\n\n\n1. How do you manage acute pain?\n\n2. Do you prescribe opioids and if so what guidelines do you yourself follow in administering them? Dosing, numbers prescribed and recall interval are all possible follow up issues.\n\n3. Do you screen for substance abuse? If so, how? Do you use any screening tools (written or verbally; CAGE-AID)?\n\n4. What do you say and how do you say it in learning about any possible abuse? Verbal and nonverbal communication included.\n\n5. If a patient has a perceived or overtly shared drug abuse problem then how do you manage this situation? Advise? Assisting? Referral?" }, { "id": 390, "title": "Left neck/ear lymph node swollen since feb 2018. Did food trap cause this?", "dialogue": "rjeoifir: Going to see doctor to check the lymph node. The swelling stays same, 1-2 cm.\n\nSorry about this weird question.\n\nIn Feb, I removed my lower impacted left wisdom tooth. When I tried to take care of the socket after surgery,\nI was not very careful. Some oatmeal grains stuck into the hole.\nI tried to rinse with water, used tweezer to pick up the grains, but I was not sure if it was all cleaned.\nI felt some stuck deeper inside and could not pick up anymore.\n\nAfter few months, the gum closed and now it looks like there was no tooth before.\n\nIs it possible that the hole can close, looks normal from outside, but still has a few grains trapped inside?\n\nMy gum looks good. \n\nIf the cause of my infection is food trap inside, maybe I will need another surgery to remove them.\n\nThis is the x-ray picture taken in Aug. Can x ray show food trap?\n\nWhat can I do to make sure that there was no food left inside?\n\nThank you very much! honestdoc: You mouth is very efficient at rejecting unwanted contaminants. If you get food stuck in the extraction site, the soluble food will break down and exfoliate naturally. Obviously larger insoluble debris will traumatize the healing process. You will never have your gums close over any contaminants without swelling and/or irritation." }, { "id": 391, "title": "3 months of dental drama", "dialogue": "magicman81: Hello everyone. I am new here but wanted to post a question. I had a dental infection 4 months ago. I didn't know it. I had a filling on tooth #4 3 months ago. The sensitivity never went away after and the dentist told me not to worry about it. Then 10 weeks ago I found a painful lump (gum boil/abscess) in my gum that shot pain to the root tip. I was given 16 days of 500 mg keflex 4x per day.\n\n\n\nFast forward. An attempted root canal 14 weeks ago turned into a broken tool in my root. Which turned into an extraction. I had very firm thick roots. The dentist said it was the toughest extraction he has ever done out of 6000. Almost the whole tooth came out with a crunch though they did have to dig out one root tip. The dentist said to get ready for pain. And pain it was. For two weeks excruciating pain. Checked multiple times, no infection was visible. It seemed to be healing normally. \n\n\n\n4 weeks post extraction and it was still hurting. Very painful to push in the gums toward the front of my mouth in my gun line. Went back to the dentist. He said we was almost positive my buccal bone was fractured when the tooth came out because of how it came out. He said it could hurt for 6 to 8 weeks. No imaging was performed. \n\n\n\n6 weeks post op and it is still very painful to push on though fine otherwise. The actual extraction site didn't hurt. When I pushed on the front of the gum line where the tooth extracted it is very sensitive and painful. \n\n\n\nAfter this (5 weeks ago) I went to another dentist for a second opinion... He did a 360 degree x ray and found a piece of infected root tip. It was extracted almost 4 weeks ago. It was very swollen and painful when he extracted, and some pus came out. He cleaned it out. Since then it has stopped throbbing. However now even with slight pressure on the inferior gum of the tooth adjacent to it there is intense pain. It only hurts when I push on the inferior gum. The dentist did say a lot of gum tissue was moved around. But should it still be hurting that badly to slight pressure on the gums? Any advice is helpful. Thanks. Busybee: Magicman that sounds awful. You lost a tooth due to negligence and then it wasn't even extracted without failing to do that properly. \n\nI know it's too late for that tooth, but for future reference never let a general dentist perform a root treatment. Always go to a specialist endodontist. They do this every day and they have all the tools and equipment but most of all the experience of dealing with so many different situations. On top of this it's best to go to a specialist oral surgeon for extractions of large molars and in particular wisdom teeth. I know dentists do this and some are very good but some aren't that experienced these days because they rarely need to take teeth out compared to the bad old days. \n\nI'm sure what you have had done will take some time to settle down but you should go to a specialist oral surgeon for an opinion on why you are still in so much pain and just to check that a nerve wasn't damaged. \n\nI hope you feel better soon. magicman81: Busybee said:\n\n\n\n\t\t\tMagicman that sounds awful. You lost a tooth due to negligence and then it wasn't even extracted without failing to do that properly. \n\nI know it's too late for that tooth, but for future reference never let a general dentist perform a root treatment. Always go to a specialist endodontist. They do this every day and they have all the tools and equipment but most of all the experience of dealing with so many different situations. On top of this it's best to go to a specialist oral surgeon for extractions of large molars and in particular wisdom teeth. I know dentists do this and some are very good but some aren't that experienced these days because they rarely need to take teeth out compared to the bad old days. \n\nI'm sure what you have had done will take some time to settle down but you should go to a specialist oral surgeon for an opinion on why you are still in so much pain and just to check that a nerve wasn't damaged. \n\nI hope you feel better soon.\n\t\t\nClick to expand...\n\n\nThanks so much! Funny enough the root canal that failed was performed by an endontist. He said that the root was very curvy and the tool just broke.\n\nI plan on going to an oral surgeon for any further extractions. My dentist told me to give my current situation another week or two. That said if it continues or gets worse I will go in immediately. I am just frustrated and am ready to be out of pain. Thanks so much for the reply. Busybee: Well best of luck. I do hope you are out of pain soon. I have only had teeth extracted as a child but I do remember that you can get \"ghost pain\" for years or weird sensations in the gum. Even now flossing it feels a little tickly compared to the other gums. Yours is so recent. Maybe give it time and see if it settles." }, { "id": 392, "title": "Does this look infected? 48hrs after extraction of 4 wisdom teeth.", "dialogue": "Sabrinnaxx123: I got all 4 of my wisdom teeth out my left side of my mouth is a little sore but my right side is deff more painful but not unbearable does it look infected? honestdoc: From the limited view of the image, the extraction sites look good. As long as you are not experiencing any swelling, just let it heal. Lower wisdom teeth are more traumatic to remove. You should consider removing your tongue ring (at least before bedtime) because it can damage your teeth and gums. Sabrinnaxx123: Okay good I didn’t know is the white stuff was normal or not honestdoc: White stuff is good. It is the epithelial healing tissue." }, { "id": 393, "title": "Should i worry?", "dialogue": "aqz: Hi doc, \nIve had this lesion for over 6 months as far as i have been aware. Its not painful and does not bother me. I do get geographic tongue that can get irritated from time to time. Ive have anxiety over this but however have been overcoming it. And now its just on my mind again. It hasnt grown in size and is the same as when i first noticed it over 6 months ago. I have been to few dentists and my gp whom dont seem concerned and said its prib due to me smoking. Also i have alopecia so doc said it could be lichen as that is also an auto immune response. I also had mild crohns few years ago which has now gone. So we dont know why i had inflammation in the intestines. Sorry to go on, i hope you can put my mind at some sort of ease. I am a panicky person when it comes to health, which means i will always think the worst. Look forward to a response. \n\nKind regards honestdoc: If it is there for more than 6 months and numerous dentists and your gp checked it, I'm also suspecting it is autoimmune response. Have your dentist/GP prescribe you Triamcinolone in Dental Paste and check to see if any improvements occur. In the meantime, please consider quitting smoking because it increases your risk of mouth cancer.\n\nSomething is causing an autoimmune response. Are you using anything irritating like different toothpaste, mouth rinses, herbal supplements, new medications, spices, and/or cinnamon products? aqz: @honestdoc Thank you so much for your response. No i havnt been recommended anything to use on it as it is not painful and does not bother me. But when i wake up the area is always covered in whitish coating which then rubs off after eating etc.. The fact that i learned to forget checking it for 6 months and it still the same does it indicate something serious? I do eat spicy foods etc and my diet is not the best. I am a very anxious and stressful person. I am going through alopecia at the moment which i believe is also a auto immune response. I am scared of going back to docs as i assume i will hear the worst now. I have a sensitive mouth which gets irritated but nothing i cant handle. honestdoc: Triamcinolone (in Dental Paste) is a corticosteroid which suppresses the autoimmune's destructive response. However, you indicated that you get a whitish coat which rubs off. Have it checked to make sure it is not a fungal infection (don't use the paste on fungal infections, it makes the area worse). aqz: @honestdoc ok but if it was fungal can it still be there after 6 months? I do get geographical tongue area which can go white time to time. Also i would like to add i have a deviated septum so sleep with mouth opened hence wake up with dry mouth/tongue. aqz: This is how it looks at the moment so its does improve slightly and the worsens etc. honestdoc: I think it is a fungal infection. You must have some immune compromised condition(s). Do you have diabetes as well? Are you taking certain medications? aqz: @honestdoc. So a fungal infection can linger for this long? No i dont have diabetes as far as i am aware and not on any medications. I was on pentasa for when they thought i had crohns disease. Im really worried to go back to docs/dentist, i fear i will be told its oral cancer... honestdoc: I don't think you have cancer. I believe you have an immune system imbalance. It can damage your body if you don't address it. Also stop smoking and try to live a healthier lifestyle. aqz: @honestdoc ok thanks for your advice. Do you suggest a biopsy? honestdoc: That may be at last resort to minimize trauma of removing the lesion. Try to treat the lesion first (get your doctor/dentist evaluation). aqz: Ok in your opinion how would you treat it qt first? aqz: @honestdoc honestdoc: Have your dentist prescribe you oral topical antifungals like Nystatin or azoles. Hopefully the lesion will respond within 2 weeks. Have your medical physician manage and control your Crohn's and other conditions because fungal infection can return. If the lesion does not get smaller, have it removed...most likely it is not cancerous.\n\nIf you continue to smoke, that lesion could get irritated and develop into a reactionary precancerous tissue. aqz: @honestdoc thanks for your advice much appreciated. Also can i ask how long you have been a dentist and which country you based in? honestdoc: I have been a dentist for over 20 yrs in the US. I'm in the beautiful Pacific NW. aqz: @honestdoc great! Just another question if this was cancer would there have been significant change in 6 months of it being untreated? honestdoc: Many cancers can get bigger in 6 mos. Some grow very slow and you won't notice the difference. In the study of pathology, when you hear hoof beats think horses not zebras (cancer is a zebra). Again, have the lesion treated and if it doesn't respond in ~2 to 4 wks, biopsy it. aqz: Hi what do you mean by hoof beats? @honestdoc honestdoc: It's just a saying that when you hear a bunch of horses running (hoof beats) you think the noise is from horses not from Zebras (not likely Zebras are in North America). When dentists evaluate lesions in the mouth, we think of the most likely reasons for the lesions (horses causing the hoof beats not zebras)." }, { "id": 394, "title": "White stuff on gum after dental extraction.", "dialogue": "Nisha: Is it normal to have white stuff on my gums after i had a surgical extraction? Or is it a sign of infection? honestdoc: The \"white stuff\" on you gums after surgery is epithelial repairing tissue. An easy sign of infection is swelling and sometimes fever. Nisha: honestdoc said:\n\n\n\n\t\t\tThe \"white stuff\" on you gums after surgery is epithelial repairing tissue. An easy sign of infection is swelling and sometimes fever.\n\t\t\nClick to expand...\n\nAhhh.. Thank you for clearing my doubts!" }, { "id": 395, "title": "Is this normal pain? Please help", "dialogue": "mineladivovic: Hello, I recently took out my bottom left wisdom tooth and the tooth right next to it. I got disolvable stitches, today is the 5th day since tje oral surgery. I have been taking Paracetamol 2x 500mg and Ibuprofen 400mg. \nYet, I am still having pain is this normal? There is no puss coming out of my gums, it looks a bit swollen but it is not red.\nWhen the doctor took out the molar, he did indicate there was an infection, which he then cleaned and sewed it up.\n\nIs the pain normal? I have attached a picture as well. Should I seek medical attention?\nPlease let me know. honestdoc: The extraction site looks good as long as you are not experiencing swelling. Lower teeth can be more traumatic to remove and can require more recovery efforts. If you do have swelling, seek followup. mineladivovic: @honestdoc thank you so much for your reply. What can you recommend for the pain? Like I have said I have used: paracetamol, ibuprofen and Codeine. What pain killer do you recommend. \n\nThank you in advance! honestdoc: You can use acetaminophen (paracetamol) 500 mg with 600 mg ibuprofen. Don't use too much acetaminophen due to liver toxicity, and take after meals with ibuprofen's toxicity to stomach and GI tract. If the pain keeps you up at night, you may need your dentist to prescribe you narcotics like hydrocodone 5 mg (usually comes with 325 mg acetaminophen) or even oxycodone 5 mg. mineladivovic: @honestdoc thank you so much for your advice, I highly appreciate it!\nAll the best to you doc!" }, { "id": 396, "title": "Post Bone Graft Question - night guard vs Essix temporary?", "dialogue": "jdanham: I had one of my upper front teeth extracted yesterday. The surgeon said there was zero bone to work with for the implant post, so he performed a bone graft. My dentist asked me to bring my latest impressions from February (used for my night guard) so they could create the temporary (Essix?) appliance before the surgery. After the procedure was completed they put in the new appliance with the temporary tooth. Immediately it felt wrong. The rear bite alignment was not comfortable and I said so, but they just said thats the way it works????\nSo being a Friday I can't really reach out to anyone for some feedback and suggestions except here. When I asked them about the need to keep the temporary in, they said it's really only needed for when I am out in public and that I can remove it at home. \nProblem for me is that with it removed I have a tendency to feel things with my tongue and the appliance, though uncomfortable, prevents me from doing anything stupid to the bone graft and surgical area. \nI am afraid to use my normal night guard (which fits perfectly) because I think it may damage the gum near the sutures, and I am also afraid that when I remove it in the morning the suction might dislodge or otherwise damage the bone graft. If the post op rules say no straws then this would definitely be as strong or stronger than sucking on a straw.\n\nIf I keep the temporary on even eating soft foods is not pleasant because of the bite alignment.\n\nI am otherwise following the rules and will be able to use salt water rinse later this evening and then the other prescribed rinse on Sunday. \n\nIn the meantime, should I avoid using the night guard? I had the temp in last night and my jaw was sore but otherwise ok. \n\nHope that I can get some feedback today, thanks for listening honestdoc: Do what you can to minimize disturbing the bone graft site. When your dental team is available, have them adjust your appliance to fit more comfortably. Once the site is healing and the sutures have resorbed/removed, I believe you can wear your night guard. MattKW: You should be OK to wear your night guard because this should not impinge on the graft site. Any suction should also have no bearing - you can't suck out something unless you can get air under it." }, { "id": 397, "title": "Pain Management", "dialogue": "Highdesert: Hi, I'm new here and I am wondering about the policy of not giving pain meds. I understand that Motrin and other NSAIDs work well for pain, but I am allergic to them; they make my bronchial tubes close. I need extensive restoration work and have undergone two procedures this past two months, that have been horrifyingly painful afterward. I have osteoarthritis in my back, with some slippage; which is basically a big spider of spurs in my lower back and I take a minimal dosage of pain meds daily. My dosage is on the low end and does not cover pain from a large molar removal and a bone graft.\n\nThe Dentist told me to take an extra pill, but I don't get extra pills; there are two a day and that's it. Then the Dentist told me to take Tylenol, which doesn't really work and at that level would put me over the amount that would be bad for my liver. I just spent the last week in terrible pain at night from my jaw and I can't do this over and over to get my teeth restored. My front teeth need root canals and I would rather just get implants, but I'm starting to panic that I will have to keep going through terrible pain.\n\nI don't know what to do. I don't want to go to another Country to get my teeth fixed, but it's starting to look like that's my only option. What has happened to Dentistry in this Country? We have the newest wonderful procedures to restore teeth, but the opioid epidemic has made the Dentists into barbarians!\n\nI just have to ask, if the Medical Community is so worried about addiction, then why don't they treat Addicts? Our Addicts are banished to the streets; to buy unsafe street drugs and become a pestilence to their communities. Our Schools push Ritalin (meth) on our grade school kids, with nothing said about what happens to these kids, when they get into their twenties. I see so many young people on the streets begging and wonder if they were drugged during their school years. Yet, the push to save Addicts is the harsh clampdown on Chronic Pain Patients, who are going through some of the toughest times imaginable right now; cancer patients and elderly not exempted.\n\nWhat really puts me over the top, though, is looking up the PERS system investments and seeing that the Legislators making these laws on our pain meds have their retirement accounts firmly in these companies making the new patented opioid drugs. They are getting rid of the old drugs that people and government entities can afford, for new drugs which will make everyone money. It's an ugly accusation and I hate making it, but there it is and I still don't know how I'm going to be able to get my teeth fixed. How can this be happening in our Country? MattKW: If you go to another country, are you hoping they'll prescribe opioids because you can't tolerate ibuprofen or acetaminophen? \n\nHas your bronchial reaction (not an allergy) to NSAIDs been diagnosed by a respiratory physician? Here's a useful and commonsense article.\n\nDo you have a liver condition that stops you taking acetaminophen (Tylenol)?\nHave you considered a selective COX-2 inhibitor?\nI suggest you go have a talk to your doctor. Highdesert: MattKW said:\n\n\n\n\nIf you go to another country, are you hoping they'll prescribe opioids because you can't tolerate ibuprofen or acetaminophen? \n\nHas your bronchial reaction (not an allergy) to NSAIDs been diagnosed by a respiratory physician? Here's a useful and commonsense article.\n\nDo you have a liver condition that stops you taking acetaminophen (Tylenol)?\nHave you considered a selective COX-2 inhibitor?\nI suggest you go have a talk to your doctor.\n\t\t\nClick to expand...\n\n\n\nHi Matt,\n\n1. Yes, some minimal pain relief would be nice. I keep my dosage low on opioids, because I don't want to build up a resistance, but when the pain is screaming I do need some relief. The Dentists I've seen have had such an attitude, it's not worth even discussing it with them. Besides, my back pills are prescribed for my back, not for Dental work.\n\n2. I discovered my allergy to NSAIDs, after I ended up in the ER. I never had those problems before I was exposed to black mold. I have asthma from the black mold and I take Symbicort.\n\n3. No, I believe my liver is good, I'm pretty healthy, other than my back (and a few other problems), but I'm already taking tylenol in my daily dosage of pain meds. Tylenol really doesn't work for that kind of pain. I would be fine with taking NSAIDs, because I think the anti-inflammatory part does play a key role, but again, I get a severe asthma attack going when I take them.\n\n4. No, I've not looked into a selective Cox-2 inhibitor, I was under the impression that they are closely related to the NSAIDs. I will do some more research on those. I don't have health insurance, so I am on my own on a lot of this problem.\n\nI've spoken to my doctor about it and he sympathizes, but I've never asked him to increase my dosage. Thank you for that suggestion, maybe I can find a dentist who could coordinate with my doctor, though I'm afraid to call around without getting branded a pill seeker. Chronic pain patients shouldn't be treated this way, we are fighting to live and most are responsible with their medications. I appreciate your reply and thank you again. MattKW: OK, best of luck. With regards to the COX-2 inhibitors, there are some that cross over to the NSAID realm. I had a conversation with a pharmaceutical advisor recently re diclofenac (Voltaren), and this will prob help you understand how it relates to your condition. sekagirl: Highdesert said:\n\n\n\n\t\t\tHi, I'm new here and I am wondering about the policy of not giving pain meds. I understand that Motrin and other NSAIDs work well for pain, but I am allergic to them; they make my bronchial tubes close. I need extensive restoration work and have undergone two procedures this past two months, that have been horrifyingly painful afterward. I have osteoarthritis in my back, with some slippage; which is basically a big spider of spurs in my lower back and I take a minimal dosage of pain meds daily. My dosage is on the low end and does not cover pain from a large molar removal and a bone graft.\n\nThe Dentist told me to take an extra pill, but I don't get extra pills; there are two a day and that's it. Then the Dentist told me to take Tylenol, which doesn't really work and at that level would put me over the amount that would be bad for my liver. I just spent the last week in terrible pain at night from my jaw and I can't do this over and over to get my teeth restored. My front teeth need root canals and I would rather just get implants, but I'm starting to panic that I will have to keep going through terrible pain.\n\nI don't know what to do. I don't want to go to another Country to get my teeth fixed, but it's starting to look like that's my only option. What has happened to Dentistry in this Country? We have the newest wonderful procedures to restore teeth, but the opioid epidemic has made the Dentists into barbarians!\n\nI just have to ask, if the Medical Community is so worried about addiction, then why don't they treat Addicts? Our Addicts are banished to the streets; to buy unsafe street drugs and become a pestilence to their communities. Our Schools push Ritalin (meth) on our grade school kids, with nothing said about what happens to these kids, when they get into their twenties. I see so many young people on the streets begging and wonder if they were drugged during their school years. Yet, the push to save Addicts is the harsh clampdown on Chronic Pain Patients, who are going through some of the toughest times imaginable right now; cancer patients and elderly not exempted.\n\nWhat really puts me over the top, though, is looking up the PERS system investments and seeing that the Legislators making these laws on our pain meds have their retirement accounts firmly in these companies making the new patented opioid drugs. They are getting rid of the old drugs that people and government entities can afford, for new drugs which will make everyone money. It's an ugly accusation and I hate making it, but there it is and I still don't know how I'm going to be able to get my teeth fixed. How can this be happening in our Country?\n\t\t\nClick to expand... sekagirl: wow!!!! in january 2018 I survived a tramatic tooth \"extraction\" the dentist that did this act of butchery REFUSED to provide me with any sort of rx pain med I too am VERY ALLERGIC to all NSAIDS the dentist refused to refer me to any other dental practioner I was informed to take benadryl with the motrin , well I ended up in the emergency room in dire straits. I will NEVER returned to the dentist that butchered my mouth. In fact my family suggested to go to oral surgeon, which I did with much anxiety. so six thousand dollars out of pocket later I am on the way to heal up receive competent dental care" }, { "id": 398, "title": "Extractions due ..anxiety about bleeding", "dialogue": "tonyinhampshire: I'm due to have one upper back old crowned tooth removed plus a lower back tooth which is broken at base...the hospital surgery is doing extraction as local dentist feels its best. I have abnormal arteries/capillaries in upper gum, area and face, but the specialist said the MRI showed the location of capillary away from the extraction site...im anxious about this because I fear massive bleeding. Is this a usual fear. Any suggestion please..Thankyou. MattKW: What is the name of your condition, please? Am I correct in understanding you have normal coagulations, but that you have an arteriovenous malformation (AVM) of the face? tonyinhampshire: MattKW said:\n\n\n\n\t\t\tWhat is the name of your condition, please? Am I correct in understanding you have normal coagulations, but that you have an arteriovenous malformation (AVM) of the face?\n\t\t\nClick to expand...\n\nyes thats correct. Maxiofacial specialist performed a MRI.to get pictures.of arteries, etc. He indicated that the scan projects the formation away.from.the extraction zone. I have a birth mark or port wine stain on same side....thanks for replying. honestdoc: You will be in the best hands. The surgeon will have experience and equipment controlling your bleeding. In a hospital setting, you will have access to blood transfusion at last resort. You may have prolonged oozing which will actually help close the wound. Keep up with appropriate followups with your surgical/dental team. tonyinhampshire: Just come back from hospital minus two teeth. They made it look so easy. All my fears disappeared. Very little blood loss. I have stitches too. Hoping for good healing....Thankyou everyone for support." }, { "id": 399, "title": "What is the sedative like during wisdom toothn extraction", "dialogue": "Allie80: So I've managed to dodge the dentist for the last 4 years but after an impacted wisdom tooth made an appearance a few weeks ago, I finally gave in and visited the dreaded dentist today.\n\nNot only have I got to have the impacted tooth removed, it turns out I've got to have the another one out along with some bone!\n\nNow, I have already got a real fear of dentists so this was my worst nightmare and the dentist offered me sedation options immediately as I was getting into a bit of a state.\n\nSo my next problem is: obviously, i'd like them to just knock me out but i'm worried that it won't work and they'll just paralyse me and I won't be able to tell them it hasn't worked. So I read somewhere that I can get a sedative to relax me but keep me concious. I just really want to know what it's like and if it's worth it or should I just go down the general anaesthetic route?\n\nAny advice would be greatly appreciated \n\nMany thanks\n\nAllie MattKW: Which method you choose depends on a few factors:\n\nHow many teeth need to be taken out?\nHow many do you want out at a time?\nHow difficult will they be to remove?\nWhat is your level of dental experience?\ne.g. If I have an experienced patient who only needs a 1 or 2 moderately difficult tooth to remove, then they can have the choice of local anaesthetic (LA) with relative analgesia (RA, or nitrous) in my rooms, or an intravenous sedation (IV) with my local oral surgeon and anaesthetist, or a general anaesthetic (GA) with my local oral surgeon and anaesthetist. If they're a young person who has 4 wisdom teeth to be removed, but who's never had much dental treatment, then I will suggest all 4 be removed in one sitting under a GA. And then there's all the variants in-between. The cost increases as the complexity increases. Without the benefit of seeing your X-rays, I'd suggest you either need an IV or a GA. Oral sedation (e.g. temaze, diazepam) is OK with the right patient, but doesn't allow for instant change of dosage that a real IV allows, and I rarely put that in the mix. Allie80: Thank you so much for the advice. Have you got any idea what IV sedation actually does/makes you feel like? honestdoc: I personally had IV sedation for medical procedures and I was totally out. I worked on people on IV sedation and to some, they don't work well such as constant moving and jerking, PITA and impossible to work on. Think drilling on moving and dodging teeth. How tolerant of pain medications, alcohol, and local anesthetics are you? If it takes a lot to numb you, you may be hard to sedate. \n\nThere are very difficult risks involve with sedation. First, you can't have anything to drink or eat usually 6 to 8 hrs before. When you are sedated, everything relaxes and your stomach contents could come up and drown you. Secondly, your heart and breathing could relax too much and the team needs to be ready to resuscitate you. In rare cases, the team may not successfully do that. Your medical history and conditions are so important to discuss." }, { "id": 400, "title": "I am worried?", "dialogue": "aqz: Hi doc just noticed the tiny flap area under tongue is discoloured, there are no symptoms should i worry or is this normal? Its the area on right, its the tiny bit of skin you can move around. Please your insight would be much appreciated. \n\nThanks MattKW: Within the realm of normal underside tongue to me. aqz: @MattKW hi thanks for your reply, when you say \"within normal\" does that mean it doesnt look normal. Should i worry? aqz: This how it looks today MattKW: aqz said:\n\n\n\n\t\t\tThis how it looks today\n\t\t\nClick to expand...\n\nNo, I mean it really does look normal." }, { "id": 401, "title": "Is this OK? Or dry socket?", "dialogue": "Chiara1234: I got my wisdom tooth took away Monday and this is the situation today, on Friday. Is this a dry socket? I still feel pain but nothing to severe.. I have a bad taste in my mouth.. MattKW: The degree of pain is the main determinant of a dry socket. If you develop a dry socket, we are only concerned with managing your pain. A dry socket will result in delayed healing, and we can't do anything about that; a dry socket will eventually heal without any intervention. Chiara1234: The problem is not really the pain, is the taste I have in my mouth all day. I'm unable to talk with people for how bad smell it.. MattKW: Chiara1234 said:\n\n\n\n\t\t\tThe problem is not really the pain, is the taste I have in my mouth all day. I'm unable to talk with people for how bad smell it..\n\t\t\nClick to expand...\n\nWell, I'd gently rinse it out with salty water, and maybe use a mouthwash to disguise the smell. It'll go away in a couple of days." }, { "id": 402, "title": "Is this normal?", "dialogue": "aqz: Hi i noticed this slight whitish area in middle of tongue i dont know if i am being paranoid. Is it something to be concerned about. I do have a geographical tongue from time to time. This seems like itd ever so slightly raised spot. I dont really have any symptoms. Just really worried if i need to get it checked. \n\nThanks honestdoc: It is hard for me to know for sure. I see it as 2 possibilities. The most likely is it is part of your geographic tongue and will go away after a couple of weeks. The other possibility is a callous like abnormal lesion call hyperkeratinized tissue. It is caused by constant mechanical (rubbing) or chemical (smoking, tobacco, alcohol) irritation. If you are a smoker, get it removed (biopsy) and quit smoking because it can be a precancerous lesion. aqz: @honestdoc Thank you for your reply. Ok this has made quite anxious now. I do always scrape my top teeth along that area (bad habit i know) and now i have been picking it also to see if it rubs off. I do smoke also. But now that i have been scrapping it. It now looks like this. Feels abit irritated now aqz: Also from all the scrapping teeth along that area has made it smooth? Ive been doing it for ages MattKW: aqz said:\n\n\n\n\t\t\tHi i noticed this slight whitish area in middle of tongue i dont know if i am being paranoid. Is it something to be concerned about. I do have a geographical tongue from time to time. This seems like itd ever so slightly raised spot. I dont really have any symptoms. Just really worried if i need to get it checked.\n\nThanks\n\t\t\nClick to expand...\n\nProbably median rhomboid glossitis, Not of any significant concern, but look at Likely Causes, and Treatment and prognosis." }, { "id": 403, "title": "Sinus lift possibility?", "dialogue": "Zaia: If an upper tooth (molar or premolar) needs to be extracted and a tooth implant put in its place, is a sinus lift always necessary? MattKW: Not necessarily for a 1st premolar (4th from front), but maybe for a 2nd premolar (5th from front). Zaia: How common is it to have this procedure with upper premolars?" }, { "id": 404, "title": "Biopsy/Drain/Grommet Recovery Time", "dialogue": "Stjoan: Ten days ago I had a biopsy done on a mandibular cyst. At that time, a drain with grommet was inserted. What is a typical recovery like after something like this? I feel like I have a constant canker sore (not getting better), and there is still some swelling a little above that area that feels like a marble and is tender to touch. I have been flushing the drain 3 times/day with salt water and some bloody saliva still comes out when I start the flush. I see the surgeon again on Thursday to get biopsy results and, hopefully, some resolution to this pain. Any advice is greatly appreciated." }, { "id": 405, "title": "How necessary is wisdom tooth extraction?", "dialogue": "Enations: My wisdom teeth seem to be fully erupted...is it really necessary to have them removed? MattKW: In your specific case, not very immediate. At least yours are not on their sides. But I suspect you will find:\n\nthey will tend to cause you to bite your cheek more often\nyou are more likely to have localised gum infections\nyou are going to have difficulty keeping the wisdoms clean, and decay is more likely.\nOne other thing is that I see you've had a 1st molar removed - I'd consider removing the wisdom tooth on that side at least because it can push the 2nd molar over. You need to keep your teeth upright.\nBut you are the rare case that is easy to watch for any troubles, and unlikely to develop an emergency situation. Enations: MattKW said:\n\n\n\n\t\t\tIn your specific case, not very immediate. At least yours are not on their sides. But I suspect you will find:\n\nthey will tend to cause you to bite your cheek more often\nyou are more likely to have localised gum infections\nyou are going to have difficulty keeping the wisdoms clean, and decay is more likely.\nOne other thing is that I see you've had a 1st molar removed - I'd consider removing the wisdom tooth on that side at least because it can push the 2nd molar over. You need to keep your teeth upright.\nBut you are the rare case that is easy to watch for any troubles, and unlikely to develop an emergency situation.\n\t\t\nClick to expand...\n\nThanks!" }, { "id": 406, "title": "Is this normal healing 3 days post molar extraction or dry socket?", "dialogue": "Angel51373: I had a molar extracted Wednesday afternoon and this is what it looks like now. It hurts a lot still. Hydrocodone takes the pain away but I can tell when the next dose is due. I’d say the pain is at its worst today thus far..about a 7 out of 10 (without pain meds). Does this look normal or like a dry socket? Jloaiza2: Did this end up being dry socket, or was it part of the normal healing process?" }, { "id": 407, "title": "Is my wisdom teeth infected??", "dialogue": "34flower girl: Just got all 4 of them out 2 days ago. The top seem to be fine, but my bottom ones are freaking me out.\n\nThey were impacted and had a flap of gum over them( I think the surgeon kept the flap in my gum- idk why since it was infected.) but it looked okay the first night and when I woke up white started appearing yesterday near the extraction site.\n\nSurgeon gave me antibiotics (amoxicillin 500g) to take after the surgery.\n\nIs this normal???? will the infection go away?\n\nAlso, is the reddish color near the back of mouth & throat ok? I thinks its from the infection.\n\nI am in no pain (didn't take pain meds at all since I didn't want the side effects,) just swollen cheeks that are sore outside where teeth extracted. honestdoc: Your extraction site looks good. The lower wisdom teeth are more traumatic to remove and require more recovery efforts. As long as you don't notice any swelling, the area should heal. Minimal pain is a good indication the body is recovering well. 34flower girl: honestdoc said:\n\n\n\n\t\t\tYour extraction site looks good. The lower wisdom teeth are more traumatic to remove and require more recovery efforts. As long as you don't notice any swelling, the area should heal. Minimal pain is a good indication the body is recovering well.\n\t\t\nClick to expand...\n\n\nI took a cotton swab to look at the whiteish stuff and it turned out to be stitches that were put in! Redness went away too." }, { "id": 408, "title": "Dry socket?", "dialogue": "Enations: This is an image of tooth #19 on my lower left side. It is 46 hours since the extraction. I am not in severe pain but I'm noticing that when air hits it I get a sharp pain which is new. Is this normal healing for this stage or should I see my dentist? honestdoc: It doesn't look like a dry socket. Tooth #19 usually can be traumatic to remove so you may need more recovery efforts. The mouth has a good potential to heal. If by rare chance you notice swelling around the tooth or under your jaw, do see your dentist." }, { "id": 409, "title": "Is this a dry socket?", "dialogue": "Ajgarcia: I got all four of my wisdom teeth pulled out exactly a week ago. I can’t really see my top extractions, but the bottom two had previously been filled with this yellowish creaming colored substance. I was brushing me teeth when I think I accidentally brushed on one of the extractions, causing whatever that yellowish/creamish substance to come out. I looked and this black hole started bleeding. I put a gauze for about 30 mins. I took it out and now it’s just this black hole. Is this a dry socket??? MattKW: A dry socket will occur 3-4 days post-op and result in extreme pain, foul odour, and bad taste. So you're past the danger period. The yellowish stuff was probably just skin peeling off - you don't form dry scabs in the mouth. You're OK!" }, { "id": 410, "title": "dental implant question", "dialogue": "s0022jh: which specialist are usually do the extraction of broken tooth at root and dental implant? also some ppl mention if I replace the lower molar, I need do the same for upper molar so both match? honestdoc: It is best to start with your primary dentist who you trust. He or she would go over a plan and expectations with you. This is very important because there are a lot of variables, different parts and tools associated with implants. There are a lot of dentists and specialists that place implants, even endodontists are starting to place them. \n\nIt is very difficult to manage, maintain, fix, replace implants when the person do not have continuity with providers such as moving to another part of the country or many times out of the country." }, { "id": 411, "title": "Dental Implants for supporting upper jaw denture : My Father", "dialogue": "zent: Hello,\n\nThank you for your time!\n\nMy father is 81 years old and lives alone in India. He is in good health and is physically active.\n\nHe has been using a full denture (11 teeth ) in his upper jaw since Aug 2014. Yesterday, the dentures came off and he could not chew or bite. Since he does not like using an adhesive on his dentures, he went to see his dentist. When I spoke to the dentist through an electronic chat after the visit, the dentist advised me of two choices:\n\n#1: Make a new denture and secure it inside his mouth with three dental implants. The implants are only for supporting the new denture. The implants will remain in his mouth for all of his life. This will make it easy to chew. The side effects are minimal.\n\n#2: Try a new denture with additional teeth (more than 11 ) and use an adhesive for as long as possible. When this fails, a new denture along with dental implants will be needed (as mentioned in #1).\n\nI would like to delay putting any implants on my father's mouth for as long as possible. But the worry is, at some point in future, he will need dental implants to support his dentures. \n\nQuestions:\nWill it make it much harder for him to go through the dental implanting procedure at an older age when he might be not as healthy? Should we just go with dental implants when he is feeling fine?\n\nI would be grateful for any experiences people might have with their parents or elderly relatives who had similar issues. \n\n\nThank you,\nZent honestdoc: Placing implants can be traumatic and integrating them into bone can be less predictable with various medical conditions. I agree that he shouldn't jump into implants. Try maybe relining them if he was able to use them before or new dentures if the old ones aren't performing properly. zent: Thanks a lot for your reply! We have sought a second opinion from a Prosthodontist and it was exactly what you said. We are proceeding with a new denture and avoiding implants" }, { "id": 412, "title": "Upper molar extraction", "dialogue": "Natalie29: hi I am due an upper molar extraction one next to wisdom\nTooth as it’s badly decayed from the inside out it’sgrown at a tilt , this molar is next to a large filled tooth . I am petrified something will\nGo wrong isit likely it could snap it’s fully through . IF it was to snap then what \n\nAny advice and nice words please honestdoc: Without images, I will generalize the procedure and what to expect. Many times the molar extractions will come out in pieces due its multi-root anatomy. Since you will be numb for this, you should not feel pain other than pressure. Any procedure may have rare complications. A rare possible complication for your case is sinus perforation. If it is smaller than 4mm, it can predictably be repaired. If greater, then an Oral Surgeon may need to repair it. Rest assured, the complications do not happen but the rarest of times. Natalie29: I don’t have the image I’m afraid .. so they won’t even attempt to pull in one ? It is an oral surgeon I am seeing only because I wanted sedation but since changed my mind and aM\nGoing with local. My dentist did say she could pull it . Will the tooth with next filling become damaged what is the likely hood of this . Thanks for replying honestdoc: There is a very small chance the filling can get damaged. My thinking is if the filling or tooth is not strong enough, it is meant to break out anyways. The damaged tooth/filling can always be repaired temporarily until the right time to restore it." }, { "id": 413, "title": "Sinus perforation", "dialogue": "AJK64: I am hoping someone here can help me and answer my questions.\n\nI am likely going to have to have a failed root canaled tooth extracted. The tooth is an upper left first molar. From the xrays taken during the endodontic treatment, it appears that one of the roots of this tooth runs directly into my left maxillary sinus.\n\nI am going to be seeing a new dentist on Wednesday to talk about my options. What can/should I ask during the consultation in order to reduce the risk of sinus perforation? Is there any way of determining for certain if the root does run into the sinus? Are there any procedures I can request that would minimise the risk? honestdoc: How certain do you know that the root canal failed? If you have no pain and no swelling, no treatment is the best. It is hard to determine the exact proximity of the sinus with the 2 dimensional x-ray but the roots are very close. \n\nHave a good discussion with your new dentist. Best case scenario, you don't need to take out the tooth. He or she may feel comfortable taking the tooth out but a sinus perforation or damage can potentially occur. If the perforation is greater than 4 mm, it needs to be repaired by an oral surgeon. AJK64: It's 10 weeks since the root canal was completed and I am still in daily pain. It has background pain (around a 3/10 constant ache) and is very painful to touch (peeks to around a 7 or 8/10 when I brush my teeth).\n\nI have had pain for about 9 months now since the problem with this tooth began and it's really starting to ruin my life and I just want an end to the pain, so looking like an extraction is my last hope honestdoc: Do you have more pronounced pain when you bend forward or walk up or down stairs? If so, it may not be the tooth but a possible sinus pain.\n\nIf it is, then extraction is the most predictable option. Again, have a good discussion with your upcoming dentist. AJK64: No extra pain on bending or climbing no. It's mainly only triggered by touching the root canaled tooth. The pain radiates up into my eye socket at times and into the side of my head too MattKW: Sad to hear it's still going poorly. The RCT looks good, but that doesn't compensate you much. I don't know why it continues to plague you, and I have to agree I'd prob extract too given your history. It's not like you haven't tried to push through. As for the extraction, the tooth will probably fracture and have to be taken out in sections. A bit fiddly but these are done all the time. Chances of sinus perforation are low if your dentist is experienced. You might ask if he's got some long-lasting LA to help control the post-op pain (Marcain, Naropin,...) so you can get a bit of rest. All the best. AJK64: Saw the new dentist. She did a thorough examination and took a few xrays. She is referring me to the maxillo-facial surgeons do they can try and figure out what is wrong. She was particularly concerned about the pain I am getting in my head. She also said that they can advise me on extracting the root canaled tooth safely and if there is a sinus perforation they are in the best position to deal with that too. Hopefully it won't be too long waiting" }, { "id": 414, "title": "Implant titanium toxicity and removal", "dialogue": "hostileto: Has any one had allergic reaction to their implant or symptoms associated with an overactive immune system, including chronic fatigue, joint and muscle pain, cognitive impairment, depression, headaches, fibromyalgia and skin rashes.\n\nI have an implant that in is number 15 and it reaches \n\t\t\n\t\t\n\t\n\n\n\t\n\n up into my sinus cavities.\nI been told not to remove it as it could be more complicated but I am afraid the implant may be toxic to me as I constantly battle cognitive impairment and more recently mild studdering. I want to say or react to something but I get interupted by this cloudiness and the inability to have structured concepts.\n\nAs you can see in the phone there is scaring and inflammation where the implant is MattKW: The most likely allergic reaction to an implant is Type IV hypersensitivity, none of which correlates with your signs and symptoms. I don't even know what that X-ray is meant to represent - I can't see the implant in it. hostileto: MattKW said:\n\n\n\n\t\t\tThe most likely allergic reaction to an implant is Type IV hypersensitivity, none of which correlates with your signs and symptoms. I don't even know what that X-ray is meant to represent - I can't see the implant in it.\n\t\t\nClick to expand...\n\n\nThe xray (right side) you can see the impant is into the sinus cavity. There is an inflammation highlighted that has been on going since I can remember. I've had mri;s done three times and this swelling is constant.\n\nMy concern is my body is consuming amount small levels of metal and causing cognitive impairment. This is my second implant as the first one was removed over ten years ago. Back in the early 90's they made one size fits all. Needless to say that one cracked and got infected. This one newer one feels noticeable but not enough to create pain. There is something there as the mri provides evidence. Doctors have told me its inflammation. I worried its more than that and more is going on.\n\nI've been told more complications would arise if I removed it and they do not provide a solution if I would rather not have the piece of metal in my skull.\n\nIf I knew now, I would have never gotten this implant and chosen a bridge. These days with 3d etching teeth/ crowns are almost perfect." }, { "id": 415, "title": "Is it Dry Socket?", "dialogue": "tabularasa: Hey everyone, \n\nI got my wisdom teeth surgery 5 days ago. I only had one (lucky me) so it was removed. It's been 5 days but Im still in \npain. The pain isnt really on the surgery site. My teeth next to my wisdom teeth hurt so bad. Almost my entire half jaw hurts. Also I can see a hole in there and it worries me. The hole is right between the first stitch and second. went to see my dentist yesterday and he said its fine. But it doesnt feel fine... It hurts when breathe deeply. I dont know why my teeth next to my wisdom tooth hurts. Still have my stitches as well.\nAlso posting a photo. honestdoc: All indications point to normal healing. Removing lower wisdom teeth are very traumatic and comes with longer healing time. Make sure you are not experiencing any swelling for this may indicate possible infection (very rare)." }, { "id": 416, "title": "Dentist says motrin enough for serious sinus lift pain", "dialogue": "Jen Billings: Hi,\n\nI've had three sinus lift operations and due to bad condition of my teeth and gums the previous experiences were very very painful. I was in pain for about ten days after the second sinus lift and even the pain medication(percocet) i was prescribed did not fully take the mind-numbing pain away. It was really brutal. My question is why is my sinus lift hurting so much? Is it because of condition of the tooth? Doc had to put in a lot of material(i think bone) during operation.\n\nI just had another sinus lift yesterday and pain was really bad that I had to ask towards the end of the operation for more injections of whatever medication they numb your gum/tooth with. \n\nI was prescribed percocet but due to what he says was a malfunction on his computer he said the prescription could not go through. After waiting two hours for them to clear it up at the pharmacy I was in so much pain I had to go back to have him inject me with pain medication on the gum to ease the pain. He said he was puzzled that motrin did not take the pain away. \n\nI took motrin and tylenol and the pain did not ease. I woke up in the middle of the night and could not go back to sleep because of the pain.\n\n29 hours after the operation I am still in a lot of pain. I could not go to work today and will probably have to take the day off tomorrow.\n\nI understand due to the opiod epidemic that doctors are very reluctant to prescribe anything stronger than a motrin. I have been prescribed 6-8 tablets in the past and took half a tablet to keep the pain at bay. Are doctors now making certain patients suffer because of the sins of others?\n\n\nThanks. sekagirl: dental post op pain IS REAL!!!! I experienced the inhuman experience in jan. 2018 in reference to a tooth \"extraction\" ( more like being butchered up!!!) I received NO POST OP CARE!!! dentist REFUSED TO PROVIDE RX FOR PAIN MED!!! I ended up in the ER with a allergic reaction to ibuprofen!! I have filed a complaint with the state board of dentristy I refuse to be butchered up by a regular dentist/ ended up receving proper dental care from a oral surgeon, oral surgeon is a dream I am receving the post op care that I need, my post op needs are met by oral surgeon. the regular dentist never considered my post op needs the only post op care I received from dentist was a baggie of some 2 x 2 gauzes ( I would have been better off receving a dime bag of herbal organic leafy smokabile herb relief) Hmm. the dental bone graft that the \"dentist\" placed cost 650 dollars placed in jan 2018. to repair the oral damages so far has cost me about 6000(SIX THOUSAND DOLLARS)dollars OUT OF POCKET!!! it is a DAMN shame that dentist refuse to provide a post op oral surgery patient pain relief !!!! shame, shame , shame, maybe it is better that one seek out dental care out of the borders of the US, I hear that folks do receive pain relief!!! from beyond the US border dentists" }, { "id": 417, "title": "What is this? 4 days post wisdom teeth removal..", "dialogue": "Mhaga81: So i had my wisdom teeth removed monday. Healing is going good for the most part except yesterday I started to have pain on the inner gums near the base of my tongue. Took a look and found this (see photo). Does anyone know what it is? Worried it’s dry socket or something." }, { "id": 418, "title": "Wisdom teeth removal extraction site", "dialogue": "Justadude: Hello! I have a slight concern about my wisdom teeth extraction sites. I had 4 (2 on the top and 2 at the bottom) teeth removed last week on Tuesday. I think my sutures came out early because, now I have two holes from where my bottom teeth were removed. I’m not in pain. It doesn’t hurt at all and the swelling of my cheeks is gone. I want to ask if this is normal. Well they close up over time, or do I need to have them stiched up again. I’m currently using warm salt water rinses and a syringe to flush them out. I’m also using Chlorhexidine gluconate 0.12%. I’m 17, male. honestdoc: The extraction site looks good. I know the \"holes\" look unsettling but whenever a tooth gets extracted, there will be bone loss. The best news is you have minimal pain and swelling which indicates good healing. Avoid over-flushing and disturbing the holes and let it close up over time. Justadude: honestdoc said:\n\n\n\n\t\t\tThe extraction site looks good. I know the \"holes\" look unsettling but whenever a tooth gets extracted, there will be bone loss. The best news is you have minimal pain and swelling which indicates good healing. Avoid over-flushing and disturbing the holes and let it close up over time.\n\t\t\nClick to expand...\n\nThank you so much" }, { "id": 419, "title": "Food in tooth extraction site?", "dialogue": "McStuber: I just got a bottom left molar pulled on friday, just ate food for the first time last night(was drinking pureed shakes for 3 days...) and am now worried I got some food particles stuck in the extraction site and around it. Can't tell if it is just membrane or something scabbing over but don't want to irritate the area if I don't have to. Any feedback would be greatly appreciated. Thanks in advance! Help please ! honestdoc: It looks like it is healing fine. Minimize disturbing the area and if you did, gently remove any debris as best you can. The mouth has great potential to heal. McStuber: honestdoc said:\n\n\n\n\t\t\tIt looks like it is healing fine. Minimize disturbing the area and if you did, gently remove any debris as best you can. The mouth has great potential to heal.\n\t\t\nClick to expand...\n\nthank you for the reply , very much appreciated. Have been taking it as easy as I can with eating, drinking, working, etc. No real pain anymore so I guess that's good. I just wonder if my gums below the extraction site are still supposed to feel swollen .. Anyhow thanks again!" }, { "id": 420, "title": "Still worried", "dialogue": "Marshaé: Causing minimal pain as long as I keep taking ibuprofen but still concerned because of the way it looks and feels in the mouth, I am taking antibiotics day 2 of them, but it worries me from the dark area and then the yellow, excuse the saliva bubbles, it also make the rest of my teeth from tooth numbers 24-31 feel tingly and it kinda causes pain near/in my ear to where I feel like anytime I lay on that side of my face it begins to start the pain again or if I bend down low enough I begin to feel it . Is it a Dry socket or just irritated?? also forgot to mention it was Fully erupted. honestdoc: It is not a dry socket. The light yellow is the developing epithelium. The extraction site appears healing WNL. If you have worsening pain and or swelling, get it checked out. Otherwise, allow it to heal and minimize disturbing the area." }, { "id": 421, "title": "Dental implant before bisphosphonate therapy", "dialogue": "Xoxatpl: I have metastatic prostate cancer and am looking at IV bisphosphonate therapy. I also had 13 and 14 extracted recently and would like to get implants. How long should I wait after the implants are done should I wait before starting the bisphosphonates? MattKW: The implants normally go in ~3 months after the extractions, then wait another 3 months to allow bone to adhere. The abutments and crowns on top of the implants can be done any time after this as they don't affect the bone. Make sure all your other teeth are in excellent condition, especially periodontal disease. But if the doctors want you to start bisphosphonates sooner, then maybe that has to take precedence over implants. Talk to dentist and oncologist. honestdoc: Sorry to hear about your metastatic prostate condition. Have you and your medical team considered immunotherapy (biologic therapy)? IV bisphosphonates have so many devastating oral side effects. Implants can be very difficult to integrate properly and to sustain it after IV bisph may result in guarded prognosis. Xoxatpl: honestdoc said:\n\n\n\n\t\t\tSorry to hear about your metastatic prostate condition. Have you and your medical team considered immunotherapy (biologic therapy)? IV bisphosphonates have so many devastating oral side effects. Implants can be very difficult to integrate properly and to sustain it after IV bisph may result in guarded prognosis.\n\t\t\nClick to expand...\n\nEven if i wait 3 months after implants are complete to begin bisphosphonate therapy? honestdoc: After your implants have fully healed/integrated (after 3-4 months or longer), to sustain them during IV bisph is very unpredictable and guarded. Again, try to consider alternatives to IV bisph. MattKW: All the studies I found are of taking bisphosphonates BEFORE implants are inserted (1) and (2). I couldn't find any studies that relate to bisphosphonate treatment AFTER implants have been inserted so I assume it would be similar to normal maintenance of natural teeth; there seems to be no reason not to do so. Therefore, I'd get the implants before started IV, if the IV can wait - talk to your oncologist; the cancer comes first." }, { "id": 422, "title": "Extraction", "dialogue": "Daisy0090: Hi guys!\nHad my bottom molar out 6 days ago.\nFirst few days went fine blood clot ect then went yellow.\nNot it’s changed to a black/brown colour. \nThe walls of my socket are white or bone. \nI have an ulcer either side of the extraction site and my tooth behind it’s gum has completely split. \nPlease tell me it’s not dry socket?? \nThank you honestdoc: Please provide multiple images if possible. MattKW: Dry sockets happen 3-4 days post-op, and are characterised by foul taste and breath, and enormous pain. You are in the clear." }, { "id": 423, "title": "Full erupted wisdom teeth removal, day after.", "dialogue": "Marshaé: Good evening, I just recently had my wisdom teeth removed, Friday 13th, I had my lower(mandibular) left third molar removed, it was rotated toward the lingual and I had no swelling in my face very little pain after the anesthesia wore off and it looks great and feels good. Yesterday Tuesday July 17th, I had the other 3 wisdoms teeth removed, and all feel normal and look normal as far as healing except the (mandibular) lower right third molar that had already formed its blood clot as well but the inside of the socket is whitish gray, and some of the gum toward the lingual and SLIGHTLY inside the socket looks yellowish white , it worries me because nothing hurts but it looks different than the rest of them. Please see attachment below. THANK YOU! honestdoc: It looks normal perhaps developing epithelial tissue. As long as you have no swelling and minimal pain, continue to let the area heal." }, { "id": 424, "title": "I was advised my implant may fall out", "dialogue": "nelsona: I had a sinus lift and an implant placed in the upper jaw.\nTwo weeks later my oral surgeon advised that my implant may fall out, as it came apart from the gum.\nHe said that if this happens, the implant may be replaced (and that the good thing is that at least the sinus lift is already done)\n\nI was just wondering, does it mean there is no hope it may still fuse with the gum?\nWhat could be the reason it happened?\nWhy would this implant need to be replaced with a new implant? Can't the same one be put back?\nI am worried that if it failed, maybe it means it may fail again?\n\nI would be grateful for advice, please. MattKW: Only your surgeon would know whether success will happen 2nd time. \nYes, they have to use a totally new implant because the surface is specially prepared. nelsona: Thank you MattKW, I was just wondering, is there a chance that the gum will fuse with the current implant? of if it hasn't done so after two weeks, then no chance? MattKW: nelsona said:\n\n\n\n\t\t\tThank you MattKW, I was just wondering, is there a chance that the gum will fuse with the current implant? of if it hasn't done so after two weeks, then no chance?\n\t\t\nClick to expand...\n\nIf it is indeed not fusing, then the bacteria will penetrate down the side, and the implant will fail. If it is failing, it is best to get it removed ASAP so that no more bone is lost. See your surgeon." }, { "id": 425, "title": "Socket Preservation", "dialogue": "Lorraine: Good Morning:\n\nJust wondering:\n\nI had a tooth extracted on July 5th, 2018 and was wondering if a socket preservation can still be done? It is now July 15th.\n\nThank your for your time in responding!\n\nLorraine honestdoc: Do you mean a bone graft? A bone graft can still be done. The surgery site needs to be reaccessed for the graft. You may experience further pain/discomfort and delayed healing." }, { "id": 426, "title": "Red lump after removal", "dialogue": "Ryan_D: I had a bilateral wisdom tooth removal last Tuesday and although the swelling and pain has now gone, I've been left with a movable red lump / sack in my gum (highlighted in picture) where my lower-left wisdom tooth was extracted.\n\n\n \nI'm not certain, but I think it was there straight after surgery. Is this normal and has anyone else had similar? Thanks for any help. Jane: Had surgery for buried wisdom tooth two months ago have swelling at back of mouth very much like yours did you find anything out about this is it normal and has yours gone plus is there anything i should be doing to help am still swilling with salt water though im not sure it helps thanks for any help jane Ashleyrhe123: I have the same thing. My dentist expressed the infection, but it closed up and bubbled back up within an hour of leaving the dentist. What was the result from yours? honestdoc: There could be a few possibilities. The most realistic is normal tissue formation in a reactive healing pattern. Another possibility is having debris or exfoliating bone (sequestrum) trapped under. The worst case scenario is prior to surgery, you had taken medications called bisphosphonates especially injectable forms resulting in bone damage of various severity. If the bump continues to become bothersome, have an image and evaluation." }, { "id": 427, "title": "Recent apicoectomy on #7 and #8", "dialogue": "Rootcanalsuck: When I was 10 years old I had a slight trauma to the front right tooth #8 my sister during horseplay I guess hit my tooth with a remote and it chipped exposing the pulp I guess so I had to get a root canal. Flash forward To when I was about 13(also around the time I got braces) I get a little what I now know is called a fistula above my #7 and it would wax and wane and I guess disappear at times, one time I went to my pediatric dentist and asked him about it and I believe he said it could be a bone fragment or something but it was fine for now because I wasn’t in any pain or anything, now I’m 20 years old and the bubble came back recently and this time it felt different and didn’t really hurt but it was draining a lot daily and I wanted it gone so I went to a new dentist who my parents had said they liked so I went there and they performed a root canal on #7 next time I go there I still have the fistula and then they take a 3D scan of my head and what I saw was bad looking, it looked like a big oval of darkness above #7 and #8, then I am referred to an oral surgeon who at first gives me some regular antibiotics and then another course of stronger antibiotics I believe it was called clavulanic acid and amoxicillin or something. Fistula still looks the same as it has if not worse, so I have the apicoectomy performed on 7,8 at the same time. 3 months later I have noticed that there is another big pimple looking thing starting to grow, what is my next option ? Should I just get it extracted and put implants i don’t have any X-rays yet but hopefully will soon these pictures are in chronological order, first one is like 6 days after the apico MattKW: Xrays before RCT, after RCT, before apico, and after apico would be helpful to see how the history developed, and to give you a fair idea of prognosis. Sounds like the oral surgeon did the apicocectomy? Not the best people to do them, better to be done by endodontist. Implants are not necessarily the easy next step because you will probably have had significant bone loss. Rootcanalsuck: I don’t have those at the moment but I will see about getting them as they are from 10 years ago, could you tell me anything based upon the pictures I posted going back to the surgeon to see what he says on Monday I’m not in paid so am I okay? MattKW: You appear to have recurrent abscesses. Apicos have a significant failure rate. Rootcanalsuck: Yeah I was aware of this, just got back from the doctor gave me amoxicillin and told me he wants to go back in, just took this X-ray today ... any suggestions... should I get a second opinion from another doctor... any reccomondations are aprreciated MattKW: Rootcanalsuck said:\n\n\n\n\t\t\tYeah I was aware of this, just got back from the doctor gave me amoxicillin and told me he wants to go back in, just took this X-ray today ... any suggestions... should I get a second opinion from another doctor... any reccomondations are aprreciated\n\t\t\nClick to expand...\n\nI wouldn't revisit an oral surgeon. If you want to really assess the chances of success, then see an endodontist. Your xray shows a couple of problems with heavy-handed apicos: the initial damage to the tooth was when you were young and the canals were large (hard to root-fill), the apices have been opened up widely following the apico, so more foreign material for the body to try to counteract, and there's no apparent end sealant to the apicos - an endodontist would prob use some MTA. i don't like your chances, but an endodontist is the best person to consult. Rootcanalsuck: Can you elaborate on “heavy handed” Apicos, I was expecting to see a little hole where he drilled through bone? I can’t tell so does it look like he did that? And because the tooth has been in my mouth for so long and never got capped or anything is that possibly why I have this problem to begin, also if I go to an endodontist will they treat me after I had the apico done by another surgeon? MattKW: Rootcanalsuck said:\n\n\n\n\t\t\tCan you elaborate on “heavy handed” Apicos, I was expecting to see a little hole where he drilled through bone? I can’t tell so does it look like he did that? And because the tooth has been in my mouth for so long and never got capped or anything is that possibly why I have this problem to begin, also if I go to an endodontist will they treat me after I had the apico done by another surgeon?\n\t\t\nClick to expand...\n\n\nHeavy-handed because of the amount of root tip removed, and the amount of root filling thereby exposed. And there doesn't appear to be any sealing of the apex. In the old days, amalgam was used to seal the apex; it worked reasonably. I did plenty of those myself. Nowadays, an endodontist would remove a very tiny tip of the root, and seal up with a more biocompatible material like MTA. \n\nThe lack of a cap (crown) is not significant in your case. It would not have given much benefit as there's not much tooth structure in young teeth. On the plus side, it also means that without a crown, an endodontist will be able to more easily get into the canal from the mouth end if necessary,\nThe bone heals over in most cases. In your case, the bone is thin because of the recurrent infection - that's why you have a gum swelling.\nYou have nothing to lose by seeing an endodontist. Their techniques have improved so much over my lifetime. That's why i'd never use an OS for an apico. Rootcanalsuck: Thank you so much for all the responses, this is just a scary time in my life as I’m only 20 years old and pretty self conscious about having missing teeth possibly in the future or if this problem never goes away because of the extent it has gone on. I’m afraid it’s going to spread to the adjacent teeth or something. But anyways I will see an endodontist and see what they say." }, { "id": 428, "title": "Recent Apicoectomy", "dialogue": "Pgulinazzo: Hello, I had an apicoectomy done a week ago. It appeared that my recent root canal didn’t take and an infection showed on the X-ray. It was on one of my front teeth. My question is that I am feeling a lot of pressure when I press down on my lip around the area where the surgery was. Also feel that same type of pressure when trying to smile or when I move my mouth a certain way. I have a follow up with the Dr on Thursday which would make 2 weeks. Is this type of pressure normal? I’ve had two apicos done on different teeth in the past and dnt recall it taking me this long to heal. Thank you in advance for your feedback. MattKW: Too early to say. There is usually some nerve disturbance following an apico of front teeth, and they can feel strange for a long time. Pgulinazzo: MattKW said:\n\n\n\n\t\t\tToo early to say. There is usually some nerve disturbance following an apico of front teeth, and they can feel strange for a long time.\n\t\t\nClick to expand...\n\nThank you very much for your reply! The pressure and heaviness go dwn the entire tooth.. not sure if I was specific enough or you may have thought the pressure is felt on my lip. Do you think infection could still be present? Thank you again for your time. MattKW: Pgulinazzo said:\n\n\n\n\t\t\tThank you very much for your reply! The pressure and heaviness go dwn the entire tooth.. not sure if I was specific enough or you may have thought the pressure is felt on my lip. Do you think infection could still be present? Thank you again for your time.\n\t\t\nClick to expand...\n\nIt would be rare for the reinfection to re-establish in only a week. Pgulinazzo: MattKW said:\n\n\n\n\t\t\tIt would be rare for the reinfection to re-establish in only a week.\n\t\t\nClick to expand...\n\nSo is this pressure I’m feeling something normal or should I call my oral surgeon to get in sooner to look at it rather than wait another week.. thanks so much for your time! MattKW: Wait. Pgulinazzo: MattKW said:\n\n\n\n\t\t\tWait.\n\t\t\nClick to expand...\n\nSounds good. I’ll wait and see and hopefully I will heal properly. Thank you very much! Pgulinazzo: Pgulinazzo said:\n\n\n\n\t\t\tSounds good. I’ll wait and see and hopefully I will heal properly. Thank you very much!\n\t\t\nClick to expand...\n\nDr Matt I am seeing my surgeon this Thursday as I had the apicoectomy done on the 27th of June.. I am still feeling uneasiness in the tooth plus when I put pressure on the surgical area I feel pressure that flows into the tooth.. I know we spoke last week, but would you have any take as to what could be going on? It doesn’t appear that anything is infected on the outside of the surgical site.. it also doesn’t seem to hurt if I put a little biting pressure on it.. thank you for your help!! MattKW: Pgulinazzo said:\n\n\n\n\t\t\tDr Matt I am seeing my surgeon this Thursday as I had the apicoectomy done on the 27th of June.. I am still feeling uneasiness in the tooth plus when I put pressure on the surgical area I feel pressure that flows into the tooth.. I know we spoke last week, but would you have any take as to what could be going on? It doesn’t appear that anything is infected on the outside of the surgical site.. it also doesn’t seem to hurt if I put a little biting pressure on it.. thank you for your help!!\n\t\t\nClick to expand...\n\nSounds within normal limits of what can be expected during recovery. This will take a few months to feel normal again, but it all sounds like going OK. Pgulinazzo: MattKW said:\n\n\n\n\t\t\tSounds within normal limits of what can be expected during recovery. This will take a few months to feel normal again, but it all sounds like going OK.\n\t\t\nClick to expand...\n\nThank Dr Matt.. My family and I are going on vacation this Friday and will be traveling on a plane. Should there be any cause for concern that I will be flying? Thank you again for easing my mind and nerves, very much appreciated!! MattKW: Pgulinazzo said:\n\n\n\n\t\t\tThank Dr Matt.. My family and I are going on vacation this Friday and will be traveling on a plane. Should there be any cause for concern that I will be flying? Thank you again for easing my mind and nerves, very much appreciated!!\n\t\t\nClick to expand...\n\nNo risks with flying, apart from crashing! Pgulinazzo: MattKW said:\n\n\n\n\t\t\tNo risks with flying, apart from crashing!\n\t\t\nClick to expand...\n\nLol!! Thank you!! Pgulinazzo: Pgulinazzo said:\n\n\n\n\t\t\tLol!! Thank you!!\n\t\t\nClick to expand...\n\nHi Dr Matt just wanted to touch base with you. I had my follow up appointment with my surgeon this morning and he echoed your words. Everything is healing nicely and what I’m feeling is normal. He scheduled me for a 3-6 month follow up X-ray. Again thank you for your knowledge and taking the time to ease my nerves.\nRespectfully yours,\nPeter" }, { "id": 429, "title": "Is this an infection? What is it?", "dialogue": "StephQ: I had my wisdom teeth removed about 3 weeks ago, and the bottom right side had a hole after 2 weeks. I just noticed this white thing inside today. Is it infected? It doesn't hurt much, but it is a little tender. I have rinsed, so I dont think its food... Any help? MattKW: Looks like food. Try and get it out with a cotton bud. Don't worry if you can't, the healing otherwise looks good, so it'll eventually come out anyway." }, { "id": 430, "title": "Implants vs root canals", "dialogue": "Sierra: i might need to have a tooth pulled bc of failed root canal. Are implants softer then root canals. \nI’ve read that root canals can cause leakage and eventually cancer in your body Rootcanalsuck: Sierra said:\n\n\n\n\t\t\ti might need to have a tooth pulled bc of failed root canal. Are implants softer then root canals.\nI’ve read that root canals can cause leakage and eventually cancer in your body\n\t\t\nClick to expand...\n\nDid you have an apicoectomy ? Sierra: Yes. I had a re treatment and they saw a shadow at end of root MattKW: Root canals don't cause cancer. Failed root canals are usually because of inadequately cleaned canals, or poorly filled canals, or missed canals. If the RCT was done by a general dentist, then retreatment should be done by a specialist. Apicocectomies are a very last resort because they don't often address the problem of contaminated canals, and they weaken the teeth; should only be done by an endodontist, not a general dentist or oral surgeon. Everything has a failure rate, including implants. Sierra: Thank you." }, { "id": 431, "title": "Bone Graft - Bad Breath", "dialogue": "Somnia: Hello!\n\nI had my left 2 wisdom teeth taken out on Friday 6/29 and #30 was extracted and a bone graft put in. My pain is pretty much gone at this point (just some discomfort and I can \"feel\" the areas sometimes but no pain at all.\n\nHowever my I don't personally smell it, but my mom was able to smell bad odor when she got close to me (she was looking at my bone graft spot as I had a question for her) and she said it smelled bad. She said it smelled like if you get dental work done, best way she could describe it.\n\nIs it normal to have odor like this?\n\nI visited my OS on Thursday 7/5 he said everything looked good, no signs of infection and took the stitches out of the bone graft area. I did notice there is some redness in the bone graft area near the tooth behind and tooth in front of the bone graft and I feel like the amount of bone graft is less than when I got it put in.\n\nSorry mainly about the odor, but thought I'd mention the above also.\n\nThanks in advance!" }, { "id": 432, "title": "Opinions please", "dialogue": "Granjoy: I am a 68 yo female going through a really rough painful, sleepless painful exhausting anxiety provoking \nexperience. Lower left wisdom tooth extracted seven days ago by an oral surgeon. Was still experiencing pain and the hubby complained about my bad breath so I reported to the oral surgeon’s office and they told me to come in. The surgeon looks at it and first says “looks ok”, then looks closer and says partial dry socket. He took stitches out and irrigated with water and advised that 20 minutes after he applies clove med I will feel better and I will need to return for more packing in a day or two.\n\nNow here is the PROBLEM: The whole was too small for him to pack the soaked gauze to stay. He did the best he could to get in the medication in but after waiting in his office for twenty minutes I got no relief. There was nothing more he could do. \n\nAnyone know of options to relieve suffering? Has anyone dealt with or experienced this problem?\n\nThank you with much appreciation. honestdoc: Try to get Over-the-counter numbing gels/ointments such as Colgate Orabase. If OTC pain medication such as Tylenol or Ibuprofen are not relieving the pain, have the oral surgeon prescribe you something for the pain. Hopefully, the pain will subside and the extraction site will start to close. MattKW: Sometimes I might fully numb up the patient with a long-lasting LA (to give them a rest), and put in oil of cloves on a cotton pellet (ZOE mix), and place a cross-stitch over it to secure the pellet. It's hard to control dry sockets with oral medication. Granjoy: honestdoc said:\n\n\n\n\t\t\tTry to get Over-the-counter numbing gels/ointments such as Colgate Orabase. If OTC pain medication such as Tylenol or Ibuprofen are not relieving the pain, have the oral surgeon prescribe you something for the pain. Hopefully, the pain will subside and the extraction site will start to close.\n\t\t\nClick to expand...\n\n\n\nThank you for your response. I am going to try the Orabase numbing gel. The space is only an eighth of an inch. Hopefully I can get it in the space without doing damage to the clotted part. I already tried Advil, Tylenol and prescription hydrocodone (Vicodin) to no avail. The hydrocodone just made me a bit woozy on my feet but did not take away the pain. Having six broken ribs was easier to cope with than this. Granjoy: MattKW said:\n\n\n\n\t\t\tSometimes I might fully numb up the patient with a long-lasting LA (to give them a rest), and put in oil of cloves on a cotton pellet (ZOE mix), and place a cross-stitch over it to secure the pellet. It's hard to control dry sockets with oral medication.\n\t\t\nClick to expand...\n\n\nMuch thanks to you also for your reply. You are so right about controlling the pain with oral medication. Usually all I need is two Advil following dental work. Unfortunately the dry socket part is only an eighth of an inch. Probably I would be better off with a full dry socket so it could be packed with clove medication. I don’t know why the surgeon didn’t try a cotton pellet. He cut a piece of gauze which would seem stiffer. MattKW: Granjoy said:\n\n\n\n\t\t\tThank you for your response. I am going to try the Orabase numbing gel. The space is only an eighth of an inch. Hopefully I can get it in the space without doing damage to the clotted part. I already tried Advil, Tylenol and prescription hydrocodone (Vicodin) to no avail. The hydrocodone just made me a bit woozy on my feet but did not take away the pain. Having six broken ribs was easier to cope with than this.\n\t\t\nClick to expand...\n\nYep, sometimes the socket will close up on top, but still be a yucky cave underneath. Hence the need for LA to be able to get in there. Granjoy: MattKW said:\n\n\n\n\t\t\tYep, sometimes the socket will close up on top, but still be a yucky cave underneath. Hence the need for LA to be able to get in there.\n\t\t\nClick to expand...\n\n\nWow you really know your stuff! Just wanted to let you know I think that’eventually that’s what happened to me. I was eating yougert and felt this foreign little lump in my mouth. Went to look at my extraction site with a flashlight and sure enough what was there before was now missing. Yuck, can’t wait for this to heal and say good riddance to the pain. At least at times the pain seems to remit for a few hours but comes right back. Just an awful ordeal is this dry socket business." }, { "id": 433, "title": "Help needed please", "dialogue": "JoeR1234: Hello,\nI had a large silicone chin implant placed 20 years ago. (Plastic surgery) I recently decided that I want to have it taken out and was shocked when I began reading about bone erosion being common with these impants - particularly when they are large and incorrectly placed high on the aleovar bone as mine is (it is also off center with more of the mass to the upper right of the midline)\nUpon pulling down my lower lip I notice that I have signifcant recession of the gingiva/mucosa in the vestibule which would indicate bone erosion and I think there is a good chance it is at the tooth roots though I have no sensitivity at this point.\n\nI read an instance online where a mandibular advancement was suggested in a case such as mine - my jaw/bite alignment is already correct thus a mandibular advancement alone would not work it would have to be double jaw surgery and this is something I can't do at this point in my life (44 single parent with special needs child). However, I would think the only reason any type of jaw advancement would be prescribed in my instance where jaw/bite alignment is already correct this would be to assist with the aesthetic damage of the bone recession after removing the implant although even in moving the jaw forward the mand symphysis bone erosion would still be present which is the crux of my question:\n\n*In an instance of significant mandibular symphysis erosion is the standard treatment bone grafting assuming proper existing jaw/bite alignment already exists? Also, can synthetic bone grafting or bone paste be used or would it need to be actual bone?\n\n*I do understand that no diagnosis can be made over the web and without x-rays - I was just hoping to learn for discussion purposes and will be pursuing x-rays. Thanks to all of the great contributors here MattKW: It's not clear that you actually have bone erosion as a result of the implant. It is more frequent that gum recession simply occurs from periodontal or hygiene issues. You may require no treatment at all, or possibly a skin graft. Before you get too worked up over this, I'd go see a dentist and then possibly a periodontist. JoeR1234: Thanks Matt - you are correct in terms of how stressed I am. I will do as you mention here" }, { "id": 434, "title": "three implants or two implants and one tooth bridge", "dialogue": "barona: My three teeth (R-H side upper jaw) 14,15,16 are missing.\nMy dentist advised they should be replaced by two implants and a one-to. He said that maybe I don't have enough width in my R-H upper haw.\nI wanted three implants as I would lose bone under the bridge.\nMy oral surgeon says three implants are not necessary. I wonder why? I wasn't offered any explanation.\nThen the two teeth 46,47 (R-H side Lower jaw) are to be extracted and replaced only by one implant.\nalthough I wanted two implants. ferberdental: Dental Implants that are required for the replacement of front teeth often vary in number, typically we do not need 3 implants to replace 3 missing teeth. Often there are space issues and placement of 3 implants can cause the implants to be too close to each other. This can make the new crowns and gums appear not natural. We often suggest placement of two implants in the lateral incisor positions and splinting a 3 unit bridge across. The lab technician can mimic the illusion of 3 teeth much easier with this setup. Goodluck ! barona: Thank you ferberdental for your response.\n\n1. I thought my teeth 14,15,16 are not front teeth as they are on the R-H side of my upper jaw.\n So I would have an implant to replace nr 14, nr 15 would be a bridge and 16 an implant\n instead of all 3 implants as per my request.\n\n2. And as far as my R-H lower jaw is concerned the two teeth to be taken out are really big, so I thought placing \n two implants would be ok?\n\nThe oral surgeon said there would be oral surgeons who would do what I want, but she thinks what she is doing is exactly what I need. MattKW: I think Ferber might not realise the notation system you're using, which is FDI. However, they are correct that only 2 implants would be required to replace the 14, 15, and 16. \nFor normal functioning, it is only necessary to have a single molar in each quadrant. Placing implants farther back for 2nd molars is more complicated because the bone gets thinner, and you are closer to major structures. barona: Thank you MattKW. Yes, I did use the numbering as per the attachment\n I think both my dentist's and the oral surgeon's goal is to make my teeth functional as much as possible. I worry a lot about losing more bone and my face sagging (being vain, lol); so I was thinking, that even though an extra tooth won't be used for chewing, it would be preventing my jaw bone loss. However, thank you for explaining the way my specialists would reason. barona: So my maxillofacial surgeon is going to do the following:\n\nUpper L-H side - a sinus lift + Implant (nr 26)\nUpper R-H side - a sinus lift + 2 Implants (nr 14 & 16) with a space nr 15 left for a bridge \nLower R-H side - Two molars (nr 46&47) to extract and replaced with one implant nr 46. MattKW: barona said:\n\n\n\n\t\t\tSo my maxillofacial surgeon is going to do the following:\n\nUpper L-H side - a sinus lift + Implant (nr 26)\nUpper R-H side - a sinus lift + 2 Implants (nr 14 & 16) with a space nr 15 left for a bridge \nLower R-H side - Two molars (nr 46&47) to extract and replaced with one implant nr 46.\n\t\t\nClick to expand...\n\nSounds good to me. Best of luck." }, { "id": 435, "title": "Will this heal quick?", "dialogue": "StephQ: So about a week ago, I had 4 wisdom teeth removed. Everything has been fine, no more pain, able to eat fine. I've been checking my gums regularly to make sure everything looks okay. It has been okay, but after checking tonight, I saw I had a hole on my lower right side. It doesn't really hurt when I eat or drink, but it does kind of hurt on that side when I bite down hard... I'm planning on calling the surgeon to see if they have advice, but I just want to know if this will heal on it's own? Or if anyone has an estimated time on how long it'd take to heal? Do I need to get it closed, sealed, is it dry socket? Any help is appreciated!" }, { "id": 436, "title": "Sharp pain post extraction", "dialogue": "rosariopatient: Hi! \n\nI got 3 wisdom teeth extracted on Tuesday. Since Friday I’ve noticed a difference in the pain among all 3. One place (the bottom left) has a sharp pain that feels deep in the gums/socket. It’s a throbbing pain that is not “terrible” however I find it unbearable so I take tylenol and I’m fine. The pain is the same today. The other two sites feel fine.\n\nI don’t have bad breath or foul taste so I don’t know if that discards the possibility of a dry socket? I went to my doctor on Friday and he said everything looked fine but still it was too early to tell.\n\nCould this still be a dry socket? Could it be something else? honestdoc: Most likely it is not a dry socket. If it is, you may be in more pain and Tylenol will not help it. Minimize disturbance and irritation around the area. If you notice swelling, then get followup." }, { "id": 437, "title": "Please Help! Apico/extraction 14 yr struggle", "dialogue": "Creeseh: Hello\n\nI will try to be short and to the point. Dentist did a root canal (2004) on left upper #16. It stayed infected with pain for a year using off and on antibiotics. I had fistula the last 4 months even with taking two antibiotics.\n\nI then get an apico from a surgeon. He reopened it two times in two years because infection would come and go. Finally he opted to pull the #16 and all was ok for a year. I did have pain still there though up in the gum area. After a year it started all over with swelling and pain. Then it would leave and come back months later. I felt nauseated alot with face and ear pain. \n\nSame surgeon decided to go back in again. He said the bone was mushy and soft. Debrided and scraped infection out and stitched me back up along gum line. I had to go back several times throughout the years with recurring issues. Currently he says there is nothing he can do since he cant see anything on cone beam scans. I have seen ENT, family MD, neurologist and list goes on. I had #15 pulled because of pain there when they said it needed root canal. \n\nCurrently upper gum #16 swells up then goes down. When it decides to swell like the picture I am adding I get nausea and sick. Joints hurt a over like I have the flu or something..\n\nThey see this and scratch their heads. I need help!!!!! In pain and going numb sometimes. Any suggestions!!!??? Please! honestdoc: Get another opinion from an Oral Surgeon preferably one with a MD degree as well as another ENT. Without an image, I'm guessing possible cyst/tumor. I can't explain why it comes and goes." }, { "id": 438, "title": "Nose problems with wisdom teeth surgery", "dialogue": "Brandon Lee: I'm having wisdom teeth surgery soon and I'm getting put under with general anesthesia, but I have chronic problems where I cant breathe well or at all through my nose. Should I be worried getting oral surgery or being put under? honestdoc: Putting you under general anesthesia is a very big deal and usually the oral surgeon will assess your risk factors such as breathing problems and any other problems such as heart conditions." }, { "id": 439, "title": "Extraction last week...", "dialogue": "Kimtall76: I had an Extraction last week. My stitches fell out today and I think my extraction went ok. My problem is a hole in my gum by my check. It’s still SO sensitive and I ‘m still a little swollen in check. I also have an earache on and off. Do I need to go back or will this heal? honestdoc: Hopefully that healed more by now. If you still have concerns, get followup." }, { "id": 440, "title": "Would going to India for Bone Grafting / Implants be \"safe\"?", "dialogue": "Vivek: I am seriously considering it because it will eliminate about 60% of the cost and I have lost ALOT of bone and its getting worse. I need bone grafting to support implants (all my teeth are missing and much of both my lower and upper jaw is missing too much bone for implants currently.) The current estimate to fix my mouth in the USA is about $100,000 ... In India it would be about $30,000... I don't have $100,000 and it will take ages to save up that much money. But there are also things that worry me about going to India. I need major work and if the doctors dont know what they're doing, I'm screwed. Also if the doctors ripped me off in any kind of way, just to get my money and only half do the services, I'm screwed. Likewise if anything happens after the surgery, there's no recourse and I would also be forced to find a local remedy. I'm also not sure how things like prescription work either or what happens when I run out...lastly is also the state of the world in general...I could end up finding myself stuck there.\n\nWhat do you feel? Should I go overseas and have it done or hope by some miracle I can come up with 100 grand so I can chew again? Busybee: If you go overseas try somewhere like Hungary rather than India. In India the healthcare market tends to be less regulated than in the West and the consumer protection will leave you more exposed if something goes wrong. They tend to be more daring in experimental treatments but such treatments aren't yet tested. A friend had poor implant treatment in the UK but his teeth were fixed in Hungary. As Hungary is in the EU there are certain safety standards. Hungary should be a lot cheaper than the US. MattKW: Start by getting an assessment of the risks of surgery and likely failure in the US. Then that's your benchmark of what you'll be up against in another less developed country. If it's high risk in US, it'll be even higher elsewhere.\nGoing OS for any complicated treatment is fraught with risks. Apart from quality risks, these are usually short-term trips that don't allow for proper observation of healing and taking care of any complications. And if you get back to the US, and the surgeons aren't satisfied with the workmanship, they're not going to want to take on your case to fix it. Look for simpler options than full implant retained prosthesis. Consider 2-implant or at most 4-implant supported dentures. US patients tend to go to Mexico; Australians tend to go to Thailand; UKs tend to go to Hungary. All are risky - you'll never go back for any problems that might arise." }, { "id": 441, "title": "red patch on my tongue", "dialogue": "soqrates: hi guys I have noticed 25 days ago a red patch on my tongue I went to dentist he said cuz of my teeth is sharp it causes that he did fix the sharpness of my teeth 10 days ago yet it didn't go and still the same \n\nim just worried if this could be cancer if anyone know plz tell me cuz im so scared of it \n\nI do get burning sensation little bit ear pain with sore throat happened 2 days ago honestdoc: It could be possible migratory glossitis. Ask your dentist to prescribe triamcinolone in dental paste. Some 3rd party insurances may not pay or cover it but the medication will help it heal faster. soqrates: the picture above 25 days ago \nthis is how its now\n\n\nhonestdoc said:\n\n\n\n\t\t\tIt could be possible migratory glossitis. Ask your dentist to prescribe triamcinolone in dental paste. Some 3rd party insurances may not pay or cover it but the medication will help it heal faster.\n\t\t\nClick to expand...\n\nthank u so much doctor for replaying \nI will visit the dentist and ask him what u told me im just worried if this is a cancer cuz each time I go to google they only show cancer stuff got me so scared soqrates: the picture above was taken 25 days ago \n\nthis picture is right now I don't know if its getting better or worse honestdoc: My tongue is like that. I have geographic tongue. It looks normal to me." }, { "id": 442, "title": "RARE Extra/ supernumerary teeth and wisdom teeth", "dialogue": "Ambarr: I've attached a picture.\nI have a total of 5 extra teeth that need to be removed surgically. The dentist told me that such cases are extremely rare and this needs to be dealt with immediately, it could cause serious issues otherwise.\n\nShould I have them all removed at once? Could it damage any nerve or cause any serious problems? How long will recovery take? \n\nAnd what's the procedure? honestdoc: I see 3 molars on top right and 3 molars on lower right. Supernumerary molar would be the 4th furthest back. The top back tooth #1 and the lower 2 most posteriors #31 & 32 are in ectopic (altered path) eruption. I don't see any extra (supernumerary) teeth.\n\nThere are risks involved. Tooth #1 has a slight risk of trauma/damage to the sinus and surroundings. #31 & 32 has more of a risk for major nerve damage. A more accurate image called a dental cone beam/CT scan can illustrate 3D positioning of the nerve and other vital structures. Other dentists may disagree but a realistic option is to not do any or all ectopic molar extractions. Another option to minimize trauma/damage is to do a coronectomy (intentionally leave roots). Tooth #4 (top right 4th back) is grossly decayed and needs extraction. Ambarr: honestdoc said:\n\n\n\n\t\t\tI see 3 molars on top right and 3 molars on lower right. Supernumerary molar would be the 4th furthest back. The top back tooth #1 and the lower 2 most posteriors #31 & 32 are in ectopic (altered path) eruption. I don't see any extra (supernumerary) teeth.\n\nThere are risks involved. Tooth #1 has a slight risk of trauma/damage to the sinus and surroundings. #31 & 32 has more of a risk for major nerve damage. A more accurate image called a dental cone beam/CT scan can illustrate 3D positioning of the nerve and other vital structures. Other dentists may disagree but a realistic option is to not do any or all ectopic molar extractions. Another option to minimize trauma/damage is to do a coronectomy (intentionally leave roots). Tooth #4 (top right 4th back) is grossly decayed and needs extraction.\n\t\t\nClick to expand...\n\n\nThank you so much for the response. \n\nSo the best option would be not to do anything at all?\n\n I suffer with a lot of pain and toothache because of this. Strong painkillers only help for so long. Is there any specific painkiller I could take that'd help? honestdoc: First, we need to identify the pain. Possible source is tooth #4 with gross decay and it needs extraction. Strong painkillers can become addictive. In the US, we have a narcotic abuse epidemic. Best options are to consult with your trusted dentist and come up with a solid plan. Yes, possible options may be to leave the back molars alone or maybe take out 1 or 2, or coronectomy on the highest risk lower molar. Ambarr: honestdoc said:\n\n\n\n\t\t\tFirst, we need to identify the pain. Possible source is tooth #4 with gross decay and it needs extraction. Strong painkillers can become addictive. In the US, we have a narcotic abuse epidemic. Best options are to consult with your trusted dentist and come up with a solid plan. Yes, possible options may be to leave the back molars alone or maybe take out 1 or 2, or coronectomy on the highest risk lower molar.\n\t\t\nClick to expand...\n\n\nThank you so much for the advice." }, { "id": 443, "title": "Day 5 Post Extraction Still In Pain", "dialogue": "nance75: Hi, I'm new here. I had my lower molar extracted Wednesday of last week, #30. That was after a month and a half wait from when the agonizing pain started (decay and infection under a filling, touching a nerve and causing bone recession). I was on antibiotics the entire time. The extraction was easy, came out in one piece, and the oral surgeon had me stop the antibiotics. \n\nOn Saturday (day 3) I noticed I was still in as much pain as when the novacaine wore off. I called the surgeon and he had me restart antibiotics. Now I'm at day 5 and it's slightly better, but I'm still living on 800 mg ibuprofen round the clock, and an extra painkiller as needed.\n\nI've had a dry socket before and I thought it would hurt more, but maybe I've been in pain so long it just feels the same?\n\nDoes this look like dry socket? I've been following all instructions to the letter, I don't smoke, I've not had hot liquids, etc. \n\nIf it's not dry socket, is there any reason to still be in pain? honestdoc: Dry socket is when the extraction site loses its clot and bone is exposed. From the difficult image, I still see the clot sealing the extraction site. Sorry for your prolong pain, continue with following the Post-op instructions and try to get as much rest as possible. If you notice any swelling including under your jaw, get followup immediately." }, { "id": 444, "title": "Intense Pain 6 days after 4-tooth extraction, white thing in the wound.. Help please??", "dialogue": "Shann: I had 4 teeth (premolars) extracted 6 days ago to make room for teeth movement (obviously I have braces). \n\nUnfortunately, the pain is still as bad as it was on the first day despite the procedure having taken place almost a week ago. It's so painful I can hardly speak, eat or drink and as a result I'm having low blood sugar and dehydration. \n\nI have washed 3 times daily with a mouthwash the dentist gave me, and for the first few days also used the warm salt water washes. \n\nI'm getting most of the pain in the lower two extraction wounds. Here is an image of one of them (the other looks similar-ish). You might also notice from the picture that the gums around the extraction site have gone a very pale pinky white colour, which is lighter in real life than it is in the picture. I have been taking medication (such as Maxigesic and Panadol) but they hardly do anything. \n\n\n\n\n\n\nSorry for the bad quality photo, it was the best I could do on my iPhone, and the farthest I could open my mouth while in heaps of pain. Does this look normal to you or should I get checked out for an infection/dry socket? It's hurting like hell I don't know what to do. drmins: Dry sockets usually start after 3-4 days after extraction,especially when there are food lodgment in the extraction site or when the oral hygiene is poor. Its always recommended to have tooth or one side (right or left) extracted on one day and then wait for it to heal,before you extract the other side. This helps you pay better care and prevent biting with the wounded side.\n\nA pack of eugenol dressing by your dentist may help. Your dentist will also confirm that there are no broken pieces of tooth (chances of which are very less). \n\nKeep smiling. Lauralie: Shann said:\n\n\n\n\t\t\tI had 4 teeth (premolars) extracted 6 days ago to make room for teeth movement (obviously I have braces).\n\nUnfortunately, the pain is still as bad as it was on the first day despite the procedure having taken place almost a week ago. It's so painful I can hardly speak, eat or drink and as a result I'm having low blood sugar and dehydration.\n\nI have washed 3 times daily with a mouthwash the dentist gave me, and for the first few days also used the warm salt water washes.\n\nI'm getting most of the pain in the lower two extraction wounds. Here is an image of one of them (the other looks similar-ish). You might also notice from the picture that the gums around the extraction site have gone a very pale pinky white colour, which is lighter in real life than it is in the picture. I have been taking medication (such as Maxigesic and Panadol) but they hardly do anything.\n\n\n\n\n\n\nSorry for the bad quality photo, it was the best I could do on my iPhone, and the farthest I could open my mouth while in heaps of pain. Does this look normal to you or should I get checked out for an infection/dry socket? It's hurting like hell I don't know what to do.\n\t\t\nClick to expand..." }, { "id": 445, "title": "I need help from Nigeria. A doctor extracted my tooth, but water is coming out of my nose", "dialogue": "Fidelis John: The Nigerian dentists said it's OK but I can't talk properly so what is the solution honestdoc: You may have a sinus perforation. Usually a perforation less than 4 mm can close up naturally. You may need to have further surgery to close the perforation." }, { "id": 446, "title": "implant movement( Dentist insists that nothing wrong)", "dialogue": "Aloviva: Hello there, \nI had th implant placed four years ago, and until now I've had no problems but recently I notice the movement of the crown.came back to dentist and he said that he feels the movement but we should leave it as it is because the X-ray doesn’t show anything.\nFive years ago the same dentist was placing the implant( on the same place) which was regected after one year and he replaced it with a new one( which is wobbly now). I don’t know what to do as I am afraid if I leave as it is it would destroy my bone. MattKW: There's too much crown on top to be held by that implant. Aloviva: MattKW said:\n\n\n\n\t\t\tThere's too much crown on top to be held by that implant.\n\t\t\nClick to expand...\n\nThanks for reply.\nWhat can be done? To replace the crown? P.S. does it look like he didn’t remove the root canal( the white blemish on the right )? Do you think the implant placement was done correctly?( not to close to the neighbor tooth) MattKW: Aloviva said:\n\n\n\n\t\t\tThanks for reply.\nWhat can be done? To replace the crown? P.S. does it look like he didn’t remove the root canal( the white blemish on the right )? Do you think the implant placement was done correctly?( not to close to the neighbor tooth)\n\t\t\nClick to expand...\n\nReplace the crown with a half-size width. You will be left with a gap in front, and may have to consider another single implant and crown. I don't know what the blemish represents, but it is possibly part of an old gutta percha from an RCT - should be easy to remove. The current implant is very close to the tooth behind, but can't see any reaction and would only consider removal if absolutely necessary. Aloviva: MattKW said:\n\n\n\n\t\t\tReplace the crown with a half-size width. You will be left with a gap in front, and may have to consider another single implant and crown. I don't know what the blemish represents, but it is possibly part of an old gutta percha from an RCT - should be easy to remove. The current implant is very close to the tooth behind, but can't see any reaction and would only consider removal if absolutely necessary.\n\t\t\nClick to expand...\n\n\nThank you very much for your answer. Aloviva: Hi again. Had a second opinion with another doctor and he said the implant wasn’t placed correctly and offered to remove the implant and to do the sinus lift with a bone craft and place the new implant in the right place. I don’t know should I risk it or just leave it wobbly crown as it is now( my dantist tried but couldn’t remove crown from the implant). MattKW: Aloviva said:\n\n\n\n\t\t\tHi again. Had a second opinion with another doctor and he said the implant wasn’t placed correctly and offered to remove the implant and to do the sinus lift with a bone craft and place the new implant in the right place. I don’t know should I risk it or just leave it wobbly crown as it is now( my dantist tried but couldn’t remove crown from the implant).\n\t\t\nClick to expand...\n\nThe implant appears well-integrated, so removal would be difficult and risky.\nI assume the crown is cemented onto the implant. They can be removed, but might have to be drilled off. Aloviva: MattKW said:\n\n\n\n\t\t\tThe implant appears well-integrated, so removal would be difficult and risky.\nI assume the crown is cemented onto the implant. They can be removed, but might have to be drilled off.\n\t\t\nClick to expand...\n\n\nUnfortunately the implant is not cemented. It’s a Bicon implant( not screwed or cemented). MattKW: Aloviva said:\n\n\n\n\t\t\tUnfortunately the implant is not cemented. It’s a Bicon implant( not screwed or cemented).\n\t\t\nClick to expand...\n\nSorry, I may have not been clear. The implant goes in first, then a screwed abutment, and then a crown is the top part. The crown is either cemented on the abutment, or screwed in as part of the abutment. From the Bicon website, it appears that their crowns for molars is cemented on the abutment. So the crown would have to be drilled off the abutment; the implant remains untouched. Aloviva: First of all I just want to say thank you for your time and replies.\nThis is the situation.\nMy first dentist who did the implant told me that he couldn’t replace the crown as he tried to knock it off (literally). He explained that this implant is type of a cone which goes on the top of abutment( not screwed or cemented) . After couple attempts of removing it he just gave up. I went to another doctor who couldn’t understand why the crown not cemented or screwed( he said he’ve never worked with implants like that before and asked me to bring the medical journal from this doctor to see what kind of the implant is there).Because of this type of the implant if he removes the crown he wouldn’t unfortunately be able to replace just the crown as they don’t work with this type of the implant here . Then he has to do the whole process again( whole the new implant) And I don’t know what to do as I am worried if he starts to remove it it could damage the other tooth as it’s too close to it. And implant itself sits quite tight. I really appreciate your help and thank you so much for your answers. MattKW: Aloviva said:\n\n\n\n\t\t\tFirst of all I just want to say thank you for your time and replies.\nThis is the situation.\nMy first dentist who did the implant told me that he couldn’t replace the crown ......\n\t\t\nClick to expand...\n\nNo, that doesn't make sense, and I've been to the Bicon website where they have the Manuals and Catalogues available for download, so I don't think your dentists have even looked. \nIf you try to remove the whole implant, you are going to lose a chunk of good bone.\nAnyway, other options are:\n\nContact Bicon and find out who they might sell their product to from their invoices. Maybe you can find a dentist in your area who uses it. Maybe they can even advise your dentists about how to retrieve this situation.\n\nFailing that, it would be possible to drill off the extra crown and leave the one on the abutment. Clumsy, and a bit of a pain, but at least that'll stop the excessive forces, and if all goes well you might be able to get another implant squeezed in the gap. Aloviva: You are right ( I suspect that the first dentist is not that good with the implants after all ).thats why I am frustrated and feel totally helpless in this situation. I tried to contact several implantologist in the area but none of them use Bicon and they even never heard of this brand /type of the implant. Do you think if I just leave the situation as it ( slight wobbly crown) and wouldn’t go with the solution of the second dentist, will it do damage to my bone in the future? MattKW: Aloviva said:\n\n\n\n\t\t\tYou are right ( I suspect that the first dentist is not that good with the implants after all ).thats why I am frustrated and feel totally helpless in this situation. I tried to contact several implantologist in the area but none of them use Bicon and they even never heard of this brand /type of the implant. Do you think if I just leave the situation as it ( slight wobbly crown) and wouldn’t go with the solution of the second dentist, will it do damage to my bone in the future?\n\t\t\nClick to expand...\n\nIt's really hard to be sure. If the implant gums are in good health, then I have to assume either the crown or abutment is loose. Maybe one of those components will come out by itself over time, and then you could look at redoing it; maybe your dentist could reduce the height of the crowns for now so they don't bother you. Ok, see what happens. It can't be worse than trying to take out the implant. Aloviva: Thanks again for your advices ." }, { "id": 447, "title": "PLEASE HELP!!! Wisdom tooth extraction site pain after one month!", "dialogue": "Suhda: Hi guys, \n\nIm panicking!!!! I took out my wisdom teeth a month ago and developed a dry socket which closed up now but still experiencing discomfort and mild throbbing. There’s some redness in the photo which my OS said iant an infection but I want to make sure it isnt’t. Can you please help? Im so scared of antibiotics because i have ibs. MattKW: Looks reasonable to me. It can take up to 3 months to fully heal. There's no indication of infection, and therefore no indication for antibiotics. honestdoc: I believe Dr. MattKW is right. I don't see anything unusual. As long as there are no swelling, and no palpation sensitive areas under the jaw and neck regions (swollen lymph nodes), allow the extraction site to heal. Taking out lower wisdom teeth are very traumatic and requires some healing time. Suhda: Thank you so much for answering. The reason Im asking is because I still get headaches and im nit comfortable eating on that side yet aftev a month. There’s a little red area where the dry socket was and I was scared thats a low grade infection. Is the pain normal one month after? MattKW: Suhda said:\n\n\n\n\t\t\tThank you so much for answering. The reason Im asking is because I still get headaches and im nit comfortable eating on that side yet aftev a month. There’s a little red area where the dry socket was and I was scared thats a low grade infection. Is the pain normal one month after?\n\t\t\nClick to expand...\n\nBe more patient. If you don't need regular painkillers, and you're sleeping OK at night, just give it a bit more time." }, { "id": 448, "title": "I am not sure what to do", "dialogue": "N3X4: Hi, i get some pain in teeth on my right down side, he fixed but not finished, he put some medicine there, and i need in monday to change and put new... (after doing that, pain stopped) i think... but he request to made x-ray after showing he say that can be very big problem and that is rare, not seen recently... \nThere is 2 teeth right like problematic, what u think i not have ANY pain never there... \nimg: https://ibb.co/dr97Ud\nSorry for my terrible english, just writen in hurry... MattKW: I'm guessing you're about 17 years old? Big problems with 7 impacted teeth, and 1 deeply decayed. It looks like the 47 molar on lower right is the one he was working on. On the lower left of your jaw is a pair of doubly impacted molars, the 37 and 38.\n\nI'd suggest you see about having all 8 teeth removed by an oral surgeon. \n\nThe 37 and 38 may not be giving you trouble now, but you are very young, and it is unlikely you will get to old age without problems of infection or decay. There is a risk of damage to the nerve when the 37 is removed, but a surgeon should be OK with that.\nThe 47 he's just started working on will be useless when the 17 and 18 are removed, so don't waste any more time and money on it.\nDo the extractions ASAP before the roots of 18, 28, 38, and 48 finish development. You are unlikely to have any pain with them for a while, but the difficulty of removing all these teeth will increase as you leave it longer." }, { "id": 449, "title": "Infected wisdom tooth extraction sites?", "dialogue": "Dtab18: So I got all four of my wisdom teeth out almost 3 weeks ago and I am still experiencing some pain on one side. Ibuprofen helps get rid of the pain but I am worried that this is not normal. I am also worried because there is a red growth that formed near the extraction site and looks like there is another one beginning to form on the other side.. I have attached photos of each. What does this mean? MaverickDMD: Could be a bony sequestrum or even osteomyelitis. Warrants a look and X-ray to diagnose but definitely get this checked out. Suhda: I hve a similar situation 4 weeks post extraction. Dentist said its not an infection did youfigure out what it was? Dtab18: Suhda said:\n\n\n\n\t\t\tI hve a similar situation 4 weeks post extraction. Dentist said its not an infection did youfigure out what it was?\n\t\t\nClick to expand...\n\n\nFirst my dentist gave me antibiotics in case of infection then once I was able to see the oral surgeon who did the surgery, he used a syringe and drained the extraction sites. After that it felt a lot better and went away soon. But I think he said it was just a flap of skin. So I suggest going back to see whoever did the surgery. Suhda: Dtab18 said:\n\n\n\n\t\t\tFirst my dentist gave me antibiotics in case of infection then once I was able to see the oral surgeon who did the surgery, he used a syringe and drained the extraction sites. After that it felt a lot better and went away soon. But I think he said it was just a flap of skin. So I suggest going back to see whoever did the surgery.\n\t\t\nClick to expand...\n\nThanks for your reply. Thing is im very wary of taking antibiotics because they send my stomach into hell. How would I know if its an infection? Every dentist here is closed for eid holidays and cant see one before 2 days" }, { "id": 450, "title": "Post extraction infection??", "dialogue": "Suhda: Hi guys, \n\nI took out my wisdom teeth a month ago and developed a dry socket which closed up now but still experiencing discomfort and mild throbbing. There’s some redness in the photo which my OS said iant an infection but I want to make sure it isnt’t. Can you please help? Im so scared of antibiotics because i hve ibs. Suhda: Here are more photos" }, { "id": 451, "title": "Molar extraction - Xray - Desperation ahead", "dialogue": "ablue: Hi there! I'm a 28 y.o man living in UK, and just been told by a dentist that I have to get a tooth that I had a root canal done about 10 years ago, extracted and have an implant with bone graft. I have no chances to pay for it, I wish I had the £3000 that he mentioned but I don't. So I'm asking first of all if the extraction is required, and also I've read around about overseas clinic if you could recommend a few?\n\nHope you can help, I'm desperate Here's my X-Ray https://image.ibb.co/chKu4d/R5.jpg MattKW: The RCT is certainly of poor quality. Have you considered a consultation with a endodontist to have the RCT redone properly? If you decide to have it extracted, there is no pressing need to have it replaced, unless it bothers you. Maybe your financial circumstances will change in the years to come, and you could do an implant later if you wish. I wouldn't go for a tourist implant - here in Australia, we have patients that go to Cambodia, Thailand, and come back with some appalling treatment. I understand that the UK citizens tend to go to former Eastern Bloc countries with similarly poor results. Not worth it. Becky: ablue said:\n\n\n\n\t\t\tI wish I had the £3000 that he mentioned but I don't\n\t\t\nClick to expand...\n\n\nTry finding an NHS dentist, it should be far cheaper" }, { "id": 452, "title": "Sterilization of Dental Implants", "dialogue": "garigazari: Hi,\n\nI am chasing for very specific information for the manufacturing of dental Implants. I've got few implants which are packed but they haven't been sterilized after their producing. So they are missing the sterilization part during their manufacturing process which as far as i know is the last part.They sterilize them after packaging. I am wondering which way of sterilization are using the companies. Can i just use Autoclave or that's not appropriate? Do they need Gamma sterilization or maybe with UV light? Any ideas? MattKW: Here's a link for you. I don't think this is a DIY project! \nhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618465/figure/F1/?report=objectonly garigazari: Thank you for the provided info. I know that's not a DIY project that's why i am wondering where should i look for help. From what i can see all of the 4th methods for sterilization are appropriate. Am i correct? MattKW: garigazari said:\n\n\n\n\t\t\tThank you for the provided info. I know that's not a DIY project that's why i am wondering where should i look for help. From what i can see all of the 4th methods for sterilization are appropriate. Am i correct?\n\t\t\nClick to expand...\n\nYou shouldn't be looking into this at all. Firstly, the cost of finding someone willing to do this will outweigh any savings you would get. Secondly, it is unethical and probably illegal to self-sterilise these products and pass them off to unsuspecting patients as if they came directly from the manufacturer." }, { "id": 453, "title": "Biopsy?", "dialogue": "E Weaver: my 5 year old son has this painless, white patch on his gums for at least 4 weeks. Nothing showed up on an X-ray either. The pediatric dentist was concerned, my general dentist was not. Has anyone seen something like this on a five year old? I’m taking him in again but I am freaking out that it is bad. Any ideas? MattKW: Strange that your general dentist was unconcerned but your specialist paedodontist (who should know more) was concerned. Hard to tell from the indistinct photo, but looks like keratosis of the gum, and I'd guess it was some habit of rubbing , or something he's using that caused light trauma. I wouldn't be biopsying just yet. honestdoc: I agree with Dr. MattKW. The only way to know for certain is to cut it out and examine it under a microscope (biopsy). Keratosis is the thickening of keratin similar to a callous but abnormal in the mouth. It can be a precursor to Squamous Cell Carcinoma (SCC) which is the most common cancer in the mouth.\n\nIn order to obtain one on a 5 year old, we need to anesthetize the area. I'm not sure we need to sedate your child. All involves risks including trauma both physical and emotional. We need to weigh the risks vs benefits.\n\nThe old school assessment of oral disease (pathology) is when you hear hoof beats, think horses not zebras. It is very rare to unheard of for a 5 year old to have SCC. According to various sources, a possible lesion similar to the one in the image has a ~97% chance of resolving with no mitigating factors such as irritation, trauma, medications & supplements, or special diet/beverages.\nIt's is hard to determine from the image but another possibility is the eruption of the adult incisor. I do have a 5 year old at home and if this was in her mouth, I would continue to watch it and monitor for possible mitigating factors." }, { "id": 454, "title": "Dry socket", "dialogue": "Johnnyrocket: Is this enough blood or is it dry socket? MattKW: Looks like a nice clot. If it occurs, a dry socket will develop 3-4 days after the extraction, then it will turn to mush. Leave it alone and wait and see. Johnnyrocket: I feel like I’m pulling it out when I swallow sometimes and it seems to be withering away... I’m almost on day 3 MattKW: Don't worry. Be patient. Johnnyrocket: I’m not sure if this is bone or not June 5 will be my 5th day Johnnyrocket: I think the blood clot is gone and I see a hole, it’s been 9 days MattKW: So, it's well past problem stage. All up, it'll take about 3 months for the hole to fill up. It won't matter if you get food in it, apart from being annoying." }, { "id": 455, "title": "Having 2 front teeth removed. What temp option is best?", "dialogue": "Anne Emily: After cracking both front teeth at about 5 years old, I've been through composites, resins, crowns, root canals, an apicoectomy and now 40 years + later, due to infection, they need need to come out. I've been feeling sad, old ugly etc about the whole thing, but wow, could be so much worse, right?!\n\nI've been reading about flippers, essix appliances....are there more options? It will be early next year before I'm healed and they're ready to place the implant.\n\nI'm hoping for an option that looks most realistic, low maintenance, least painful and lowest risk of causing a lisp. I know nothing is a \"perfect\" option, but what are your recommendations? MattKW: Simple 2-tooth partial denture, \"flipper\". Bearable. Busybee: What about a snap on smile ? MattKW: Busybee said:\n\n\n\n\t\t\tWhat about a snap on smile ?\n\t\t\nClick to expand...\n\nCheap versions aren't good; expensive versions are better but much dearer than a simple denture. I have never seen any in real life, only on the web, but I have reservations about how they would affect speech, eating, and general comfort. Would love to hear from anyone with real experience." }, { "id": 456, "title": "Tingling throbbing face 3 days after wisdom tooth extraction", "dialogue": "Mindy: I had my impacted wisdom teeth removed Thursday morning, starting later this evening I noticed a tingly-throbbing pain radiating from my chin up to my ear and eye and as the nights progressed it's become constant. It's not excruciating but it's defintely noticeable. When I went to the bathroom to rinse my mouth, I checked to make sure the blood clots were still there and the side that is really throbbing definitely looks still in place and on the other it seems to be not not sure since it's a litte further back. I'm not having any sensitivity to cold air or water and the sockets themselves aren't hurting more than usual. Is this normal or could it be the start of dry socket even though blood clots are still in place or something else? MattKW: Too early to say. A dry socket will just HIT you about 3-4 days post-op, and you've have pain that isn't relieved by painkillers. Just rest and take it easy for now. Mindy: Thank you! I have to leave to go on a 9 hour flight this coming wekend and have been so paranoid that something will go wrong in the healing process to make it a rough one or delay it somehow. Thanks again." }, { "id": 457, "title": "Slightly wobbly crown on 5 year old implant", "dialogue": "toothfairy: I had five upper implants placed five years ago, and until now I've had no problems - in fact, for me, getting the work done was a sanity-saver after over a decade of losing crowns etc. \n\nRecently, though, I've noticed a slight wobble in an upper front left crown. The original work was done in Marylebone, but I live in North london, and at present it's very difficult for me to get into town. I've tried finding a local dentist to sort this, but none of them use a system that's compatible with the one used in Marylebone, which is: Implant Direct - Screwplant Platform size 3.7mm (this information was sent at my request by the dentist who placed the implant).\n\nCan anyone help, please? And how much should I be worried? My oral hygiene is obsessively good, for obvious reasons! I'm dealing with other health problems right now, too, so this is such a downer. I was hoping for a quick local fix MattKW: If you Google the manufacturer, they should be able to give you the name of their distributors. The distributors will prob have a list of dentists who buy their products, and their sales rep might even be able to suggest what could be wrong. Sales reps are usually very willing to come out to a dental practice and help resolve problems." }, { "id": 458, "title": "Wisdom tooth extraction", "dialogue": "Mee: I got my upper wisdom tooth surgically extraction two days ago. I have a dissolving stitch over the gum but the stitch (what I think is the stitch) is covered thick with blood and appears to hang down quite a bit. Is this normal? MattKW: All OK. Mee: MattKW said:\n\n\n\n\t\t\tAll OK.\n\t\t\nClick to expand...\n\n\n Thank you. Having looked at it again it may be a bit of gum that’s hanging down but the stitch looks to be there somewhere. Is this also normal? Will the gum reduce itself? The pain has being getting better every day and is almost gone." }, { "id": 459, "title": "Salvaging an implant with fractured screw / custom cast post and core", "dialogue": "SeekingASolution: Hi!\n\nI am hoping for any input on this case, and if anyone can recommend any professionals who have worked on salvaging implants with cold welded screws, wither by retrieving the screws or making custom cast post and core fixed crowns / similar - or any other solutions. \n\nBackground: I have a narrow implant at 22 which has a fractured screw. Three attempts to remove it have failed. It's long (15-17mm) and well osseointegrated. I don't want to remove and replace it! I also am not keen on giving up on it and having it embedded with a gum graft and having a resin bonded bridge over the top, as I'm worried about the adjacent teeth having to be shaved down and overloaded. \n\nDoes anyone know of anyone who's done this work - in Australia or overseas? Or can you suggest where I can start looking? \n\nThank you!!! MattKW: I can't see you have any option but to remove it. Implants are made to extremely tight tolerances and you can't repair them. Have you been to a prosthodontist to have the screw removed, or is it a general dentist? A prosdo might also have other ideas about how to replace the implant rather than a resin-bonded bridge (used in rare circumstances). The company reps for the implants are often very helpful, and know people who might also be able to help. SeekingASolution: Many thanks for the reply. \n\nInitially I went to the general dentist who placed the implant, then to a prosthodontist who recommended either a new implant or a bridge. He may have only recommended the bridge because I said I didn't want another implant. So I came to the same conclusion - it would need to be removed. Then I saw a periodontist for an unrelated area, and he considered a new implant a 'challenging non-pragmatic option' because of the length (15-17mm) and its osseointegration. I was reluctant anyway so this started me looking for alternatives, and I read many articles about fractured screw removal techniques, and a few about a post and core approach. \n\nI have also contacted Neoss and am hoping they will get back to me.\n\nIn the meantime I will keep looking!" }, { "id": 460, "title": "Implant #2 failed.", "dialogue": "Trudijane: A month ago, my upper right molar Implant failed due to an infection. I also had the most ungodly pain prior to it being pulled by my periodontist. It was after I got billed for the removal of the implant that got me upset - as I did not expect that at all. And, here is why.\n\n2 years ago, I lost my upper left implant. Shortly after it was put in, my dentist discovered a hole in my gum through which you could see the screw of the implant. Long story short, my periodontist spent close to a year of trying to repair it saying at first it would be a cinch to do. It turned out to be a nightmare of procedures, surgeries, mistakes and healing. Ultimately, I couldn't stand it anymore and neither could he - so I lost that implant and he did not want to replace it because of all the problems with it.\n\nHe no longer uses this brand, but he said he was watching another tooth (same brand) on the upper right molar since it was the same brand. 2 months ago, I developed a horrible infection with unbearable pain and it took his colleague (after a CT scan) to see what the cause of the pain was. There was all this infectious material beneath the implant - so it had to be pulled once again.\n\nSo now I have these 2 big gaps on both my left & right side after paying a lot of money for both. I guess he felt responsible for the first implant failing and the need for it to be pulled - but then why in the world would he bill me for pulling out the 2nd failed implant? I made in clear that I paid for these 2 implants in good faith, and both of them had failed and I wondered why he billed me for pulling out one implant yet not the other. I AM paying for it - because I really don't want to get into any legal issues, but I am still mad & upset about it - but mostly because of the 2 failed implants ...I'm not even sure how to chew with 2 huge gaps on both sides of my mouth.\n\nHe said it actually cost a lot more (all the procedures and all) so he made it sound like he gave me a huge discount. I really like this guy, but he is now semi-retired and maybe he's losing it or something ... I don't know. But to charge me for pulling yet again another failed implant doesn't seem right or ethical.\n\nEventually, I would like to have the implant replaced (with another brand). What are my rights here???\n\nThank you. MattKW: You'd have to talk to local regulatory body or consumer board. You would most likely have to get all records and get a second opinion from someone with a high reputation - the regulator may be able to suggest someone. I can't tell you here if it's something the manufacturer did, that the periodontist did, or that even yourself did was wrong. Sometimes things just fail for no apparent reason. So talk to someone and gather the data. SeekingASolution: Ouch!!! I really feel for you! Sounds like an awful time \nI have had a problem with an implant having a fractured screw, and I did what Matt suggested - I gathered as much information as I could, and got other opinions from another dentist, and prosthodontists. I also spoke to my sister who's a lawyer. I then spoke to the dentist who placed the implant, and he agreed to refund me for the cost of the implant. I felt bad for asking but someone told me it's likely he would have insurance to cover it. But that's just my experience, as a non-professional. I think Matt's advice is sound - especially since you allude to mistakes being made in the treatment of your first implant..." }, { "id": 461, "title": "Lump/Swelling at Wisdom Tooth Extraction Site", "dialogue": "ome8217: Hi!\n\nA week ago I had all four wisdom teeth extracted and have been doing fairly well. A few days ago after using the syringe to clean out my right socket, I noticed a lump on the inside of my cheek. It wasn't given me any issues until last night, when I used my syringe and may have poked a bit too far and caused the socket to bleed. So now, along with the socket, the mystery lump feels sore too and it's uncomfortable to chew on the right side of my mouth now.\n\nI'm worried that the lump may indicate an infection, but when I called the oral surgeon the nurse on the line insisted I wait another week to see if this is scar tissue instead. I'm just worried because I'm having quite a bit of pain now and don't want to just let an infection sit for another week. \n\nIn the picture I attached, you can see that the gum is purple on the inner corner and that's where the lump is. I'm also still having issues with the socket bleeding, as you can see lol. Any thoughts? Anyone else have lumps like this after wisdom teeth extraction? My parents are not very helpful regarding me trying to figure this out.\n\nNote: I don't have a fever and my lymph nodes seem normal." }, { "id": 462, "title": "Root canal fracture left in sinus after Apicoectomy", "dialogue": "Eyad: Hello, \nI would like to ask about the xray attached i’ve done an Apicoectomy and after the operation I’ve done an xray that showd some parts of the root canal fillings in my sinus left there flooting, so what should i do? MattKW: Yep, looks like it's in the sinus. It seems too far up to be in buccal tissues. A CBCT would help confirm and narrow down exact position. You need to have it removed before it develops into a granuloma. Not a big deal, go see an oral surgeon. Eyad: MattKW said:\n\n\n\n\t\t\tYep, looks like it's in the sinus. It seems too far up to be in buccal tissues. A CBCT would help confirm and narrow down exact position. You need to have it removed before it develops into a granuloma. Not a big deal, go see an oral surgeon.\n\t\t\nClick to expand...\n\nThanks Dr. for your reply I appreciate it" }, { "id": 463, "title": "MEDICAL EMERGENCY - Vasovagal syncope post local anaesthetic", "dialogue": "PositiveCopy: Around 2 weeks ago I had a very nervous patient enter the clinic for the extraction of a broken down LL8. The patient had not eaten all day so we provided them with a glucose drink pre-treatment. Although the patient was nervous (taking many deep breaths during initial examination), he said he was comfortable enough and happy to undergo the treatment. I administered the LA (Left ID block followed by a long buccal infiltration) and waited around 5-10 minutes for full anaesthesia to be achieved. Once the patient was fully numb and I was just about to perform the extraction, he suddenly experienced vasovagal syncope and lost consciousness for around 20 seconds. Thankfully this was spotted the second it happened and was managed immediately. The patient quickly recovered but still felt slightly uneasy and anxious for a good while after the incident. We therefore decided alongside the patient to postpone the treatment to another day and ensure he left with an escort. I know it is difficult to say, but is it likely that this event was caused by the local anaesthetic (there was no flashback on aspiration and the event occurred at least 10 minutes after the ID block) or was this more likely due to a combination of the stress, hot weather and lack of food pre-treatment? MattKW: [QUOTE=\" or was this more likely due to a combination of the stress, hot weather and lack of food pre-treatment?[/QUOTE]\nYes, it won't be the LA. Some of these patients haven't been eating or sleeping well for several days, plus taking lots of analgesics, and generally working themselves up in a lather. It was good that you gave him a glucose drink pre-op, and the escort home. I've had a few who faint pre-op because the pain has been relieved by the LA, although most faint post-op. I had one fellow faint before I even started, just at the quote! Maybe this fellow would benefit from nitrous (or even IV) sedation next time. If he's not in great pain, then an OPG might allow you to assess if other wisdoms need extraction and a GA might be better suited." }, { "id": 464, "title": "Bad Smell but no Pain after Upper Wisdom Tooth Removal", "dialogue": "Giselle21: Hi, this is my first post here, female, 24 yo. So I went to the dentist last week to get my upper left wisdom tooth removed (very back down there, so I couldn’t see it but I could feel it when I touched the gum). After taking a panoramic dental x-ray, there were actually 3 of them (the other 2 are bottom wisdom teeth)! *Gasp*. I opted to only have my upper left wisdom tooth removed in that visit, and planned to have the other two removed next month.\n\nAfter having the tooth removed, I didn’t feel any substantial pain as I obediently put my gauze, took my meds and ate porridge a couple of hours after the procedure. Fast forward a couple of days, I felt the string of the stitch dangling over the removal place, but I couldn’t be sure whether it was the stitch went loose or it was only the end-tail of the stitch. Of course, I couldn’t brush that specific location and so I only gargle with salt water and the prescribed mouthwash by the doctor. Thing is, I felt that there were food pieces there, but I couldn’t check for sure since it was way too far down there. When I feel the location with my finger (a clean one, of course) there was a bad smell, but no slightest pain at all.\n\nFast forward one week (now), the location isn’t painful at all. I can even brush the location very, very carefully already and it doesn’t feel painful or bleed at all. But that location still smells bad and when I feel my way along the gum, I feel that the gum doesn’t seem to close (it feels hard, not soft like gums should be). I worry that it may be a dry socket, but why doesn’t it feel painful at all? And what about the bad smell that specific location emits?\n\nCan anybody give me some insight about whether this is normal or not, because I really worry if I have a dry socket. Also I worry that the gum won’t close soon and the root of the tooth beside it will be uncovered for an unhealthy time.\n\nNote: Due to my schedule I can only go to the dentist at least two weeks from now, and I don’t have access to syringes or Waterpiks like some will suggest. Any insights will be greatly appreciated. Thanks! Uptown101: The cause of bad breath after a tooth removal is the flow of blood. The extraction site may have occasional bleeding for first two days which can cause both an odor and an unpleasant taste in your mouth. This blood clot and lack of refreshment is the first reason to cause bad breath after tooth extraction. Stay hydrated to get rid this type of bad breath. Consume fresh juice to keep your body hydrated and eat healthy foods. \n\nHope this helps!" }, { "id": 465, "title": "Adult braces", "dialogue": "Claire Claire: Hi, I'm 38 years old and have a big overbite and don't like my smile. Have seen an orthonditist who's said I'll need surgery to take out teeth to put braces on due to overcrowding. My teeth aren't in the best shape. I don't know where to begin with my treatment. Can you put braces on teeth that aren't fantastically healthy? MattKW: Well, there has to be no active decay underway, so first you need to get everything in order before starting ortho. It would also depend which teeth the ortho wanted extracted - there's no need to fix up any decay in those particular teeth. Other things might matter too, like the ortho will not want you to have crowns or veneers placed until after his treatment. I'd get a treatment plan from a dentist, and then cross-check it with what the ortho wants to do. Uptown101: The first step is getting a referral, usually from a dentist. Your first meeting with the orthodontist will be the consultation. He will look at your teeth and determine what needs to be done in order to straighten your teeth, or if you would even benefit from an orthodontic treatment. After the consultation, the orthodontist will design a treatment that is specific to your needs. Not every person has an underbite or an overbite,and not every person has gaps in their teeth or overcrowding. This initial appointment will be much longer than any of the future appointments. It involves conditioning the surface of the teeth, to provide a place to cement on the brackets, cementing the brackets in place, and placing the first wire." }, { "id": 466, "title": "Redness on hard palate", "dialogue": "aqz: Hi i have had this red area non painfull for a week or so it has got better i have had a stomach bug for the last few days which i am bed bound with dont know if this has something to do with it. I keep getting red areas in hard palate which come and go.but never completly go away. My dentist is not refering me my gps just says its smokers palate. What do i do? I am so anxious that its oral cancer and am obsessed with checking my mouth numerous times in a day its driving me insane. Please help. \n\nThanks \n\nI would like to add i am mouth breather and have dry mouth especially in mornings due to deviated septum could this be irritating my palate? Should i be concerned. And i do also suffer from geographical tongue at times of high stress and anxiety. Busybee: Hi aqz, as I mentioned before you should stop smoking and see if that helps. If your dentist is not concerned and it doesn't hurt then don't worry about it. As far as I know cancerous lesions are more likely to be white, black or a growth (a noticeable lump). Your dentist knows what to look for. If you are really worried pay to have a biopsy just to put your mind at rest. \n\nBut I will just repeat that you should definitely give up smoking because that's really bad for both your oral health and your overall health. aqz: @Busybee hi thanks for ur message, i know i should give up the smoking i am trying so hard. My question is why is redness not going away and some days its more red then others. That must be something sinister? I posted on dental twins but they have only peaked my anxiety even more raising all sorts of questions. My just at my wits end and want to feel normal again. Busybee: If you breathe through the mouth then you might not be getting enough saliva to the area. This isn't great for your oral health. Combined with smoking it's not a healthy mix. MattKW: Doesn't appear sinister, but looks more like smoking-related irritation due to the hot gases as you inhale; as you dentist suggests. Most cancers of the mouth are on the floor of the mouth (under the tongue), or side of the tongue where the carcinogens sit in the saliva. aqz: @MattKW thanks for your response, its been on and off for months now hence why i am concerned. Could my mouth becouse of deviated septum be causing it too? MattKW: No. Septa have nothing to do with it. aqz: @MattKW ok thanks. I am always rubbing area with tongue now becouse of being anxious. I dont know if that is making it worse. It doesnt hurt what should i do now? aqz: @Busybee thanks for your kind words and advice. aqz: @Busybee @MattKW this morning it looks better this is what i mean it comes and goes. MattKW: Maybe because you can't smoke when you're asleep. Leave it alone and stop rubbing it. aqz: erythroplakia is that what it is? @MattKW Busybee: Have you tried to seek help in giving up the smoking habit? I know how addictive it is and I gave up many years ago after trying many times. But giving up makes so much difference to your oral health. I used to get mouth ulcers every now and then and none since giving up. It's really not worth risking your health. Do try to get some help. I used patches, it wasn't easy but you have to want to do it. This lesion is nothing compared to what you are doing to your lungs etc. Please go to your doctor and ask for support. aqz: @Busybee i knoww i am trying too, it doesnt help when my anxiety is through the roof at same time. Its the only thing that seems to keep me calm at the time. But i know i have to give up this horrible habit before its too late... thank you so much for your kind and supportive words means alot. Sometimes your nearest and dearest cant understand what your going through. But a stranger can so ironic. Thank you once again.x Busybee: Well Nicotine is a stimulant so it won't calm anxiety! Try valerian. MattKW: aqz said:\n\n\n\n\t\t\terythroplakia is that what it is? @MattKW\n\nClick to expand...\n\nErythroplakia is a red area, usually fiery-looking, and is a serious concern for possible cancer, definitely need a biopsy. Again, most likely in floor of mouth, tongue back of mouth. Yours does not look erythroplastic." }, { "id": 467, "title": "Prices for services at White Cap Institute in Heber City, UT.", "dialogue": "JeffJ: This is a school that instructs licensed dentists on implant technology and they have workshops where they use patients. They will not give me ANY price info at all, not even a range. I live in CA. where they do have lower priced dentists (around $1500) but because I may need up to 9 tooth implants it adds up (the dentist says that I need ancillary services that could push the final price to 20K) and I do not want to go to a dental school with unlicensed dentists, but am concerned that White Cap may be just half the price of expensive dentists, than it would be the same price as what I would pay the regular dentist nearby. I can only find a few reviews of the place on google reviews from their students (which talk about all the recreational fun they have at the school almost more than the courses) and I think only one from a patient that does not mention ANY prices at all, and some on facebook from again, students only. If someone has been a patient there, can you please tell me what you paid for what services you received and am wondering if patients signed a confidentially agreement, that under the penalty of death, they can not reveal their prices. or a student there and knows what the patients paid for what kind of service please post, thank you." }, { "id": 468, "title": "Partial Denture before implant", "dialogue": "ImNotGinger: I am 24 living in the uk and have recently had my upper right pre-molar removed (No5 I think?) and have been asked by my dentist what I was leaning towards for treatment. I have all of my other teeth but got an acrylic partial denture with no metal just with one tooth on and was going to get an implant within the next year. Would just leaving the gap until the implant is placed have any long term adverse effects or would it be advisable to wear the denture? MattKW: If you've had wisdoms removed (or not present), the it's unlikely you'll get any closure of the 15 gap (FDI; or UR5). Usually the 1st and 2nd molars interlock quite well with opposing teeth to stop any movement. One-tooth dentures can be such a pain. Talk to your dentist, or the person who's going to insert the implant." }, { "id": 469, "title": "Dental Implant and open/bad bite", "dialogue": "Dental Impatient: I had an extraction on tooth 19. I am scheduled for an implant a month from now. I have a notoriously bad bite. My teeth don't touch each other in the front. They do in the back, but in an odd way that's developed over the years. I grind them a lot too, especially at night. My current dentist is not wanting to put a crown on it until my bite is sorted out, but that procedure is extremely expensive and could expose other issues (possible root canals, crown replacements) that will add to the cost. Is it a legitimate danger to put a crown on an implant in this situation? Can it really jar the implant? Should I even be getting one? I don't want to get to the point where I need a bone graft if I decide I want one later. MattKW: Too hard to say for sure. Generally it should be OK to put an implant back there; you're simply replacing what was there before. But, once you do the implant, you may not be able to later change your bite because it will \"lock\" in your current position. Why not get a 2nd or 3rd opinion? Dental Impatient: Can you explain what you mean by lock in the current position? Wouldn't the bite depend on the shape of the crown placed? MattKW: Orthodontics will move teeth because there is a fibre connection to the bone. An implant forms a direct bone connection, no fibres, so cannot be moved later by ortho. My daughter was missing 2 teeth by chance, had ortho to make proper spaces, then had 2 implants. The orthodontist then used the implants as anchors to finalise the job. So if you're happy with your bite, or don't like the risks or cost of the suggested treatment, then look at doing the implant as the final solution. I'd still suggest you get proper 2nd or 3rd opinions before making any decision. Dental Impatient: I see. So orthodontics becomes a lot trickier once I start getting implants. I've never been interested in ortho, it was never recommended to me as a child, and I've heard a lot of bad stories about invisiliign. I've had a couple of grand bite fixing strategies thrown at me, but both have involved crowns/building up or down teeth. I guess that either means my bite is so bad that there's no way to tell if ortho will help, or my teeth don't need it. Liza: How mush cost of dental implant? BeenThere: I've seen ads in my area for $4,000 to $20,000 (it costs the higher amounts if you need bone grafts), and other ads for $2,000 (but, I suspect those may only be part of the total cost involved -- I'd be Very Dubious about what they're providing for just $2,000 -- it's also something of a specialty, I'd be apprehensive about a dentist doing implants and would have a higher comfort level with a specialist). \n\nIn your area, estimates may be free or quite inexpensive (so, you may be able to readily get two or three estimates to get a sense of the cost). Your dentist knows you and what's likely needed, it's a common topic, so your dentist ought to be able to provide a rough local cost estimate or a referral to one or two specialists doing implants in your area so they can advise you. \n\nI was reading up on implants earlier today: Did you know? about 4% of patients are allergic to the titanium used -- it might be worth getting a specialty allergy test before going ahead with an implant procedure (as an allergic response to the metal could greatly contribute to implant failure)." }, { "id": 470, "title": "3 Days Post Tooth Extraction.. is this normal? In lots of pain.", "dialogue": "HedgeWitch: The socket has continued to bleed and my cheek is so swollen I got a black eye. There is lots of throbbing pain and painkillers don’t seem to help, but I really can’t see this being Dry Socket." }, { "id": 471, "title": "Double teeth extractions help!", "dialogue": "sarah pelham: I'm due to have top left and right canine teeth removed for braces in a month. They're very high up but not impacted.\nI'm also due to have lower left and right incisor extracted. I was hoping both canines would be done in one appointment and the bottom ones done in another. But my dental plan says top left canine and bottom left incisor, then next one the right?\nIs it possible to have both canines done in one sitting instead or is there an issue with anesthetizing that area to cover both?\nI really don't want to be left with one canine in. MattKW: In the old days, it was common to take out all 1st or 2nd premolars, so I'd do a side at a time. That's just for patient convenience so only one side is sore. I think maybe your insurer is applying that sort of logic to your different situation, so maybe talk to them. I would do it the way you're suggesting. There's no physical problem doing the canines together, and then the incisors together, or even all at once. It sounds like an admin issue at their end. sarah pelham: MattKW said:\n\n\n\n\t\t\tIn the old days, it was common to take out all 1st or 2nd premolars, so I'd do a side at a time. That's just for patient convenience so only one side is sore. I think maybe your insurer is applying that sort of logic to your different situation, so maybe talk to them. I would do it the way you're suggesting. There's no physical problem doing the canines together, and then the incisors together, or even all at once. It sounds like an admin issue at their end.\n\t\t\nClick to expand...\n\n\n\nThank you so much. I spoke to him today just before the extractions and he was happy to do both canines today. \n they’re all out now and didnt feel any pain. sarah pelham: It’s now been 2 days and so far so good. I now have two V kind of shapes where my teeth used to be (they were high up in the gums but not impacted so still completely visible like fangs).\nHow long will it be until these huge gaps close? Does it take longer being canine teeth that have been indented that way for a long time? MattKW: sarah pelham said:\n\n\n\n\t\t\tIt’s now been 2 days and so far so good. I now have two V kind of shapes where my teeth used to be (they were high up in the gums but not impacted so still completely visible like fangs).\nHow long will it be until these huge gaps close? Does it take longer being canine teeth that have been indented that way for a long time?\n\t\t\nClick to expand...\n\n2 weeks for initial healing; 2-3 months until it's rounded out completely at most." }, { "id": 472, "title": "Extraction gel foam", "dialogue": "Melissabarr123: I had an abscess molar which requires intervinus antibiotics. Once the infection was cured I had the molar extracted (yesterday). The roots were deep, all the way to my sinus cavity. My dentist inserted gel foam and then stiches. \nThere was a clot that formed but after 8 hours the stiches has released and the blood clot disappeared. 21 hours after extraction the gel foam started to come out. I contacted my dentist and he is not back in until Tuesday . He recommended I try to push the gel foam back in and get lots of rest . I'm very afraid of dry root is there anything I can do to prevent this ?. Please help.\nAt this time I have no pain \nFirst picture is with the clot and stiches second picture is the gelfoam coming out. Babygmommy: Did you ever find a solution. I'm having this same problem as we speak" }, { "id": 473, "title": "Sinus lift while on Plavix-bad idea?", "dialogue": "CBarrett: I probably should have asked this question before I had it done 2 weeks ago. Im in constant pain that only Ibuprofen will relieve. I also have stronger pain meds that I am resisting taking.. Pain is a symptom of something wrong, right?.\n\nThe side of my face from my nose up to my eye hurts, not a lot of swelling and no skin heat on the sinus. Im generally feeling sort of sick..Not getting better. I had a follow up with the periodontist, took some pics, said everything looks good and is healing properly. He would only be worried if there was increasing swelling up the side of the face, which he says is not the case. He says to keep taking the pain meds.\n\nBehind his back, I went to ENT MD I knew and he said that the Plavix- an antiplatelet - should have been a consideration before going under the drill. The blood is not coagulating as it should, and the med is causing the blood to pool above the bone in the sinus area. Its not draining properly. He said the danger of an infection is greater, and he gave me an antibiotic to take-Cefuroxime..\n\nIf anybody has any insight into this, I would greatly appreciate some feedback. MattKW: You shouldn't be taking ibuprofen in addition to the Plavix, so stop that now and go to acetaminophen. Plavix is not an absolute contraindication to dental surgery (which is what your ENT friend said, \"a consideration\"). Did the perio know you were taking Plavix, and did he tell you to take ibuprofen for pain relief? Either go back to the perio, or go for a proper consultation with an ENT so you can arrange tests or scans." }, { "id": 474, "title": "Surgeon won't pull.....\"dark area\" under tooth.", "dialogue": "RockRad: Hi---I am in pain with a molar. The oral surgeon said it looks good and won't pull it until he figures out that area where my finger is. Those white wavy lines are supposed to be all the way down. He says there are none there and it has to be explored. Via more imaging. However, I am not so sure why he insists! Has anyone seen anything like this? I can tell it's the tooth! It had fillings, etc. I can feel it! Has anyone had a dark area there? He says it could be anything from normal me to infections to a blood vessel , etc.......Any info appreciated. MattKW: So, you're saying that he wants to remove the 1st molar due to some pain you're having? What's wrong with the tooth, and why does it have to be extracted rather than RCT? A dark area about where you're indicating is usually the depression for the submandibular salivary gland, but everybody knows that. RockRad: MattKW said:\n\n\n\n\t\t\tSo, you're saying that he wants to remove the 1st molar due to some pain you're having? What's wrong with the tooth, and why does it have to be extracted rather than RCT? A dark area about where you're indicating is usually the depression for the submandibular salivary gland, but everybody knows that.\n\t\t\nClick to expand...\n\nThank you for the reply! Yes, I was sure he was fishing for more scans. No, I was looking to get it pulled. He said he could not because that dark area could be a big problem. That was when I got suspicious. \n\nThe dentist who took the xray did not say anything. This man is an oral surgeon. So he said no pulling unless he could take more scans of that area. ugh.......this tooth is hurting me and I want it out. \n\nBut Why would he tell me he had to investigate that if it's a no brainer? Just for the money? He is already rich, being an oral surgeon for a long time......." }, { "id": 475, "title": "Can anyone tell me what this is?", "dialogue": "Amarie: I went to the dentist yesterday and when the anestetic wore off i noticed this lump near the injection site. Does anyone know what it is? MattKW: You would've probably had a palatal injection about there. The injection doesn't normally cause anything except a bit of bruising. If your teeth were abscessed, then perhaps it's part of the abscess surfacing? Really hard to be sure. I'd give it a couple of days. Mother Nature often cures things if given some time. And you seem to have a lot of erosion of your teeth - do you have lots of acidic drinks or juices? (soft drinks, fruit juices). Amarie: They didnt say anything about absess.Yes I drink alot of soda. Most of my teeth are bad. But My mother always had the same issue with most or all of her teeth being gone from erosion. But i figured i would give it a few days to see if it went down at all. MattKW: So, ... Mum lost most of her teeth from erosion, and you're going down the same path? Maybe try and give up the soda unless you want to end up like Mum." }, { "id": 476, "title": "Should I be concerned?", "dialogue": "baplove: Hi guys! I literally have no one who can give me substantial advice about this so I’m taking it to the internet. So the (long) backstory is I'm 17, I had four impacted wisdom teeth and I got them taken out on April 5th (four weeks and one day ago). My surgeon put dissolvable stitches where my bottom two teeth were. Fast forward to Monday, April 16th, I had my check-up. I went in and my surgeon looked at my gums and said they were healing great and he didn’t need to irrigate them or anything. \n\nBy then I thought I was home free. WRONG! SO fast forward AGAIN to Friday, April 20th, my left bottom side of my mouth was hurting pretty bad and I could barely go to sleep. It hurt all of Saturday and it started swelling up and hurting really bad Saturday (April 21) afternoon. (This is where it gets pretty gross so stop reading if you get queasy easily) So when I looked inside of my mouth I could tell it was really swollen, I could barely close my mouth because the inside of my cheek and my gums were so swollen. I couldn’t press my teeth together without biting the swollen tissue. So by then I had done my own research and concluded that it was probably infected. There was a little cut on the inside of my cheek because it was so swollen I think I bit it a little and I poked at the area and some puss and blood came out… so definitely infected. But what worried me about this was that it was a couple centimeters away from where the stitches were, I read a lot of other people’s experiences having an infection after wisdom teeth removal but nobody says where in their mouth the infection actually is. I would think it is supposed to be right where the tooth was removed but that wasn’t the case for me? \n\nMy mom called the doctor on call and I took all of the ones they gave me. On April 23 I went in to see my oral surgeon so he could take a look at my mouth. He irrigated where the stitches used to be (they had dissolved by then and the gums were almost all the way healed over). He also said that the antibiotics should do the trick and if they don’t and it gets infected again he’ll probably have to reopen the area and clean out the hole (idk what to call it sorry). I can’t remember exactly what day I finished the antibiotics, I think it was April 28th or 29th. The day after I took the first antibiotic pill the swollenness went down and it didn’t hurt anymore, and it hasn’t hurt since. \n\nHowever, the problem I’m having is that I’m worried the infection is still there. I think this because I sometimes still taste puss in my mouth (I know, gross) and I was looking back at the area today (Almost a whole month after the surgery) and I didn’t notice it before because the inside of my cheek covers it but there’s a little hole at the bottom of my back molar on the outer side, and when I pressed near it more puss came out. It also comes out some along the edges of my gums on the outer side of the molar, the same way it did when I originally had the infection. It literally makes me so grossed out thinking about it. I don’t want to go back to my surgeon if it’s actually nothing because I’m so busy with exams and schoolwork right now. However, I read a lot of people’s experiences with infections in their mouth and about abscess and things of that nature and I’m afraid the infection is under my molar and it’ll stay there in my mouth for months on end until it rots my teeth out (I know that sounds dramatic but that’s actually what I’m really worried about). Anyone who is still reading thank you, I’m sorry for so many words but I hope someone can give me some advice on this or can let me know if they have experienced the same thing, thank you! MattKW: Hard to say. If there's any pus coming out, then \" better out then in\". But I doubt it's really pus at this stage if your swelling has subsided and the pain has gone. You've probably got a decent bony defect which might be collecting food debris. I wouldn't be too concerned unless it worsens (pain/swelling)." }, { "id": 477, "title": "Dry Socket?", "dialogue": "teenuuuh: I got 4 wisdom teeth out a week ago and I notice that there is something stuck in the gap. Idk of its food or not, but during the day I picked at it and it the consistency was like cottage cheese type and smelled really bad. I tend to play with it a lot which I know is bad and can decrease the healing process. I poked it with a qtip to see if it could be food stuck, and it was lightly bleeding and kind of hard. My mouth has not healed yet apparently and when I stretch my mouth, I can see a whole bunch of the white thing stuck in there. Could this be an infection? How can I self treat this and will it go away? baplove: hello!!! it looks and sounds like it's a piece of food stuck in there. I would recommend you don't mess with it anymore and try to use salt water rinse to get it out!! If that doesn't work then maybe call your surgeon/doctor and ask them. I would recommend not messing with it because a piece of food alone probably won't do much but messing with it or poking at it with anything may cause an infection or disturb the blood clot. It doesn't look like an infection" }, { "id": 478, "title": "Does this look normal?", "dialogue": "Kaitcarroll93: Had top two wisdom teeth and Lower right wisdom tooth and the one beside of it removed too .. not in too much pain but my jaw is hurting some but pain medince usually takes care of it just afraid of dry socket .. does this look like it is healing normal? MattKW: If it turns into a dry socket, you will get enormous pain that can't be resolved with standard painkillers; also will get foul breath and taste." }, { "id": 479, "title": "Constant Pain", "dialogue": "Curtis1011: Hello all,\n\nThanks for taking the time to read my post. Ive had a long few months and honestly dont know what else to do. My dentist told me my upper left back two molars had deep cavities, so I paid a lot of money out of pocket to have the filled. One by one the filling \"didnt take\" and I was in constant pain. I ended up getting them both extracted. Its been two full months now since I had it done and I still have constant pain there. I have numbness in my cheek and my nose on and off too. The gums hurt almost non stop and are super sensitive. It is definetely not dry socket as both healed up quickly. I switched dentists and she x rayed it and said theres no infection and it shouldnt be hurting. I rinse with salt water all the time and take excellent care of my mouth. I also flush my sinuses often as I get a lot of sinus pressure and always have. Is this just a matter of waiting for a few more months so the gums can heal or what do I do? I cannot put into words how annoying this is to constantly be in pain and have numbness. Any advice is more than appreciated, thank you in advance!" }, { "id": 480, "title": "Is this dry socket?", "dialogue": "Brendon: Hey uh, I got my wisdom teeth removed last friday and I’ve been super paranoid sense then that I possibly have dry socket... sense i’m so paranoid about it might be the only reason it hurts so bad but I really don’t know if it’s dry socket. Please help!" }, { "id": 481, "title": "Please help, my father is in a rough situation. Need advice for implant(s) for partials? Mexico?", "dialogue": "mjames27: Hello,\n\nMy father is nearly 80 years old. His wife (my mom) passed away and he has recently had a stroke. He's pretty broke (social security paycheck to paycheck) and I am working. I have some bucks left over on a credit card, and my brother said he will be able to help\n\nHe has 1 or 2 teeth on his top and maybe 5 or 6 on the bottom. All of the teeth on the bottom need to be pulled from what we understand.\n\nWhat he's considering is getting 2 implants on the top, and 2 implants on the bottom, and using them as anchors for a partial denture. He also said he wouldn't mind getting a full denture on top, but would not want one on the bottom.\n\nIs this the best way to go about this? He keeps talking about single implants to mount a partial-- but I don't think this is a good idea, and he's just trying to save what little money we have. I keep insisting.\n\nWe live in California and prices are outrageous, so he's considering going to Mexico to get all of it done. The pulled teeth, extractions and the partials made.\n\nPlease help if you have any advice on what we should do! He's so embarassed, lonely and he can't eat much of anything now, he's losing weight. I'm worried. I don't know what to do.\n\n\nEdit: His bone structure seems to be good." }, { "id": 482, "title": "I think he is a con", "dialogue": "Richard039: An oral surgeon puts 99% of all his patients to sleep so he can charge 6 or 7 hundred dollars for anesthesia. My dentist said he would just pull my tooth for $100 but the oral surgeon want to put me to sleep and charge me 6 or 7 hundred dollars for anesthesia. I have 1/3 of my teeth pulled and some by oral surgeon but not one dentist wanted to put me to sleep and I had some tough teeth to pull. I think this dentist should have his licence pulled. I told my dentist who is young and new and has a new business that if he doesn't want to lose patients not to send any more of his patients to him. So is this dentist a con man, am I living in an alternate universe, getting old and the law just doesn't care about people getting rip off, or is OKC just that way? MattKW: Depends upon a number of factors. I was trained in a surgical era, and happily taken out many wisdoms. However, many young patients now have no dental experience of needles, fillings, and so if they have 4 wisdoms to go, then I am more likely to send to OS for all simultaneously under GA. Also means they can deal with all suffering in one go, which might otherwise interfere with work or study commitments. I also use an OS who does LA, also has an IV setup, so he doesn't automatically give them all GA if he thinks they don't need it. Young dentists might also not be so willing to do oral surgery in these days of more litigation. This also affects my decision making - I work in a city, so have OS just around the corner, and it might be seen as silly if I take potentially unnecessary risks. In a country town with no OS, I'd do more surgery myself. Richard039: The factor is pulling 1 (one) Tooth. If you have no training in needles then you have no business being a dentist in the first place. I'm not taking about 4 teeth, I'm talking about 1 (one). I'm not taking about young dentists might also not be so willing to do oral surgery, I'm talking about an oral surgeon. You have given to much information. I'm not sure if you understand my post. MattKW: Sorry if I gave you so much info that you were overwhelmed. I did have some difficulty understanding the exact point of your post, and the treatment being offered. If you have an itemised quote and xray to put up here it would prob make more sense. Richard039: I've shorten my post because I might have given too much information. \"An oral surgeon puts 99% of all his patients to sleep so he can charge 6 or 7 hundred dollars for anesthesia.\"" }, { "id": 483, "title": "Pain...?", "dialogue": "Blondee23: So ten years ago I had my wisdom teeth removed. For those ten years I have not been able to eat anything with any flavor (I was just taken down by feta cheese) without sharp pain in the places my wisdom teeth used to be. There are no holes, there are really no signs of removal (other than the fact that they took a rather large chunk of bone out of one side), there’s just pain. I never felt that before. I mentioned it to the surgeon and he told me that it would get better with time. For an entire decade I haven’t been able to eat anything without closing my eyes in pain and counting to ten. After that the pain goes away for the rest of that consumption. It’s almost like getting in a swimming pool...ten seconds of discomfort and then you’re good to go. But I feel like it’s been long enough, it’s no longer just healing. What is causing this?" }, { "id": 484, "title": "IMPLANTS: Is bone grafting a rip-off and/or high profit item?", "dialogue": "Lucubrate: When asking for a quote on an implant, offices list grafting as a whopping $500-$1,000. Yet it only took one minute to place them so that charge is not labor. Is grafting material/parts that expensive?\n\n\nSo far all my friends who had an implant, \"needed\" bone grafting. When is bone grafting NOT needed?" }, { "id": 485, "title": "Is this erythroplakia?", "dialogue": "aqz: Hi ive had this red area for few weeks just need some advice? Docs and dentists dont seem bothered and this is causing me severe anxiety?" }, { "id": 486, "title": "[SW Ont, CND] Anyone know a dentist that has one of the lower costs for implants and some exp??", "dialogue": "Darkmatter: Yes, I know I'm asking a lot. A specific area, South Western Ontario, Canada, hoping someone in the area knows a dentist that does implants at below average costs, AND I would need them (3) done very soon. I want to have the crown in place for a reunion during the 2nd last weekend of Sept... My dentist has good prices but can't get me in until June. I tried, he says he simply can't do it unless someone with a large enough time slot cancels.\n\nThat won't leave enough time for the screw have a high chance of passing the torque test AND have enough time to have the crowns made and put on for around the 20th. Also I know that if you fail the torque test you're basically starting over from scratch. \n\nOf course I also don't want someone with a bad reputation or anything like that since this is 3 implants we're talking about. I should also add that I don't live in a major urban centre so I am disqualified from the possibility of getting them done at a university, although that wouldn't fit my time constants anyways. I am willing to travel some ways away if this miracle is possible.\n\nSo, is there anyone here who knows how to manufacture a miracle for me? lol\n\nThanks. Lucubrate: In my geographical area, the best deals are at \"implant centers\". Have you checked around? Some places have appointments available in a few days, install the implant same day as extractions, and make their own implant crowns on site. I'm on the West coast of the USA." }, { "id": 487, "title": "Oral Implants, Temporary Cement for Bridge", "dialogue": "Will Geisler: I have a permanent bridge permanent cemented over my lower front teeth. Since the placement, the bridge is uncomfortable, irritating my gums, and causing a lisp. I am having the bridge completely redone next week (by the same doctor) to eliminate some of the bulk from the labial side for the purpose of improving the comfort and fit. \n\nIn July, I am considering an beginning the process to have an oral implant placed (with the two adjacent teeth crowned) in that area as an alternative to having the bridge. The hope is the implant will be more comfortable, and that I will have an easier time keep the area clean First, a bone graft will be needed (5-6 month recovery), then the implant screw placement (2-3 month recovery, then the tooth placement and two adjacent crowns placement. \n\nThe oral surgeon is recommending that when I have the bridge replaced I should use temporary cement instead of permanent cement. This is so the oral surgeon can take it off for the bone graft and take it off again for the implant screw. I am concerned that the temporary cement may cause the bridge to fall out during the 8 months or so it will be in use. Your thoughts?" }, { "id": 488, "title": "I finally got an implant - - - super-easy and quick", "dialogue": "Lucubrate: Today I had an extraction and implant. It took a mere 40 minutes and was slightly less expensive than having a combined root canal and crown. That forty minutes is shorter than a root canal treatment alone. From now on, will seek an implant and not a root canal treatment nor a crown nor both.\n\nThere was slight pain for maybe eight hours, now pain-free. Still difficult to think there's a screw embedded in my head." }, { "id": 489, "title": "Horizontal wisdom teeth", "dialogue": "ohiomom: I need to have 2 top molars pulled, however, a wisdom tooth is horizontally on top of these 2 teeth. My dentist said the extraction of these 2 teeth will not cause any problem with the wisdom tooth. If these teeth are pulled will the wisdom tooth be exposed and ultimately need to be extracted? MattKW: If the wisdom teeth eventually come through, they will be poorly angled and probably have to be extracted; they will be a nuisance to you. Usually upper wisdom teeth are easy to extract." }, { "id": 490, "title": "Is this dry socket?", "dialogue": "Joshua Higgs: https://drive.google.com/file/d/1KsXtH8oaLUA0Rik6WWnITpCDPDC3mNZP/view?usp=drivesdk\n\nHelp please. I had 8 teeth removed 7 days again and this one has been hurting for the past 5 days.\n\nCan anyone tell me if it looks normal or is dry socket? \n\nThanks Uptown101: Hello,\n\nYes it is normal. In those who have it, dry socket can be uncomfortable but easy to treat. Dry socket is a hole in the bone where the tooth has been removed. After a tooth is pulled, a blood clot forms in the socket to protect the bone and nerves underneath. Sometimes that clot can become dislodged or dissolve a couple of days after the extraction that leaves the bone and nerve exposed to air, food, fluid, and anything else that enters the mouth. This can lead to infection and severe pain that can last for many days." }, { "id": 491, "title": "Wisdom tooth extraction. Blood clot came out", "dialogue": "Carlos Magana: My blood clot came out after two days. It really hurts and idk what I should do or if it's even out all the way can someone help and tell me if it is out all the way and I should worry about dry stocket. KVMCruces: Seems like your blood clot was dislodged before the wound could fully heal... you may have a dry socket. Typically w/ a dry socket it starts to hurt about 2-3 days after extraction.\nThe tissue should be white/light - yours appears to be browning. If it has a nasty smell than yeah, im gonna say you do." }, { "id": 492, "title": "Number of years warranty on different implants?", "dialogue": "Lucubrate: I heard some have no warranty, a few are five years, and a few are lifetime. How to determine this information? Is the warranty on \"parts only\" or also on the dentist's labor? MattKW: The warranty only applies to the parts. Good brands very rarely fail due to parts failures, so this is largely irrelevant. And when laypeople talk about implant failures, this is a wide term that can also mean failure of the crowns, and healing issues. You need a good implant surgeon (I prefer a periodontist), with a good general dentist (or prosthodontist) who can assess your situation and give you the pros/cons for your particular situation. Some patients just don't have the right situation to allow for implants, and a good dentist will tell you so. Lucubrate: MattKW said:\n\n\n\n\t\t\tThe warranty only applies to the parts. Good brands very rarely fail due to parts failures, so this is largely irrelevant. And when laypeople talk about implant failures, this is a wide term that can also mean failure of the crowns, and healing issues. You need a good implant surgeon (I prefer a periodontist), with a good general dentist (or prosthodontist) who can assess your situation and give you the pros/cons for your particular situation. Some patients just don't have the right situation to allow for implants, and a good dentist will tell you so.\n\t\t\nClick to expand...\n\n\n\nSo you would allow an implant in your jaw with no warranty? How much does an implant cost? Do any periodontists warranty their work? MattKW: Lucubrate said:\n\n\n\n\t\t\tSo you would allow an implant in your jaw with no warranty? How much does an implant cost? Do any periodontists warranty their work?\n\t\t\nClick to expand...\n\nThere is no such thing as a \"warranty\" for medical/dental work. We're working within a biological system, not a car, and many things can go wrong that are unexpected. That's why we talk about risks. You can't sue for an implant that fails if the dentist or whoever laid it all out for you, and performed their work to the level of their peers. You can sue if they do something patently stupid, like putting in implants without taking X-rays or similar. We take calculated risks all the time, like driving a car or crossing the road - but I wouldn't drive with a drunk. And legally, if I promised a patient a warranty, my insurer would not cover me. Lucubrate: I'm raising this issue because implant warranties DO exist. Straumann is said to be lifetime, and Implant Direct indicated five years, Your last sentence is unclear.\n\nI'm not referring to negligence, but rather implant warranties. MattKW: Lucubrate said:\n\n\n\n\t\t\tI'm raising this issue because implant warranties DO exist. Straumann is said to be lifetime, and Implant Direct indicated five years, Your last sentence is unclear.\n\nI'm not referring to negligence, but rather implant warranties.\n\t\t\nClick to expand...\n\nYes, if Straumann say lifetime, that's good. But I can't think of a case where a Straumann implant failed. Their quality control is extremely good. Sometimes though, labs might mix a cheaper non-Straumann component with a true Straumann product, and that's asking for trouble. So always ask for Straumann components throughout, and ask for the barcodes that accompany each component. I scan all mine into the patient records, and give patients a copy themselves (I won't be around forever). Lucubrate: MattKW said:\n\n\n\n\t\t\tYes, if Straumann say lifetime, that's good. But I can't think of a case where a Straumann implant failed. Their quality control is extremely good. Sometimes though, labs might mix a cheaper non-Straumann component with a true Straumann product, and that's asking for trouble. So always ask for Straumann components throughout, and ask for the barcodes that accompany each component. I scan all mine into the patient records, and give patients a copy themselves (I won't be around forever).\n\t\t\nClick to expand...\n\n\nExcellent, but most dentists use other brands... not Straumann. Is it cost? Lack of salespeople? Stupidity? Usually if a product stands out, like chocolate ice cream, the word spreads and product sales grow. MattKW: Straumann can be costly. But you get what you pay for in most of life. Lucubrate: MattKW said:\n\n\n\n\t\t\tStraumann can be costly. But you get what you pay for in most of life.\n\t\t\nClick to expand...\n\n\n\nThanks for your reply.\n\nHow much more money is Straumann than say BioCare? Why don't periodontists offer a selection of two or more for their patients?\n\nWhat goes wrong with an implant years later? If it's rare, why don't all implant companies offer a loooooong warranty?\n\nWhen it goes bad, how does the patient know? Or is it only an Xray diagnosis? When whatever goes wrong, is it easily correctable?" }, { "id": 493, "title": "Wisdom tooth extraction day 2.", "dialogue": "Carlos Magana: Feel like the blood clot came out today. I am having some pain but no soreness in the jaw. I was just wondering if this looks normal. I'm really scared about getting dry stocket. Please help me determine if I should go back to the doctor's office or not worry about it" }, { "id": 494, "title": "Best brand of implant? Strauman? BioCare? Implant direct? Hoissen? Blue Sky? etc.", "dialogue": "Lucubrate: There are so many brands of implants! How does one decide which to use. The Internet shows that Strauman and Nobel BioCare are the leader sellers, but implant doctors also use Blue Sky, Implant Direct, Hoissen, and Neodent Implant systems. Some dentists insist on BioCare or Strauman.\n\nSome dentists avoid Strauman. Is that because it's more expensive?\n\nDoes one just make certain the screw is made in the USA and leave the decision up to the dentist? MattKW: Usually the dentist or surgeon will have a preference, so it's not really up to you. The main thing is - does the company have a solid history, and will it be around in 20 years if something breaks? Straumann and Nobel are my favourites. Lucubrate: MattKW said:\n\n\n\n\t\t\tUsually the dentist or surgeon will have a preference, so it's not really up to you. The main thing is - does the company have a solid history, and will it be around in 20 years if something breaks? Straumann and Nobel are my favourites.\n\t\t\nClick to expand...\n\n\n\nThank you. Breaks? Yikes. You mean that the screw can only be replaced with the same brand?\n\nWhat makes a brand a \"favorite\"? Tech support? Price? MattKW: You cannot mix different brands or copies. Always ask to see that brand from lab is correct, and not a cheaper copy. Straumann are all barcoded, sometimes labs try to use copy, so I always ask for original packaging and invoice. Price is only a small factor - reliability and support are more important. Would you rather buy a BMW or a Lada? Lucubrate: MattKW said:\n\n\n\n\t\t\tYou cannot mix different brands or copies. Always ask to see that brand from lab is correct, and not a cheaper copy. Straumann are all barcoded, sometimes labs try to use copy, so I always ask for original packaging and invoice. Price is only a small factor - reliability and support are more important. Would you rather buy a BMW or a Lada?\n\t\t\nClick to expand...\n\n\nLada, since my Mom is Russian. Kidding.\n\nAre Straumann and Biocare the best? What about Blue Sky, Implant Direct, Hoissen, and Neodent? MattKW: I'm not familiar with those other brands, sorry. KVMCruces: Lucubrate said:\n\n\n\n\t\t\tLada, since my Mom is Russian. Kidding.\n\nAre Straumann and Biocare the best? What about Blue Sky, Implant Direct, Hoissen, and Neodent?\n\t\t\nClick to expand...\n\n\n\nI work in a dental lab and none of our dentists have ever used Blue Sky or Implant Direct.\n\nWe work with Nobel, Straumann and Hiossen. In the last 7 years, I've only seen 2 Neodent cases come in.\nHope that helps. Lucubrate: KVMCruces said:\n\n\n\n\t\t\tI work in a dental lab and none of our dentists have ever used Blue Sky or Implant Direct.\n\nWe work with Nobel, Straumann and Hiossen. In the last 7 years, I've only seen 2 Neodent cases come in.\nHope that helps.\n\t\t\nClick to expand...\n\n\n\nKind of helps.... the implant doctor I prefer uses only Blue Sky, Implant Direct, and Neodent. This doc will use Biocare if I pay $1,100 more. What? What?\n\nCannot believe $1,100 more for a BioCare. This office likes Blue Sky, Implant Direct, and Neodent. Why ???? KVMCruces: Lucubrate said:\n\n\n\n\t\t\tKind of helps.... the implant doctor I prefer uses only Blue Sky, Implant Direct, and Neodent. This doc will use Biocare if I pay $1,100 more. What? What?\n\nCannot believe $1,100 more for a BioCare. This office likes Blue Sky, Implant Direct, and Neodent. Why ????\n\t\t\nClick to expand...\n\n\n\nI'm not familiar with Blue Sky or Implant Direct so I'm not sure how they compare to Biocare, Hiossen or Straumann.\n\nThere could be a number of different reasons why your dentist prefers to use those implant companies over the others.... the only way to know for sure is to ask him/her directly. Lucubrate: KVMCruces said:\n\n\n\n\t\t\tI'm not familiar with Blue Sky or Implant Direct so I'm not sure how they compare to Biocare, Hiossen or Straumann.\n\nThere could be a number of different reasons why your dentist prefers to use those implant companies over the others.... the only way to know for sure is to ask him/her directly.\n\t\t\nClick to expand...\n\n\n\nSo you are familiar with Neodent ? Are all these brands safe to use AND also made in the USA? KVMCruces: No, not necessarily. \nAs previously stated I've only had maybe 2 Neodent implant cases come in over the last 7 years at this lab.\nI know that Neodent is affiliated with Straumann and we use Straumann quite often.\n\nAs far as it being safe, I think that goes without question...\nThey're a Brazilian implant company and is 1 of, if not the, largest leading implant company in Latin America. \nThey do have US based locations - just not sure if the implants are manufactured here in the states. \n\nYou can always call them and ask or your perhaps your dentist may even know since he/she is familiar with them. KVMCruces: Lucubrate said:\n\n\n\n\t\t\tSo you are familiar with Neodent ? Are all these brands safe to use AND also made in the USA?\n\t\t\nClick to expand...\n\n\n\nOops just realized you asked if ALL these brands are safe & made in the states...\n\n\nYes, all of the implant companies are FDA approved and safe to use.\n\nHiossen/Osstem - South Korea\nBiocare - Sweden\nStraumann - Europe (cant remember exactly from where... I think Germany or Switzerland maybe?)\n\nAll 3 have US based locations and they do manufacture here in the states as well. Lucubrate: KVMCruces said:\n\n\n\n\t\t\tOops just realized you asked if ALL these brands are safe & made in the states...\n\n\nYes, all of the implant companies are FDA approved and safe to use.\n\nHiossen/Osstem - South Korea\nBiocare - Sweden\nStraumann - Europe (cant remember exactly from where... I think Germany or Switzerland maybe?)\n\nAll 3 have US based locations and they do manufacture here in the states as well.\n\t\t\nClick to expand...\n\n\n\nThank you so much. My son has an \"MIS\" implant. Are those acceptable?\n\nTwo friends had \"Implant Direct\" and it seems they are in Southern California. Are those good too? Lucubrate: MattKW said:\n\n\n\n\t\t\tUsually the dentist or surgeon will have a preference, so it's not really up to you. The main thing is - does the company have a solid history, and will it be around in 20 years if something breaks? Straumann and Nobel are my favourites.\n\t\t\nClick to expand...\n\n\n\nMatt & KVM:\n\nWhat about grade of titanium? I heard that Grade 5 should be used. Is Grade 6 better? How to find out which implant uses which grade?" }, { "id": 495, "title": "Needing serious dental work - VERY worried.", "dialogue": "Vivek: Not worried about the actual work but the possibility that I may never have it completed.\n\nIn a VERY long summarized story, my mother was taking doctor prescribed steroids during her conception with me for a medical condition she had, Socradosis. The doctors didn't know she was pregnant, I was born out of the womb with nearly a full set of teeth, 4 of which were impacted.\n\nFast forward 10 years down the road... My enamel was abnormally weak and brittle across all of my teeth. By age 15 all of it decayed, no enamel whatsoever left. My teeth were now bare, and rough and incurred serious decaying issues as well as bone loss. Also most of them were crooked and in short spent 10's of thousands of dollars among dentists trying to correct the issue but most did not want to touch me and referred me to another dentist or another specialist and generally it lead to alot of confusion between multiple dentists as to what needed to be done to correct my mouth...and absolutely nothing but a few cleanings were achieved\n\nBy 22 I began having abscesses in my molars\nBy 27 I began having excruciating pain from multiple teeth along with these abscesses and began having extractions done.\nConsulting among multiple dentists, all agreed my teeth were beyond repair and my best option was either dentures or a full mouth set of implants... issue is, the implants were going to cost over $80,000\n\nMedical nor Dental insurance did jack about covering any of it.. and I did not qualify for a care credit loan... so I was on my own and the abscesses kept coming until I finally made the decision to just accept Dentures...\n\nI had ALL of my teeth pulled but the dentist didn't tell me about several impacted teeth in my lower jaw that he thought he could just put dentures over... my lower jaw COLLAPSED -- the dental bone literally is now divided into two halves, one on each side of my cheek and almost nothing in the center.. I can push my tongue straight to my lips with absolutely impeding it.\n\nDue to the severe bone loss and especially the impacted teeth, the dentures did not work. The Dentist should have referred me to an oral surgeon who could have told me the effects the impacted teeth would have had on dentures before yanking all my teeth out... I got an attorney but he basically is doing absolutely nothing about it as its too complicated of a case.\n\nI am losing bone...and FAST... I have been without teeth for 7 months now, and my lower jaw is very brittle.\n\nOral Surgeons are telling me my only options at this point are implants as I do not have enough bone to support dentures. They also have to regraft my lower jaw after pulling the impacted teeth out.\n\nIn short... I am still looking at $80,000 ... just to emphasis as to how hopeless I am feeling about this situation -- After this happened, literally 2 weeks after the extractions I managed to find a second job. (I had been looking all year but one finally came to past.) I was working two jobs and making 6 figures and even at that rate I still had absolutely no chance at footing the dental bill along with my house, car, utilities, and student loans (whom refuse to defer over the situation.)... and the 2 job deal didn't work long, someone found out about my second job and became jealous and in short got me fired.\n\nAnyway what are my options, is there any thing else I can do?\n\nI really want my mouth fixed.\n\nI can show photos of my mouth if necessary but I will warn it does not look pretty so I won't post them unless it is condoned. MattKW: A few things about your post. Firstly, I noticed it appeared in a Christian forum in 2013. Secondly, the research shows that glucocorticoids during pregnancy have limited effects on a child (lots of women take it for asthma for example). Thirdly, if there are any dental defects, these are only related to the primary teeth (formed in utero), not the adult teeth (which start growing AFTER birth). I find your story non-credible. Vivek: Now this game... Okay first, I understand the whole dillema about not trusting someone online, especially a new forum member with absolutely no posts here on this site before. I created an account because I'm looking for a solution as to what I can do and for most of my life I have been keeping this issue pretty silent but its coming to a point where its just too difficult to deal with.\n\nI have trusting issues too, however; you're making a huge assumption based on very little evidence.\n\nFirst off,\nMy story does appear on a christian forum, but it was not 2013.. That was my JOIN DATE to the actual site - It was POSTED on August 4th 2017 right after the incident happened (top left corner of the post shows the date it was posted. The date that is under my Username is my Join Date.)\n\nLink: http://christianchat.com/prayer-req...ibly-wrong-incurs-major-toll.html#post3223012\n\nand regardless of how credible you may or may not believe it is it makes no difference to the fact that it happened and have dental records proving it from countless dentists who were unable to fix it. I am sitting here without a single tooth in my mouth and am living evidence that it can happen and have dental evidence of said occurrence.\n\nLastly, if you don't have have any constructive feedback, I really don't care about your opinion. I'm asking for help, not criticism.\n\nI should also re-itterate that I am not looking for donations, but I am trying to find another way if at all to fix my jaw\n\nEDIT: Vivek: For good measure, I even attached my dental records from my most recent dentist of which all of my teeth were extracted omitting all of my personal information (I basically used the snipping tool built into Windows to cut them out of the pdf document.)...\n\nAs stated before (post under moderation so you might not yet see it) My story does appear on a christian forum, but it was not 2013.. That was my JOIN DATE to the actual site - It was POSTED on August 4th 2017 right after the incident happened (top left corner of the post shows the date it was posted. The date that is under my Username is my Join Date.)\n\nI can say as much as I want to but whether you trust me or not is far beyond my control but in the end I am only asking for help - not financially but just advice as to what I can do about this. Becky: By way of background, spammers will often copy and paste forum posts so that they appear genuine, which I'm guessing is why @MattKW was suspicious. Sounds like you have been through a difficult time @Vivek and I hope you find the help you need. Vivek: I understand his concern but I can promise this situation is very real..and very frustrating as well.\n\nWhat I am very worried about right now is I am afraid my jaw bone has thinned to a point beyond repair and I'm hoping it hasn't come to that point. MattKW: I sincerely apologise for my reaction. I felt it was a spam/troll, and things didn't look right. I'll back out of this thread. Best of luck." }, { "id": 496, "title": "5 Days after Wisdom Teeth Removal", "dialogue": "Caitlyn Ford: Hey there! I had all 4 of my widsom teeth removed and yesterday and today I have noticed my gums do not look the same on both sides, and one side has a hole. It’s not a black hole because there’s no blood or anything. It doesn’t hurt but it looks like my 2 flaps of my gums separated. Like it didn’t seal completely like the other side. Should I be concerned? Because right now I’m very worried and freaking out a little bit. Thank you Vivek: Caitlyn Ford said:\n\n\n\n\t\t\tHey there! I had all 4 of my widsom teeth removed and yesterday and today I have noticed my gums do not look the same on both sides, and one side has a hole. It’s not a black hole because there’s no blood or anything. It doesn’t hurt but it looks like my 2 flaps of my gums separated. Like it didn’t seal completely like the other side. Should I be concerned? Because right now I’m very worried and freaking out a little bit. Thank you\n\t\t\nClick to expand...\n\n\nI personally believe it will take alittle more time but I am no dentist expert.\nWhen I had mine pulled (along with several other teeth) I had several bone spurs and openings in my gum that took quite awhile before they sealed. It \"may\" be necessary to have them sutured, but I do not know." }, { "id": 497, "title": "Can a bread chip crack a tooth so it splits into two pieces ???", "dialogue": "Lucubrate: My right upper cuspid tooth was healthy until two weeks ago when I chewed on a salad. I had sudden severe pain even going to the center of my upper lip and the tooth has been painful and swollen ever since. The salad had 4 mm. thick hard bread chips buried inside and other else was there when I spit out. I showed the spit salad to the dentist. Then a periodontist filed the surface down so my other teeth now touch. He said this tooth is split in two down the center!!! Can a hard bread chip really do this to a cuspid tooth just with one strong bite?\n\nThe dentist and periodontist say yes, but they might be trying to make me feel better. MattKW: A canine? Or a premolar? Canine is 3rd from front, premolars are 4th and 5th from front. Lucubrate: MattKW said:\n\n\n\n\t\t\tA canine? Or a premolar? Canine is 3rd from front, premolars are 4th and 5th from front.\n\t\t\nClick to expand...\n\n\n\nTooth #12... what's the name of it? It is split!!! MattKW: OK, 1st premolar. These teeth typically have 2 roots, and there is a shallow groove running between the roots on the mesial surface. Even if undamaged by decay or fillings, these teeth can split through the middle, and that's the end of them. Had a lady once who broke #12 one week, extracted; then came back 2 weeks later having broken #5 in same way. Both were virgin teeth, with deep cuspal inclines. Lucubrate: MattKW said:\n\n\n\n\t\t\tOK, 1st premolar. These teeth typically have 2 roots, and there is a shallow groove running between the roots on the mesial surface. Even if undamaged by decay or fillings, these teeth can split through the middle, and that's the end of them. Had a lady once who broke #12 one week, extracted; then came back 2 weeks later having broken #5 in same way. Both were virgin teeth, with deep cuspal inclines.\n\t\t\nClick to expand...\n\n\n\nReally? But this bread chip was only 4 mm thick. It was buried in soft finely cut lettuce and kale. \n\nCan I do without this tooth or should a new tooth be implanted?\n\nJust posted a new thread on implant screw selection. I'm scared of getting an implant. MattKW: They can crack with little force if you're unlucky. Sure, you can do without the tooth, unless you don't like the appearance. OK, over to other forum... Lucubrate: MattKW said:\n\n\n\n\t\t\tThey can crack with little force if you're unlucky. Sure, you can do without the tooth, unless you don't like the appearance. OK, over to other forum...\n\t\t\nClick to expand...\n\n\n\nIt's tempting to try out the implant since the TV ads for ClearChoice show that it preserves bone, and I can experience what an implant is like since I'll need one in the future on a back tooth molar.\n\nI do feel a shallow groove on #12 and also the same tooth on the left side. My other teeth don't seem to have that sunk in long area. Had no idea that this tooth is more vulnerable than the others.\n\nThe implant docs around here seem to prefer crowns made of zirconia and not enamel or gold or a combo." }, { "id": 498, "title": "Impacted Adult #18 - Nerve Damage", "dialogue": "mangobanana: Hello,\n\nI am F. 24 years old USA. I have an adult molar that is embedded in my jaw bone. The roots of #19 are wrapped are the lingual nerve. \n\nI was not going to have surgery because of the risk of nerve damage, however I was recently made aware via 3d scan that #19 is starting to decay. I was told I would have to have #19 and #18 removed and two implants put in, in the future. I was also told that I am starting to lose bone in the area.\n\nWhat are my options? Please help. Also if someone know anyone in the USA who has performed a surgery on this type of case please follow up with me. I am looking for a surgeon skilled with working around nerves. \n\nI am attaching two x-rays one from 2013 and one from yesterday. \n\nThank you. MattKW: Can't see decay from these xrays, but will take your word for it. I would strongly suggest extraction of 17 - it will never be any use for you, and is part of reason that 18 is tilting over. Having relieved the tilting, it may not be wise to risk a complete extraction of 19, but perhaps a coronectomy would be more suitable; might then straighten 18 back and upright again (braces). Here's a link with pictures: https://www.njcenteros.com/procedures/coronectomy/ This would also allow you to keep 18; then maybe later remove roots of 19 and consider implant at that stage. 16 would prob require extraction at some time following extraction of opposing 17 mangobanana: MattKW said:\n\n\n\n\t\t\tCan't see decay from these xrays, but will take your word for it. I would strongly suggest extraction of 17 - it will never be any use for you, and is part of reason that 18 is tilting over. Having relieved the tilting, it may not be wise to risk a complete extraction of 19, but perhaps a coronectomy would be more suitable; might then straighten 18 back and upright again (braces). Here's a link with pictures: https://www.njcenteros.com/procedures/coronectomy/ This would also allow you to keep 18; then maybe later remove roots of 19 and consider implant at that stage. 16 would prob require extraction at some time following extraction of opposing 17\n\t\t\nClick to expand...\n\n\nHello! thanks for the response. If you look at the 2018 xray for this week #17 is gone. I will look into a coronectomy. I was told I would need a surgery to straighten #18 because of the bone there to remove bone.. MattKW: Not sure about that. Maybe seek ortho opinion before doing any surgery for 19 and 17. Zuri Barniv: Have they considered orthodontically extruding #19? We do this with impacted teeth all the time. Busybee: Do dentists and neurosurgeons ever work together? It's crazy that such a risky procedure should be carried out by anyone but the top specialists. I do think that there should be more regulation of the profession when there are so many differing opinions and dental work is potentially life changing. An MDT approach to some situations is appropriate and I don't mean just in a dental hospital. MattKW: Just wondering how you might achieve that with the wide crown and fully formed, complex roots on this tooth, and where the anchorage would come from? How sure would one be of success compared to simpler coronectomy, and later implant. Zuri Barniv: The point of an extrusion is to dramatically reduce the risk you speak of. You don't need a neurosurgeon for that, but you might involve one if you were removing the tooth. In the end of the day, it is up to a skilled surgeon and no amount of consultations is going to change the outcome in a meaningful way. Zuri Barniv: MattKW said:\n\n\n\n\t\t\tJust wondering how you might achieve that with the wide crown and fully formed, complex roots on this tooth, and where the anchorage would come from? How sure would one be of success compared to simpler coronectomy, and later implant.\n\t\t\nClick to expand...\n\nAs I understand it, #17 is gone, you would upright #18 and use a TAD for anchorage. Worst case scenario it doesn't move, so you move on to something more invasive. Best case it is extruded even a little which would reduce risk overall the more it came out. Coronectomy is great assuming you don't develop an infection there, which would really mess things up. MattKW: If you wanted to simply remove the 19 surgically, then yes, it might be crazy and risky. But a coronectomy wouldn't be a problem for an oral surgeon or oral maxillo-facial surgeon (not sure what you have in USA). There is no need for a neurologist. I communicate regularly with all my specialist colleagues, and they work together on complex cases; they don't all have to be in the same institution. MattKW: Coronectomy carries about 5% risk of infection. I don't know the stats for TADs but it's got its own risks of screw fractures (putting in and taking out) plus bone damage, and it might not even work, and there's the cost. Busybee: Zuri Barniv said:\n\n\n\n\t\t\tThe point of an extrusion is to dramatically reduce the risk you speak of. You don't need a neurosurgeon for that, but you might involve one if you were removing the tooth. In the end of the day, it is up to a skilled surgeon and no amount of consultations is going to change the outcome in a meaningful way.\n\t\t\nClick to expand...\n\n\nA skilled surgeon and the right plan. But what is the right plan if dentists have so many different approaches? It's the same as any other complex clinical procedure - a multidisciplinary approach gives move chance of a positive long term outcome. Dissent leads to creativity, but as an individual you're not likely to disagree with yourself! MattKW: There can be a number of different approaches to all clinical matters. It doesn't mean they're all wrong, but that they carry different risks - that's what Zuri and I are discussing here. The same thing applies to a MDT, and different MDTs can have different suggestions too. For a patient, they may worry about costs, pain, success rates, aesthetics, ... if mangobanana gets some opinions from specialists, then I'm sure he/she will work it out. Zuri Barniv: I will tell you what I tell all my patients in these situations: start with the least risky option that has the greatest chance of success and go towards riskier options if the former ones don't work. Zuri Barniv: MattKW said:\n\n\n\n\t\t\tCoronectomy carries about 5% risk of infection. I don't know the stats for TADs but it's got its own risks of screw fractures (putting in and taking out) plus bone damage, and it might not even work, and there's the cost.\n\t\t\nClick to expand...\n\nI agree it should be considered, but even a 5% risk is not trivial. Can you image if that thing gets infected and now you HAVE to extract it? I wouldn't want my hand forced like that. And the risk of nerve damage when there is an active infection there is even higher. TADs have risk, but the risk is much lower. And if something goes wrong, it will be around the TAD...very far from that nerve. The biggest risk is cost, as you say. But with a highly complex and risky situation like this, I think cost should not even be a factor. You should do the least risky thing first, even if it might not work. MattKW: Good philosphy in general. What is the least risky option with best chance of success here? I think it's coronectomy overall. Zuri Barniv: MattKW said:\n\n\n\n\t\t\tGood philosphy in general. What is the least risky option with best chance of success here? I think it's coronectomy overall.\n\t\t\nClick to expand...\n\nYou might be right, I would still explore extrusion as a first option, but that's me." }, { "id": 499, "title": "Tooth extraction pain", "dialogue": "Lainey62: Hi, I had a bottom back molar removed four days ago. It was a difficult extraction and took the dentist nearly an hour of tugging and pulling to get it out. It was infected. Afterwards I did everything right with the oral care regime. Tonight I noticed that it looks like white bone at the base inside the wound, what could this be? I don’t think it’s dry socket as I have had the misfortune to have one of those before and it was excruciating, the worse pain ever. I am in pain , but I seem to have toothache in every tooth now and paracetamols are no longer helping. I’m not due back at dentist now for six months. So, my questions are, what is the white bone in wound? Why have I go toothache in every tooth, could it just be down to the trauma of a terrible extraction? Thank you for taking the time to read this. Jgold07: I'm pretty sure the ache in the rest of your teeth was caused by the difficulty of the extraction. I'm in the same boat right now (sort of). I had an implant removed and it was very difficult for the oral surgeon to get it out. He had to do lots of tugging as well, which puts a lot of pressure on the jaw, making the rest of your teeth hurt and maybe the swelling also causes them to shift a bit too. Shifting will definitely cause aching. \n\nThe \"white bone\" might not be bone, but healing tissue. That's kind've what mine looks like right now. My surgeon said it was normal.\nBut I really don't know. I'm certainly no expert on these things. Lainey62: I am feeling loads better now. Yes the white stuff is just the soft tissue healing. Still in some discomfort but I no longer need the painkillers so that is a good sign. Sorry to hear you had a bad extraction though. Hope you feel better soon. Thank you for replying." }, { "id": 500, "title": "Implant failed. Removed and had another bone graft.", "dialogue": "Jgold07: Long story short, my implant on my #8 failed after only 4 years and so it was removed last Wednesday.\n\nI asked the oral surgeon when I arrived that morning if he'd be waiting to do the bone graft until the infection (which was discovered over 1 month ago) was completely cleared up. He said he would see how it looked and should be able to do the graft that day if it wasn't looking too bad.\n\nAfter numbing me up and opening up the area, he said it \"looked alright, just a bit irritated\" and so proceeded with the bone graft. There'd been a lot of bone loss so he had to put a lot of the graft in there. After being sewed up, he sent me off with my prescriptions, one of which was my second course of amoxicillin for the month.\n\nIt's been nearly 6 days. Most of the swelling has gone down but there is some throbbing going on. I originally had throbbing and pressure similar to this 4 weeks ago when I first discovered something was wrong with the implant and the dentist found that it was slightly infected.\nI'm concerned about there still being infection up in there. Anyone here know if it's typical to have throbbing after a bone graft? Is this just the area healing and the graft integrating? I have a follow up appointment for Wednesday but am having anxiety over this at the moment and hoping to find out if throbbing and mild on/off pain is typical.\n\nSorry for the wall of text." }, { "id": 501, "title": "Oral surgeons specialized in angulated implants in Bay Area, CA", "dialogue": "Arman: Dear Members,\n\nDoes any of you know notable oral surgeons in Bay Area, CA who specialize in angulated implants? From what I understood these special types of implants (they have been recommended to me due absence of enough bone) are not as commonly placed as regular ones. I need to find an oral surgeon who does this on regular basis, because the success of the procedure highly depends on the skills of the surgeon which in my opinion highly depends on how often they perform this procedure. If you know of anyone, please kindly write their name so I can make an appointment with them.\n\nVery best regards,\nArman TallPoppy: Are angulated implants the ones that engage cortical bone? If so be cautious, heresay is that if they fail they fail quite disasterously. Why, don't you have a tooth behind for a bridge? Stuff like monolith zirconia requires only half or one mm tooth reduction. \n\nI kinda think if might be rare to find those who does those types (if I am correct) in usa let alone bay area. MattKW: Angulated implants bring their own set of risks; the manufacturers promote these types of things, but they don't take responsibility if they fail. I would seek a specialist prosthodontic opinion if you really want to explore this path. There may be other alternatives such as implant-supported dentures, or maybe you just aren't a suitable candidate for implants? Don't just keep going until you find someone who'll take you on. The best results come from specialists who take the least risks. My thought when treating people is always, \"Would I do this to my mother?\". Arman: The\n\n\nMattKW said:\n\n\n\n\t\t\tAngulated implants bring their own set of risks; the manufacturers promote these types of things, but they don't take responsibility if they fail. I would seek a specialist prosthodontic opinion if you really want to explore this path. There may be other alternatives such as implant-supported dentures, or maybe you just aren't a suitable candidate for implants? Don't just keep going until you find someone who'll take you on. The best results come from specialists who take the least risks. My thought when treating people is always, \"Would I do this to my mother?\".\n\t\t\nClick to expand...\n\nThe reason I want angulated implants is because I do not want to do sinus grafting due to very thin sinus floor. Sinus grafting comes with risks, such as possible infections in the future. The procedure I want to do is All-on-4, or All-on-6 if I want to do sinus grafting too. What do you think? MattKW: I understand. All implant surgery comes with risks, and you have to be fully informed to make a proper decision. It shouldn't be up to an oral surgeon to determine if you are suitable, it is primarily up to the restoring clinician because they have to determine where and how the implants come to the surface. They then communicate with an oral surgeon to see if he/she can make it work surgically. I strongly suggest you see a prosthodontist or two for opinions. I attach a snip I took of the first 2 names that came up on Google. I'd like to hear how you get on, please. Best of luck.\nA few mins later... Arman, is that your OPG in the OS forum? If so, you have some serious problems with your existing dental work, and your natural lower front teeth appear to have periodontal disease." }, { "id": 502, "title": "Can sinus with thin (about 1mm) floor be bone grafted for implant in one procedure?", "dialogue": "Arman: Can sinus with thin (about 1mm) floor be bone grafted for implant in one procedure, or it might require more than one because it's too thin? Sinus image is attached." }, { "id": 503, "title": "Dry socket", "dialogue": "Grainne m: I had a molar extracted 2 days ago. It has been extremely painful since extraction. The dentist kept on saying I was very likely going to get a dry socket and this being extremely painful. Is this it?." }, { "id": 504, "title": "Bone exposed after wisdom tooth extraction", "dialogue": "Cassy: I noticed this bone exposed on my gum the day after having my wisdom teeth taken out. I went back to my oral surgeon who said it was fibrous tissue lining my jaw bone & it should be fine & heal on its own. I'm looking for second opinions bc it's more painful than anything else I've dealt with. My tongue is constantly rubbing it & I feel like it's getting worse. Dentgr: Looks like bone to me. You could ...\n1. Wait and see(if it won't go away...step 2)\nBut if I were you I would...\n2. Have a minor surgery and have it trimmed Maski: I have the exact same thing after a tooth removal, my dentist thinks it will regrow by itself if not it will have to be removed. It is extremely painful, he gave me an oral antibiotic rinse to use which has helped immensely. It is a prescription you might ask him about it MattKW: Agree with Dentgr. It's lingual bone, and this sometimes happens. If it's wobbly, then OS can take it out easily with a bit of anaesthetic and firm tweezers; if it's firm, then need anaesthetic, push back tissue, and trim back, maybe with a Rongeurs." }, { "id": 505, "title": "Numbness post wisdom tooth extraction", "dialogue": "mparker4015: About 12 days ago I had the lower right hand wisdom tooth removed under intravenous (it was impacted and pushing on the adjacent tooth).\n5 days after the surgery I started to sense some numbness in the chin/teeth area (the same area anaesthetised during surgery). The numbness has slowly intensified mostly in the lower front right teeth. The clinic informed me that this is not surprising given the proximity of the wisdom tooth to the mandibular nerve, which seems to either have been disturbed during surgery or affected by subsequent swelling/healing (although swelling is largely gone).\n\nJust wanted to see if anyone else had a similar experience so I can gain an idea of how long it will take for the numbness to return to normal and if the gradual worsening could become an issue (it hasn't been complete numbness, and the degree of numbness is stimulated by brushing teeth, moving jaw etc.. There has also been slight tingling, itching).\n\nMany thanks" }, { "id": 506, "title": "Large white tissue thing?", "dialogue": "Shayla Brown: I had a tooth extraction 3 days ago and this particular socket gives me the most pain. I checked earlier and found this white mass thing? is this the beginning stages of dry socket? please help, this has been the absolute worst tooth extraction experience I've had thus far and I just want it over with. MattKW: No, looks more just like some sloughing tissue of no concern. You don't form dry scabs in the mouth because it's always wet, so you get this white appearance. A dry socket will have brown mucky stuff inside, smell terrible, taste crappy, and give you more pain than painkillers can tolerate. The good news is that they nearly always occur in lower teeth, in smokers. I'm guessing you're quite young and having extractions before braces? It is also very rare to have dry sockets in young people for these premolars." }, { "id": 507, "title": "WISDOM TOOTH HEALING", "dialogue": "Demark: I need to know if this it healing right . I have some pain every now and again . I got my top left wisdom tooth pulled Thursday morning and it’s sunday morning . My jaw is a bit stiff but everything feels fine. However I feel extra skin in my point ( is that normal) also I have a scab looking healing process ( any answers ?) KVMCruces: Hi Demark,\n\nI had all 4 of my wisdom teeth taken out at the same time but I have to say yours looks a bit worse than my healing process. I wouldn't worry though, when my sister got hers removed it looked very similar to this.\nAs long as you're following the after care instructions your dentist provided you with and you're not getting any leakage than you should be fine.\n\nIf you see any major changes or if the pain doesn't subside or worsens then definitely make a trip to go see your dentist. \nHope this helps." }, { "id": 508, "title": "Dry Socket?", "dialogue": "MaciekO: Do I have a dry socket I had a tooth extraction and my mouth feels swallowed image in the post KVMCruces: Yes, it would appear so.\nDoesn't look very good either. \n\nWhen did you have the tooth extraction? Did your dentist dress (pack with gauze) the socket?" }, { "id": 509, "title": "Wisdom teeth with sore throat", "dialogue": "Julia Zaj: Hi I’m scheduled to get all four of my wisdom teeth out this Thursday and I have a sore throat . It’s not because I’m sick though, I was at my friends birthday party on Saturday and we sang and screamed a lot . So I was wondering if I should reschedule or go with the surgery. Uptown101: If your sore throat is worst rescheduling is a good idea." }, { "id": 510, "title": "Protruding bone after extraction?", "dialogue": "Sambalamb: The bone you see behind Molar 31 extraction has recently appeared about the 4th day after surgical extraction. They had to really get in there due to the crown breaking off below gum line. They seemed sure they recovered all pieces so I’m curious if this is a broken bone within the jaw? Medium Soreness associated. Should I be worried??" }, { "id": 511, "title": "Does this look like dry socket?", "dialogue": "madisonklane: I had my 2 teeth removed 3 days ago. I have lower throbbing pain in my jaw. It’s bareable tho and I’m not in agony it’s just annoying. And it has spread to my ear and stuff. Any replies would be appreciated!" }, { "id": 512, "title": "We need a Congressional investigation: Cost of implants and crown", "dialogue": "Lucubrate: Oh my! What a shocking experience. My dentist overlooked decay under a crowned tooth which has had a root canal. She said she can't take over the crown, eliminate decay, and place a new crown especially since the decay on Xray goes close to where the two roots join.\n\nSo I called a few oral surgeons for a quote, and a few dentists who do the top part.\n\nOh my! Seems that the 15 minute extraction, then two hours in the dental chair (graft, implant) is a whopping $ 5,500 to $7,000. Then the tooth is $2,000 - $3,000. The total cost for 2.25 hours of work is $7,500 to $10,000.\n\nSomeone please explain this outrageous price for one tooth and 2.25 hours of oral surgeon time. Trump and Congress need to investigate.\n\nIf anyone knows a more reasonably priced oral surgeon on the San Francisco Peninsula, please private message me or post it here. Becky: You could fly to the UK, have a holiday, and get your dental work done at a private clinic all for a fraction of that cost" }, { "id": 513, "title": "White Mass on Jaw Bone", "dialogue": "LaraDeLu4488: Hi,\n\nI went to the dentist yesterday and an X-ray that was taken showed a large white mass on my jaw bone below tooth#20. The dentist checked the tooth and it was alive and there is no swelling or pain associated with this area. I am now being referred to an oral surgeon to have a biopsy done. I couldn't get an appointment until next week and I'm freaking myself out over what it could be. My dentist told me it was probably \"benign\"-- which makes me think tumor? cancer? I'm just confused as to what could possibly cause a large white area on an X-ray-- I've had dark areas before that indicated infection-- but never white! Does anyone have any ideas of what this could be?! I've attached an X-ray that I found from earlier this year that also shows the white area (but nothing was said at that time). It isn't as bright or noticeable in this photo, but it definitely is there and isn't something that just popped up in the last few months. I appreciate any help you can provide!\n\nLara Stephsol: LaraDeLu4488 said:\n\n\n\n\t\t\tHi,\n\nI went to the dentist yesterday and an X-ray that was taken showed a large white mass on my jaw bone below tooth#20. The dentist checked the tooth and it was alive and there is no swelling or pain associated with this area. I am now being referred to an oral surgeon to have a biopsy done. I couldn't get an appointment until next week and I'm freaking myself out over what it could be. My dentist told me it was probably \"benign\"-- which makes me think tumor? cancer? I'm just confused as to what could possibly cause a large white area on an X-ray-- I've had dark areas before that indicated infection-- but never white! Does anyone have any ideas of what this could be?! I've attached an X-ray that I found from earlier this year that also shows the white area (but nothing was said at that time). It isn't as bright or noticeable in this photo, but it definitely is there and isn't something that just popped up in the last few months. I appreciate any help you can provide!\n\nLaraView attachment 758\n\nClick to expand...\n\nHi I know this is really old post but I just found out I have the exact same thing as you posted here. Our x rays are almost identical and same tooth! What did this end up being? I’m worried. Thanks!" }, { "id": 514, "title": "Puffy Gums", "dialogue": "Chris Hageman: On Jan 8th I had a molar extraction upper right side & last monday my gums were puffed up beside the site towards the inside of my mouth but next day it seems to be pulled into the hole tight by the skin but still feels puffy & if i push on it with my tongue it tastes salty but it has no pain with it just a weird feeling & taste. Is it part of a normal healing process or should i worry?" }, { "id": 515, "title": "Please help, I have bad anxiety", "dialogue": "Carlos Fierro: I had two wisdom teeth and my #12 molar removed, and they put stitches around the area of #12. Its been 8 days since my surgery. I was taking a shower and a tiny bit of blood came out when I was scrubbing my face near #12. Is it from the stiches, because they do feel lose, or did I lose my blood clot. Please help, I have intense anxiety and I don't want a dry socket. John lopez: Did you get a dry socket?" }, { "id": 516, "title": "Wisdom tooth extraction", "dialogue": "John lopez: What is this (black/grey bubble)? I got a tooth extraction 3 days ago on Wednesday at 11:00am. Today is Friday 10:27pm. I just feel light headed and sleepy. I haven’t taken any medication for atleast the past 15 hours. No pain... please help" }, { "id": 517, "title": "Implant Dilemma", "dialogue": "andysmith: Hi All.\nHoping to get some thoughts on a dilemma I'm in.\nI recently had the last four of my bottom teeth (front) removed, and am now waiting a few months before the next stage, which is implant surgery.\nI was supplied with a temporary bottom denture until that procedure starts.\nI was planning a full bottom set, fixed bridge.\nThe thing is I find that I am very comfortable with the temporary removable denture.\nI've been wearing it all day every day for the last few weeks, and after an initial adjustment period, I don't find it stops me living life normally in the slightest.\nI fit it in with fixadent and sits perfectly in place, doesn't move or irritate me at all, and I find I can eat at least two meals a day without issue.\nSo now I'm wondering if the rest of the procedure is really worth it, but what about bone loss.\nWill that really have a huge impact on my facial features.\nObviously one looks on the internet, but I notice most of the photo's used to illustrate the issue, are elderley people with very sunken features, and clearly full denture wearers who don't have them in at the time of the photo.\nThat leads me to wonder if the whole issue is being overplayed by the industry as a means of selling the procedure.\nI was going for implants because I could not bear the thought of ordinary false teeth, but now find I am perfectly happy with them, so the only reason left to have them is preserving my facial features as far as I can.\nIs there really any point in going further by spending thousands on the next stage.\nI'd appreciate some input.\nAny advice or thoughts given here will not, under any circumstances be communicated to my dental technician\nMany thanks." }, { "id": 518, "title": "Extraction concern", "dialogue": "sekagirl: I recently visited my dentist for an infected tooth, this tooth I had already has a dentist appointment with the same dentist to have this tooth removed. well I went to dentist for the infection . in the office I received a total set of mouth x rays done, the x ray did show an issue with involved tooth, the tooth is broken at the gumline, there is clearly seen the root canal white thin post appearance. around the tooth was swollen, red clearly infected. my dentist prescribed amoxicilin 1000 milligrams three time a day, peridex mouth wash.when I inquired for an rx pain medication, dentist gave em an rx for predisone.\nI informed my dentist of the pain I am experiencing is not being relelived by the motrin, tylenol naprosyn that I heve been taking prior to ciming to dentist was not releieving the tooth pain. my dentist did not provide me with a rx for a strong pain medication. I did go by the pharmacy to fill the rx's as per dentist prescribed. the prednisone provided no releif from tooth pain. I called my dentist the next day, informed the dentist that I received no pain releif and if I could receive a prescripton pain medication for dental pain releif. well,the dentist informed me that I should try naprosyn, motrin or tylenol for pain relief. I did not obtain releif from the over the counter suggested medication. I did take the prescribed predisone, peridex mouthwash and amoxicillin medication as prescribed\n3 weeks later I remain on amoxicillin,predisone, and still taking the suggested over the counter pain medication still I remain in pain. I have an appointment with the same dentist to have tooth removed and a bone graft to be done in prep for an implant. I am wondering , since I did not receive any pain releif from the suggested over the counter medication and prescribed medication of amoxicillin peridex mouth wash and predisone , I am considering to canceling all my dentist appointment with this dentist and seek out another dentist. I am not a drug seeker, all I request is a rx pain medication for the couple of days after the tooth extraction \nthis dentist I have been a patient for 5 years, I have never attempted to \"scam\" any sort of rx for pain. this dentist has a DEA license, he has no encoumbered license. I am wondering If I go ahead keel next weeks appointment, have the extraction , would I receive rx pain medication , or will I receive the suggestion to take over the counter med ? I am bit fustrated I receive no pain releif any suggestion? Robert Tucker: A little ball of cotton wool soaked in clove oil placed on the tooth? Stronger than mouthwash, I would think, and may give some pain relief.\n\nCan you not ask if he'll prescribe an analgesic? Can you not ask your medical doctor? If the procedure is going to involve trauma to a live nerve, tricyclic antidepressants can be very helpful. I think only a medical doctor can provide an off-licence prescription for these.\n\nNaprosyn, motrin or tylenol? Never tried naprosyn – Wikipedia says there's a risk of stomach ulcers. Strongest OTC painkiller mixture I've tried is 2x tablet of paracetemol 500mg with 8mg codeine phosphate and 2x tablet ibuprofen 200mg, all four tablets taken together. One shouldn't take any of them for more than 2 or 3 days – I can't take more than a couple of doses of codeine. Check all this with your pharmacist. sekagirl: well, dis the worst thing, got the extraction done, have been in pain/ sick eversince, dentist informed me he does not provide rx pain med, instructed me to take motrin took motrin as he suggested, been vomiting green bile since then. cancelled follow up appointment with dentist will not go to this dentist any more" }, { "id": 519, "title": "Is this healing correctly?", "dialogue": "BMB: On January the 11th I had tooth 14 extracted. It previously had a failed root canal as well as a metal post, and was extracted by an oral surgeon. I now have some pain and swelling, nothing too horrible. I am concerned that the extraction site is not healing properly (I think it looks strange). Could anyone give me some advice if it is healing properly or if I should make an appointment with my oral surgeon for an exam? Thank you very much, I greatly appreciate any help!" }, { "id": 520, "title": "Is extraction of wisdom teeth needed", "dialogue": "Irfan Ahmad: Recently, I visited an orthodontist (PhD & FRCS 'Ortho') in India’s capital city with issues of 3 dental cavities who have shown up after my last dental check up 4 years before and occasional puss formation in recent months in the gum of tooth with RCT. The doctor advised extraction of all four wisdom teeth. I visited a prosthodontist (a diplomate) who was against extraction. Now I am in dilemma, to extract or not to extract." }, { "id": 521, "title": "Wisdom tooth extraction site", "dialogue": "RadEllie: Hey all! So I’m 28 and Just had all my wisdom teeth extracted on Friday, the 29 of December. Thank God for small favors, I only had three. Two on the top that seemed to pop out quite easily, and one on the bottom that was partially bony impacted. The only one that’s really causing me grief is the bottom one. I had an increase in pain today (Tuesday) which I find odd since I’m 4-5 days out from the surgery. I took a peek in my mouth and it doesn’t look great to me, but it’s not like I look at these all the time so I really have no idea. Does this look normal for 4-5 days post-op? RadEllie: Chances are some poor soul googling in the future may stumble upon this. So I went back in to my oral surgeon today, and this indeed is a dry socket. It feels a lot like a toothache, with sensitivity to liquids and air. They flushed it out, packed it with a pellet soaked in clove oil, and at the moment I’m feeling a lot better. Here’s another picture from today. When in doubt, trust your gut and go see your surgeon. Chances are something is indeed off about your recovery. RadEllie: After three days flushing out with medicated mouth wash twice daily, looks much better already, though it still hurts something awful. Dry socket is no fun, but it isn't the worst pain I’ve ever had." }, { "id": 522, "title": "Need advice on having a coronectamy done or not ?", "dialogue": "Tiffany_96: i am schedualed to have a coronectamy done January 11th but I am nervous because my gut feeling is telling me I should have the entire tooth removed rather than just half and leaving the root in. I went tin NYU college of dentistry and every time I go they have some staff that tell me I should have a coronectamy done and than they have other staff that say they can actually take the entire tooth out so I’m nervous and confused because one day staff gives me one answer and the next day they give me a different one I want to know if the complications in a coronectamy is just as high as having the whole tooth taken out ? Help please !!" }, { "id": 523, "title": "Implants", "dialogue": "valentina caceres: Hello !\n\nI hope you could help me , \n\nI need implants and my dentist propose the following:\n1) I need the piece 14th but as you could see in the picture the piece number 16th has almost closed the space so the dentist wants to do orthodontic to pull back the piece 16th, but also he want to take the piece 18th out. \n\nI don't want to lose another piece, it is possible to move the piece 16th without taking out the piece 18th?\n\n2) for my piece 44th, I have a crown on my piece 45th which has create space between the 43rd piece so the doctor wants to open a space with orthodontic to add the 44th and then reduce the space to include the 46th. \n\nI don't want to have 2 implants down , there is a way to reduce the space between the 47rd and 45th without adding the implant 44th" }, { "id": 524, "title": "Dry socket paste rinsing out", "dialogue": "Allison: I had four wisdom teeth removed 8 days ago. On the 4th day, I had dry socket symptoms and the dentist packed it with a brown paste that smelled and tastes HORRIBLE! I’ve been doing saltwater rinses and using a syringe to clear the food out of my sockets. The past two days, when I rinsed with the syringe, some of the paste came out. Is this normal or should it stay in there longer than four days? I’m in no pain, just occasional temperature sensitivity and soreness." }, { "id": 525, "title": "Extraction under local with a huge abscess - agony. Why?", "dialogue": "Lola Wyatt: Please can anyone help me understand why LA was used for extraction when I was told it would be a GA - as 2 drains needed which would be left in place for up to 48 hrs to drain the abscess? I was an inpatient month before with it and had 3 days IV antibiotics & had surgery cancelled twice. Abcess did go down significantly and i was allowed home on strong,Consultant prescribed antibiotics (same as I had IV) Everything was going really well then in less than 24 hours the whole side of my face came up again and dentist sent me straight into hospital. It was bedlam - patients in waiting room, canulas in waiting to go for elected extractions and many discussing pros & cons of not cancelling so near to Christmas - I must have looked so rude, not joining in just trying to hide my tears.Surgeon saw me and said tooth had to come out asap but no Consultant Anaesthetist available (require one as I have had 4 major ops on my C spine) therefore he wanted it done under a local. I have a high threshold of pain - have had to learn coping techniques due to neck injury. I wanted to co operate and for the agony to stop. I screamed as needles wen tin and shook from head to toe. Every needle was agony. They said it was the worse one they had done under local yet when finished I was simply told to make a follow up appointment. I was shaking, crying and felt a complete idiot. My face is still badly swollen and they didn't give me more antibiotics - ones from dentist ran out today. I am so upset that I was treated this way - but on the other hand am I making a fuss? My neck keeps going into spasm due to tooth being extracted this way and as neck pain is on the right and abscess on the left iit is so difficult to lie down. Am I simply making a fuss I can hardly sleep as still in pain and feeling very shaken up. I realise that having been on IV a couple of weeks earlier and not being well for several weeks that I am probably feeling low but I actually feel that the Consultant couldn't care less how much it would hurt. I have never complained before _ I am so grateful for such wonderful care after my accident and very defensive of the NHS. Thank you for listening - sorry for rambling on - Lola" }, { "id": 526, "title": "Is my molar extraction site infected?", "dialogue": "Andrew88: I have gotten my tooth pulled 5 days ago. This Is the 2nd tooth I had pulled out an don't remember it looking like this. I don't have any swelling redness or any of that I don't think. I had a nasty taste but I think it might be from the dissolving stitches they put in?? And I don't know if its infected or a dry socket or if it's normal. I don't have dental insurance and really can't afford to go to the dentist for them to tell me nothing is wrong so any help is appreciated thank you. I do have pain but nothing ibuprofen don't take care of. And it took them an hour an 15 mins to get it all out. She did say it was abscess too" }, { "id": 527, "title": "Sudden pain 3 weeks after wisdom tooth extraction. Is it normal.", "dialogue": "jmhimara: Some basic information: Male, Age 25, No previous medical issues, Good dental hygiene\n\nI removed one of my wisdom teeth (upper right) nearly three weeks ago. The procedure went well according to my dentist, no complications. And for the first 2 weeks everything seemed well, and I experienced little to no pain during this time. Then, at the beginning of the third week after the extraction, I suddenly began to experience pain in the area of the extracted tooth. I would describe the pain as both stinging (right where the tooth was extracted), and generally dull radiating pain that covers my entire right jaw.\n\nSo far I've been able to control the pain with ibuprofen/tylenol, but I'm worried that I'm taking too many (so far 4/day for 5 days straight). I'm also worried that in these 5 days since I started experiencing the pain, nothing has changed. It has gotten neither worse nor better.\n\nI went to see the dentist last night and he could find no reason for the pain. He said there's no sign of infection, and it's a bit too late for a dry socket. He also said that as far as he can tell, the extraction site looks fine and is healing nicely. In the end he suggested that my gum tissue may be a bit sensitive and the pain should go away in a few days.\n\nHas anyone experienced similar symptoms so late after a wisdom tooth extraction? What was the cause? This is my first one, so I don't really know what to expect. Busybee: Could be nothing or could be the nerve was affected by the extraction. It's a potential complication which the dentist should be aware of." }, { "id": 528, "title": "Post-extraction abcess and numbness", "dialogue": "Kimdutch: Hi everyone, I had my 4 wisdom teeth and 2 molars extracted on Nov 22. I developed an infection that threatened my airway and was admitted to ICU for 3 nights. The pain was severe. After I was discharged the pain didn't get better and a 2nd CT scan showed than an abcess had developed under my ear/neck/jaw. It was surgically drained by my oral surgeon 1 week ago. During most of this and persisting to today I have a 1/2 numb tongue as well as the inside gums on the bottom left (same side as the abcess). I mentioned it to the ICU doc/nurses, ER docs, my surgeon and no one seems concerned except for me. I have limited jaw opening. Better now. At the worst I couldn't fit my medication between my teeth. Now with heat and stretching I can fit 2 fingers. I'm obviously getting very worried. I do have some tingling in my tongue and it feels sometimes hot and sometimes ice cold. My livelihood has been affected - I'm a teacher and talk for a living and my speech has been afftected. I'm very fortunate to have great sick benefits and am on medical leave but am supposed to go back next week. Any advice or suggestions about the numb tongue? I don't recall it being numb right after the extraction so I'm hoping it's from all the swelling. I see my surgeon again today. Thanks. Busybee: I'm not a dentist but I do know that wisdom teeth extraction can sometimes affect the nerve which is close by. Apparently can take a couple of months to fully recover. As far as I know it's more likely to have complications if you have them extracted as an adult. Other than that any infection will have some weird symptoms. Try to focus on your recovery instead of dwelling on it because the medication could also be causing some strange sensations including anxiety. I'm really sorry you're going through this by the way you really have had a rough time. I do hope you have a speedy recovery. Kimdutch: Thanks for your reply. The surgeon explained that the nerve has been squished by all the swelling and it would take some time for the feeling to come back fully. I hope he's right. I was scared to have my teeth extracted so I waited. I'm 41 and put it off at least 15 years becasue they weren't causing any problems. I'm still on antibiotics until the end of tomorrow - almost 2 weeks of them now. I still cannot open my jaw very far without heat at stretching. I hope that improves once the swelling goes down too. He also explained that the abscess would have left s pocket of scar tissue that my body needs to figure out what to do with. Right now it feels like a knot in my cheek." }, { "id": 529, "title": "Avoiding bone autograft?", "dialogue": "DocRod: Hi,\n\nI had my upper laterals extracted a few months back due to failed RCTs.\nMy dentist gave me a choice between an orthodontic treatment to close the gaps and shape my canines as laterals or widen the gap between my centrals and canines for implants. So I went with the latter, thinking about aesthetics, occlusion and whatnot.\nI should probably mention that I'm a third year dental student myself so I fret about things as such haha\nNow that my teeth are perfectly aligned, he said that I needed a bone graft before the implants, which was to be expected given the bone resorption. However, I expected him to fill the resorbed area with some bio-oss and leave it a few months to heal.\nHe said that bio-oss on its own is not an option in my case and that I needed some bone from the chin area or the ramus.\nI'm looking to see if there is any way that I can go through the implantation process without needing an auto-graft because thinking about it terrifies me. I am not ready to go through all of the pain and the swelling that comes with it.\n\nP.S: I'm getting a panoramic and a CBCT soon so I should be able to provide pics as soon as I get them.\n\nThanks! padma: Can you post updates to your situation? What is panoramic and CBCT? is it a 3D scan? Are they expensive? Can that help analyze whether you need a bone graft? Where did you get that done?" }, { "id": 530, "title": "Abscess after wisdom tooth extraction?", "dialogue": "Hannahk93: Hi everyone!\n\nI had all four wisdom teeth, and two other impacted molars removed last Friday. I also had a bone graft done as well. \n\nI’ve done well healing, but i still have some swelling/ pain on my upper right side where a top wisdom tooth was taken out. I can see something hanging down, which is very sore and almost looks like an abscess possibly? I don’t know if it isn’t or not, but I was hoping you guys could take a look. I actually just visited the oral surgeon yesterday and he said everything looked like it was healing well. The pain/soreness just started today. \n\t\t\n\t\t\n\t\n\n\n\t\n\n The pain isn’t a dry socket pain either. \n\nSorry for the gross pictures! MaverickDMD: Doesn't look quite right. No harm in antibiotic 5 days at this point. If infected granulomatous tissue present may need removal." }, { "id": 531, "title": "Major dental work. Extraction of 8 teeth and dental implants", "dialogue": "Lrdonovan40: I have a lengthy question. And may be to complex for you to answer. I kind of laugh to myself when I see people asking about 1 tooth. My son is 22 years old. At the age of 18 he was in a bicycle accident and avulsed eight teeth #8,9,10,11,22-26 which were replanted. He had root canal therapy on teeth # 8,9,10,11,22,23 and 26 as well as a lingual bar splinting, creating natural pontics for teeth #24 and 25. We were recently told that he now has both internal and external resorption noticed on recent full mouth series. We have had 3 consultations and they have all come up pretty much with the same plan. Extracting 7,8,9,10 11,22,23,26,27 and doing bone grafting then implants. Anyway we are talking over $50,000.00 worth of work. He has already had interim partial dentures made but realized that we wouldn't be able to go forward with the treatment. Therefore we have already spent $3000.00 and have nothing done. We have even been to Tufts Dental and Mass General Dental Schools to see if they could do the work cheaper but we were told it was to complex for the school. It is not possible to get a loan in that amount. We have no other means of obtaining the money for this. We don't know what other options we have. They consider this all cosmetic, so insurance does not cover any of it. My question is do you know of a way to have the work done pro-bono or any kinds of grants that may cover this?" }, { "id": 532, "title": "Swolen Jaw Bone", "dialogue": "Kisitu David: " }, { "id": 533, "title": "Why do I have reoccurring ear and throat ache s after sinus lift surgery?", "dialogue": "Martha: After sinus lift surgery my ear has a recurring ache along with a sore throat only on the side where surgery occurred. What could be causing this to happen. I didn't have this pain before surgery. Asked the dentist and he just looked at me." }, { "id": 534, "title": "Mouth ulcer developed near extraction...very painful", "dialogue": "Tasha: Im new to this forum. Had #2 extracted 4 days ago. simple extraction was what I was told. developed a awful mouth ulcer\nnear the extraction on roof of mouth, cannot eat or drink at all. almost more pain than extracttion!! I am using orajel 24/7\nand just hoping it will heal. So, the tooth pain decreased yesterday but today, my inner cheek near the extraction is hurting a lot\nthrobbing, and I cannot tell if my tooth is hurting or not bc the mouth sore is so painful!!!! Im worried I have a dry socket?? How can I tell?? I cannot seem to see up there into the socket...\nI read that a canker ulcer can develop due to novacaine injection and trauma form the dental work can precipitate this....\nThank you for any input!!!" }, { "id": 535, "title": "Subcutaneous emphysema after extraction", "dialogue": "Sissy: Should I have to pay my dentist if he failed to use the proper equipment( I have later found out that he should have been using a surgical drill specifically for extractions) and I ended up in the emergency department with subcutaneous emphysema? Furthermore, he kept working even after his assistant pointed out to him twice that there was swelling around my eye during the first extraction and continued to do two more extractions and two more bone grafts. After, he was finished and my right eye was completely swollen shut, he said there was no reason to panic and he then said that I would be fine driving home. I told him I couldn't drive home like that. He then instructed his receptionist to call Urgent Care and said that I could drive myself there. They told her that they could not take me if my eye was completely shut and that I needed to be seen in the emergency room. I told him I could not drive myself there. He did end up driving me there ( he is also a personal friend from the gym). They saw me right away and they took blood and gave me a CT scan of my head, face, neck, and gave me Zofran for nausea via I.V. By this time, not only was my eye was swollen completely shut but also the right side of my face and neck were swollen. They told me it was Subcutaneous Emphysema. I ended up driving myself home the 25 minute ride. I spent 5 days in bed in horrific pain and watching my swollen face turn a brownish yellow color as the swelling finally went down. I have to see him next week to have him look at the sutures. I don't even think he put any of this in my chart! Am I wrong in feeling I shouldn't have to pay for that day since he caused all of this and his handling of the situation was very unprofessional." }, { "id": 536, "title": "Wisdom tooth impaction surgery", "dialogue": "abstruse123: Hi !\nI recently visited a dentist when I observed an ulcer at far end of my lower jaw. \nThen, I discovered that I got an impacted wisdom tooth in my lower jaw.\nMy wisdom tooth is horizontal and there is a gap between it and the next molar.\nAt present, I don't have any pain. Only discomfort.\nI was told that the next molar started decaying due to the food trapped b/w the two tooth.\nI was then informed that my wisdom tooth is to be removed and also the next molar needs a filling.\nMy question is how long I can delay the surgery before the next molar needs a root canal treatment?\nCan I go for surgery say after 2 months? \nI am in a tricky situation as I have an exam coming up within 2 months, exact date of which is not yet known.\nMy dental x-ray is attached. May the experienced dentists here please advice me. Zuri Barniv: It may already need a root canal. I would deal with it as soon as possible and certainly not more than another 2 months." }, { "id": 537, "title": "Failed molar extraction", "dialogue": "Marklschumacher: Hello,\n\nI am a 66 y/o white male. I have a history of TMJ and have had 5 cervical disks removed with a bone fusion and appliance in my neck.\nI had a failed molar extraction today. I was told I still must have an infection, as the local anesthesia failed to work. I started antibiotic therapy a week ago and took Clindamycin 300 mg's, 2 times a day for 7 days. My dentist has now prescribed Clindamycin 300 mg's 3 times a day for 4 days. I am to return after 4 days to again attempt the extraction. My questions are: Does this sound like a good approach? Should the infection be resolved after 4 more days of therapy? Also, in retrospect, should I have consulted an oral surgeon to have the extraction under sedation or general anesthesia?\n\nThank You,\n\nMark S." }, { "id": 538, "title": "6 days after extraction", "dialogue": "budgie: 6 days ago i had a bottom, back tooth out at hospital. tooth was decayed and had to be drilled out and had it stitched. everything was fine for a day and a half. i expected pain and expected the tooth next door to be bruised. but i was in a lot of pain and thought it would pass. i have had dry socket before and know the pain and the smell but still, i nipped in and saw my regular dentist as the pain was bad and taste was horrible. he said it wasn't dry socket and it had healed up nicely.\nhe gave me a mouthwash to use for 7 days.\n\npain was really bad that night and called hospital to tell them who said to come down and they would have a look. he also said it had healed up nicely and no redness, although my mouth outside was a bit swollen. he said it was the kind of pain he would expect as he took some bone out. he gave me a syringe and told me to use the same mouthwash and if it was still the same 7-14 days they would have me in again.\n\nbut the pain is still exactly the same. i have finished the antibiotics and am taking painkillers around the clock, ibuprofen, paracetamol with some codeine here and there. it takes the pain away for 4 and a half hours and its back and 6 days on its still the same pain.\n\nit feels like someone has pushed a sharp knife in my gum and is pushing down, sometimes still a rotten taste and an the most annoying tingling in rest of bottom teeth and also the tooth next to the one that was pulled still 'feels' incredibly bruised and can't bite down on it.\n\nsurely i shouldn't STILL be in this amount of pain, as i said i expected pain but not still and the same level. \n\ni must mention i have ATN on that side of mouth but this is not ATN pain.\n\nshould i phone hospital today and tell them im fed up with this? could it be an infection?\n\nThanks." }, { "id": 539, "title": "Hole in gums?", "dialogue": "Emb.1: Had my wisdom teeth removed back in June, I had 2 upper and 1 lower one. The upper 2 healed just fine but I had a lot of issues with the lower one. It didn’t heal properly and a pocket formed in my gums along my back lower molar (measured 7mm deep). I ultimately went back to my doctor and got a debridement last week. Surgeon reassured me before the procedure they wouldn’t find anything but post op told me that some of my bone had died which they removed then during the procedure. I am now 8 days post op and not too confident that everything is healing properly again. \nAll but one of my sutures came out within the last few days and I am now noticing a significant hole in the back socket there. There’s an odd yellow discharge that comes from the wound and last night after brushing my teeth normally, the hole began bleeding profusely. I called the doc and he told me all was fine and refused to see me for a check up. Along with that, there is also a bad odor stemming from the site still. \nI am not entirely comfortable with this but also not sure if I am over reacting or not. If possible I’ll try to attach a picture. Any advise on how to move forward would be great, thanks!" }, { "id": 540, "title": "Dentist won't step up pain medications after series of extractions.", "dialogue": "Vouksh: A little background. I was recently diagnosed with Hodgkins Lymphoma, and will be going through chemotherapy. However, before I can start treatments, I have to have a lot of teeth removed (20 of them, in fact). The entire top, plus 4 on the bottom (the wisdom tooth + the molar in front of them). I'm bipolar, and went 20+ year with depression, and my dental hygiene suffered. So far, I've had the bottoms done, and the top 8 on the right taken out. And every procedure is more painful than the last. And all this has been done over the course of 3 weeks.\n\nHowever, my dentist hasn't proscribed anything more than Tylenol 3's, which were fine for the first two extraction the bottom, but after the 8 on the top were just pulled on Tuesday, the pain was so bad I ended up going to the ER for stronger medication, where they gave me 5mg percocet, which has helped greatly.\n\nI have one last series of extractions to be done tomorrow (Friday) and I know it's going to leave me in even more pain than the last. Is there anything I can say to convince my dental surgeon to give me something stronger than just Tylenol 3's? Because I really don't want to have to go to the ER a second time in a week for basically the same problem. That would probably throw up some red flags on their part. I'm not a 'junkie'. I actually hate taking opioids, but I hate the pain in my mouth even more." }, { "id": 541, "title": "Dentist refusing to do extractions?", "dialogue": "AnnMarie: Can a dentist refuse to extract teeth that you want pulled? I'm 54 and finally decided to get full top dentures and like all my siblings before me have bad teeth. The enamel is very thin and fracturing is inevitable. I have dealt with tooth pain, pulling and trauma for to long and want to be done with it once and for all. I explained this to my dentist but he still refused to pull two back teeth and two eye teeth. One of the back teeth was nothing but pure filling and that one he decided to crown so I'm left 2 weeks waiting for a permanent crown that I know will not hold. He shaved it down then admitted that they don't have a very good temporary cement so I have to endure the sensitive stump that is part filling until my appointment time. The temp. crown came off on the drive home from his office.\n I just wanted to be done with all this. He actually yelled at me after the 8 shots of Novocain and told me to decide what I want to do but he is NOT going to pull good teeth. I did it his way and I'm not feeling very positive. My question is, can a dentist say no when the patient knows what's best for them? This feels like they want to keep me coming back. I can afford the dentures now but may not in a few years when the so-called \"good teeth\" break. Zuri Barniv: A dentist can treat or not treat whatever they feel comfortable with. You, the patient, can do the same. It sounds like the two of you don't have a compatible mindset. Tone-Analyst: I tried 3 different dentists over the last few months, non would pull a back teeth that's been hurting for a year because they don't see anything wrong with it on the x-ray." }, { "id": 542, "title": "Tooth Extraction Site", "dialogue": "MilGoe10: I had a tooth extracted over a month ago and it looked normal the other day. However the extraction site felt weird the last few days so I checked and it definitely looks not normal. I was wondering if anyone would take a look at pics I took of it and see what it looks like to them? I know I need to get it checked but I can't get in to the dentist for a few weeks! TIA. MilGoe10: Close up pic" }, { "id": 543, "title": "Extraction Question", "dialogue": "Bryan Blount: I had a molar extracted yesterday afternoon. Just now I noticed this white tissue looking substance in the socket. It's not covering the entire socket, just looks like a strand. Is it possible I got tissue lodged in there or could it be granular tissue? If it's tissue paper, should I try and get it out? Bryan Blount: Here's a picture." }, { "id": 544, "title": "Advice needed for Cosmetic surgery, oral surgery and orthopedics", "dialogue": "Alisha1987: Hello There! I was born without bottom front teeth so when I had braces at 10, yes 10 they left Baby teeth in and told me I’ll need 1 implant when I’m an adult. I got my braces off at 12.5 and then they removed Baby teeth after which they should have left in. I never wore my retainer with a plastic tooth on it and now I’m a grown adult and bottom teeth shifted dramatically forward into my lips/gums. I know I need a lot of help but not sure where to start and I really wish I could just close the space without a dental implant and then put Verneer’s on remaining lower teeth but I know it would mess up my bite. Any dentists out there that can help? I live in New York, here are my freakshow teeth. Thanksfor helping!" }, { "id": 545, "title": "Exposed jawbone after extraction", "dialogue": "Adamnewbitt85: Hi all I'm new here but 5 days ago I had a pre molar removed after a failed root canal a year ago but the problem is that I had to go back on Thursday to remove pieces of bone from the gum but now my gum covering the tooth next to the extraction site folds back and is very loose showing the exposed jawbone and on either side of the hole there are pieces of bone still there.\n\nIs this normal or shall I go back in to see my dentist I've attached some pictures any advice from dentists on here would be great" }, { "id": 546, "title": "Discomfort nearly one week after extraction", "dialogue": "Eric2005: Today is Thursday. I had a difficult molar extracted last Friday so it's nearly a week. The dentist prescribed a narcotic pain killer but I didn't use it as ibuprofen seemed to be working. About three days later however discomfort resumed. It's like a low level pain. Dental assistant said that this can happen. Is this normal and just how long is this likely to continue? I see oral surgeon for follow up next Tuesday....I should add to make matters worse two days ago I burnt the roof of my mouth and it's still painful! Troy costin: Eric2005 said:\n\n\n\n\t\t\tToday is Thursday. I had a difficult molar extracted last Friday so it's nearly a week. The dentist prescribed a narcotic pain killer but I didn't use it as ibuprofen seemed to be working. About three days later however discomfort resumed. It's like a low level pain. Dental assistant said that this can happen. Is this normal and just how long is this likely to continue? I see oral surgeon for follow up next Tuesday....I should add to make matters worse two days ago I burnt the roof of my mouth and it's still painful!\n\t\t\nClick to expand...\n\nI had my bottom left wisdom tooth about 3 weeks ago and still have problems with pain etc" }, { "id": 547, "title": "Not sure if correct - hole not stitched", "dialogue": "Troy costin: Question with regards to wisdom tooth extraction .\n\nI got my left bottom wisdom tooth removed approx 3 weeks ago . 3 days after it got infected , went back and put me on antibiotics , but got worse I then went on IV antibiotics - after that it was not getting better I went to different dentist , and he said I had dry socket so I got it re opened and formed the blood clot - it’s now been 8 days since the re form of blood clot and it’s still sore so another antibiotics .\n\nBut one concerning part where they must have opened my gum up ( not tooth hole ) it’s not been stitched up both dentist didn’t see an issue . But food gets stuck in there . Should this be stitched up ? Also as mentioned by other posters feels like gum stitched to mouth - but when I pull back it looks like a lumpy sore , ulcer type thing .\n\nAnd there is still a little bit of swelling running on my left side jaw line . Just wondering why would they leave a hole unstitched - would I over time fill up with food down that hole ." }, { "id": 548, "title": "Surgical Removal or standard extraction?", "dialogue": "Carthian: Hi, im trying to determine if ill need annoral surgeon or a dentist for this tooth extraction." }, { "id": 549, "title": "Any root remnants?", "dialogue": "regular student: Any root remnants # 2 site after extraction? Zuri Barniv: x-ray is not clear enough." }, { "id": 550, "title": "Wisdom tooth removal help", "dialogue": "Scaredd: I had my upper left wisdom tooth removed tuesday afternoon, didnt bleed for very long at all and havent had any pain. I checked the site about 15mins ago and it looks strange like i can see the hole but it looks like there's another bit beside it thats all grey. Im so scared of getting dry socket. I had very bad pain all the time before the extraction which is why they removed it. Please help. It could just be the angle that it is and they grey could be in the hole.. just need reassurance. And if it is in the hole is this normal healing or signs of dry socket?" }, { "id": 551, "title": "Chronic dull pain. Hard palate bone loss?", "dialogue": "dfsdf3sd: I have a pain in the upper right side of the hard palate (near the first and extracted second molar) for a year now. Multiple dental procedures where done on the second molar before eventually it was extracted. Nonetheless pain persisted. Doctor diagnosed with Atypical Odontalgia and prescribed medication accordingly.\n\nA head CT was made. I have the CD. But report is not ready yet. I will talk with doctor in a few weeks, and will ask him this question. But if any specialist can shed some light on this before my appointment it would be great.\n\nPlease look at this video. https://streamable.com/wkbi3 You will see that the right side (where the extracted 2n molar) has much bigger dark spots around 1st molar, compared to the left side. What is this? Is it a bone loss? Is there a such thing as hard palate bone loss?\nHere is another angle showing oval spot on the right side that is not present on the left side.\nhttps://streamable.com/q90et\n\nPlease advice." }, { "id": 552, "title": "Had an Extraction and They found a G?", "dialogue": "Lonnie: Hi Guys,\nI was back and forth with my dr about a root canal vs an extraction. Due to the reoccurring trauma of this particular tooth over many years I decided on the extraction. Once in the dr. said it was good I went with the extraction because he found something that started with a \"g\" once he pulled the tooth. I can't remember what word he used and now I'm curious. I want to say galauma? I can't seem to find it anywhere online. Does anyone know what this is? Thanks, Lonnie regular student: Granuloma?" }, { "id": 553, "title": "How would I know if my wisdom teeth extraction is infected?", "dialogue": "AlyssaLizette: Hi all. I got all four of my wisdom teeth taken out on Monday (6/12). It's now day three and I'm worried sick that my left side is infected. I do believe both teeth have clots over them but they are now turning brownish in color. On my left side there's a bit of white on top (which looks like a small worm). What would this be? Andrew T: Did you ever get this answered? I'm having the same feelings." }, { "id": 554, "title": "Tooth Extraction", "dialogue": "deany4: Hi all,\n\nI had a tooth extracted yesterday. Just wondering, when does the pain usually start to disappear? And also, is this blood clot looking ok? I’m paranoid of a dry socket. Apologies for the below pictures, just wanted some advice.\n\nhttps://www.dentistry-forums.com/attachments/61871615-c0fc-4271-8758-15905420a355-jpeg.1128/\n\nhttps://www.dentistry-forums.com/attachments/b59f1234-a72f-4890-a156-ddc927da1fda-jpeg.1129/\n\nAny help would be appreciated. kate LANKESTER: looks like clot still there which is good.to avoid dry socket do not rinse too hard round area,avoid smoking too for a while as I had dry socket twice and told my smoking increased chance of this.dry socket is very painful,my pain started getting much worse about 4 - 6 days after extraction,when pain should be lessening,so is a good indicator if any pain doesn't subside after few days.hope this helps Andrew T: I am in the same boat. I had a tooth extraction and it's coming up on 72 hours. Didn't have pain after the surgery. Still not feeling any pain. More of just paranoia. My extraction site looks different when I'm looking in a mirror with light. It has a white or yellow film that is spotty over it. I havent done anything that should dislodge the clot. I'm just hoping it is not infected. I woke up this morning with a weird taste in my mouth but I feel that it's the sensation of me biting my tongue." }, { "id": 555, "title": "root extraction", "dialogue": "kate LANKESTER: had a tooth removed 2 weeks ago,but dentist cannot remove root,and says i should go to hospital to have removed.I am terrified of dental work after bad experiences,and am really worried about this surgery.does anyone know will I be under anaesthetic or awake for this procedure?my other option is to let gum grow over root and see how it goes.has anyone been through this?please advise,as I'm really worried" }, { "id": 556, "title": "Cost of Implants", "dialogue": "Eric2005: What is the approximate cost of an implant? I live in a Northeastern city. \nAlso would like to know approximate costs of root canals and crowns.\nThanks." }, { "id": 557, "title": "Wisdom Teeth Extraction: Is bone grafting necessary?", "dialogue": "Ha Pham: I'm getting all 4 of my wisdom teeth removed, and my oral surgeon recommended that I get a bone graft for my bottom left wisdom tooth that'll be removed. My friends never had bone grafts done, so I was wondering if it's necessary since I'd have to pay more money out of pocket. Thanks!\n\nNote: The picture is flipped. The right side (as you see in the picture) is actually the left side of my jaw. Dipsey: Normally need to meet clinical criteria of existing bone loss to require bone graft. Not normally routine unless you want to part with more $$$. Maybe get a second opinion." }, { "id": 558, "title": "Dry Socket ~5 days after impacted wisdom teeth?", "dialogue": "Juni: I've been extremely paranoid about dry socket since my wisdom teeth removal on the morning of the 15th this month. I'd rather ask here first because I think I might be worrying too much.\n I had 4 impacted wisdom teeth and they used dissolvable stitches. I followed all care instructions very carefully, I don't smoke, I haven't used a straw, eaten crunchy food, used alchol mouthwashes, I'm not on birth control, I'm young (18), etc. so I know I'm not likely to develop it. Today one of the dissolvable stitches (bottom right) came out. When I look at the extraction site I don't see a blood clot, it's more open at the top than it was but it's still like an elongated crevasse, so I can't see far enough down to see bone. It hurts more than it did before but that could just be my paranoia.\nShould I be concerned? Do you think a deep base tissue layer may have already formed? deany4: How did you go with it? Dipsey: It's healing don't panic! There is no mistaking a dry socket the pain is 3000% else it's fine." }, { "id": 559, "title": "Tooth Extraction", "dialogue": "BeckyO_92: Hi,\n\nCan someone help?\n\nI recently had a tooth out under local anaesthetic and had a really bad experience as the tooth was broke. Since the Extraction I had not stopped thinking about the experience and have ended up with really bad anxiety about going the denist. When returning for my check up yesterday the denist informed me another tooth on the opposite side needs to come out also. This tooth is also in bad condition as it is cracked. He wanted to take it out there and then which I declined and have now made an appointment for in 2 weeks time however I am worrying myself sick about the whole thing.\nThe denist already didn't seem to happy that I declined today however I literally just went in to panic and couldn't face it. Just the idea of the needles in my mouth and all that painful pressure just terrifies me! (I think I've been over thinking a little too much!!!)\nCan anyone advise if there is a way in which I could possibly have the tooth taken out under general anaesthetic at the local hospital? If so - how do I go about this?\nI literally cannot bring myself to go to this appointment now I have worried myself so much about it. Dipsey: Give yourself a little time so you can face another visit. Tell the dentist your fears and they will make you pain free as possible. I doubt will find a dentist to do a general but some might offer a twighlight drug to make you feel a bit more relaxed." }, { "id": 560, "title": "Is it possible to get an infection or dry socket 2 weeks post extraction? Picture", "dialogue": "Wisdomtooth1w3: Hello I got 3 wisdom teeth removed 13 days ago the top two haven't given me any issues but the bottom was imoacted. My stitches dissolved yesterday day 12 and since then I've been getting a sharp pain that comes and goes. Is this a dry socket or possible infection? Is it normal to have pain two weeks out? My gums are also very red. Dipsey: Dry socket is exposed bone where an initial clot doesn't form or it falls out. Unlikely after 2 weeks more likely infection from bit of food or possibly fragment of tooth or jawbone left behind. You will probably need some antibiotics and or an x-ray to see how the bone socket is healing. Wisdomtooth1w3: Dipsey said:\n\n\n\n\t\t\tDry socket is exposed bone where an initial clot doesn't form or it falls out. Unlikely after 2 weeks more likely infection from bit of food or possibly fragment of tooth or jawbone left behind. You will probably need some antibiotics and or an x-ray to see how the bone socket is healing.\n\t\t\nClick to expand...\n\n\n\nThank you! I was able to make an appointment for tomorrow so hoping to get some final answers there." }, { "id": 561, "title": "Can someone tell me what this is please?", "dialogue": "Lobna: I've been having pain very much similar to a tooth abscess pain in my lower right end molar (root canaled,crowned), except there is no swelling in my face, or any white spots on my gums. I went to two separate dentists and they both insist that my root canal look perfect. The pain goes away after a few days of antibiotic then comes back stronger after I go off medication.\nOne of the dentists told me to go get a dental panoramic x-ray to see what's wrong and he found a cloudy mass in my jaw in place of my extracted wisdom tooth, and he says there's some residual bone from the extraction that had cause some infection and he'll have to give me a minor surgery to clean up the bone and infected tissues. The thing is I have had that tooth extracted over 2 years ago and it hadn't bothered me since, and I still have the tooth here so when I came home I took a look at it and it seems complete to me, right down to the very tip of the root, so I don't know which part of it is still supposedly lodged inside my jaw. Also the pain I've been experiencing radiates from right beneath my molar, not from behind it where the extracted wisdom tooth used to be, and the pain used to be only when biting down before it became permanent. Finally I have looked at this cloudy area for a long time and it just does not seem like a bone fragment to me, So i'm including a picture of my x-ray with the crowned root canaled molar from where I think the pain radiates, and the area behind it where the cloudy lump appears to be. Can someone please help me identify that lump and whether there truly is a problem with the root canal or not? Thank you for your time. calcium48: when did the pain start? Lobna: calcium48 said:\n\n\n\n\t\t\twhen did the pain start?\n\t\t\nClick to expand...\n\n3 weeks ago calcium48: \"ere's some residual bone from the extraction that had cause some infection and he'll have to give me a minor..\"\n\nDifficult to say over the internet, but after several years it's unlikely to be the bone that's causing the problem.\nHow long do you take the antibiotics for? (your post suggest 2 days) calcium48: it's not easy to precisely locate tooth pain.... Lobna: I had a few dentist friends and relatives look at it and it turned out to be some calcification from an old inflammation in the socket. The pain in from a crack at the root of the molar opposite to it, which is causing an infection right beneath the crown. Thank you for your help" }, { "id": 562, "title": "Wisdom Teeth Removal", "dialogue": "23birds: Hello. On 22, 3 days ago, i had my 8th tooth (my right wisdom tooth) removed by 2 normal dentists who were not surgeons.\nThe operation was with a local anesthetic and did not hurt or have any problems while they were doing it. Although everythi g went good, i am worried about the fact that they were not surgeons. One of them told me that i should buy a Eludril mouthwash the first night (9 hrs post operation) and gently use it by tilting my head. I had read about NOT using any alcohol mouthwash the first 7 or 14 days and i was really sceptical. I did it anyways but only for the first night. No dry socket whatsoever. Now its been two days later and ive been only using saltwater rinses (again by tilting head, not swishing) and i am not sure whether i should have followed his instructions. I think that he gave me wrong instructions and i don't want to do infect my tooth or get a dry socket with or without the mouthwash. In your opinion should i use it or not? Because those are instructions by the dentist and people say to follow them, but every extraction guide says to avoid these mouthwashes as they may irritate the blood clot and the mouth.\nAny answers will be helpful. 23birds: 23birds said:\n\n\n\n\t\t\tHello. On 22, 3 days ago, i had my 8th tooth (my right wisdom tooth) removed by 2 normal dentists who were not surgeons.\nThe operation was with a local anesthetic and did not hurt or have any problems while they were doing it. Although everythi g went good, i am worried about the fact that they were not surgeons. One of them told me that i should buy a Eludril mouthwash the first night (9 hrs post operation) and gently use it by tilting my head. I had read about NOT using any alcohol mouthwash the first 7 or 14 days and i was really sceptical. I did it anyways but only for the first night. No dry socket whatsoever. Now its been two days later and ive been only using saltwater rinses (again by tilting head, not swishing) and i am not sure whether i should have followed his instructions. I think that he gave me wrong instructions and i don't want to do infect my tooth or get a dry socket with or without the mouthwash. In your opinion should i use it or not? Because those are instructions by the dentist and people say to follow them, but every extraction guide says to avoid these mouthwashes as they may irritate the blood clot and the mouth.\nAny answers will be helpful.\n\t\t\nClick to expand...\n\nwhatever guys i decided to do it and I've been fine for the last two days, if not maybe more reas sured for my dental hygiene. This forum gets zero replies... Sidsolomondds: Where did you get these 2 \"dentists\" from? 23birds: month later guys im all good gotta rinse my mouth after meals cuz meat and bread gets stuck in the hole lol, in a reply to sidsolomondds: one of them is my personal dentist i have from 2 years, he told me if you want to i can call my collegue and we can do it together (i assumed he was a surgeon). i was like okay . and so one day before the surgery he calls me to confirm everything and i asked him whether he is a surgeon and he replied no he is an orthodont. i was basically like uh ok, but was too awkward to cancel the whole operation. so yeah dude i was scared as **** so whatever u do try choosing someone you can trust, who has good background and gives u a good gut feel cause my experience was truly horrible." }, { "id": 563, "title": "Antibiotics not helping tooth infection", "dialogue": "Joshino520: Well I went to my dentist on Friday because my tooth was hurting like hell! I believe it's an abcess but we didn't get to check because my mouth was so swollen i couldn't have opened it up enough for her to even take an xray, she put me on 500mg amoxicillin and metronidazole and 600mg ibruprufen to be taken once every 8 hrs, ever since i took them they never helped in subsiding pain or anything of the sort only when i go to sleep and wake up I wouldn't really feel any pain until 2 hours later I can't eat a lot because if my top tooth touches my bottom tooth (molar) it would hurt because it's somehow sensitive I finished the pain killer yesterday and I feel no different in terms of pain, the last time I had an infection and pulled my tooth out it hurt SO MUCH just to pull it even though the dentist injected me like 3 times and i'm afraid of pain I can't get anything like laughing gas or anything of the sort because I live in a third world country.. I don't know what to do Joshino520: PLEASE someone help me i am in so much pain" }, { "id": 564, "title": "Extraction done - Bone Exposed", "dialogue": "BKaur: I have had issues with my teeth since I was a child.. Have had MUCH dental work and seems like the more work that was done, the worse the teeth got.. had 6 crowns on the top and I was allergic to the material they were made from and they had to be removed and I ended up with denture on the top.. Had a partial on the bottom and eventually, the teeth I had left on the bottom had to come out and a full denture made. I had the extractions done (4 teeth... 2 on each side of the mouth)... To fit the denture in, the dentist had to do quite a bit of clipping of the bone on the left side.. much pain after... the pain am having now is mostly do to the back of the denture which will need to be adjusted... I have no bone in the back of the mouth after all the years of wearing a partial... so they had to build up the denture in the back to work... \n My concern is... the extraction site is showing the bone.. the gums do not appear to be healing over the bone.. the bone where the teeth came out of is exposed... She didn't put stitches in the gums to seal it... I've never had this issue with other extractions ... it concerns me that food particles (when I start eating more solid food could get down between the gums and the bone and cause infection.. right now am taking antibiotics.. All my dental procedures also had to have 2000mg of antibiotics before the procedure was done because of my knee replacement.. after the extraction, she told me to take the antibiotics every 6 hours til done... I am doing that.. but am concerned about the bone being exposed... How do I make sure that the gums are going to grow over these bones on each side of the mouth?? I go back to see her Wednesday... \n\n thank you" }, { "id": 565, "title": "Necessary to remove wisdom tooth to fit crown on adjacent molar?", "dialogue": "Mom2: So I have a cavity that takes up 2/3 of my second molar and dentist was able to save the tooth, he did a root canal and will need a crown. However, dentist is telling me I should remove my adjacent wisdom tooth so that he can fit a crown on molar. He referred me to oral surgeon and I went. Surgeon agreed that I should remove it for same reasons dentist told me. I never heard of pulling out wisdom teeth in order to fit an adjacent crown. Does this make any sense? I have all my wisdom teeth and none are impacted but fully grown in. Don't they shave down the tooth that needs crown? Why do I need wisdom pulled? Should I seek 2nd opinion? \n Thanks in advance" }, { "id": 566, "title": "Tooth extraction", "dialogue": "Chad B: Hello, I just had my bottom right tooth extraction last Tuesday (5 days ago) and it still hurts and I don't even know if it's really healing... it has like a whitish/yellowish tint to the hole/socket ScreaminRay: Gums should appear pink or if inflamed red. Yellow and white are never good colors contact the dentist who performed the extraction and advise him of your concerns." }, { "id": 567, "title": "Failed implant experience, deciding next move", "dialogue": "KBB: This is going to be a long post and I thank anyone who has any advice and thoughts on my situation. I really appreciate any help you can give me.\n\nBackground health information:\nAge: Early 30s\nNot a smoker, not diabetic, no known health problems. I do not take any daily medication.\n\nOral Health: Really good. I’ve never had a cavity in my life. I brush 2-3 times a day. I use mouthwash 3 times a day. I get my teeth cleaned every 6 months on the dot. I’ll admit that I am not the most consistent flosser in the world. Prior to the events that I will speak of, the dental-related things I’ve had done are (A) all four wisdom teeth were removed with no problem and (B) I had invisalign braces.\n\nOkay, here we go. In 2012 I was the victim of an assault that ultimately knocked out 3 of my upper front teeth (both maxillary central incisors and my left maxillary lateral incisor). I had bone grafts to repair the damage done to my jaw and the 3 lost teeth. Next was the decision on what to do for the missing teeth.\n\nMy dentist and periodontist agreed that I should have implants put in. Implants would:\n· Last the rest of my life\n· They would look more natural\n· The screws of the implants would hold my bone together, slowing the loss of bone from missing teeth.\n\nMy dentist and periodontist advised me NOT to get a conventional dental bridge/crown instead of implants because:\n· I would have to shave down 4 of my healthy teeth in order to make abutments. On my left side, my canine and nearest premolar. On my right side, my right lateral incisor and canine.\n· The lifespan of bridges are not long (5 years on average?).\n\nI decided to go for implants because I wanted something that was going to last for the rest of my life, given my age. I also really didn’t want to ruin 4 of my healthy teeth for the bridge, and potentially have problems later in life as those 4 teeth develop problems of their own.\n\nI underwent the implant process. I had one post placed where the left lateral incisor had been. The other post was placed where my right central incisor had been. I also had to go through a gum graft, because my gums had receded quite a bit from all the surgeries. During the healing time, I wore my invisalign brace, which had 3 fake teeth placed into it to hide the gap. The periodontist wanted me to wear that instead of a regular denture because the invisalign wouldn’t put any pressure on the healing gum or bone.\n\nDuring this entire process, I never had any problems.\n\nOnce the posts were done, I was given a temporary implant-supported bridge (one bridge for all 3 missing teeth). I wore that for 8 months. I had no problems and it felt like my real teeth. Then I was given the permanent bridge.\n\nThat is when the problems started. First, the dentist couldn’t remove the temporary bridge. That was an ordeal. Then the permanent bridge didn’t fit well and the dentist had to work on it. During the 10 months that I wore the permanent bridge, it fell out twice.\n\nAfter 10 months, I had visible abscesses forming on my gum in the areas around the posts. The periodontists tried to treat the abscesses without surgery. They took several x-rays and the bone looked fine around the implant. \n\nEventually, it became evident that surgery was necessary to detoxify the area. During the surgery, they found out that I had bone loss around both implants. The periodontist believed that the permanent bridge had put stress on my bone and over the 10 months, caused the bone loss. I had some bone loss around the left lateral incisor. I had a lot of bone loss around the right cental incisor. Basically, the bone loss was on the front of the implants. I still had bone up to the top thread on the back side of the implants, but bone loss on the front side. This is why they didn't see the bone loss on the x-ray, since that is a 2 dimensional image. Both implants were still integrated with the bone that was there and the implants were not mobile. The periodontist tried to graft bone to the implants, but he informed me that it was not likely to take.\n\nIt’s been 4 months since that surgery and the left lateral incisor seems okay, but the right central incisor doesn’t look great. The bone graft didn’t take and my gum has pulled away from the top of the post. I can see several of the post threads now when I look at my mouth. I had a CT-scan of my jaw and it confirmed that I didn’t get much bone growth from the graft. On the plus side, I have not had any infections or abscesses since the surgery. There was no sign of an infection on the CT-scan.\n\nMy current problem is what do I do going forward?\n\nThe periodontist suggested that we bury the implants/put them to sleep. Basically, we give up on implants and I get the conventional dental bridge. \n\nThe periodontist said that there is not enough bone on the implants currently to do an implant-supported bridge. If I want implants, I would have to have the current implants removed and start all over. However, part of the problem is that my implants are integrated into the bone (what is left there). He’s afraid that removing the implants would cause more damage to the bone, requiring multiple rounds of bone grafting and gum grafting. He’s not sure how much bone he’d get back if he did a bone graft. He mentioned that he could try INFUSE Bone Graft material, but that would be expensive and I would have to deal with a lot of facial swelling after the surgery.\n\nI’m honestly just stuck and not sure what to do. My doctors keep saying that they have never encountered a case like mine before. I had originally chosen implants because I didn’t want to lose 4 more healthy teeth to make a conventional dental bridge. I wanted something that would last my life and wouldn’t have to be replaced every 5-10 years.\n\nI’m looking for any advice that people may have. \n· Has anyone ever been through a similar situation? Has anyone ever treated someone with a similar situation?\n· Has anyone had an implant that was NOT mobile removed?\n· Has anyone used the INFUSE Bone Graft material before? What is the swelling like?\n· Does anyone have a conventional dental bridge on their upper front teeth? If so, what has your experience been with it? How long have they lasted? I don’t know anyone that has a bridge, or at least, no one has ever told me that they have one. What does it mean when a bridge fails? What does getting a bridge involve besides shaving the abutment teeth?\n\nI really appreciate any help/advice that I can get. Thank you. Zuri Barniv: This is quite a story and I'm sorry to hear about your troubles. It's unlikely anyone on any forum could give you meaningful advice as your case is complicated and there are many details that can only be provided in-person. The few things I can tell you is that implants do not last a lifetime (necessarily). We hope they will, but no responsible dentist should ever tell you they will as a fact. As far as implants \"taking\" or integrating into the bone, there are so many reasons for bone loss around an implant. Usually, the problem is excess cement (glue) that seeps under the gums during the time the permanent bridge is placed. Overloading the implants is another cause. Another reason is if the implants were not placed in the most optimal location inside the bone. If the implants were not \"guided\" by a computer-made device, the risk of this goes up a lot. As you can see, there are plenty of things that could have gone wrong and there are certainly more reasons than I listed.\n\nAs I say on this forum many times, if you have a complicated case and the situation seems to be getting worse....stop, and get a second opinion. Seek out a \"prosthodontist\" (a special kind of general dentist) or even another regular dentist who has EXTENSIVE experience with implants for their thoughts. Whatever it costs, $100-200...it's worth it. And keep in mind that every dentist will tell you they are experts in implants because they took a course or two. They are not. You need to find someone who is truly seasoned when it comes to implants and that takes some effort as well, but it will be well-worth your time. I hope that helps,\nDr. Barniv Mary hart: I have had implants 4 years. I had a sinus lift and bone grafts. A couple months ago I got a salty taste in my mouth and it is constant. It comes from one of the implants. I went to a different periodontist because I never cared for my first one and wish my dentist hadn't sent me to him. The second periodontist found that the first had gotten the implant into my sinus. Right now I am scheduled for a surgery to look at and clean around the implant. I'm not sure what after that. Any suggestions or thoughts would be appreciated. \nI don't think the first periodontist would have ever told me he got the implant into my sinus." }, { "id": 568, "title": "Bottom wisdom teeth age 45", "dialogue": "Scared4: I supposed to be having my two bottom wisdom teeth pulled out with sedation anesthesia. I have read a lot of horror stories of this and am thinking of canceling my appt because I am terrified, I have never been put under sedation. I am so scared of a bad outcome. Can anyone ease my fears that I am doing the right thing??" }, { "id": 569, "title": "2 teeth being extracted tomorrow", "dialogue": "Natalie: Hi, I'm new to all this, and not really a thing I would do, but I really need some advice as I'm really scared ... I'm not 1 for going to the dentist as often as you should, any way I finally went, petrified, had to take my mum with me embarrassing as I'm 32 ...\nIv got to have 2 teeth extracted... as he could see how absolutely scared silly I was he requested Iv sedation.... well tomorrow the day will have finally come... ... I'm going to have have teeth removed via Iv sedation... I'm panicking and thinking all sorts, if it dnt work, if I will feel anything, and because the 2 teeth I'm having removed are halfs tooth and one has had infection in which Iv had mess for,I'm panicking that there going to be a nightmare to get out.\nAnyone recently had this done to give me any sort of advice on how the producer will go or what it is like n and if its all going to be ok" }, { "id": 570, "title": "Abcessed tooth extraction tomorrow", "dialogue": "Genesis41026: Hey ladies and gents, I'm extremely concerned for tomorrow, I have an abcessed tooth and my dentist referred me to an oral surgeon to get my #30 pulled. I've read online that if my gum and face and throat is all swelled up that the local anesthesia won't work (because infection) and that I will feel everything,I've only been on antibiotics (penicillin) for 3 days. The receptionist at the oral surgery told me it will be 100% pain free even if it's badly infected. Please give me some advice if anyone has had a similar experience, everything I read says dentists always prescribe antibiotics and they don't extract until infection is under control plz someone reply as I'm scared out of my mind that I wont be able to get numb and I will be in deep pain and trouble" }, { "id": 571, "title": "Dental Bridge questions", "dialogue": "RAJANIKANTH ANKAM: Hi,\n\nI am getting dental bridge treatment. Right now my dentist extracted the broken teeth and placed three temporary teeth. But it is falling off every day. I already visited them couples of times \nand they are fixing it everyday. I cannot make it to dentist like this everyday to fix the falling temporary teeth. Can I simply apply some dental adhesive until I get my permanent teeth fixed? Is it safe to do that?\nPlease help me.\n\nThanks,\nRajanikanth Zuri Barniv: No, that is not a good idea - don't try your own glue on this. The work on the teeth that hold the bridge is not adequate for some reason and what you are experiencing is not normal. You need to talk to the dentist and come up with another solution that will not require daily visits. Sweet_as_Sugar: Dr. Barniv,\n\n Do you have any advise for my situation? I have been crying for three days and I don't know what to do.\n\nThank you. Zuri Barniv: If you are in the United States, then start by contacting your local Dental Society or State Dental Licensing Board so they can help you with your situation." }, { "id": 572, "title": "Bone Spurs/Spicules", "dialogue": "Brendie1967: So had 2nd molar removed on left side on July 6th..had curvy root and was told it was a real pain to get out but they got it out. It's now July 15th I've been in the office almost everyday getting them pulled out. Friday I was told not enough to surface on newest ones to pull out but that my gums were very angry and swollen looking still and not healing as fast as they'd like. Gave me stronger pain medication (pain was going into my ear)...takes edge off for about an hour.\n\nWaiting 2 more days to get back in there to have them tray to take these latest ones out. Is it normal to have so many? Why is it still swollen?\n\nAny advice or input from anyone who's had similar is appreciated.\n\nThanks!" }, { "id": 573, "title": "Is this Benign Alveolar Retromolar Keratosis?", "dialogue": "chiefengineer: I had 4 impacted wisdom teeth removed at 22 years of age (I am mid-sixties).\nThe sockets were stitched and irregular, and always compelled me to cleaned them\nwith my tongue. A year ago the bottom scars turned white not long after\nI started drinking daily lemon water (bleaching agent?) to prevent kidney stones.\n\nThe scars feel like granulomas and look pretty much\nexactly like THIS (on the side I chew), and just a spot of white on the other:\nhttps://www.researchgate.net/public...s_-_a_retrospective_clinicopathological_study\n\nMy dentist noted some widening of the patches and sent me to an oral\nsurgeon who screened me for tobacco (none) and told me my beer drinking\nalone could not cause this, but in order \"to be sure\" insisted upon\nbiopsies on both sides which \"get bone\".\n\nI have three questions:\n\n1) If I ask for a panoramic xray and a brush biopsy of one side\nand the doctor says \"no, those don't work\" what are the questions to ask to find\nsomeone who will do something less invasive like this?\n\n2) If there is such a thing as \"BARK\" which isn't even a leukoplakia\nisn't there a simple way to identify this?\n\n3) If this could come from tongue rubbing and chewing on extractions from the\n1970's, hasn't the dentistry world come up with some test that avoids cutting\nup scars...like maybe a needle biopsy?" }, { "id": 574, "title": "A bit of suture stuck in wisdom tooth extraction hole", "dialogue": "Rvld6: Hi\nI had my left lower wisdom tooth removed last week, and 5 days later got the stitches removed after a follow up with my dentist. The gum was stitched onto my inner cheek, so the hole is beside the gum. A little bit of suture was left because it was sewn too deep into my gum. The dentist said it would come off on its own eventually and it did. But it fell into my tooth extraction hole. I've been rinsing and gargling with saltwater several times but it doesn't seem come off.\nHow do I get rid of it? Should I be concerned? Will it infect my tooth extraction hole? Please help." }, { "id": 575, "title": "Do I need to get my wisdom teeth removed?", "dialogue": "wtfaditya: They are not causing any problems, and 3 out of the 4 are partially sticking out of the gum. One is fully out." }, { "id": 576, "title": "Extractions and Implants", "dialogue": "Brian: Due to previously botched bridge work on my wife's lower jaw, all but 6 teeth extracted and three separate bridges, we are now considering mini implants and an over-denture due to our limited budget. The remaining 6 teeth are rotting and several are infected. The doctor has recommended my wife, who is 55 yrs of age, diabetic and hypertensive, have all six remaining teeth and her upper left molar extracted, for a total of 7, and then have 4 mini implants placed immediately. My question is whether this is a wise course to pursue or should she wait for some healing before the implants are placed? I have read several forums concerning this course of action, but they all seem to talk about a single replacement. Digital x-rays are attached. Any and all advice would be welcome." }, { "id": 577, "title": "Long recovery time after having teeth removed and foul smell after having hole packed!", "dialogue": "Amyps: Hi All,\n\nI was wondering if anyone could help me.\nI have had a lower wisdom tooth and incisor removed Friday just gone. The lower incisor had previously had on and off infections. I think this is due to The top of that tooth being snapped off around 6 years ago when a dentist was attempting to remove it.\n\nThe second day after removal of the teeth I was surprisingly feeling a lot better. I did have pain but it was manageable with paracetamol and ibrufen. That night I woke up in tears with excruciating pain. Both holes had no visible blood clot and had vile yellow puss looking stuff in and around the holes. \n\nI went to an emergency dentist the next evening (day 3 after extraction) and was told I had dry socket. The dentist cleaned the holes and packed them with a brown looking substance that was dissolvable and antiseptic, it tasted a lot like Clive oil. The pain reduced dramatically straight away. I was told that the dressing would dissolve on its own and would not need changing but it keeps trying to come out and it smells so bad as if something has died in there! I mean I am not sure but this can't be good for the healing process. I removed a small part of it that was hanging over and as gross as it sounds it nearly made me sick it smelt that bad! \nI took the Monday off work just incase as I was still realy tired. Throughout the day I thought I was fine. Still in pain but again was manageable.\n\nOn Tuesday I decided to go to work so I got ready and felt fine, but on my way to work I started to feel realy dizzy, light headed, sick. my eyes were heavy as if they wanted to shut and I was really short of breath.\nI got to work and was sent home as I was sick when I arrived (this will partly be due to being on a bus they make me feel sick at the best of times) I could hardly focus on my computer screen.\n\nThis morning I feel exactly the same apart from I accidentally made my tooth bleed from brushing which will not be helping my situation, but other than that it is only the lower incisor that is hurting but I still feel the same - sick dizzy and have the shakes when trying to move around.\n\nI have tried to find anyone else in the same position or any information to read about it but I am still searching. I can find lots on a normal wisdom tooth or other tooth extraction but that's it, I am now on day 6 and have not yet returned to work and I think I'm going stir crazy! I also don't kkkw how much longer I can deal with the disgusting taste and smell that is in my own mouth\nI don't want to go back to the dentist as they said I will not get antibiotics unless there is bad swelling, and there is only slight swelling.\n\nI would love to have some sort of idea of what is happening, whether the dressing should be gone by now and when I should start feeling myself.\n\nI would be grateful if someone could help me! \nThank you" }, { "id": 578, "title": "Wisdom Tooth Extraction for Diabetics?", "dialogue": "dentists_dm: Hey everyone!\n\n can you guys help me out in knowing the factors to be considered for a Diabetic before going for wisdom tooth extraction ?" }, { "id": 579, "title": "Incisor with a long history of purulent root – is a bone graft feasible?", "dialogue": "saquiwej: Hello,\n\nI have had a bone graft surgery six months ago. It was an upper incisor number 9. The tooth in question had been dead for more than a decade before I finally decided to have it extracted. As, after it had died, apart from some periodical pulsations it did not cause pain, I neglected it for a long time. It was because of general health considerations that I at last made up my mind to have it taken out. By the way, it offered very little resistance to the dentist’s forceps. But, as one image stands for a thousand words, as the Chinese put it, I will try to upload the two X-rays showing the site before and after the extraction. There is an interval of about two years between the two, the time I hesitated as to the best course to take. My question is, whether bone grafting is possible at all at an extraction site where the surrounding bone is to such a degree decayed. The dentist told me that the outcome was not guaranteed, but all the same undertook the operation. I will have to return to him in two months, and I just want to have some independent expert opinion.\n\nAnother question in the same context: The dentist advised me not to wear any temporary place holding replacement because the pressure might cause the graft to fail. I wonder whether the two adjacent teeth will not gradually close the gap, especially if the graft fails. Even if it takes, is the bone formation itself at the graft site sufficient to prevent the two teeth from moving closer?" }, { "id": 580, "title": "Please help...Was my sinus perforated?", "dialogue": "Helpme: Please help. I had this implant put in in November. I am experience massive infection and pain even after being on twice a day 875 Augmentin for 9 of the last 11 days. I have one DDS telling me the implant and sinus' are 100% fine and the infection is because food/bacteria is coming up from openings in the gum around the post. I have another DDS telling me that my sinus was perforated and the implant needs to come out. I am sooo miserable and I just want to feel better, but don't know what I'm supposed to do here." }, { "id": 581, "title": "Help! Second Molar Extraction", "dialogue": "tooth: Hi, I got my bottom left 2nd molar tooth extracted yesterday. (under 24 hours ago)\nFirst question: Is it normal to see white spots in the extraction site? Or is it turning into a dry socket. (didnt smoke, rinse or drink out of straw) and can I drink hot-warm soup?\nSecond question (URGENT): My dentist told me that no replacements, crowns, implants would work because \"it is too far in the mouth\" which I think is not ideal. Is this true? Will I have a blank spot on the last tooth (I dont have wisdom teeth yet) for the rest of my life?\n\nthanks" }, { "id": 582, "title": "Broken Tooth After Extraction Pls Help It Hurts", "dialogue": "Ahmed285899j688: Hi! Yesterday i had extraction of my first molar tooth and when they removed it the tooth was broken and i had a piece in my mouth.\nThe dentist told me it is the bone it is nothing.\nBut when I touched it with my tongue it was hard and it hurt. It still hurts! Help?!\nHere are photos of the tooth and the \"bone\":" }, { "id": 583, "title": "Which dentures do you think is better ? and Which do you think would be better for me ?", "dialogue": "Tracey: Hello, this has been a really fast and overwhelming situation for me. In the past year my teeth has really went down hill. I knew going into my appointment and being in a lot of pain that I had a few that's in really bad shape and most likely I needed to have those pulled. While at my appointment it was worse than I thought and not only did I have a lot of broken off teeth but they are rotted on the inside to the roots. So it was brought to my attention that even if I just got the four on the outside pulled that pretty soon the other ones would brake off and would have to pull those and so on and it would keep re-occurring over and over . So while I was there I had a total of twelve pulled, which left me with six teeth on the top front teeth and six of the bottom front teeth. The dentist had also talked to me about getting dentures while I was there here are my choice's :::\n\n 1. I could have a root canal on each of the teeth on the outer side that's left. 2 of the 6 that's left on the top and 2 of the 6 on the bottom. Then I could get a partial for both top and bottom. But he did want to let me know that it's a possibility that I could have some aggravation with it slipping out and trouble eating with the top partial. That I wouldn't have if I got a full set of dentures for the top.\n\n 2. I could get the other six teeth that I have left removed and get a full set of top dentures. He did let me that most people don't have unnecessary problem's like I would with a partial. I could also get my bottom six teeth pulled and get a full set of bottom dentures, but he don't recommend that because people has problems with those on the bottom because you don't have the roof of ur mouth on the bottom to have that suction too and they tend to move around and all that stuff. For me to get a partial on the bottom, due to me having six teeth on my front bottom teeth to hook to so they don't move around. I would still have to do a root canal on the two teeth that's on the outside of my bottom teeth.\n\nPlease look at my options and give me your feedback on what you think my best option is. I'd really appreciate other people's onion who knows what their talking about...\n\n Thank you,\n Tracey \nP.S. I also heard that there are different choices you can get... What kind of dentures did you choose and what are the positive's and / or negative's about them and if you changed them why or why not ? dentures and / or partials ..." }, { "id": 584, "title": "Cheek Sutured to Gums After Wisdom Teeth Extraction???", "dialogue": "Jordan Williams: So I got all four of my wisdom teeth out 4 days ago and the pain is now becoming manageable when I eat more regular food. I had a bowl of cereal and was using my tongue to get some of the bigger crumbs before I did my salt water rinse and I felt something weird along the bottom right extraction point. My right cheek has been swollen on the inside more than my left. I took these two pictures (both of my right bottom extraction point). I have dissolvable sutures, but I was wondering if my oral surgeon accidentally sutured my cheek to my gums or could it be the start of a dry socket? It doesn't hurt when I smile, laugh, cough, sneeze, etc. What should I do? Thanks!" }, { "id": 585, "title": "Should I really extract my wisdom teeth?", "dialogue": "EveningWalk: Hello!,\n\nI hope you are doing well! I am scared and ambivalent about wisdom teeth removal and I apologize for this essay-length posting. However, I would really appreciate any comments or suggestions to this post. Please let me know if you are a dentist/dental student, etc.\n\nMy main questions (once you have read the information below it):\n\nIs the red circled region's pain a cause of impacted wisdom teeth?\nAre what the oral surgeon and dentist saying true?\nShould I extract all my wisdom teeth?\nShould I remove the wisdom teeth all in one sitting?\nI am 25 years old, and am a male. My bottom 2 wisdom teeth are impacted like the x-ray shown below (it's not my x-ray); and upper 2 wisdom teeth are going in the opposite direction also similar to the x-ray (yellow circled teeth--not sure if those are wisdom teeth though).\n\nMy current situation:\n\nI have sensitivity to eating and drinking sweet things, at about two teeth away from each side of the lower wisdom teeth (see red circled region in x-ray).\nI cannot handle chewing food that requires tension, such as eating medium-hard/hard bread such as baguettes, crunchy food like granola bars and nuts. These things also cause toothaches in the same region. I remember about 2 months ago, i ate semi-hard bread and had pain there for a week :/ At that instance, i assumed this was due to impacted wisdom teeth and I decided to remove them.\nI have had discomfort of opening my jaw all the way since I was like 11 years old. The tension is what causes discomfort at the sides. \n So I went to a dentist and he believes my theory of the red circled region's pain as a result of the impacted wisdom teeth to be true. He referred me to an oral surgeon and yesterday I had my x-ray taken again.\n\n The surgeon said he will have to put me in IV sedation (not sure if this is entirely relevant, but I tend to get dizzy easily and have frequent headaches) and will have to cut my gums and all to extract the lower two wisdom teeth and said I should remove the upper wisdom teeth too anyway since it will supposedly get in the way of closing my mouth or something. It was also mentioned that if I don't remove my lower impacted wisdom teeth, food may get trapped there and cause infection and will eventually start eating away the adjacent teeth. I got scared when I saw that there are risks of nerve damage and of my jaw breaking etc. while reading the consent form. Even if these are rare cases, it's still scary :/. The oral surgeon's assistant told me not to worry and that in her 20 years of working there, she never saw any serious case like that.\n\n They offered me a 25 percent discount and are charging me ~ $1,700 which is still quite expensive, no?. Thank you so much for taking your time to read this! Please advise. calcium48: If i were you I would have the 2 lower wisdom teeth out at the same time, as they are no good for eating chewing anyway.\nLeave the top ones for now and see how it goes, but as they will hard to clean it make cause decay to the adjacent teeth.\nI'm not a fan of having them all out at the same time, but that may be cheaper. EveningWalk: calcium48 said:\n\n\n\n\t\t\tIf i were you I would have the 2 lower wisdom teeth out at the same time, as they are no good for eating chewing anyway.\nLeave the top ones for now and see how it goes, but as they will hard to clean it make cause decay to the adjacent teeth.\nI'm not a fan of having them all out at the same time, but that may be cheaper.\n\t\t\nClick to expand...\n\nThank you sooo much for your input! calcium48: The issue about the nerve will always be there (i guess) whether you have them removed now or later.\nNot an easy one to call.\nThere are risks either way. Katerina SG: Hi there, I am a dental student in my last year. I can not see the x-ray, but it doesnt matter. In the university clinic, where I work we dont take the lower wisdom teeth at the same time. We do side by side, because you get an anestesia and a main nerve in the lower jaw is 'switched off (left or right)'. It means that you can not control half of your tongue . If you do it on the both sides, you can not control your tongue and you could kind of swallow it, which is pretty dangerous. we recommend to take out the wisdom teeth side by side, but upper and lower together. When you dont have the lower one , the upper one dosent have any function. \n\nThe issue about the nerve is not that bad, because it is only responsible for sensation on the skin on the part under your lips. Most of the time is reversible, but takes up to 3 months. Katerina SG: And you better have one side to chew on till the other side recovers Parthadental: After having read your complaint and going through the radiographic images you have provided :\n1. The red circled area could be an overlap or an artefact or prximal caries which has to be verified clinically.\n2. About removal of your wisdom teeth- Yes you should get them extracted immediately as it can definitely cause a cavity in the adjacent tooth causing damage to it. It can even cause difficulty in opening and closing of the jaw or even a cyst formation in some cases.\n3. Yes you should get all your wisdom teeth extracted. Your upper wisdom teeth do not serve any purpose and could cause cheek bites hence it is in your best interest that you should get them extracted.\n4. Ideally it is advisable to remove all your wisdom teeth in one single appointment because you may not have to take double dose of antibiotics and painkillers. Plus according to the radiographs provided it does not seem to be that complicated and if handled by a good maxillofacial surgeon then can be done without much difficulty. After the extraction you may have swelling in the extracted tooth region for around 3-4 days and difficulty in opening of the mouth. In a weeks span you will be back to perfect normalcy. Also it is advisable mto avoid smoking and alcohol after extractions and to have only soft diet.\n\nWe wish you the best of health.\nRegards\nPartha Dental Zuri Barniv: Ummm....did any of you notice that the two images are exactly the same, just mirror images of themselves?" }, { "id": 586, "title": "New teeth after cancer surgery on lower jaw", "dialogue": "Rich: After my left lower jaw was removed, mouth reconstructed using my leg bone, etc, a year ago I am experiencing my first \"appliance\" or teeth built on a cobalt chromium base. How do you keep it in place? I have a frame that goes over back right side teeth around the left side and sits on reconstructed gum. There is nothing on left side of gum to anchor the device. How do you hokd it in place when you talk, chew food, drink? Katerina SG: Are the teeth on the right side still there? In the University clinic, where I work we do implants and kind of fixed denture on them. I just picked this xRay from internet.\n\n\n\n\n\nhttps://www.zwp-online.info/fachgeb...eoplastischer-rekonstruktion-des-unterkiefers Rich: My right lower teeth are still there in my reconstructed jaw. Nothing in very middle to all the way left. The Dr is talking three implants, hyperbaric chamber sessions, in the future. Risks are their after severe radiation which ended last August, 30 sessions." }, { "id": 587, "title": "Do I have options?", "dialogue": "corygreeengreen: Do I have options? I'm a young college kid, I don't have $6,000 laying around but it is getting harder for me to chew. I would be very grateful if someone can give me advice on the below issue. I need to know if I have options, if this quote is high or average for this procedure, Is there a place locally that can help me find an honest dentistry? I feel like each one I go to is trying to play me for my money. \n\nissue: I attached my xrays. The dentist told me I have two teeth that need to be extracted and replaced with implants. He wants to do a bone graft on both. The quote he gave me for this procedure was just under $6,000, which was including the ppo dental plan that I have through my employer. I'm sketched because it seemed more like a sales pitch than a treatment plan. The dentistry is pushy and is pressuring me to get this done. Zuri Barniv: If money is tight, have the teeth removed and grafted but then have the dentist make you a lower hard mouth guard that you would only wear at night and it would keep the teeth from moving around over time. Then you can wait and do an implant next year when your insurance renews and another implant the following year. You could take as much time as you need without rushing. Hope that helps.\n\nI have a blog post on finding an honest dentist if you need help with that.\nDr. Barniv corygreeengreen: Zuri Barniv said:\n\n\n\n\t\t\tIf money is tight, have the teeth removed and grafted but then have the dentist make you a lower hard mouth guard that you would only wear at night and it would keep the teeth from moving around over time. Then you can wait and do an implant next year when your insurance renews and another implant the following year. You could take as much time as you need without rushing. Hope that helps.\n\nI have a blog post on finding an honest dentist if you need help with that.\nDr. Barniv\n\t\t\nClick to expand...\n\n\nThank you for your response. I emailed my dentistry earlier today and am waiting for their response. They told me originally that I could choose to just get the extractions and fillings but that they wouldn't recommend it in the long run. Why is that? \nWhat I really want to know is if these are my only options.. I don't have anywhere near the money they need but it's getting to the point where I can hardly eat solid food because of the pain.. EveningWalk: I feel you, I'm a 25 year old guy and I have trouble chewing on crunchy and semi-hard food and have gone through deciding back and forth if I wanna have my wisdom teeth pulled. Try looking for a university/college in your area who provide what you're looking for. They have students doing the procedures so the cost should be lower. Just call ahead and ask. Try visiting ada.org and searching up local relevant places. corygreeengreen: EveningWalk said:\n\n\n\n\t\t\tI feel you, I'm a 25 year old guy and I have trouble chewing on crunchy and semi-hard food and have gone through deciding back and forth if I wanna have my wisdom teeth pulled. Try looking for a university/college in your area who provide what you're looking for. They have students doing the procedures so the cost should be lower. Just call ahead and ask. Try visiting ada.org and searching up local relevant places.\n\t\t\nClick to expand...\n\nI'll look into that thanks for that!" }, { "id": 588, "title": "Post Wisdom Tooth Extraction: Bumpy Gums", "dialogue": "Nicole: I had two of my wisdom teeth extracted a week ago, and while neither of the extraction sites are causing me problems, the gum nearest to my last molars (the two that are nearest to the wisdom teeth that were extracted) is bumpy and sort of discolored—the top one has bumpy pale spots and the bottom one is reddish. I do not feel any unusual pain, but I still feel a bit bruised when I smile fully and I can't open my jaw all the way. There is no foul odor or taste. I was prescribed amoxicillin and I finished the bottle this morning. Is this an infection or are my gums just healing from the surgery?" }, { "id": 589, "title": "Implant vs Bridge", "dialogue": "izzi: Hello, I am a 48 year old male, as I am need of a second opinion and I am need of full mouth restoration, 98% in implant; as I was advised by my Dentist that its recommend to get the bottom front teeth, bridged/crowned than implanted. She said that having implants on the bottom, as I will have implants on the top, might cause a collision while chewing food; considering that they are not my teeth. By having a bridge/crown on the bottom front instead will prevent this collision, as I know that the bottom front teeth that is just grinded down is mine; but supported with a bridge and a crown.\n\n Can please advise your comments, if what this Dentist said me actually is true. izzi: Can please advise your comments, if what this Dentist said me actually is true. Zuri Barniv: It is very common to put implants on the top and bottom where they meet. I am not sure what your dentist means by \"collisions\", because you want teeth to collide. That is how you chew food. As long as the heights of the final implant crowns is very carefully adjusted, there should be no additional issues." }, { "id": 590, "title": "Bumps on gums??? HELP!!", "dialogue": "Ap23: I need a professional opinion! Could this be hpv? These bumps seem to have spread and I've tried everything to get rid of them. The doctor doesn't seem to know what they are? Should I be worried? Zuri Barniv: I cannot see what bumps you are referring to." }, { "id": 591, "title": "Teeth removal and dentures estimate", "dialogue": "Krista Leech: I have 11 exposed teeth and 15 broke in the gums. I want then removed by oral surgeon and then fitted for dentures... I need an estimated cost... Can anyone help with their experience?" }, { "id": 592, "title": "Botched Wisdom Teeth Surgery", "dialogue": "Madison Alexis: I recently got all four of my impacted wisdom teeth out on Friday. Since then, I am in more pain than I have ever been in. Now I know that it's normal to have an huge amount of pain. But I'm not sure unthreatening pain I am experiencing is normal. So I was wondering what some signs are that the doctor, or something I do, messed up the healing process. In a scale from 0-10 my pain is a 100, ANY help is really, really appreciated. Thank you." }, { "id": 593, "title": "Dry Socket", "dialogue": "klmklm: Hi does this look like a dry socket? If it is, what should I do? Thanks\n\nP.s. Sorry for the image" }, { "id": 594, "title": "Gums disolving and discolored after tooth extraction. Please help!!", "dialogue": "Tiana: I have my right upper 3rd molar pulled 3 days ago. I needed a root canal but I don't have insurance and it was too expensive and it was hurting me really badly and needed to come out asap. The night it was pulled there was a white bump right next to the extraction site. The next morning the bump and gums had kind of \"dissolved\" in a sense and under it was a whitefish greenish color. This morning I noticed it's bigger than yesterday and it's more green than it was before. I haven't touched it with my tongue but it's on the roof of my mouth so the side of my tongue brushes against it when I talk. I don't think it is a dry socket because there is a dark colored blood clot in the actual socket(I drew an arrow in the photo) and I feel no pain or discomfort. Also I've been extra cautious to avoid a dry socket. Please let me know if you think it is one though. I am having bad breath though(although it's not fowl or rancid, just a little sour). I don't know if this is an infection or something more serious. I circled the area in the photo. It's on the roof of my mouth not the actual extraction hole. Also please disregard the last tooth behind it. I know it's super gross but that's my wisdom tooth that just grew in and it's so far back my toothbrush can't reach it. I'm getting those out next. Please help me I'm freaking out and my dentist is closed til Monday!!" }, { "id": 595, "title": "Need to decide betwen extraction and root canal!", "dialogue": "Trygvie: I have an abscessed tooth on the upper right side, the 5th tooth in from the front. One dentist tells me I should save the tooth and have a root canal. Another dentist tells me I should have it extracted and maybe later have an implant put in. And still a third dentist tells me that implants don't work over time.\nSo I am very confused about what to do. My teeth are in good shape otherwise except that the lower right tooth immediately below the one in question was removed several years ago.\nAll my other teeth are in good shape. I am 60.\nCan anyone offer me advice about what to do? Should I have the root canal and save the tooth? There is a visible infection on the xray around the roots. I have pain and swelling and was on antibiotics a few weeks ago which helped a little. Now I do oil pulling twice a day with coconut oil which helps with the pain.\nThanks for your help." }, { "id": 596, "title": "Tongue lesions then soreness", "dialogue": "tim5309: I cannot determine the offending cause of this current chronic soreness on the dorsal (top) surface of the tongue near the midline groove. This started out with visible lesions/ulcers on and around the tip and sides of the tongue 6 weeks back. I would usually associate the sores with the irritant SLS in my toothpaste, but this time, the sores took 3 weeks to subside even though I had switched to a SLS-free toothpaste right away. I was then treated with an antiviral (acyclovir) for about 10 days and noticed no change. Bacterial culture results were negative as were labs for autoimmune diseases. I don't believe a fungal culture was run, however, there are no visible signs of thrush (i.e. white patches). I also had no striae (white lacy patches) that is common with oral lichen planus. The lesions abated, but the soreness continued.\n\nThe oral surgeon diagnosed this as glossitis https://en.wikipedia.org/wiki/Glossitis. I was concerned it could be BMS https://en.wikipedia.org/wiki/Burning_mouth_syndrome , however, by definition, BMS has no visible signs (i.e. painful lesions) which I displayed at the onset. I am very health conscious, have taken a plethora of supplements for years and a few meds (blood pressure/thyroid) and never had issues, eat all organic, no processed food, & exercise regularly. I am unable to tell if any food, supplement or med causes or even worsens the soreness as it just hangs. It's not a burning or throbbing soreness, but rather just tender when touched or when I flex my tongue as well as some dryness when breathing through my mouth. There are no visible signs or redness or swelling at this point.\n\nAll input appreciated as to possible causes and treatment." }, { "id": 597, "title": "Concerned over tooth extraction site. Help", "dialogue": "Lintongirls: Can anyone tell me if this looks OK? I went in because I had an abcessed tooth and took augmenting for a couple of weeks prior to extraction. Upon extraction at the dentist, a simple extraction lead to one that lasted over two hours of banging and cutting with only local anesthesia. I've been in pain since, but Its getting worse instead of better. I have allow grade temperature and feel generally worm out and can not sleep well because of the pain. I'm on a different antibiotic now. My dr can't fit me in and my dentist is off and honestly I don't want to go back in to her after this right now. Should I go to the er?" }, { "id": 598, "title": "Removal of some bone ????", "dialogue": "JudithElaine: HI, I visit my dentist every 3 months. Recently I noticed some sensitivity from my front crown. I had a X Ray, and it was discovered that my crown is decayed inside (still white outside), but unfortunately decay has spread to the bone above the tooth.\nI am to have both the crown and some bone removed. I will be having this done at NHS dental clinic and not my dentist.\nI have requested sedation (which I wouldn't have done if it was just the tooth I was removed) will be having my appointment to be assessed early next month. I will admit, although I am normally quite brave, this is putting the wind up me a bit. I will have a temp. false tooth, then a new one in 6 months when the bone has healed. Has anyone else had this problem on here ?" }, { "id": 599, "title": "Pain persists after Lower Wisdom teeth removal 3 weeks earlier", "dialogue": "Aravind243: Hi,\n\nI really need some help and guidance as I am quite suffering from pain for past 3 weeks and not sure until when this would continue. Here is my story:\n\nI was having sensitivity issues in my lower teeth and the dentist suggested to remove my lower wisdom tooth. It was really tough for them as they said they have applied too much pressure to remove it. But then, dentist suggested no stitches needed as any infection should go out. \n\nI did not get any swelling, but there was numbness for the 1st day and then 2nd day onwards pain was there in the day time and I was having paracetamol in the night and got better sleep. 2 weeks went, but the day pain was still there, did not go. Went to the doctor again and checked for dry socket issue. Dentist mentioned, it was all good and there is no dry socket and asked me to rinse with warm water..\n\nBut, the pain was still there and then it started in the night as well and pain killer did not help. I was not able to sleep at all. \n\nWent to dentist again for third time 2 days back, this time a senior dentist came and mentioned, my tooth is not clean and this has created bacteria and that is the main reason for the pain (Am not sure).....they suggested cleaning the entire tooth which took 1 hour. It was horrible time for me. \n\nNow, it is paining all day, and did not change at all. Pain killer is not helping me either.My question is:\n\n1. Is this starting from day 1 due to cleaning issue? \n2. Or is my healing takes more time as I am reading several websites that it might even take 3 months?\n3. Or is there any infection should I consult another dentist?\n\nOne main thing, is If there is very high pain, If I am drinking normal water, it goes away for a min, but the pain comes back....So, with this for past 2 weeks, am drinking close to 8-10 bottles every day..\n\nCan someone provide suggestion please!!!" }, { "id": 600, "title": "Looking for affordable dental implants", "dialogue": "chanlee05: I am a domestic violence survivor and in desperate need of dental work. I am a single mom of 5, college student and just lost my job due to being self conscious about my smile. I have several teeth knocked out and my insurance doesn't cover implants. I do have partials but they are damaging my other teeth and have being looking for any charities that would consider helping me. It is a hindrance because I can not be as active as I would like to with my kids and their school activities and obtaining and keeping a job if it requires face to face interaction with people. I am such a people person and would love to get my self esteem back up to be able to enjoy my kids and a job where I am helping people. I currently so speak to others in domestic violence situations by sharing my story. Are there any charities or dental organization that can please help me?" }, { "id": 601, "title": "Site after tooth extraction", "dialogue": "Sjohn89: I have been doing my best to keep my site clean after a tooth extraction, but I developed an uncer, and I am a bit worried about the look of the area. Is this anything I should worry about? I am going to post a picture below if anyone could please let me know if this is ok." }, { "id": 602, "title": "Periodontist or 2 weeks post extraction complication", "dialogue": "cadams0315: I had a very difficult extraction of #3 done two weeks ago yesterday. The canals and bone was crumbling as soon as my Oral Surgeon began the surgery. He literally had tiny bone fragments and particles of broken teeth to get out plus the tooth itself, along with suctioning out a massive infection. A 45 minutes procedure took 3 hours.\n\n Any who, I had a recheck 7 days later. All was well. Except for some sensitivity to the adjacent teeth which my Oral Surgeon said was normal. I was told this would get better each day. He was right because by the 10 day, I will pain free. Three days of no pain. I was loving life.\n\nI then called a Periodontist because I wanted to see if I could talk to him about my receding gums. There was a cancelation yesterday. Which is day 14 since the extraction. The Periodontist examined my gums. Poking and prodding which didn't hurt at the time. Then he talk to me about what was going on. Much to my surprise it wasn't bad news. By the time he was done showing me a short 3 minute video, I began to feel pain around the extraction site, the adjacent teeth and the gums. Plus my cheek was beginning to feel sore. Today, exactly 24 hours after going to the Periodontist, I am still feeling pain. Why am I am feeling this pain? Is there something that has gone wrong with the extraction that I should be concerned with at this point?" }, { "id": 603, "title": "Sunken LEFT cheek following tooth extraction some yrs. ago", "dialogue": "music-fps: [I don't know if this is the best subforum for this posting but I figure that some kind of surgery might be or will be in order for me.]\n\nEarly last month I, a guy in his late 60s, noticed that my LEFT cheek is now sunken. In that same time when I noticed this, my facial skin, in the area of the LEFT cheek sinking, looked quite ruddy to me as if it had changed for some reason-- my face usually isn't ruddy in color. The sunken LEFT cheek remains that way today. I looked up on the Internet what could cause this. I found some medical reason explaining why just 1 cheek would sink. And then I finally found the matter of a tooth extraction causing this cheek sinking due to bone loss. At first I thought that tooth #15 (an upper LEFT one) was pulled out a few years ago but today the clinic told me that that tooth was extracted in 2011.\n\nI'm wondering of course if this sinking will continue and what can be done about it. Can a super costly implant fill in the space of lost #15 and will that implant cause the LEFT cheek to appear normal? Since the extraction occurred 6 yrs. ago, is it too late for an implant to be installed if that might or will help?\n\nI also recall reading some online self-help for this. In that self-help recommendation, one is told to do an exercise by filling the mouth with air to puff out the cheeks. Then there was something about causing a strong smile while fully wrinkling the nose. I don't know what this is supposed to do but I thought maybe it improves some facial muscles to bring about cheek fullness. Is this just baloney?\n\n[Later this month I meet with my current dentist who's not the one who pulled out #15. He works though in the same clinic where my past dentist who did the extraction worked 'til ~ 1.5 yrs. ago.]\n\nCan any of you tell me more about this cosmetic problem and what can be done about it? Is a bone graft done for this? music-fps: I didn't think about the following 'til some time after posting my LEFT cheek sinking problem here.\n\nThis past Jan. into early Feb. I had a strange, extremely painful canker sore in the upper left gum by the extracted tooth #15 which was pulled out 6 yrs. ago. The canker sore physical pain was so bad I couldn't sleep and my daytimes were miserable for some weeks. I consulted my dentist twice in Jan. and once at the start of Feb. Since this LEFT sinking seems to have happened rather quickly and since it must have been occurring when I had the odd canker sore, I wonder if some strange infection or virus could have caused the canker sore and the cheek sinking.\n\nHave any of you ever heard of a link or causation of canker sore to cheek sinking in the area where a tooth had been extracted some years ago?" }, { "id": 604, "title": "Need an extraction, bone graft, then implant - what kind of dentist?", "dialogue": "banker22: Hi all\n\nI have an infection in one of my teeth, and have been advised by a top dentist that I require a surgical extraction, bone graft (bovine), and implant a few months later. Unfortunately this dentist is based in the UK and we are moving to the US shortly. What kind of dentist does this in the US? Oral surgeon? DDS? DMD? What should I look for? Can anyone recommend what I need in the Atlanta area?\n\nThanks" }, { "id": 605, "title": "Wisdom Tooth extraction bleeding after 48 hours", "dialogue": "Krzyzstof: Hi There! I had a wisdom tooth extraction, the 16/32 pieces from the left side 48 hours ago. My recovery was really good the first 48 hours, i had no pain, no swelling and i ate okey. But today i woke up earlier than usual with a lot of blood coagulated-like in the left side of my mouth, one of the two sockets was bleeding but not like the usual fluid bleeding, but a more gelatinous bleeding, what should i do? clean all up almost to the root of the teeth and make a new coagulate or just clean as much as i can? There is no more bleeding by the way, but the blood is still there like jelly.\n\nThanks in advance." }, { "id": 606, "title": "In pain. I need advice please.", "dialogue": "Alayne: Due to severly deviated septums, a growth (possibly cartilidge) that has almost completely blocked one nostril and TMJ, I either sleep with my mouth closed grinding my teeth or sleep with it open in order to breathe. I also now breathe most of the time with my mouth open during the day.\n\nThe grinding and constant air on my teeth has caused them to become brittle and go from being a great set of teeth to loosing the majority of them over the last few years. I have only my front teeth left and none to chew with without pain.\n\nI have a couple that have broken down flat to the root. The upper right canine is infected and I'm on 1000mg of amoxicillin a day and have been for 3 wks now. I have some cheek swelling and have lost weight because I can't chew or sleep well with the pain. It doesn't seem to be taking care of the infection fully. \n\nBefore you ask me to go to the dentist or surgeon I need to point out that I can't right now or I would. All if my time and money is being put towards a husband that had heart surgery and is not able to do much with weekly doctor visits and my father in law who has Parkinson's disease, dementia and is being checked for kidney cancer and needs eyes on him 24/7 due to his instability. While I have a tooth infection they have serious life threatening issues that are more important. Plus since I'm unable to breath through my nose surgery is impossible. I'm scheduled to see a ENT specialist but not for another 3 wks. \n\nIf you have any suggestions how to reduce the pain or anything I can do to get by please let me know. I can't get ahold of the root pieces of the tooth or I would just pull them out. \n\nThank you." }, { "id": 607, "title": "Combining NHS treatment with private", "dialogue": "Payney: I need some work undertaken and have been quoted a costing based on private dental costs. I require two extractions, a root canal and several crowns. Can I mix and match so for example having the extractions and root canal work on NHS, then the crowns undertaken privately.\nThank you" }, { "id": 608, "title": "extraction..dentist shoveling hard under tooth", "dialogue": "toothhealing: went to access dental for a single root tooth removal....they assigned me a young lady dentist...i thought maybe she was a intern for she walked around checking in with orders of the older dentist...but im on medi-cal so i accepted who they assigned me ..anyway..she started shoveling hard under the tooth and root trying to get the tooth out cause it would not disconnect after gentle leveling attempts....i eventuallly stopped her after awhile i was worried about the nerve underneath being damaged..she then went and got the oral surgeon and he cut it out quickly and kept apologizing for her not being able to get tooth out...i was very respectful and calm about the whole thing...my question is ..i have another tooth second molar bottom to be extracted that split down the middle....is it normal procedure for her to shoveling with leveler that hard under the tooth to get it loose...i am worried about this molar being extracted on bottom level..now......... Dr. John Jay: Sorry to hear about your terrible experience. If you have denti-cal (you mentioned medi-cal which is covers your medical not dental needs in California) then chances are that you'll end up with an inexperienced younger dentist. However it's great that there was an oral surgeon around to jump in and save the day. Your concerns about nerve damage are legit. Nerve damage can occur if your dentist is not careful during tooth removal surgery. I hate to tell you this, but removing difficult broken teeth does involve some shoveling as you call it. The more broken down your teeth are, the harder removing them becomes. Also infected and broken teeth are more difficult to numb up and may require additional shots. Either way, it's good that you found an oral surgeon who knows what he or she is doing. My advice to you is to go directly to the oral surgeon next time you need a tooth removed. Removing broken down teeth is difficult for general dentists, particularly the younger ones. It's probably worth spending a little out of pocket, I'm guessing the oral surgeon probably charged you for bone graft placement, then to risk permanent nerve damage or other serious complications. And don't even think about not removing your other broken tooth piece! Rotten root pieces can cause many medical and dental issues if neglected and left in your mouth. Hope this helped and best of luck to you.\n\nDr. John Jay\nDentist and occasional blogger at dentaldecider.com" }, { "id": 609, "title": "Sinus lift", "dialogue": "Sharon: I had a sinus lift and implants placed 11 days ago. Instructions said not to bend over or lift ect. It didn't specify how long....today I forgot and accidentally bent over would I have done any Harm?" }, { "id": 610, "title": "Still in pain after Wisdom tooth extracted 11 days ago", "dialogue": "Ashlee: I had one of my wisdom teeth removed 11 days ago and I am still in a significant amount of pain. I went back to the dentist on the 4th day and was told I had \"dry socket\" and the healing is now abnormal and prolonged. They packed my socket with that clove material/fibre. This did relieve some of the pain temporarily but tasted absolutely disgusting and fell out after 2 days. I then went back again on day 6 to have the socket packed again. This again provided temporary relief but has fallen out again. \nIt's now day 11 and I am still in excruciating pain with a large open hole in my gum. It doesn't seem infected, no pus or fever. And when I was at the dentist a few days ago he told me it wasn't infected. I clean it everyday with warm salty water. I am solely relying on painkillers to get through the day, which is making my job difficult. And often I wake up from the pain in the early hours of the morning when the painkillers have warn off. I still cannot eat properly (limited solid foods) or drink water without triggering more pain. And I feel like the pain is not isolated to the area of the extraction but is actually up the side of my face and into my ear. \nI know that dry socket makes the healing slower but should I still be in so much pain? \nIt's almost unbearable! Dan Deffett: How is the pain Ashlee, i had a wisdom pulled a week ago and it is throbbing, i went back to the dentist to have stitches out and he said it was healing good, how is your pain\n\nDan Ashlee: Dan Deffett said:\n\n\n\n\t\t\tHow is the pain Ashlee, i had a wisdom pulled a week ago and it is throbbing, i went back to the dentist to have stitches out and he said it was healing good, how is your pain\n\nDan\n\t\t\nClick to expand...\n\nHi Dan\n\nI had this tooth removed in October and thankfully I am in no more pain. However because I ended up with Dry Socket it took about 4 weeks before I had no more pain.. and I still in fact have a hole in my gum but it is healing over slowly. Such a slow and painful process. Dan Deffett: Thank you for responding Ashlee \n\nHow long was it before the pain was gone, do you smoke, i read that will cause dry socket, did you get a partial once it was healed Dan Deffett: I went back to my dentist this week to have my stitches removed he did not say anything about dry socket he did say it was healing well but it has been 8 days and I am still in pain Ashlee: Dan Deffett said:\n\n\n\n\t\t\tThank you for responding Ashlee\n\nHow long was it before the pain was gone, do you smoke, i read that will cause dry socket, did you get a partial once it was healed\n\t\t\nClick to expand...\n\nIt took about 4 weeks before the pain was gone but only because i had Dry Socket.. i've been told it shouldn't normally take 4 weeks. No i do not smoke, and i am not sure what a \"partial\" is but i do not think i had this.. Dan Deffett: A partial is a denture , i am wondering if i have a dry socket, did you dentist tell you you had a dry socket Ashlee: Dan Deffett said:\n\n\n\n\t\t\tA partial is a denture , i am wondering if i have a dry socket, did you dentist tell you you had a dry socket\n\t\t\nClick to expand...\n\nOh sorry... no i did not get a denture.. yes my dentist told me i had dry socket.. it is a very painful experience If you have no clot/scabbing in the hole where the tooth was removed then you may have dry socket.. Good luck! Dan Deffett: Thank you, i am taking Tylonel , it has only been a week maybe i am worrying for nothing," }, { "id": 611, "title": "I have a lipoma in my lower lip.", "dialogue": "nels: An experienced general surgeon told me he could revome it or should I see a stomatologist?" }, { "id": 612, "title": "Wisdom tooth extraction pain", "dialogue": "Dan Deffett: Hello\n\nMy first day on here, i had a moler extracted a week ago and i have been back to the dentist to have my stitches removed, i told the dentist i was still in pain he gave me Tylenol , is this normal to be in pain this long ?\n\nThank you\n\nDan" }, { "id": 613, "title": "Cost... What's Fair? (Loose screw saga)", "dialogue": "jaygreg: Seeking opinions on a rather touchy situation....\nTwo implants (#18 and #19) are 22 years old. During the first six years, the crowns atop the implanted stems worked loose six times. Finally, in the sixth year, one implant stem actually snapped. All has been well until a month ago; both are coming loose again.\n\nDuring the first few months following the initial surgery, it was discovered that the dentist (not the surgeon) was unaware the crowns had torque specifications. He had no torque wrench and I was sent back and forth to the surgeon who torqued the crowns.\n\nRemedy hasn't materialized yet because the doctors, I assume, are in conference with one another. Cost probably isn't even being discussed. This may become an issue I'd like to avoid but I also want to be fair. I distinctly recall the surgeon telling me the \"servicing\" of those implants was NC for life. But those crowns... here's where things may get sticky.\n\nFrom my decades of experience with simple nuts and bolts, the more a nut is placed on and removed from its bolt the less of a grip it seems to have; easier to remove the next time. Because one of these implants had its screw tampered with at least half a dozen times (the other snapped, was replaced, and never loosened) - which wouldn't have happened if it were torqued properly in the first place - we may have a shared responsibility here. I'm inclined to lean in that direction. \n\nWhat say you... and what's a fair share on my part? jaygreg: I’ll probably be facing a decision on this Monday or Tuesday. Since one implant sustained six torques and the other broke on the sixth but has remained secure since (they got the torque routine down pat by then I guess), I’m inclined to think I should be fully responsible for the last implant but half responsible for the first. Does this seem fair?" }, { "id": 614, "title": "Upper right first molar extraction", "dialogue": "Lauren95: I've just had my molar extracted (upper right first) due to being killed off by the second molar! No one has mentioned an implant or anything to replace the tooth... what will be the impact of this?\nThanks in advance" }, { "id": 615, "title": "Lasting pain (for weeks) after seating of crown on implant abutment", "dialogue": "HumanInPain: Problem\nSince the crown has been seated on the implant (with maxillary sinus lift) abutment I’m in constant pain in the area around the implant. The pain increases when force is applied to the crown/implant. Clindamycin brought no pain relief.\nTooth number 15 (ISO)\n\nSymptoms\nConstant moderate pain. Increased pain when force (vertical to the head of crown, horizontal on front/back) is applied (e.g. with tongue, chewing) to the crown. No pain when crown is removed (= no force applied to the implant).\n\nHistory of Events\n\nApril 2014\n\nFirst root channel treatment\nPain completely gone\nNovember 2014\n\nRoot channel was redone (different dentist)\nNote from dentist: channel was not clean\nClindamycin for several (6 days)\nPain back as soon as antibiotics treatment was over\nNovember 2014\n\nroot channel redone (unsure what was the reasoning. missed extra channel?)\nDVT/CBCT was taken. Analysis did not show any findings.\nDecember 2014\n\nroot channel redone with extra injection of a high dose substance (unknown)\nPain relief for only 1 day.\nTooth was extracted\nPain completely gone.\nAugust 2016\n\nPlacement of implant (Ankylos C/X) with \"small\" maxillary sinus lift + bone grafting\nNo (noticeable) complications and no pain after 1 day\nEnd of November 2016\n\nSeating of crown on implant abutment\nImmediate severe pain\nDecember 2016\n\nAfter 5 days, crown was taken off and sanded to decrease pressure on neighboring teeth\nSome pain remained\nEnd of December\n\nPain still persistent\nClindamycin (12 x 600mg) for 6 days\nAntibiotics did not bring any (also not temporary) pain relief zeezee22: Has your bite been checked? Is the tooth knocking against others when you chew or catching when you chew laterally? Also maybe if it is an infection, then Clindamycin may not be healing the infection and perhaps another antibiotic may be more suitable for your particular infection. I note that only Clindamycin has bee tried and maybe something like Metronidazole would be a choice to treat any anaerobic infection or Doxycycline if the the infection is bone related. You must speak to the dentist to see what he thinks could work. Perhaps you could discuss these options to check what your dentist thinks would be suitable. Otherwise, perhaps your body is still healing and needs a bit more time HumanInPain: Hello zeezee\n\nThank you for your time looking at my case.\n\n>Has your bite been checked?\nYes. According to the dentist all contact points (occlusal and approximal) are good. He strongly recommends against sanding the contact points any further.\n\n>infection\nThere are no indications of an acute infection. Clindamycin was prescribed to rule out a possible lingering infection in the sinus.\n\n>dentist visit\nI was posting the case here because the dentist/implantologist has no explanation for the described pain. He never came across a similar case before and stated that it was very atypical that I had severe pain for 5 days after the crown has first been seated. This pain was only relieved after the approximal contact points of the crown have been sanded.\n\nI’m wondering whether a restricted orthodontic movement could explain the symptoms.\n\nI have also attached a new x-ray." }, { "id": 616, "title": "Extraction Concern?", "dialogue": "Gracep98: I got my wisdom teeth extracted yesterday, and today I was eating some soft food (apple sauce) and I thought that a piece of something had gotten into my teeth. I quickly and gently wiped my tongue across the side of my gums when a huge piece of dead gum (at least I assume it was dead, it was nearing the color black) came off. It ripped out and I started bleeding, and the flap began right around where one of my extracted teeth were. I'm very worried that I may have accidentally taken off something that wasn't meant to be removed, as it also had something that looked like plastic floss which I imagine was some stitching. The flap of gum was extremely long, spanning from the back of my mouth all the way to my front teeth and then broke off. Is this a big concern? If its completely normal I'd rather save the money in going back to the surgeon two days after my extraction, although I'm concerned about dry sockets. Thank you for your time!" }, { "id": 617, "title": "Got my wisdom teeth out last week", "dialogue": "laila927: I got all 4 wisdom teeth out 8 days ago, and I have some questions:\n\n1. Where exactly is the \"extraction site\" that I am supposed to clean with the syringe? My dentist gave me the syringe yesterday and I tried to use it, but I just assumed that it went in the area where there was a little hole (not my gum). Am I supposed to put it in my gum? \n\n2. Also, each time I used the syringe (last night and this morning), it made my bottom right area hurt even worse (it has been hurting me more than the others, which are painless now). Do I have an infection? \n\n3. If I get food trapped in the hole left from the extraction, will the new tissue just grow over whatever food is trapped? \n\n4. How can I be sure that no food is trapped in my extraction site, and is that what might be causing the pain in my lower right area? \n\nThank you" }, { "id": 618, "title": "Alveoplasty left with exposed bone?", "dialogue": "Illidari: I had an alveoplasty done 3 days ago after a wisdom tooth extraction made my jaw shift and make a spicule shoot out the back of my jaw anyways during the alveoplasty she sutured up the cut she made but couldn't suture the hole that was left from my bone poking through the gums were to thin so the stitch wouldn't hold \n\nMy question mainly is will my gums heal she said they would but I am freaking out over my jawbone still being exposed it's smooth and not spiked \nAnd the thought of going through another surgery is awful and I'm just scared \nI am on a soft food diet for quite awhile please help me out with advice all I am seeing is that gums don't grow back but all the links are for receding gums which don't apply to this. \nPlease help!" }, { "id": 619, "title": "Spot in mouth", "dialogue": "Cathy Heavlow: I have a spot in my mouth that has been there for about 2 months and my sisters dentist looked at it and said I would need a biospy done and I have searched to see what it could be and to me it looks like it could be melanoma cancer please someone tell me what they think Cathy Heavlow: " }, { "id": 620, "title": "Wisdom tooth extraction question", "dialogue": "AshleyH: I had all 4 wisdom teeth removed 1 week ago and this evening after I brushed, I rinsed with the prescription mouth wash prescribed by the oral surgeon. After I rinsed, I noticed this white, sharp looking thing coming up from both sides of the extraction hole. Is this normal??" }, { "id": 621, "title": "Opinions on Implant Pain?", "dialogue": "Catriona: Hello All!\nI'm posting this here for my mother. Here's the story, and hopefully we can get some answers.\n\nA few weeks ago we went to Mexico for some dental work. I had some cavities worked on, and my mother needed a few crowns and found out she needed an implant. She went back a week later and had the work done. \nShe started feeling immense pain shortly after. She was given an antibiotic and a pain killer - which relived her pain somewhat, but not by much. Several days later, the pain was unbearable and it looked really red and almost \"infected\" looking. She called the dentist and went back down for them to take a look. They said the implant may have been initially too big, and that it would probably be best at the moment to just take out the tooth (leaving the screw inside) and let it heal. She came home, and a week after she was still feeling pain. She contacted an oral surgeon in America and had him take a look. He said he didn't see anything particularly wrong with the way it was done, just that it may have trapped some bacteria down inside and there was a 50/50 chance that it could recover from more antibiotics. He sent her home. The next day she was in tears and set up an appointment with the same doctor to just have him remove everything from the implant site. They did so.\n\nShe is on day 4 of having it out, and she is still feeling incredible amounts of pain. She is still on pain medication and the antibiotic and she is sick of being on pills and feeling \"loopy\" all the time. I took a picture of the tooth site, and am wondering if anyone can give any insight as to what the cause of the pain may be??\n\nThank you! PlacidWay-US: Hi @Catriona May I ask how many implants does your mother have? If it's a single dental implant the pain will not last more than 2 to 3 days. If she had several implants and also had dental bone grafting the pain may last for weeks. In your mothers case probably it is infected, it can be an infection of the soft gum around the top of the implant, or a deeper infection in the bone surrounding the implant. So better again ask your dentist about this they should know what causes the pain and what needs to be done. Good luck! svor1988: They may have hit a nerve? My pain still comes back over 10 years later due to repeat infections and my body fighting it off. I get a feeling if my immune system goes under this implant will be the end of me.\n\nOh, the most skilled practitioners do a conical CT scan before placement, that way they reduce the probability of issues with inappropriate screw size and hitting a nerve.\n\nReally sorry to hear her story. I hope she tells everyone she knows not to do what she did.\n\nSome people (<4%) due get allergic reactions to titanium. I've seen academics recommending a titanium allergy test be mandatory before such invasive placement.\n\nHer molars should scoot forward to fill that space. Sorry again to hear of such pain. lovelyrose: I am sorry for your mum. I can't help much, my dad had some dental work done in Hungary. But he has been very happy and didn't complain much at all about pain Plaza Dental Group: Dental Implant placement causes very little discomfort compared to other surgical procedures. If bone grafts or tissue grafts are performed along with the implants there may be slightly more discomfort, but still only minor. The pain is easily controlled with over the counter analgesics such as ibuprofen, but for the first day a narcotic may be needed." }, { "id": 622, "title": "Having my wisdom tooth extracted each week", "dialogue": "wisebunny: Hey, \n\nI just had my wisdom tooth extracted, and next week I will be having another one extracted. I'm currently on antibiotics because it's infected. Is it safe to extract one after such a short period? I'm really nervous and scared." }, { "id": 623, "title": "Is wisdom tooth removal safe if you have other oral issues?", "dialogue": "Jojo830: Hi there,\n\nI am 30 years old and am finally going through with getting my wisdom teeth removed this winter. I've been trying to grow them in for two years now but there is too much crowding and pain that radiates into my neck, jaw, and ears from them.\n\nI am a little concerned because I have a few other dental issues and I'm not sure if I should take care of those first. I have a couple shallow cavities that I have been putting off getting fillings for because the don't bother me much. Then I have a tooth that broke a couple years back (#15 second molar). It was filled (a huge filling!) 4 years ago. I am overdue on getting a crown for it because I haven't had dental insurance to help pay for it. It hurts from time to time and I have bad breath that comes from that area so I'm worried that I have bacterial issues.\n\nSo basically if I have other dental issues will I be more likely to get an infection after my wisdom teeth are removed? Should I just try to bite the bullet and get the other work done first? It's just so pricy but I really don't want any complications from my wisdom teeth removal. \n\nThanks very much! svor1988: Keep shopping around is my advice. Bad breath may indicate a dead tooth or serious decay (e.g. under a crown). Keep those cavities clean in the meantime & avoid soda.\n\nYou may wish to consider extracting #15 and let the wisdom tooth push forward to close that gap. Would be cheaper than fixing #15 and extracting the good wisdom tooth..." }, { "id": 624, "title": "Discolored Gum after Wisdom Tooth Extraction", "dialogue": "Alexander Sean: Hello,\nYou can all just call me Alex. Yesterday here in Ontario Canada at about 2:30-3pm my time I underwent an elective wisdom tooth extraction for a fully grown bottom wisdom tooth that had a cavity on it too big to repair. I have always neglected my oral hygiene but nothing to the extremes that you would see on Google images and the like. I just neglect my brushing. Anyhow, the extraction was quick and without incident, took about 15 minutes and 5 shots of numbing but I was fully awake without any anesthesia and the tooth was out in a few minutes. After getting home, I followed all my dentists instructions. No strenuous activity, no solid foods, no straw drinking and no smoking. (I don't smoke cigarettes anyway.) When I got home I waited for the bleeding to subside and then I ate some oatmeal, some vanilla ice cream and some soup before bed drinking water all the way. Today the pain has barely been present but I have been taking advil liqui-gels every 4 hours just to be sure. It is now 10:30pm the day after the extraction and I am just now getting a good look at the extraction site. I was given no stitches which was odd, but now I am seeing white/yellow streaking all around the gum socket. This can't be normal and looks like an infection but is it possible to be infected that fast? I can't afford another consultation let alone another procedure and yes...I am already on government assistance and have used up all the dental funds with the extraction yesterday. Anyone who can verify if I am in danger of sepsis from leaving this alone for a month please reply. I have included a picture of the extraction site to the best clarity I could get. Please forgive the crudeness of the image and my rambling. Sincerely,\n\n-Alexander. Dentgr: Hello Alex!\nI don't think there's something to worry about.\nIt seems to me that this is a normal healing process.\nDon't worry about not having sutures. We don't usually use them if it's just a normal extraction.\nTake care! Alexander Sean: Dentgr said:\n\n\n\n\t\t\tHello Alex!\nI don't think there's something to worry about.\nIt seems to me that this is a normal healing process.\nDon't worry about not having sutures. We don't usually use them if it's just a normal extraction.\nTake care!\n\t\t\nClick to expand...\n\n\nThank you very much! I appreciate your reply. I will leave things be. If you could tell me one last thing, in a few hours it will be 48 hours after the surgery. I would very much like some solid food..like a hamburger or some chicken. The nurse said for some reason no solid foods for a week but the sheet they sent me home with says only the first 48 hours. Can I have solid foods now with careful chewing? Dentgr: Go for it. Just use the other side. And don't forget to drop off some hamburgers here as well." }, { "id": 625, "title": "When to eat solid food after a no stitch wisdom extraction?", "dialogue": "Alexander Sean: Hello, \nAlexander here. At 3am today it will be exactly 48 hours after my 1 wisdom tooth extraction that required no stitches. The nurse sent me home with a sheet that details aftercare including salt water rinsing and stressing no solid foods for the first 48 hours. However when talking to the nurse after the extraction she sternly said no solid food for about a week but all.the things I've read online just stress about the first 48 hours. These non solids aren't agreeing with my digestive track and my body is starting to punish me for it. I would like to have a hamburger or a sandwich or some chicken or some pizza. Is any of this okay after 48 hours with no stitches? My previous post on this forum details the condition of my extraction site with no changes today. Please help me out one last time. Thanks!\n\n-Alexander" }, { "id": 626, "title": "Socket exposed post implant", "dialogue": "kieran: HI, \n\nI had an extraction and same day implant with bone graft on upper first molar about 10 days ago. The stitches fell out after less than a week and the head of the implant is showing and I can feel the sharp edge of the tooth socket. \n\nThere is only slight pain if I bite hard on the tooth next to it and there does not appear to be any swelling nor is there any bleeding. \n\nIs it normal for the gum not to cover the bone completely and will it grow over or do I need to get this looked at? The problem being that I am no longer in the same country as where I had the work done, otherwise I would have simply returned already. \n\nAny advice appreciated." }, { "id": 627, "title": "What will I feel if I don't use anesthesia...", "dialogue": "hokie1525: I am 42 and am needing one of my wisdom teeth removed. To preface, all of my wisdom teeth came in straight since I had extra room due to removal of other teeth for orthodontia when I was a child. No dentist has ever recommended removing them since they are healthy and cause no pain or other problems.\n\nRecently, part of one of these teeth broke off. They tried to fill it, but it only lasted about a month. The recommendation is to go ahead and have it removed. The oral surgeon said the procedure won't last more than a half hour, from sitting in the chair to leaving. Extra half hour if I choose to have IV anesthesia due to recovery time.\n\nI would prefer not to do the IV, just have a local. I'm looking for some description of what I will and won't feel during the process. They talk about pressure, grinding sounds, etc, but not really pain. I'm not an anxious patient; frankly more anxious about anesthesia side affects like lingering grogginess, deliriousness, and vomiting. Surgeon thinks my attitude suggests I could do well without it.\n\nThoughts? Anyone have a more concrete description of the experience?" }, { "id": 628, "title": "Problem after tooth extraction", "dialogue": "Tanya M Dixon: I had my last upper mollar removed 6 days ago and I'm not sure its healing properly. The side of my gum between my cheek and the socket seems to be gone! And it still throbs, although not badly. Advil seems to deal with the pain. Is this normal?" }, { "id": 629, "title": "Le Fort 1 plate needs removing prior to implant?", "dialogue": "Starliter: Hi,\nI have an infected molar tooth just below a jaw titanium plate which needs to be removed. I have been told my the surgeon that the plate will have to be removed for an implant to be put in place but another dentist told me that that the plates usually sit on the surface of the jaw so shouldn't impede on the implant. I am concerned about removing the plate due to unnecessary risk of complications (black eye, numbness, problonged headaches, swelling etc).\n\nThe surgeon has admitted he has never taken out any plates before which exarcebates my concern.\n\nCould someone advise on whether this is necessary? \n\nAlso, I am having discharge from my right nostril (closest to the tooth) whenever the abscess flares up so not sure if this means the infection has perforated through to the nasal cavity which would require bone grafting? I am trying to determine if hospitalisation is necessary or if this can be resolved at a dentists with local anasthetics.\n\nThanks in advance" }, { "id": 630, "title": "Implants/bone grafts", "dialogue": "jezzabel: Would like some advice.I had a three tooth bridge that need replacing and decided to see whether implants were a possibility.Went to a specialist who took an x Ray and said implants were a possibility.the implants were a front tooth and the next one along.Surgery was booked ,drilling started and then they found weak bone so placed liquid coral in and sutured.Time went by then they tried again mana aged to get one in. 15months after treatment started I was sent to have a 3D X-ray ,resulting in bone graft surgery ,bone removed from my chin.3 weeks later it was taken out as it was sitting free and hadn't taken .I've now been told the only solution is a four tooth bridge ,this is all after 18months of backwards and forwards to the dentist.\nPlease advice. svor1988: Not looking worth it anymore? Dental implants were among the worst decisions in my life. I didn't know the molars would just push forward to close the gap naturally. Sorry to hear your complex and ultimately unnecessary experience.\n\nAs it is a front tooth this is more a cosmetic issue I guess. I'd just chew/bite on the other side. I've read about too many bridges going wrong and killing their supporting teeth to even consider that- bridges don't last forever anyway. Nikolai Fesenko: When choosing a bridge it is necessary to remember that tooth bridges have advantages and disadvantages. \n\nAmong advantages, there are high solidity, high color stability, relatively low price, fast production (5-10 days). \n\nAs for disadvantages, they are the bridge construction transfers the chewing load on the roots of teeth, which are under the crown of a tooth. That is such a construction overloads the supporting teeth.\n\nFor producing the bridge construction it is necessary to make preparations and sometimes to fill canals. This weakens the teeth solidity noticeably.\n\nThe bridge construction makes crowned teeth work simultaneously, while naturally it is required the independent mobility of each tooth.\n\nThese three above mentioned factors lead to teeth destruction. The process of destruction is very slow and drag on years. But the more pronounced tooth decay before the prosthetics, the less the bridge construction will serve.\n\nThe larger the length of the bridge construction, the worse will be the prognosis." }, { "id": 631, "title": "Root canal", "dialogue": "potatotate: Can a tooth have infected pulp with no pain or other symptoms? \n\nAwhile ago i had a cavity filled, and recently the tooth chipped some. Gradually more and more fell off and eventually (a few minutes ago) the filling fell out.\n\nWhat's underneath looks exactly the same color as diagrams of infected pulp, except that it doesn't hurt at all\n\n(The filling went down to about the gumline, and acording to the diagrams i looked at, dentin doesn't go that deep, so logically, what i'm seeing is pulp)\n\n\nWhat procedure will i likely have to get, and what kind of anesthetic will i be treated with? (Like, will only my mouth be numbed, or will i be put fully unconsious) svor1988: Certainly a local anesthetic.\n\nHope you get help from somebody else here.\n\nBut in case they don't, yes it is possible for pulp to be infected and you don't feel pain. They would use a tap test or a cold/hot test for diagnostics. Go see a dentist ASAP, with emergency booking if possible. Sounds to me like the original filling wasn't completely cured by the placing dental practitioner, thus it had insufficiently bonded to the tooth, allowing infection to set in underneath, leading to the failure you now see. Composites should last 8+ years.\n\nIn my experience, my main dentist always used their curing light for two cycles for each filling. They said they wanted to make sure it stayed. The next dentist I saw cured 3 adjacent composites for less than half a cycle in total. One fell out the next day, another a month later.\n\nLooking around online I see one issue where older curing tools won't cure newer composite formulations well. There are also differences between the effectiveness of these curing light device models.\n\nThe former dentist was cheaper, however he made a mistake. So I thought by paying a more expensive dentist, that wouldn't happen. Boy I was wrong. Plaza Dental Group: By viewing your snap I can say it’s a case of cavity but as a doctor I have to analyse you live in order to detect your oral problem. A root canal is normally done when there is a problem, such as inflammation or infection, which can result in tooth decay, a cracked tooth or a continued need to treat the area. Undergoing a root canal helps prevent pain and the possibility of developing an abscess. Root canals on broken teeth are necessary if the fracture is extensive enough that the pulp is exposed. Other indications for a root canal include deep decay and resorption. If the dentist has confirmed through examination and pulp tests that the root system is vital and healthy, then a root canal is not necessary and should not be performed. Once a root canal is done, the blood and nutrient supply of the tooth are depleted, causing the tooth to become brittle and weak. As the saying goes, \"Don't fix something that isn't broken." }, { "id": 632, "title": "Getting all on 4 dental implants", "dialogue": "kingnz56: I'm in my 40's and live in Canada. I have damaged teeth on my lower left side ( 3 teeth next to each other). I'm planning to extract them and get all on 4 dental implants. I don't want to get partial dentures, the thought itself is very much depressing me. I have scheduled an appointment with Dr. Hagi from Thornhill Smile Centre in Toronto for next week. Has anyone been to this place (allondentalimplants.com)? Can a diabetes patient get all on 4 dental implants? I have type 1 diabetes so I'm just worried about all the procedures. svor1988: I don't recommend such invasive cosmetic surgery. Lots of potential risks. I sure pulled the short straw when I got suckered into an implant at age 18. Search for 'dental implant negligence case' for some horror stories.\n\nYour molars naturally push forward and may result in the gaps closing up." }, { "id": 633, "title": "Help! Numbness in my lip and chin after implant drill hit nerve!", "dialogue": "yellowcouch: My dentist drilled to far when implanting a implant. Im in shock like not being able to wake up from a bad dream. My Dr said it hasnt happened to him ever in 20 years. Just my luck. They say the feeling will return but im not so hopeful. 2 questions.\n1 The day after he had me come in for another CBCT scan to double check the implant that he did eventually install wasnt violiating the nerve canal. From the scan it is at 3mm above the canal. My question is, he insured that implant is ok where it is and by removing it will not alleviate the problem im having with numbness. He said if the implant was still causing problems i would be having pain. Is is ok to leave it in? Im getting mixed views on that. 2nd question- can the CBCT scan that i had the next day after the nerve was damaged hinder the repair of the nerve in any way because of the radiation?\nIm so sorry if i sound paraniod but the thought of being like this the rest of my life is really scary!\nThanks\nMike RightBoy91: 1 word\n\nCOMPENSATION !\n\nseriously . svor1988: Yes, radiation does slow cellular function. Cellular facilities exist for DNA repair and such due to radiation. Just don't do more than one CT scan in an area every 2 years. I've seen a 20k settlement to my dad's friend for a chipped tooth from a NJ/MD restaurant due to glass in his food. I'd expect damages to be on the order of 100k+. You're at risk of biting through your own lip at night or while eating and not even knowing it. A lawyer in your jurisdiction would know more. Cases in my state pay hardly much for emotional damages.\n\nSearch for 'implant nerve damage case malpractice OR negligence' to see cases. I guess the legal term for this would be negligence. You can read through these cases to understand what happened.\n\nMake sure you contact your insurance company and state medical board about this.\n\nFrom my understanding a conical CT scan should be made before placement, to accurately size the implant.\n\nIn my case, the orthodontist had used xrays to size the screw, and after he'd drilled the hole his assistant came back from the storeroom saying they were out of the size he wanted. He said get the next biggest size, and he explained to me that it would hold better. It perforated my sinus cavity and I suffered immensely due to sharp never ending pain, bone loss, palate damage, permanent semi-dry mouth, and constant mucus draining into my mouth alongside the implant. Not to mention around $10k+ of restorative surgeries. I lost months worth of work over the years due to being bed ridden from resultant infection and sickness. It was a miracle they didn't fire me." }, { "id": 634, "title": "DDS did not clean my mouth prior to oral surgery and bone graft. Was this inappropriate?", "dialogue": "RST: Good morning,\n\nI am very concerned because I had three wisdom teeth extracted yesterday and I am afraid that the standards of care were not followed. One of them was impacted and required a surgical approach and they used bone graft on both lower sites following the extractions. I am afraid that the DDS who did the procedure did not take all the measures to prevent infections and I am very scared that this can cause me a lot of issues in the future. Right before the surgery I asked the team what they would use to clean my mouth. The assistant said that they would not use anything. Then, when the surgeon came in, I asked him the same question and he looked at me like I was crazy and said that they, in fact, would not use anything. I asked again, so you don't clean with iodine or anything at all? He said no. I frowned and was trying to make sense of his answer. Then I thought to myself: well, maybe it is because the mouth is so dirty that there is no point. While that was happening they were already starting the laughing gas and he pushed the midazolam in my IV. Next thing I know, I am going home and the procedure is done.\n\nThis morning, with a little more mental clarity, I started reading about the protocols for oral surgery and bone grafting and they all say that chlorhexidine is usually used as a rinse or iodine swabs can substitute but it is critical that asepsis be done prior to a procedure like the one I had, mostly because bone grafts were used.\n\nI am freaking out now and I am extremely mad for not advocating for myself; yesterday, I was scared to death as it was the first time that I had any sort of surgery and anesthesia and I did not even have enough time to think and challenge the DDS's answer. As a nurse, I have read a lot about clean VS sterile procedures but I have no experience whatsoever in oral surgery protocols. Also, I am very concerned because, despite all the contact isolation measures used in hospitals, I could have been exposed to MRSA the night before the procedure given that both of my patients were positive for it.\n\nSo, I have three questions for the forum:\n\n1) What is the current evidence-based practice accepted by the dentist community on this matter? Should the DDS have at least rinsed my mouth prior to the procedure?\n2) What can I do in order to prevent complications such as osteomyelitis. Should I ask him for a prescription for additional antibiotics that are known to be effective against MRSA. I am currently taking amoxicillin only.\n3) Unfortunately, I cannot go back and stop the procedure. When can I stop worrying about this? How long after the surgery an infection is still likely? Catriona: I had my wisdom teeth extracted and never had any kind of rinse or antiseptic. he was one of the best oral surgeons in California too. Just make sure you take the antibiotics. I had a friend that died from wisdom teeth extraction because he didn't take his antibiotic. RST: I am sorry about your friend. I did take all of my antibiotics and I am doing well. I will continue to watch the sites closely for any signs of infection. svor1988: They really rely on oral antibiotics don't they? Yes my dentist used iodine swaps prior to cutting in. And they sanitize all their tools.\n\nSaliva does a pretty good job of keeping your mouth clean. Sorry to hear about your friend. Wisdom tooth extraction is an unnecessary practice in my opinion. Read about that if you want. I wish insurance companies would require proof that each extraction is medically necessary.\n\nIf his were medically unnecessary. I am curious if your friend's next of kin (or dependents?) could have pursued a wrongful death suit." }, { "id": 635, "title": "Sinus Communication - Flap Came Loose", "dialogue": "orange 123: I had an upper molar extracted 10 days ago and had a sinus communication. The oral surgeon repaired the sinus communication, but now I can feel some suction along one side of my gums. It's almost like the flap that was covering the extraction has come loose on one side. I don't think there is an opening to the sinus because I haven't felt air going in or out, and I haven't had any fluid go up my nose. \nIs it possible that the sinus communication is closed, but now there is a space between the flap and the gums? svor1988: Non-dentist here. I'd say yes. For me the surgeon had to do that surgery 3 times. Each time it wore out and the hole opened again. Beyond 3 times he said he'd have to take tissue from elsewhere in the mouth rather than just sliding it down.\n\nYour bone should heal closed given there isn't infection up in there. Mine wouldn't close forever because an adjacent molar (which had had a root canal) was still infected on at least one root, and prevented the sinus perforation from healing. After pulling the molar, the perforation healed. Hope that helps somebody." }, { "id": 636, "title": "inner lower lip scar tissue healing from mucous oral surgery", "dialogue": "verythirsty40: hi i had a inside lower lip mucous removed from an oral surgoun 1 month ago and it is healing good but still feel some scar tissue inside he told me it should heal about now is there anything i can do to help heal it up faster if you can let me know thanks Plaza Dental Group: I would definitely recommend visiting with a board certified plastic surgeon for revising the lip. I would also wait until the age where the deformity bothers her as this will only allow the scar to soften with time. This excess lip scar tissue can be removed with a simple outpatient surgical technique that will reduce the bulkiness of the lip. Good luck." }, { "id": 637, "title": "Dental surgery then issue with tongue", "dialogue": "DavidGeer: I had a molar removed. Two days later, I went off the soft food diet and ate some tortilla chips. I crunched down on one in such a manner that I drove one of the points into the soft tissue underneath my tongue, in the back on the same side as the pulled tooth. It has been a week and a day since the oral survery and six days since the tongue incident. Both still hurt, mostly the tongue. I have stayed on the soft food diet and am still taking 3 to 4 ibuprofen every four hours for the pain. The tongue never bleed from this that I know of. I am 54. What should I do? everway9: Hello. If your pain has not gone away to the extent that you still require pain killers I would advise you to contact the dentist and ask them for advice. Depending on how much trauma was caused during the extraction it can take over a week to heal and the swelling to go down. Also as you know tortilla chips can have some pretty sharp pointy edges. It may be wise to ask your dentist to check that there are no foreign objects lodged in the socket. Can you feel anything in there?\n\nMost importantly.. what strength Ibuprofen are you taking? The maximum dosage of for an adult is no more than 400mg in six hours. It's concerning to hear that you are taking 3-4 tablets every 4 hours. Even if they are the smaller 200mg tablets you should not take anymore than 2 of those every 6 hours.\n\nPlease be careful with painkillers and always read the label.\n\nBest wishes." }, { "id": 638, "title": "Wisdom teeth extracted - dislocated jaw and infection: advice for traumatised patient!?", "dialogue": "MNUe: Hi,\n\nI had two wisdom teeth (upper and lower right) removed under local anaesthetic four days ago. The extraction was complicated as the tooth itself was 'hard', as in like a diamond, and difficult (partially erupted, impacted, near the nerve nerve and a big tooth). The bottom was cut out in pieces which took about 45-50 minutes. I should add that my jaw was dislocated in the process (about 15 minutes into the first tooth). It was reset on about the 12th attempt after the upper was removed . Two days later I noticed a brown discharge and what I would consider unusual swelling (from almost my temple to down the front of my neck in a v-shape, down to my collarbones. I saw an out of hours dentist one day ago (three days after the procedure) who confirmed it was infected. They removed the sutures and some of the infected material. I was then admitted to A&E for IV antibiotics. In the past day I have noticed a significant reduction in the swelling, which is great but I am concerned about two things. First, recovery time. This seems like a particularly complicated extraction with a number of complications likely to result in longer recover times. Can anyone give me a guide on when I might feel normal again (basically if I miss a pain killer window now the hammering in my jaw starts again)? Also, in terms of recovery, should I be seeing a dental surgeon to check on my progress? I am worried about dry sockets, proper healing and ongoing infections. Thanks for any help you can provide." }, { "id": 639, "title": "wisdom tooth AGONY", "dialogue": "martin barclay: Hi,can anyone advise on what's possible? i'm desperate.\nFor over 3 months i've lived with a lower left impacted wisdom tooth.\nI've going through terrible infection,swelling and all consuming pain.\nbut above all the inability to open my mouth.My weight is plummeting\nim seeing a British NHS dentist as i can't afford private dentist,\nso far i've had 3 courses of antibiotics no change, lots of pain killers, no help \ni've been referred to a dental surgeon.But NHS referral takes 6/8 weeks.\nmy main question is.If I can't open wide enough how's the surgeon going to get\naccess to the tooth?" }, { "id": 640, "title": "erupted tooth exposed root questions", "dialogue": "kaitlin4599: ok so im having a tooth pulled on monday on the printed paper that the dentist sent me home with its listed as extraction erupted tooth/exposed root any idea what this means? also is this a simple procedure or a difficult one ive had teeth pulled before but never one labled as erupted tooth/exposed root lastly what should i expect during and after dental visit\n\n\nedit how long will it take for the blood to clot once the tooth is pulled\n\non final thing how long as in hours or day will it take before i can eat solid food for the first few hours after the tooth is pulled i pan to eat soup as in ramen noodle or even just chicken broth" }, { "id": 641, "title": "Pano", "dialogue": "Joe Miller: Thoughts on pano? Lower right apical to 29,30,31 what is the oval circle?" }, { "id": 642, "title": "8 day post extraction!", "dialogue": "Krystin Williams: Hello! I am going to first thank anyone who is able to assist me in ANY way!\nI had all 4 of my wisdom teeth removed Aug 24, 2016. I originally could not have the surgery until the infection that had caused me to go to the dentist in the first place was killed. My dentist gave me Penicillin to take for 7 days and then I came in for the extraction on the 24th. Healing seemed fine, but about 4 days after the surgery I had excruciating pain that did not let me sleep and constantly made me cry because I'm a 22 year old wimp :/. Anywho, I went to the dentist and he put Eugenol on the bottom left extraction site, but he did NOT specifically say I had dry socket, although it seemed like it. He also gave me a syringe to use for cleaning the site of food debris. Using the syringe is INCREDIBLY painful with the salt water solution I am told to use, but it does get the food out. The pain is only ever on the bottom left side. My upper 2 and bottom right molars have no pain and I can eat on the right side of my mouth fine. It is only the left, where the infection was. It has been 8 days, and I still am popping Ibuprofen DAILY for the pain. My tongue is no longer pasty and yellow as it was days before, however the extraction site on the left still tastes disgusting and makes my breath smell. It also hurts like hell when I wake up, lay down at night, or clean it, as I mentioned before. I have officially stopped eating because of the pain on the left side as well as having to clean it after eating. What am I doing wrong? And WHAT IS WRONG WITH MY MOUTH? How long until the pain stops? PLEASE HELP ME IM SUCH A DISGRACE WITHOUT FOOD!" }, { "id": 643, "title": "Can You Take A Benadryl Day Before Wisdom Teeth Surgery?", "dialogue": "Skoonix: My 16 year old is having all 4 wisdom teeth out tomorrow morning - early - and we knew to keep her away from Advil and Aleve but she does have seasonal allergies every now and then and she was sneezing and she took a Benadryl Allergy tablet. Is that a problem with her getting the procedure tomorrow? I called two pharmacists who haven't heard of any interaction problems but was wondering if anyone knew." }, { "id": 644, "title": "Cyst over back tooth in Maxilliary...very scared!!", "dialogue": "stuart31: I recently had a diagnosis of a cyst above a back tooth in the maxilliary area. There had been some swelling there for some time that my dentist failed to diagnose, although this swelling was painless after an initial bout of a couple of days pain. \n\nSix months ago I started to use a salt water rinse and overnight the swelling 'burst' taking with it some bone and soft tissue. The soft tissue seemed to regenerate very quickly though and now the area feels normal apart from a foul tasting discharge every now and then.\n\nThe cyst was seen on a CT scan and I am due to have this removed. My concern though is that the cyst is cancerous, as my consultant said that it may or may not be, which has made me very worried. I have no other 'red flag' but wondered what the odds were?\n\nAlso on a side note, would this area ever be suitable for a dental implant or should I consider a denture?\n\nThanks for any help you can offer!\" clb_: Was the cyst hard or squishy? Asking out of concern for myself to as my maxillary area is inflamed and hard and hurts a lot. stuart31: clb_ said:\n\n\n\n\t\t\tWas the cyst hard or squishy? Asking out of concern for myself to as my maxillary area is inflamed and hard and hurts a lot.\n\t\t\nClick to expand...\n\nThe cyst was 'squishy', and painless for the most part after some initial pain which subsided after a couple of days.\nI had an operation to remove the cyst about a month ago, also some surrounding bone was taken and two teeth (at the back so not noticeable except by me). Turns out it was benign, although there are many types of cyst and I don't know yet which this was. I had a GA and the worst part of that are the after effects of the operation....bad throat infection and now a GI infection from the antibiotics!!! The Cyst removal has healed quite well! \nI wouldn't worry too much, if it is a cyst I now gather they are usually (if not all the time, frankly) benign lesions, and if caught early can by removed under local anaesthetic. I had mine for years, but no-one noticed until I had a CT." }, { "id": 645, "title": "Please help - extraction over 2 weeks ago", "dialogue": "clb_: hi,\n\nI had an upper molar extracted 17 days ago, I had to go back two days later because I had a bad taste in mouth, he cleaned it out and put that tobacco looking stuff in it and stitched it up, about 5 days later I had the stitched removed because they were getting manky.. anyway I'm now in kinda constant dull pain and my maxilla bone right at the top of my mouth above the main molar is large and hurts so bad especially to touch, my dentist said its just because of the tooth extraction but I don't know, has anyone else had to deal with this? I'm scared it's a bone infection because I'm starting to feel unwell and I just feel like it's getting worse and I don't know what to do my dentist doesn't seem concerned. \n\nI grind my teeth in my sleep, and over the course of the extraction I've had amoxicillin and metronidazole." }, { "id": 646, "title": "How long does the pain of a dry socket last after being treated by a doctor?", "dialogue": "Pauluk: Today is my 4th day after being treated by a dentist. \n\nMy treatment was as this: \n\n1. Clean socket and irrigate blood trough the wound \n2. Put a medicament inside to help the healing. \n3. Close the wound with stitches. \n4. Comeback in 10 days to remove stitches. \n**During these day I wash the wound with salted water \n*** NO smoking at all \n\n\nMy first day after this was horrible even with painkillers but now the pain is manageable with pain killers only. I feel that this is a never ending situation and I am afraid that the treatment might not be working as the pain is still intense and really interferes with my day. \n\nCan anyone share their experience and let me know if this was the correct treatment? \n\nI read in some forums that after being treated the pain would normally go away immediately, also that the correct treatment is by returning to your dentist to repeat the cleaning of the wound every other day. \n\nThanks for your kind advice." }, { "id": 647, "title": "Normal healing after wisdom teeth?", "dialogue": "Ashleyn95: I have no pain really just this annoying scab rubbing against the inside of my mouth. I had my wisdom teeth (all four) removed 7 days ago, and I have almost no pain but i look in my mouth and there's a gross dark colored looking scab and there's a little bit of white on it . It's really gross looking but isn't painful is this normal? AF05: It could be scar tissue or gum/ tissue remodeling around the area where the tooth is removed. It doesn't feel like exposed bone, does it? Either way, go back to the surgeon for a check to make sure that thing are OK and your are not dealing with a possible dry-socket in the near future. Best of luck and keep me posted. Regards," }, { "id": 648, "title": "Horseshoe shape upper dentures", "dialogue": "Dona: Does anyone know about these type of dentures, knows anyone that has them?" }, { "id": 649, "title": "molar extraction at six years old........", "dialogue": "joaquin: hi there!!\n\nI'd just like to ask, is it advisable to extract a molar on a 6 year old ???\nmy little brother is suffering from tooth decay due to past incidents that involved not having him drink water after he drank infant formula, fast forward 3 years we visit our dentist and she recommends a full treatment of his teeth... which involved quite a few root canals the first few went well and then one day his right side molars just started hurting we went to our dentist and she started a root canal which was quite painful (from the sound of his screams) he's in pain right now and we're considering an extraction (which our dentist did not recommend since he'll be needing them untill he's 12.\n\n we really need advice about this ..... Dr David Lee: Hi joaquin,\n\nSorry to hear about your little brother. \n\nI assume that you are talking about baby teeth molars since you said the dentist said he'll be needing them until 12. If the baby root canal (pulpotomy) is not providing relief for the pain, then extraction of the baby tooth is advised. In terms of the consequences of extraction, it is best to maintain the space for the adult teeth by using a space maintainer. If you have any x-rays, it would help in providing you with more information.\n\nPlease don't hesitate to ask for more advice!" }, { "id": 650, "title": "Wisdom Teeth removal holes recovery", "dialogue": "kb1234: Hi! I had my two bottom wisdom teeth (left and right) removed last Monday, March 16th. Lately, the right side has been hurting A LOT! I noticed that the hole is larger than the left side and that the hole encompasses my right 2nd molar--meaning, my right second molar does not have gum completely surrounding the tooth, and the back of the tooth is open into the wisdom tooth hole. I included a photo to show this issue. Should the gum be surrounding my tooth or is that normal for the tooth to be open into the wisdom tooth extraction hole? If it matters--my wisdom tooth was impacted on both sides and on the right side was erupting through the gum but was sideways against this 2nd molar.\nPlease, just take a look at this photo and let me know if you think it is healing correctly.\nThank you so much!!! drmins: The flaps could have been approximated little more closer.Did the suture come out too early? But nothing to worry.\n\nIts recommended to pay better oral hygiene care and strictly avoid any food lodging into the extraction socket.It can lead to dry socket. The best measure is to have saline gargle many a times a day.\n\n(I always recommend not to undergo surgical removal of teeth on both sides on the same day as it can interfere with the diet intake and oral hygiene care.) kb1234: drmins said:\n\n\n\n\t\t\tThe flaps could have been approximated little more closer.Did the suture come out too early? But nothing to worry.\n\nIts recommended to pay better oral hygiene care and strictly avoid any food lodging into the extraction socket.It can lead to dry socket. The best measure is to have saline gargle many a times a day.\n\n(I always recommend not to undergo surgical removal of teeth on both sides on the same day as it can interfere with the diet intake and oral hygiene care.)\n\t\t\nClick to expand...\n\n\nOn Saturday the surgeon took out two stitches as it was causing muscle pain, so that may have caused it to open up more? It is still wide today and I am in a lot of pain. drmins: From the pic,its very much possible to be a dry socket.\n\nIts normal to have a pain during post-operative days,which can lessen as days advance. Did you start a throbbing pain at around 3-4 days after extraction?\nDoes the pain radiate to other parts like the forehead or ear on the same side?\nIs there any foul smell or unpleasant taste Though your oral hygiene is good as seen in the pic,there can be food lodgement in the socket.\n\nIf these questions are positive,seek treatment with your surgeon immediately. Mean while,take saline gargel many times a day. jyotindra.suthar: kb1234 said:\n\n\n\n\t\t\tHi! I had my two bottom wisdom teeth (left and right) removed last Monday, March 16th. Lately, the right side has been hurting A LOT! I noticed that the hole is larger than the left side and that the hole encompasses my right 2nd molar--meaning, my right second molar does not have gum completely surrounding the tooth, and the back of the tooth is open into the wisdom tooth hole. I included a photo to show this issue. Should the gum be surrounding my tooth or is that normal for the tooth to be open into the wisdom tooth extraction hole? If it matters--my wisdom tooth was impacted on both sides and on the right side was erupting through the gum but was sideways against this 2nd molar.\nPlease, just take a look at this photo and let me know if you think it is healing correctly.\nThank you so much!!!\n\t\t\nClick to expand...\n\n\nhi i have same problem here..\n\nso kindly explain how many days are required to complete feel this gape?" }, { "id": 651, "title": "Irreversible pulpitis on wisdom tooth.. Surgery 3 weeks away. Will pain go away?", "dialogue": "devirecui: Hey folks I recently had fillings done on my tooth # 16 wisdom tooth. It was pretty deep and after I was in intense pain. Still am and it is continuous with no relief even from ibuprofen. Cold water helps and it is definitely a referred pain situation. Anyways I could only get squeezed in for an appt for surgery on July 13th and its going to be tough to last until then. Should I start to get an earlier surgery or just tough it out? Will the pain get any better? Or worst?" }, { "id": 652, "title": "Wisdom teeth extraction infection?", "dialogue": "Ryan McCarty: Hello. My girlfriend had all four of her wisdom teeth taken out 10 days ago and now her gums are killing her. Here is a photo of what the bottoms look like. any help please! Is it infected or what. thank you! Elizabeth Darden: I think you should go to your dentist as soon as possible. It's looking painful for you girlfriend." }, { "id": 653, "title": "Custom Abatement", "dialogue": "herbert: I received an estimate from my dentist on dental implants (wisdom teeth). I did some research on this procedure and discovered that after the implants are placed sometimes an adjustment might be needed due to the base of the implant moving or shifting. My question is....is it normal practice to be charged for an adjustment on each implant before any work even begins? Zuri Barniv: Once the implant is placed, it will not move, shift or anything like that. I have no idea what it means \"adjust the implant\". What I do see is that you are getting \"custom abutments\" and that is what you may be referring to?? That is not an adjustment to the implant. That is what goes above the implant. It is a bit unusual that all the implants need this \"custom abutment\" as in most cases, a \"stock abutment\" is perfectly fine and it costs a lot less." }, { "id": 654, "title": "2 Teeth need pulling", "dialogue": "Alex12783: I have 2 teeth that need pulling and my wife and I have a referral for an excellent oral surgeon, but my fear is the stupid numbness, wether I go through the injections or put me to sleep. How are those experiences? Since this is my first time I am 32 and in good health, how fast does it take for me to be knocked out? and do you feel pain afterwards? I just don't want to feel scared can anyone on here put me to ease with this, please help" }, { "id": 655, "title": "Will a Blot Clot Form??", "dialogue": "Ria: Hi, I just had a tooth extracted this morning because of an infection. The tooth removal took a long time and was painful. The dentist said it was a difficult one. I went home and took a look at the hole in my gums. The bone is very visible inside the extraction hole. Is there any chance a blot clot will form or am I doomed to have a dry socket? Its not very painful, but from reading, I'm scared it will be in a couple of days. The problem is that the hole isn't bleeding allowing a clot to form. I tried the gauze for a long while to no avail. I have an appointment in 3 days where they would just check up on it. What should I do in the mean time or should I go there immediately (which is probably not be possible)? \nI'm terrified for a pain worse than my last tooth ache and I'm currently traveling so I really don't want to visit the dentist everyday... Please lend me your expertise." }, { "id": 656, "title": "Wisdom Teeth?", "dialogue": "Tbshirk: Hello everybody! My name is Toby Shirk, and I am 15 years old, and I got my wisdom teeth removed today. My first question is my mouth has been aching all day, and the meds they prescribed as well the Advil aren't doing anything. Is this normal? Secondly, the people who did my extraction told me no solid foods for today, but tomorrow morning, i'll be good to go on everything. However, according to a few websites, I am supposed to wait 48 to 96 hours before fully being able to eat solid food. Why is this? And lastly, after making some oatmeal (One of the only enjoyable foods I can think of that my dentist said was fine and isn't bad for me like pudding and icecream) I noticed that the oats seemed like something I shouldn't be allowed to eat. Couldn't they get stuck in the little holes? So I poked around online, and sure enough, the first website I came across said I should wait until the 3rd day of healing, as they make get lodged in the wisdom teeth sockets. Any help to these questions is greatly appreciated. Thanks!" }, { "id": 657, "title": "Should healthy wisdom teeth be removed if not causing problems?", "dialogue": "Starz99: I am 35 years old and have had all 4 wisdom teeth since I was 17. They came in just fine with no issues. I have some minor crowding, but I'm still able to keep my teeth clean and my teeth and gums are healthy. I did not get my first cavity until age 30, and it is so small, my new dentist can not even see it on the x Ray or tell where it is. I also have a \"watch\" on another molar.\n\nOver the years, I have been to 3 or 4 dentists and none of them have said anything about needing to remove my wisdom teeth, but my new dentist is recommending that I have them removed. He says since they are harder to clean, they can cause problems as I get older and he basically believes that ALL people should have wisdom teeth removed, regardless of whether they are causing problems. He thinks I should have them out now, because the older I get, the worse the surgery recovery will be.\n\nI'm wondering what other professionals think. Should I have them removed now (even though I'm not having any problems) just in case I encounter problems as I age? What could happen if I DONT remove them? I'm wondering if anyone over 30 has had fully erupted wisdom teeth removed? Will the surgery be worse since the roots are fully formed?\n\nThanks in advance for any advice/thoughts/opinions/personal experiences! PlacidWay-US: Hmm... I don't think there is a need for extraction as you said it does'nt bother you and you're able to keep it clean. If the wisdom tooth is not causing any pain whatsoever, and is not causing any discomfort such as causing you to bite your cheek, then there is no need for extraction. Maybe it is your dentists personal decission or maybe he has reason so don't b afraid to ask him." }, { "id": 658, "title": "recurring extractions lately", "dialogue": "Olga Talroze: Hello,\n\nMy teeth have always been sensitive but lately there has been a string of trouble. A year ago I had a lower right molar extracted on suspicion of a fracture due to pain and inflammation. It already had a root canal treatment in it and the fracture was identified when extracted. \n\nA few months later I had lower right molar extracted due to pain which seemed to come from the root. In fact it took a while to pinpoint which one was the source of pain. Treating the root canal didn't seem to help so it had to be extracted. No obvious fracture was observed for that one.\n\nNow I have the same kind of pain (and sensitivity to hot liquids) in my lower right remaining premolars. Again, I'm not sure which one is the culprit. The pain is coming from the root of the tooth, inside the gum. The pain is bad but I am also terrified to keep pulling the teeth out. \n\nX-rays haven't shown anything in the past cases. Probably won't show anything now as well. My dentist is at a loss to explain. Please help me figure it out, what is going on in my mouth!? I rarely drink, don't smoke, exercise, eat healthy etc. \n\nThanks!" }, { "id": 659, "title": "Need help from Oral Surgeon", "dialogue": "Michal Dabrowski: I was at a hospital for dental examination on my wisdom teeth. Student told me i would need to have my bottom wisdom teeth removed. Just trying to find out if it has to be done or i can leave it alone . Thank you in advance!" }, { "id": 660, "title": "I have numbness in my chin and lower lip after dr hit nerve.", "dialogue": "yellowcouch: My lower lip and tongue are numb after dr drilled to far down while placing implant. Im in shock and a daze knowing this might be permanent. Anyone else have this situation and how did you cope with it?\nMike Zuri Barniv: What country do you live in? yellowcouch: United States Zuri Barniv: Was it a general dentist or an oral surgeon that did the work? Do you have ANY sensation in your lip and chin or is it totally numb? What has the dentist done so far? The first thing that should be done is the implant should be removed or pulled out part-way after you have a cone beam (3D) x-ray. Has any of this been done? The answers will help me help you.\nDr. Barniv yellowcouch: The implant was placed by my periodontist 2 weeks ago. During the procedure the implant drill went to far down into the nerve canal and nicked or bruised the LAN nerve. I felt what was like an electrical shock. He backed the drill up and then proceeded to place the implant. Later that night i informed him that my lower right chin lip and gum were still numb. They are not completely numb but have an altered sensation like pins and needles. The hardest thing to deal with has been the feeling of tightness in my lower 4 teeth on that right side. They feel as if i have toothpicks stuck between them. Very hard to deal with! The following day he did a Cone Beam CT scan to make sure the implant wasnt violating the nerve canal. It wasnt. It is about 2mm away from the nerve canal. He feels that the implant can be left where it is and i will regain feeling within 1 or 2 months. I then got a second opinion from another dentist who without seeing the imaging recommended to remove the implant. Now this is my dilemma. Whether to leave it in or take it out. My question is....If the implant is not impinging on the nerve canal what is the harm in leaving it it? Wouldnt taking it out possibly cause more trauma to an already damaged nerve? Plus i want to eventually have a tooth there. Could the implant in any way be contributing to the feeling of tightness on those 4 teeth or is that a result of the initial nerve damage? Will leaving it in hinder the nerve repair process? I know thats alot of questions, im just trying to make sense of all this so i can make an informed decision whether to have it removed or not. . Ive attached a x ray taken just after the implant was placed to give you an idea of its position. The tooth to the left was extracted right after the implant was placed. Thanks in advance for any help you can give me. Zuri Barniv: This is a very unfortunate outcome to say the least. There are reasons to remove the implant but of course there will be various opinions on the matter. I am experienced but not an expert on the subject. You may or may not recover sensation to the nerve and there is a chance for other complications. Where in the USA are you? There are universities that specialize in these types of issues and they would be a great help. Beyond that, it is difficult for me to give you much more over the internet, unfortunately. yellowcouch: Thanks for your reply. If you know of anyone that deals in this matter please let me know. I am located in Pennslyvania. Thanks Mike Zuri Barniv: Penn I do not know. But you might see if there are any teaching universities for dentistry nearby and ask them if they have a department that deals with \"iatrogenic Inferior Alveolar nerve injuries\". If they don't, ask who they recommend you see that specializes in these problems." }, { "id": 661, "title": "Tongue polyp? Please help im scared", "dialogue": "Chloe198616: Hi there, \n\nIve had what i call an overgrown tastebud on my dorsol of my tongue for probably 7 or so years (maybe longer). Its about 1-2mm in diametre, hard ball like and white fury on the top.... Ive never given it a thought until recently my dentist (new) asked me how long id had it and if i wanted it removed? Is this something i should have done? She says it would be sent for a biopsy, is this to confirm its cancer? Im 29, a mum of 3 and fit and healthyotherwise....now im in panic zone has anyone had this before? I cant find any info anywhere on it. Zuri Barniv: Impossible to even slightly help you without a good picture. Chloe198616: Sory, i was unsure how to do that. The dr has called it an ellevated tongue polyp?" }, { "id": 662, "title": "Wisdom tooth extraction site look normal?", "dialogue": "Katie Lucille: I got one too wisdom tooth removed about 4 days ago. I'm not having a ton of pain, it comes and goes but is never super intense. I have read about the importance of the healthy blot clot formation in the socket... And I am scared of something going wrong. The blot clot is there, but covered in a grey/white color. Does this look normal? See image... PlacidWay-US: Hi @KatieLucille , I think it's natural and it will just wear off. As long as you don't feel something is wrong or feel severe pain no need to worry. That gray thing is natural hehe it also smells bad when it wear off. Good luck!" }, { "id": 663, "title": "Teeth spread after wisdom teeth extraction", "dialogue": "Audreyk: Hello, \n I waited to get my wisdom teeth taken out and over the last 6 months my lower teeth have shifted a bit as the wisdom teeth have been putting a lot of pressure on my teeth and jaw. I finally had my wisdom teeth extracted this week. My question is will the remaining teeth shift/spread out now the impaction is gone? Zuri Barniv: Yes, because it is an old-wive's tale that wisdom teeth cause your other teeth to crowd in the front. That is simply not true.\nDr. barniv" }, { "id": 664, "title": "Apico #15 later extracted - #16 same 4 years later", "dialogue": "CharlesH: Hello ,\n\nLooking for a possible road to recovery and help. No way of going into what I have went through with one root canal then a 2nd 4 years later. I will give a short story explaining what has happened and see if someone ( there seems to not be many available here) can understand what went wrong.\n\n2002. - dentist performed #15 root canal. Seemed to go as expected but approximately about 9 weeks later developed knot high in gum above #15. This was painful and several rounds of antibiotics ( last 2 together were very strong). would not make the hard knot go down. Finally got Apico from Surgeon which went well for a few months then swelling around area where extraction and knot on gum was swelled again. I had terrible headaches and believe me or not very painful joints and stiffness in hands, legs and feet. He did a cone beam scan and went back in to scrape the bone.. Said there was soft mushy bone in there and got all of it out. Continued to have tender spot there and intermittent month on \\ off swelling for 3 - 5 days a month. I normally got sick those days and didn't want to get out of bed.\n\n2006 -2007. - The spot at #15 still causing problems on and off with surgeon and dentist not seeing anything worth opening me back up. At least that's what they said. #16 gets a knot and I go back to my surgeon and he really says he can't see anything on cone beam again. He sends me to endo and he takes film before procedure and says I really don't see that you need root canal on the tooth. He said one spot seemed questionable and I passed all hot\\ cold test. He decided to go ahead after talking to surgeon. About the same time later on #16 did the same thing as #15 and surgeon said apico or pull it. I wanted it pulled to just get all this over.. It is today and I am in terrible pain at #15 & #16 being the main flare up. #15 is inset where he had to grind it and that area sometimes gets tender with pain. #16 has a knot that is bigger than a tooth would be if it was one in there. This happens several times a month which is increasing along with headaches. I explained to my neurologist that as this swelling in #16 gets to the max my body seems like I am getting the flue.. Everything seems stiff and painful. \n\nThat's the quick version and all my docs see this and seem not to know how to treat me. Surgeon just done another cone beam and said he didn't see anything alarming but verified the large swollen knot and pain. He pointed out it could be small bone infection \\ micro debris in there butt he could just not go opening me up. What should I do? Neuro said it is not nerve related and is puzzled. Please see one attached photo and this is not the biggest it has gotten at all. Probably along the lines of in the middle.\n Thanks. Charles CharlesH: Anyone??????" }, { "id": 665, "title": "Wisdom Teeth Extraction Complication", "dialogue": "dbean16: Hi, I was wondering if anyone could answer some questions I have about a post wisdom teeth extraction complication. I got all 4 wisdom teeth removed on 01/03. Two of them were impacted. Everything seemed to go well and the swelling went completely down. About a month after the removal, I felt a lump on the bottom left side of my jaw. I called my surgeon to ask if this was a problem, and they told me I was fine. Two months later (three months after surgery), the lump was still there and it felt like it was getting bigger. My face was slightly swollen and tender to touch. I called my surgeon again and they prescribed me with Pinicillin to help the swelling. They were going to have me come in for an appointment, but I was unable to because I'm at school which is four hours away from home. About two weeks ago I felt something sharp coming out the hole. I was able to get it out and it was a bone/tooth looking sharp fragment. I called again and they said I would be okay. Yesterday, I woke up and my face was much more swollen and I was in a lot of pain. I called and they finally referred me to someone to get it looked at. I just got back from that surgeon, and I had an abscess caused by many bone fragments left in the hole. They just numbed me, cut the hole back open, and got out a pretty good amount of bone.\n\nI'm really just wondering if this was my original surgeons fault, or if it is something that just happens. My original surgeon refused to pay for it since I wasn't able to drive four hours back home. What caused so many bone fragments to get stuck?" }, { "id": 666, "title": "Depressed Over Needing A Tooth Pulled", "dialogue": "BrandiBroken: I went to the dentist a few day ago and I was told one of my front teeth either need to be extracted or to have a root canal done. I would have zero issues with a root canal - I have had a few of them and even had one on this tooth before - but the price would be the issue. $35 to get a tooth pulled is easier to cover right now rather than the $700+ for the surgery. But I am just anxious and depressed over losing the tooth for good. \n\nI have had bad teeth most of my life and it's always made me very self conscious. Twice in my life I have had major work done and in 2009-2011 I had a great dentist who did a massive restoration plan and they redid fillings all the time which was the first time in my life I was able to manage to have a nice smile. It was insanely costly but at that point in my life it was manageable but my life changed greatly between then and now. Stay at home mom without insurance is a lot different! \n\nI lost a canine tooth back in 2002 I think it was. I got a flipper made but if I took it out for even just overnight I couldn't get it back in for the life of me. My dentist got really crabby about me coming back out all the time to have it looked at so I just gave up. I was too embarrassed about the missing tooth that within weeks I convinced my parents to home school me so I wouldn't have to go anymore and I just had a rough time. I never wanted to even leave the house or see anyone and it took years for me to go back to having anything close to a life. It would be the end of my teenage years for when I moved, got a job and started being part of society again and just accepted the missing tooth. \n\nWhen I met my previously mentioned awesome dentist she said the space for the canine was too small for an implant unless I got braces first because my bite had changed so I put that on the back burner for the time. She had told me getting a new flipper made was also not going to work but then she told me to come in one day and said they would at least try because they knew I was going to see my family the next month for the first time in six years. Two days later I had a flipper and it was perfect. Happiness galore. \n\nI was told I can get my front tooth removed and they would make me a new flipper. I do have to be enrolled with their company (meeting is tomorrow) in order to get one made (which is also making me nervous). I'll hopefully have prices on it after that - which is what I was waiting on before getting it pulled - but in any event I will have at least a few days without a flip and even so the idea of losing the tooth just stresses me out. \n\nI always wear my flipper, no one in my life really knows I wear one. My husband knows I have one for a missing tooth but not even he has seen me without it in. \n\nI don't drive and my son is in preschool otherwise I would probably ask him to go see his parents while I had everything done but alas... hiding out in bed and avoiding talking or when I do putting a hand over my mouth sounds like nothing I am looking forward to." }, { "id": 667, "title": "Red extraction site two weeks post", "dialogue": "Prayerworks: I had an upper molar e traction exactly two weeks ago. The extraction site is red, but not swollen. Is this normal?" }, { "id": 668, "title": "Sinus communication", "dialogue": "Prayerworks: What are the chances of a sinus communication happening 10 days after two upper molar side by side extractions, if the root was very close to sinus cavity? I was feeling fine prior to day 10. Thanks for your input." }, { "id": 669, "title": "Curious about this", "dialogue": "atumsuden: I was told by my wife and a few others I should get dentures but I've heard from a lot of people they are horrible to have, I've been looking at overdentures which seem a lot better, My teeth are extremely bad I went to a dentist 3-4 years ago and he quoted me around 13k-15k to fix my teeth completely, I have diabetes and used to have acid reflux, and I think that is what really wrecked my teeth... Im curious about the overdentures and how much I could expect to have to pay, I know dental insurance is pretty bad everywhere and your not usually likely to save that much with having it, I have not so great credit but I been trying to build on it for the past 2 years or so but my teeth hurt really bad and I know its making it harder for me to control my diabetes as well... Does anyone recommend overdentures and have any idea around how much they would cost or if there might be a cheaper alternative without going down the normal denture road....." }, { "id": 670, "title": "The most painful extractions", "dialogue": "everway9: Hello. I'm new here so a big HELLO to all! I hope your all doing good!\n\nUnfortunately I have never been good when it comes to dental hygiene and because of that I have had a lot of teeth extracted in my time. I think I have been lucky, that in the past the most painful part of the extraction procedures have normally been the 'Lidocaine/Epinephrine' injections prior to the extractions. However, today I experienced the most painful extraction I can remember. It was one of my upper front teeth... number 8 incisor to be precise. I had to keep stopping my dentist from continuing with the extraction and get more anesthesia 3 times as the pain was too much for me to bear! I have quite a high pain tolerance and have experienced the pain associated with 'Pancreatitis' and 'Gallstone removal' which is pretty painful, (a story for another time) and no, being a male I have never experienced childbirth, although I have been told by a few women who have experienced Pancreatitis that Pancreatitis is just as bad or even worse than childbirth ). Anyway I got to the point where no matter how much anesthesia I had, it just made no difference. We had to continue. I cannot describe in words the type and amount of pain I felt. Ok the extraction only lasted a minute or so but it was horrible.\n\nI'm a curious person and would like to hear from anyone else here who has had the misfortune of experiencing multiple extractions. If so, which of your teeth were the most painful to have pulled? And/or have your experiences been similar or completely different?\n\nI look forward to hearing from you.\n\nThanks in advance.\n\nAndrew \n\nP.S. Please vote for your most painful extractions. Thanks sonickdmd: This all depends upon the dentist you are going for. A dentist can make your treatment painful or pain free. Being a dentist I always recommend everyone to have the best dentist in their area. everway9: Thanks for your input.\n\nAt least someone has made a contribution. dentalimplantslondon: And I also go with sonickdmd, Actually its totally depends on dentists is experienced or new comers. Only experienced dentist can provide painless treatment." }, { "id": 671, "title": "Pain started in extraction site on day 11", "dialogue": "Prayerworks: I had two upper molar extractions side by side 12 days ago. No sutures. Was healing very nicely. No pain at all. However yesterday I started to feel a discomfort in the extraction site and today (day 12) there is a constant dull ache in the site, and jaw joint. I also get stronger twinges of pain depending how I move. No sign of swelling. Roof of mouth on that side also hurts. What does this sound like. I have an appt with my dentist on Thursday." }, { "id": 672, "title": "Concern about lingering issues after extraction before implant", "dialogue": "McMike: Hello.\n\nI have a history of sinus issues that sometimes cause dental pain, mostly left side, upper and lower jaw.\n\nLast year June 2015 I stared having pain in #18 lower left molar that eventually led to a crown prep, based on diagnosis of tooth crack. Things got worse, so diagnosis was changed to root crack and extracted in July 2015. The extraction was somewhat difficult. \n\nI am also concerned that I react badly to deep bone injections for numbing. Since I had a lot of lasting jaw pain after this process, (and after injections for replacing filling upper right, I had jaw pain and local tenderness that lasted a couple weeks). During the initial crown prep injections, evidence of infection/pus came up through on of the injection channels as its \"way out\", which relieved much of the original pain.\n\nAfter extraction, graft materials was packed for implant prep. First couple days post-op seemed on track, but got worse and eventually became persistent infection/dry socket. Things eventually calmed down after the dentist cleaned out socket and much antibiotics. Amox and clindamycin.\n\nI hate taking antibiotics. They wreck my insides. I have taken to much in my life already. A second opinion I got said to do augmentin and flagyl, but I resisted and my main doc prescribed the clindamycin. (I just took another round for strep last month).\n\nNow after months and an image he says the graft survived and is ready for implant.\n\nHowever, I still experience dull deep pain from that area from time to time. It could be lingering sinus issues which are flaring up. It could be psychosomatic due to the gap in my teeth.\n\nWhat i am concerned is that there is a lingering issue, maybe deep persistent infection, nerve damage, something like that. So that when he does the implant, it flares up and I end up with a failed implant and then cascading into a bridge, with no guarantee that does not continue with the failures.\n\nMy life experience is that I am that one-in-a-million person who has the rare side effects and adverse outcomes, especially on elective surgeries. I am the guy who gets the dry socket after a routine extraction.\n\nAdvice and comments are appreciated.\nThanks." }, { "id": 673, "title": "any difference in the appearance of the face of someone that extracted a lower left first molar", "dialogue": "troubledsoul: (in any tense of the future)" }, { "id": 674, "title": "feeling depressed, please tell me exactly what happens after a tooth extraction", "dialogue": "troubledsoul: I am 22 years old and recently extracted my lower left first molar. I replaced it with a bridge, but lately I've noticed that my jawline is not as defined/strong as it once was. So upon research on tooth extraction, I've been reading things like When teeth are missing, the alveolar bone, or the portion of the jawbone that anchors the teeth in the mouth, no longer receives the necessary stimulation, and begins to break down, or resorb. The body no longer uses or \"needs\" the jawbone, so it deteriorates and goes away. The rate the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals. However, most loss occurs within the first eighteen months following the extraction, and continues throughout life. \" and \"Bone height loss can be up to 1.5 mm in 3 months and decrease in the width of alveolar ridge can be as much as 50 percent within 12 months. Even with complete healing, there is generally some erosion or resorption that can lead to shorter and thinner surrounding bone than compared to prior extraction. This can cause gum tissue defect which can lead to significant cosmetic and functional problems.\" so now I'm freaking out. If the above were to actually happen I would look a little like my grandma.. \n\nno but seriously I've been depressed lately because one of my favorite features is my bold jawline, and having to slowly watch it get sucked away... and look like a potatoe.. isn't something I'd wish on even my enemy. \n\nAdvice please" }, { "id": 675, "title": "Extraction question - foam/dry socket", "dialogue": "Tiffany: Main question: If I don't see clotting, but the bleeding stopped after oral surgeon put foam into socket, does that mean I'll get dry socket? How long until it would dissolve and cause dry socket to occur? Now on to the details!\n\nI went to the dentist on Monday to get two teeth extracted (#2 & #30, I believe). The upper molar (#2) was just fine the next day, but for two days following the extraction the lower one was still bleeding as if it were the first day. Some of the bleeding was coming from the tooth in front of the extraction as well. I went back the day after the extraction and the dentist noticed the bleeding from the tooth in front, and said this was from my gums which aren't the healthiest, and that the extraction site itself seemed to be clotting okay. I went back the second day because it was bleeding just as bad if not worse, and he sent me to an oral surgeon who filled it with some sort of foam and stitched me up. He did say that some of the bleeding seemed to be coming from the tooth in front, so he stitched between that tooth and the one in front of it as well.\n\nHow does this foam stuff work? From what I've read, the foam just absorbs the blood to help it clot. What worries me (& I do get worried easily) is that I don't see a clot at all! It honestly just looked like my normal gums with stitches all over, only 2 hours after I left the surgeon. It still looks like that today, two days after I saw the surgeon, but there's also a lot of white tissue now which I'm guessing/hoping is the granulation tissue. \n\n*******I mean, the foam stopped the bleeding, but since I don't see any red/blood, should I be concerned that once the foam dissolves that I'll have dry socket? What if the bleeding for the first two days was PURELY from the tooth in front, so when the surgeon cleaned out the socket to put the foam in, the socket wasn't bleeding anymore to produce another clot?********\n\nI think that's all! I can add any information if it seems I missed something. I've called the dentist a bunch throughout this past week, and they probably think I'm the most annoying patient. They seem to brush me off a little too so I don't know how serious they take me now after I ask so many questions! I've just heard such horrible things about dry socket that I'm petrified to get it, especially since I have work the next three days and wouldn't know what to do if this occurred at work and I don't have coverage for me to go home!" }, { "id": 676, "title": "92 and extraction, is it recommended", "dialogue": "Stormy: Hello\n\nMy mother is 92 and her dentist says she should extract a tooth that is leaning against her 3 unit bridge. This tooth does not bother my mother. She switched toothbrush heads on her Oral B electric toothbrush and it has irritated the gum around it. She is really having an issue about this and I do not blame her. The dentist says she will need to take a tooth from her bridge as well and then make her a new bridge. If the tooth is not infected should she do this? If there was an infection shouldn't she have been given antibiotics? \n\nThank you for your time" }, { "id": 677, "title": "Sinus Lift Complication?", "dialogue": "Mistydawn: Hello, I had a lateral sinus lift, both sides six months ago. I blew my nose on the fifth month and four bone particles and slight bleeding occurred. Now, after six months had passed, I slightly blew my nose , because of post nasal drip, and I, have been having pain in sinus. I think the oral surgeon tore the membrane because from day one it felt sore and scabbed. What do you think could be wrong? I have to be able to blow my nose without pain, especially if I would get the flu. Thanks" }, { "id": 678, "title": "Going to the hygenist before my implant is placed", "dialogue": "Jonathan Wells: I wanted to double check on this. My implantologist asked me to go to the hygenist before he inserts my implant. Often after going to the hygenist my gums swell and take a little time to settle which I think is quite common. I can only see the hygenist a week before I have my implant appointment.\n\nDo you think a week is enough time for me my gums and teeth to settle before my implant is inserted? Dentgr: It's enough time if you don't have periodontitis or severe gingivitis. Jonathan Wells: Thanks,, I get a little come bleeding when I brush and have some gum disease, gingivitis but i wouldn't say it was excessive. DanyRoden: Use a soft toothbrush and warm water with sea salt rinse it thoroughly, it will help you to heal gum sore." }, { "id": 679, "title": "Front teeth implant placement", "dialogue": "kelly123: I may be at the \"end of time line\" with my crowned four front teeth. THree are root canals and one now hurts all of the time. Dentist said 6 months ago that the canal was overfilled but would dissipate. It hasn't. I don;t think I want an apieo.; really think I am \"over\" trying to save them. The crowns are too big, anyway, because they are hiding a big gap. IF I get implants, can I have the \"teeth of my dreams\" or do the rods need to go where the roots currently are? Had braces so bottom teeth are fine. I am 40; and have small features. Would really like smaller teeth if I go this route. Thnaks for the reply! DanyRoden: Yes, Implants can give you \"teeth of your dreams\".\nI think you should concern dentist before more problems occur in a root canal and give you more pain. PlacidWay-US: Hi kelly123, you should first consult your dentist if there is a need for you to have implants since dental implants are usually needed when an individual had an accident or other specific trauma of the mouth, Gum disease (periodontitis), Tooth decay, Imperfections of the root canal, and other congenital defects. If you will have dental implants you can assure that it is strong and durable but mplants can be created with many different materials. Your dentist will determine what type and quality of implant is better for your specific situation. Good luck! kelly123: DanyRoden said:\n\n\n\n\t\t\tYes, Implants can give you \"teeth of your dreams\".\nI think you should concern dentist before more problems occur in a root canal and give you more pain.\n\t\t\nClick to expand...\n\n\nThank you both very much for your answers! The root canals are actually from trauma I suffered about 15 years ago; hit by a car while running. The rest of my body was FINE---only my mouth took a hit! In any event, I have had a minimum of 15 years with the restorations. My hope is always that \"new advances\" are made in the duration...I am not as concerned about the finances as I am about the end-result. PlacidWay-US: kelly123 said:\n\n\n\n\t\t\tThank you both very much for your answers! The root canals are actually from trauma I suffered about 15 years ago; hit by a car while running. The rest of my body was FINE---only my mouth took a hit! In any event, I have had a minimum of 15 years with the restorations. My hope is always that \"new advances\" are made in the duration...I am not as concerned about the finances as I am about the end-result.\n\t\t\nClick to expand...\n\n\nThen I must say you really need an implant, most of the people who had the same experience as yours go for dental implants. There are lots advancement in this procedure, depending on your need or lost teeth like All on 4 dental implants, all on 6 and all on 8 dental implants. If you will ask me i prefer to have these treatment done in Mexico. To give you some insight about the cost of each treatment here: For All on 8 dental implants in Mexico it ranges from $7200 - $10,500 this may be costly because of the number of implants. For All on 6 dental implants it costs $5,400 and $3600 for all on 4 dental implants in Mexico. I thinkk this can give you an insight how much you may spent for the said procedure also you can look into other countries like Costa Rica and India or in your country." }, { "id": 680, "title": "bad smile", "dialogue": "drummer25: I never developed enamel on my teeth and they have proceeded to decay in my mouth, i dont have a great insurance company and i would love to get all of them out and dentures put in. If anybody can help or can lead me the right way. It would be very appreciative. Zuri Barniv: You'll have to be more specific about what it is you need advice on, but if you are going to get dentures and have some finances available, at least two dental implants to hold the LOWER denture is highly recommended. drummer25: I need help with a full moith extraction and dentures or implants PlacidWay-US: In terms of dentures it might be costly so better check if there are foundations that could help you. But on the teeth extraction, you may look into some dental schools, there are dental students who provide extraction as their practicum maybe you can volunteer. Some people do that since it is free but still can be risky." }, { "id": 681, "title": "Wisdom tooth extracted today... please help!", "dialogue": "drogers407: I had #17 (lower left wisdom tooth) extracted this morning. According to the instructions the doctor gave me, I'm supposed to replace the gauze pack after an hour as long as the bleeding is \"controlled\" (define controlled?) but it's been over 2 hours now since I left his office and I'm terrified to take the gauze out. I'm afraid that the socket will start gushing blood as soon as I take the gauze out and pretty confident that I'll faint if I see the socket. No one else will be home to help me for a few more hours.\n\nI'm also starving, as I was instructed not to eat after midnight. I have some yogurt and applesauce that I can eat, but most of the left side of my face is still numb and I'm afraid of hurting myself, not to mention getting something in the socket. Can I eat with the gauze still in? I've been drinking water with it in and it seems okay. However, the left side of my throat and my ear hurt when I swallow (reminds me of having strep throat) so I don't think I'll be able to eat much.\n\nAs you can probably tell, I'm a big, wimpy crybaby when it comes to stuff like this. Please help me. DanyRoden: Hey drogers, Hope now you are absolutely fine and eat normally.\nTake Care...!!!" }, { "id": 682, "title": "Help PLEASE: Extraction of lower left second molar, will there be a visible change in my facial..", "dialogue": "troubledsoul: appearance or any jaw, alveolar, and/or basal bone loss? \n\nI am 21 years old and I've extracted my lower left second molar about 3 weeks, and lately I've noticed that the left side of my face looks slightly thinner than the right and my cheekbone is slightly more defined (or I'm just hallucinating). This caused me to do research, and upon all the reading I've done online, this site in particular freegrab.net/Dental%20tooth%2... has me freaking out because I've read \"missing teeth cause changes in the jaw bone structure. The bone that supported the missing teeth begins to shrink or thin away. There is a loss of width and height of the jaw bone. The process is referred to as bone resorption. This is a natural process of your body saving bone nutrients and structure it is no longer using. Jaw bone loss happens most rapidly during the first year of tooth loss and is four times greater in the lower jaw than in the upper. When a tooth is lost, the lack of stimulation causes loss of the jaw bone. There is a 25% decrease in width of jaw bone during the first year after tooth loss and an overall 4 millimeters decrease in height over the next few years. Without chewing pressure to stimulate the bone, the jawbone begins to dissolve away immediately after extraction and continues forever unless an implant is placed. \" \n\nI love the shape of my face, my jaw in particular really compliments my features. It's bold and wide, I wouldn't modify it if I got payed. So reading this really has me anxious. I have gotten my temporary bridge today. The reason I got a bridge instead is because the tooth on the left needed a crown anyway, and I read various stories about mental, neurological problems as well as physical developing from tooth implants. It also cost me a thousand dollars less which was convenient. However reading all of this stuff online has me regretting the choice I made I was thinking of asking my dentist if I could do an implant instead. I read this on the link that I provided \"How Implants Stop Bone Loss: Dental implants fused and integrated into the jaw-bone serve as anchors to support teeth. They function the same as natural teeth in that the implant provides pressure stimulus on the opposite side tooth. As you may recall, bone needs stimulation to stay healthy. An implant-supported tooth, or teeth, allow for normal function of the whole jaw including the nerves, muscles and jaw joints. Moreover dental implants fuse to the bone, stabilizing and stimulating it to maintain its dimension and density.\" Therefore apparently, contrary to what I first believed, a bridge does not stimulate the bone or prevent bone loss, and there is no stimulus on the opposite side tooth.\n\nHelp please. What would you do in my situation? And what is the long-term outcome of my decision?" }, { "id": 683, "title": "Is this a Dry Socket?", "dialogue": "jackson21: Any help? Tooth was extracted Monday morning, dull achey pain, terrible taste." }, { "id": 684, "title": "Is coronectomy best option?", "dialogue": "Terri Beith: Female age 71 with severe VonWillebrands, (bleeder). I have two lower wisdom teeth, one that's partially exposed, with a filling that's probably 15 years old. The other is mostly covered and impossible to keep clean, no cavity there yet. There is often an odor from that tooth indicating trapped food. I saw an oral surgeon and he recommended a coronectomy on both teeth. I will be treated with a product to control bleeding. The procedure will be done under general anesthesia taking around 2and 1/2 hours. He gave me the option of having it done in February, or just waiting to see if things stay the same or decline. I'm concerned that waiting might mean my age will become an issue. I'm the strongest I'll ever be. Also osteoporosis could get involved. I'd appreciate any advice. Thanks." }, { "id": 685, "title": "Possibly need an implant..need pros/cons/unbiased answers", "dialogue": "laurentx3: okay so here's the story..I had a root canal done on my very last bottom molar in December 2012. Everything went fine until I noticed a giant abcess towards the end of sept 2015. Called my dentist who got me in to see an endodontist. The endodontist said it was infected (obviously) was treated with penicillin 500 for a week, then clindamycin 300 another week after (which ultimately caused me to develop c diff) the endodontist cleaned out the tooth completely and I went and had another crown put on and all was dandy until a couple weeks later I found out I had c diff. I had to clear out the c diff before I could go back to the dentist and have my bi annual cleaning done. After 2 rounds of flagyl 500 and 1 round of vancomycin 125 it was gone and I went and had my teeth cleaned. They also did an x Ray which showed that it's possible my tooth is still infected. I go to my endodontist tomorrow to see what he says but I already know that both my dentist and endodontist want me to get an implant if I need to have this tooth pulled. \n\nBasically what I need to know are all the pros and cons and issues that could come with getting an implant. I'm 22 which is one of the reasons I know they want me to get an implant. But it's my last molar. You do 80% of your chewing on your 6 year molar (is what I'm told) so I could function without this one. \n\nTell me everything you know. I need to hear it all. I've heard of people who have had implants and are now in chronic pain. Which I'm scared of. Autumn gorby: laurentx3 said:\n\n\n\n\t\t\tokay so here's the story..I had a root canal done on my very last bottom molar in December 2012. Everything went fine until I noticed a giant abcess towards the end of sept 2015. Called my dentist who got me in to see an endodontist. The endodontist said it was infected (obviously) was treated with penicillin 500 for a week, then clindamycin 300 another week after (which ultimately caused me to develop c diff) the endodontist cleaned out the tooth completely and I went and had another crown put on and all was dandy until a couple weeks later I found out I had c diff. I had to clear out the c diff before I could go back to the dentist and have my bi annual cleaning done. After 2 rounds of flagyl 500 and 1 round of vancomycin 125 it was gone and I went and had my teeth cleaned. They also did an x Ray which showed that it's possible my tooth is still infected. I go to my endodontist tomorrow to see what he says but I already know that both my dentist and endodontist want me to get an implant if I need to have this tooth pulled.\n\nBasically what I need to know are all the pros and cons and issues that could come with getting an implant. I'm 22 which is one of the reasons I know they want me to get an implant. But it's my last molar. You do 80% of your chewing on your 6 year molar (is what I'm told) so I could function without this one.\n\nTell me everything you know. I need to hear it all. I've heard of people who have had implants and are now in chronic pain. Which I'm scared of.\n\t\t\nClick to expand...\n\n\n\nI'm in the same boat as you I'm supposed to have implant tomorow laurentx3: Autumn gorby said:\n\n\n\n\t\t\tI'm in the same boat as you I'm supposed to have implant tomorow\n\t\t\nClick to expand...\n\n \nPlease tell me how it goes! Good luck" }, { "id": 686, "title": "Default Pressure on adjacent tooth after dental implant?", "dialogue": "yellowcouch: I had a dental implant crown put on today. The backside of the crown is very tight and pitting pressure on the tooth behind it which is the last tooth on the upper left side. It is hard to get floss through it. \nMy dentist adjusted both the front and back of the implant. It was super tight on first try in. My question is , is it normal to have this pressure and will it eventually go away. In the past i had a simliar problem and my dentist had to use a abrasive strip thing to go between the teeth to relieve the pressure. Is this something i should just wait and see with? I know an implant doesnt budge so that would mean my real tooth behind it would be the one to move and adjust.\nAny advice would be greatly appreciated.\nMike Zuri Barniv: If you can floss but it is very tight, you might give it more time to see if, indeed, the teeth behind and in front of it shift slightly and make it easier. If you cannot floss it at all, then it's time for the dentist to get out the abrasive strips." }, { "id": 687, "title": "Tooth Extraction Infected?", "dialogue": "Elizabeth: Hi, it's been about 6 days since I got 4 teeth extracted for my braces. All of my extraction sites have seemed to be healed except for one. I still have a hole and it seems to have a white/grey substance in it. I have felt no pain these past days so I don't think it's a dry socket. Any thoughts on what it is? Thanks." }, { "id": 688, "title": "What is the abrasive sandpaper like strip used by dentists called?", "dialogue": "yellowcouch: Does anyone know what that abrasive sandpaper like strip dentist use to loosen contact that is too tight between teeth is call?\nThanks \nMike" }, { "id": 689, "title": "Hole after extraction", "dialogue": "Jess92026: I had a canine extracted 5 days ago and wanted to make sure everything is normal. I don't have any real pain but concerned about the bone graft that was put in. Stitch put if fell out within 24 hours and now I feel like I have a hole there. Worried that the graft fell out. Again no paid but odd feeling when I breath in with my mouth closed at the site of the extraction so not sure what to do. Any feedback would be appreciated." }, { "id": 690, "title": "6 Day Post Extraction. Help! *Photos*", "dialogue": "PoodleMama3: Hi...\nI had a molar extraction on Thursday. Saturday I went back in for a check-up and everything looked great. \n\nIt's been almost 6 days and the pain is still bad enough that I am taking advil every 6-8 hours.\nThe thing is... it's not pain where the molar was... it seems to my on my palate where I had an injection for the feeling. \n\nI posted a photo of the extraction and circled the area where 75% of the pain is coming from. \n\nIt's driving me nuts!!\n\nAny ideas?" }, { "id": 691, "title": "bronchitis and teeth pulling?", "dialogue": "KateLyn: I have bronchitis and i had a tooth pulled the other day.. I have had three friends tell me that this shouldn't have happened.. Now I'm worried bc im feeling very sick.. Any idea if it was wrong for the dentist to pull my tooth while i have bronchitis???" }, { "id": 692, "title": "Snap on dentures? I'm confused.", "dialogue": "janedoe1625: What is the difference of dentures that snap on and dental implants, or are they the same thing? Thank you. Also, why is there such a big difference in cost? I have been quoted $30,000- $40,000 for full dental implants, but read that some places charge $10,000 or so. Why such a different? Thank you for any information or feedback. Zuri Barniv: Some dentures can snap on and off implants, this is called an \"overdenture\". Some dentures are permanently connected to the implants, this is called a \"hybrid\". There is an enormous difference in cost because of the enormous difference in time, energy and expertise needed to do hybrid dentures." }, { "id": 693, "title": "How do I deal with a really dishonest dentist", "dialogue": "libbilee: I went for an exam to see if I would be a good candidate for a denture on screws. It was supposed to be free. I did a return visit supposedly to get an estimate which was also supposed to be free. This office wasn't well equipped and the old dentist said things that didn't sound right. So I decided to go elsewhere. The filed on my insurance and got money from them claiming they did films they didn't do and other things. They stated calling me claiming I owed money. Then the started sending bills. The first bill had a $50 charge for a late fee. It goes up every time they send one. Don't tell me to go to the dental board. I have done that and they are taking forever to answer and they state on their web site they don't do anything about disputes about fees. I filed with the BBB. I filed with the dental board for my state and they are taking a very long time. Besides, they let it be known that they don't do anything about fee disputes. These people don't care how they look apparently. They just argued, argued and argued that I owed money. I spoke with the attorney generals office for my state and they say small claims court. I don't have money for courts. What can I do? Zuri Barniv: Why don't you ask for a copy of your x-rays, which you are lawfully entitled to. When they don't have anything to send, you say, \"Yes, you charged my insurance for it and committed insurance fraud in the process. Perhaps I should report you. I recommend you drop your bogus charges and never contact me again.\". Then hang up..." }, { "id": 694, "title": "Sedatives cravings after wisdom teeth removal", "dialogue": "Martin Pirst: Hi\n\nI got my wisdom terth removed today and I've been feeling some cravings towards the sedation process I took this morning. Is this normal? If it is when will I stop having these cravings? I'm not a dentist so I'm not really sure which sedative they used on me. It was intravenous though.\n\nThanks!" }, { "id": 695, "title": "Wisdom teeth extraction complication, no sensation on adjacent molars", "dialogue": "JohnZ622: Hi everyone,\n\nOn August 15th I had extraction of 3 mesioangular impacted unerupted wisdom teeth (3 was all I had). They were the upper left (#16) and the two bottom ones.\n\nAbout four days after the extraction, I noticed a small pus pocket near my remaining upper left molars (around #15). The pain grew until it became a huge headache and I was prescribed antibiotics.\nThe antibiotics eventually calmed down the infection. However, during the process I noticed that the leftover upper left molars (#15, 14) feel numb. When I touched them, they felt like stones. It also hurt a bit when I bit down on them.\n\nAbout six weeks after the surgery, I went to my general dentist for routine cleaning. He noticed the abscess and proceeded to perform a vitality test on #15 and #14. They were both completely unresponsive to cold.\n\nI followed up with the oral surgeon. He commented that the abscess/pus pocket is not over the wisdom teeth but rather over #15. The conclusion he reached was that the negative vitality test could not have been caused by the extraction.\n\nIs this too co-incidental? These two teeth never gave me problems before. I do remember him thinking that the pus pocket was the location of a flap that he opened during the surgery. Now I have been recommended to seek root canal for both of those teeth.\n\nThank you so much for reading this. Please share any advice you have." }, { "id": 696, "title": "Extracted Implants", "dialogue": "Wisdom73: Well as I sit here recovering, thought I would share my story since before my procedure I had searched online for people in similar situation as myself but couldn't find much. Of course though I just found this forum which looks like there are lots of different implant tales, just not sure how many folks have had them removed.\n\nMy story is I have a genetic condition called ectodermal dysplasia which can manifest itself in many different ways from hair, nails, and in my case teeth. I was born with all my baby teeth, but only had seeds for 12 adult teeth. So as a kid when those adult teeth came in, it was decided to extract all the other baby teeth that did not adult teeth to replace them. I had that done and then was given partials that clasped to the teeth I did still have.\n\nHad those for 5 years or so until about 1989-1990, which is about the time when dental implants were approved for use in the US. My dentist proposed placing 10 dental implants, 3 on each side on the upper, 2 on each side in the lower. In order to have this done I had to undergo a sinus lift procedure to beef up the upper jawbone to place the implants in, and then my nerve in my lower jaw had to be moved so the lower implants wouldn't interfere with it. When all was said and done, I did get to finish out my senior year of high school with a nice new shiny set of teeth and was one of the first dental implants patients.\n\nNow fast-forward roughly 20 years. I began noticing some swelling and discharge from the upper right side. I took an antibiotic and it went away. About a year later, it flares up again. I did this back and forth with it for about 5 years. My old surgeon with the dental group I was with passed away, and replacement surgeon drops a bomb on me and says the implants in that area a infected and need to come out, and not just those but he wants to remove all the implants and then give me all new ones. I jumped ship and found a new implant specialist in the area who came highly recommended.\n\nMy new surgeon attempted to save these troubled implants last year with a periodontal flap procedure and bone grafting and guided tissue regeneration. The problem implant area had lost significant bone due to the infection. It took for about 6 months, but then came back again. I had lost so much bone that the implants were mostly exposed now. They were first generation implants which had a slot in the base of the implant to allow bone to integrate to the implant. Mine were so exposed that slot was have uncovered with part of it still recessed in the bone, the other half exposed which created a cavity for infection to continue.\n\nSo plan was to remove them. My new surgeon was concerned that the jawbone in this area is so weak, that removal by individually twisting them out could possibly cause a fracture. He went in with the whole crown still attached to the 3 implants, and basically cut them out of the bone and removed as one piece. He then used two packages of freeze dried bone to try and reinforce the jaw in that area as there wasn't much bone left. \n\nNow recovering, and just glad that it is over with. My side of my face swelled up like a balloon and my eye was swelled shut but that has finally gone down as well and my face is almost looking normal again. 6 months to recover and see how the bone is doing. Surgeon wants to eventually give me another sinus lift and new implants on that side. I am however opting just to do a partial for those teeth, then care for my remaining implants so hopefully they never need to removed. Wisdom73: Update. Suddenly noticed yesterday a new firm lump swelling in my cheek. It's in an area where it does appear to be in the cheek itself, not on the gums where they extracted the implants. Still, told the dentist who then wanted to see me immeditately. Went in, and he says the antibiotics I'm on aren't effective enough. I'm allergic to penicillin, so was on biaxin. Was on my way for a fun weekend at the race track when I stopped to see him. He lanced the cyst right there and squeezed on the lump to push all the fluid out...and pushed hard. Even when numbed, this was excruciatingly painful. Now on clindamycin instead, and had to cancel this weekends plans. He says I also should consider staying home from work another week to allow my body to heal. Not fun, not fun at all." }, { "id": 697, "title": "Bell's Palsy & Wisdom Tooth Extraction", "dialogue": "Rachel: In 2002, I had my wisdom teeth removed. Immediately after the surgery this is what I looked like:\n\nhttps://www.dropbox.com/s/7nubzzrb6pahe1q/2002mov00484.mpg?dl=0\n\nI was 26 at the time, heathy and active with no family history of facial paralysis or Bell's Palsy. My dentist said it had nothing to do with my wisdom tooth surgery. I remember waking up in the middle of the extraction of my right lower tooth, I started yelling because it hurt, at which point my dentist injected additional numbing agent. \n\nI recovered most of my facial movement within about 24 hours but I still have a noticeable drooping of my eye and mouth on the right side of my face along with persistent tingling and numbness along my right cheek and jaw. \n\nTwo questions:\n\n1. Was this a result of my dentist's actions during surgery?\n2. What are my options for treatment? \n\nIt's been getting worse as I age and I'm at the point that I'm willing to try medical intervention." }, { "id": 698, "title": "Weekend \"on call\"", "dialogue": "marieramsey: Do any surgeon's have their assistants take weekend call for them? If so, how do you compensate? Comp time?" }, { "id": 699, "title": "TERRIBLE odor and taste soon after bone graft", "dialogue": "donna: Putrid odor and bitter taste (sometimes chemical) started aboutn2days post op. Now 6 days and getting worse. People notice-it is smelling up a small room! Soggy yellow stuff under the stitches (was gray the first couple days), but had a membrane initially placed over the bone graft. Lower molar was extracted because there was decay and smell under crown (was root Canaled) and furcation. Pain is nagging and itchy, taking Tylenol every 4 hours. Stitches are not red. Is my bone graft infected? Still taking erythromycin 300mg every 6 hours and salt rinses. Dr.Vishwanath: It might be due to food impaction. I feel you need to give it time to heal. Don't panic. If you are not hypertensive you can use salt water to gargle your mouth which fecilitates healing. If you are already using a mouthwash it would not be necessary. And take the antibiotics as prescribed by the dentist. Avoid hard and hot stuff as much as possible from the treated side. Hope it helps..\n\nMrDentist" }, { "id": 700, "title": "advice on wisdom teeth removal please", "dialogue": "roohilhamid: hello a few months i had some point in mouth, and i went to the dentist and did an xray, noticed one of my wisdom tooth was impacted. a few months later, i had an appt with a oral surgeon, and he said i have to remove all but i only noticed 1 impacted wisdom teeth, i have attached my xrays and i wanted a professionals opinion on whether i should remove all, 1, or a few. The pain that it caused was only for 2 days a few months ago and i havent had any pain again." }, { "id": 701, "title": "What is the difference between a simple extraction and surgical extraction?", "dialogue": "b11_: What is the difference between a simple extraction and a surgical extraction?" }, { "id": 702, "title": "Implant supported bridge- need advice", "dialogue": "VitaminA: I have been missing teeth number 12, 13, 14, 15. Right now I'm in the process of discussing implant supported bridge to fill in the gap. Ideally, I would be opting for placing implants to replace tooth #12 and #15 and creating a bridge to replace #13 and #14. My dentist says that it won't possible because I have too much bone loss over where tooth#12 used to be and the only solution is to create a natural tooth and implant supported bridge.\nIs that only option I have? What else can be done here? I'm scared of connecting a healthy tooth with a implant because I've read that most dentists don't recommend it. Zuri Barniv: Don't connect a natural tooth to an implant, that is something that usually ends badly. You are better off doing a bone graft where #12 is so an implant can be supported there instead. VitaminA: Thank you for the answer to my question. My dentist says I don't have enough existing bone around #12 to do a bone graft. What can I do in this situation? Do I have any other options left? Zuri Barniv: I can't think of many situations where a bone graft cannot be done in the #12 area to allow for an implant. The technical terms for what you MIGHT need is a \"block graft\" or a \"sinus lift\", and if you sent an x-ray I could tell you more. But your dentist may not be able to do some of these procedures as they are more advanced, so is telling you there is no option for it. This is why you need a second opinion from someone like an oral surgeon. Also, an implant supported bridge from #12-15 is longer than I would personally feel comfortable with, but if #12 was a natural tooth which was in poor shape, there is no way I would consider connecting it to an implant in the #15 position." }, { "id": 703, "title": "So I Got Tooth Extracted And I Need Help!!!", "dialogue": "WarnerPC: so 6 days ago i got a tooth extracted, it was fine and all there was some pain. yesterday i woke up and part of the clot was gone, there's still a clot down there but now its pussing. im not sure if it will be okay, can someone give me help WarnerPC: I was also wondering when i can use mouthwash? JJ_8613: I'd call doctor who did the extraction and ask. I'm thinking puss is not normal, but I don't know for sure. Dr Sapna Sharma: Hello,\nYou should immediately visit your dentist who did the extraction.\nIt seems to be \"Dry Socket\". Don't worry, a palliative dressing will solve your problem.\nYou should take some precautions; don't take stress, avoid excessive exertion, don't consume alcohol or tobacco products.\nMouthwash is just an adjunctive to your oral hygiene care which is compromised because of extraction. You can continue using it till you are able to properly brush your teeth. But be sue your mouthwash does not contain any allergic,irritating components and alcohol in it." }, { "id": 704, "title": "Smoking after wisdom teeth removal.", "dialogue": "joseph randel: Hi all,\nI have a couple questions about the risks of smoking marijuana after getting 4 impacted wisdom teeth removed. I have waited about 80 hours since my surgery, could i still develop dry socket? And if so, how likely. Also, could smoking marijuana hinder the healing process in any other way?\nThanks! Zuri Barniv: Smoking anything after surgery increases your risk of delayed healing and other complications. Why not just eat a brownie and call it a day?" }, { "id": 705, "title": "Urgent: Bleeding after implant!", "dialogue": "Ravikanth: Hello,\n\nI have an implant done on 8/14/2015. It has been bleeding ever since (it has been 48 hrs). I visited the dentist day after, he said it is very unusual and no idea why it is happening. He removed the temp crown cleaned it up, put more bone graft and put back the temp. Today, my temp is fully covered with soft blood clot. I still have pain but manageable with ibuprofen. My dentist says he has never seen something like this and inquiring in his circle and dental forums.\n\nAny inputs are greatly appreciated.\n\nThanks,\nRavi Zuri Barniv: This looks like something called a liver clot. It happens occasionally and there are many reasons this can happen - they are beyond the scope of a layman forum. Suffice it to say, your medical history needs to be reviewed carefully and if you haven't had a complete blood count in many years, that can be done to rule out some systemic issues. You might also be having a reaction to the bone graft, the gums weren't sutured well or some foreign body may still be trapped under the gums like a piece of tooth, a bone splinter or something else which prevents the site from clotting properly. The list of possible causes goes on and on...If you are in the USA and this was not done by an oral surgeon, now would be the time to consult one. Ravikanth: Thanks Dr.Barniv. I do not think dentist is an Oral Surgeon. But all these guys do are implants. Anyways, i consulted my PCP to do a blood test. The reports came in today. I see following which are high but my PCP says it is ok. I am not convinced, would you know what this means?\n\nFollowing are above normal:\n\nMyelocyte %(complete blood work) = > 1 normal value suggested as 0%\nAbs Myelocyte(complete blood work) = > 0.1 normal value suggested as 0 K/uL\nBilirubin Total (from liver panel test) => 1.3 normal is suggested as <1.1 mg/dL\n\nDo you see any correlation or pattern here?\n\nDo you recommend me to consult Hematologist?\n\nThanks,\nRavi Zuri Barniv: I am not qualified to interpret the CBP so if your doctor said it is ok, we need to go with that. If all these guys do is implants, I'm surprised they have never encountered this before. It is not that unusual, just not common. Are you located in the USA? Ravikanth: Yes. i am in USA. Zuri Barniv: Not sure if the matter is resolved by now or at least getting better, but if it is still a problem, I would recommend getting the advice of an oral surgeon. Ravikanth: Well, the bleeding stopped. The \"liver clot\" is slowly receding. I still have some discomfort and slight pain but I can deal with it. I am making sure that tooth is not touched by food or anything else. \n\nI am now much worried about my blood work. My physician says it is OK but i am not convinced. Especially with Myelocyte% (related to cancer sometimes). My Monocyte % (related to auto immune disease) is also increasing since 2009. But still my doc says it is ok.\n\nMonocyte %\nyr 2009 - 2\nyr 2010 - 6\nyr 2011 - 6\nyr 2012 - 7\nyr 2015 - 11\n\nI see a pattern but he doesn't. He is the professional, i have to trust him, but i'd rather take a 2nd opinion. Zuri Barniv: Whenever you are worried you should get a second opinion, but I'm glad at least the clot issue is getting better.\nDr. Barniv" }, { "id": 706, "title": "Permanently replacing all teeth - costs, longevity, insurance coverage?", "dialogue": "tjc9000: I'm so sick of going to to dentist every few months. I don't know if it's age, or stress, or coffee and smoking, but no matter how often I brush and floss, I keep getting cavities on a regular basis.\n\nIn addition, I have sensitive teeth (since always, not just recently), and can barely tolerate ice cream or hot beverages.\n\nHow much would it cost to have all my teeth extracted at once, and then replaced with something artificial and permanent? \nIs there a significant difference, cost-wise, between different states?\nDoes dental insurance cover this?\nBesides cost, what other things should I be aware of and watch out for?\nHow long does it last?\n\nAlternately, if there's a way to somehow \"seal\" the surfaces of teeth, to reduce the likelihood of cavities, I'd love to hear about that as well.\n\nThanks in advance for any advice! Zuri Barniv: Extracting all your teeth and then placing 6 implants on the top and 4 on the bottom to support non-removable dental bridges costs about $60k in California. Dental insurance coverage is meaningless when you are talking about that much money. It might last many decades or, perhaps even a lifetime, if properly designed and maintained, but no one can guarantee anything for a human body." }, { "id": 707, "title": "Sore throat and tongue after wisdom tooth extraction", "dialogue": "advil_lover: Hi,\n\nNo doubt a similar question has been asked before, but here goes.\n\nI am a 56 year old male in good health. Six days ago I had my lower right wisdom tooth extracted. The tooth had developed normally but was shaped to hold a crown. The crown came loose and the dentist recommended extraction because there wasn't enough tooth above the gumline to effectively re-cement the crown.\n\nIt was a difficult extraction because there wasn't much tooth above the gumline. The dentist had trouble gripping the tooth, and in the end split the tooth in two pieces so she could grasp and remove each piece.\n\nThe day after the extraction I developed a sore throat and the back of my tongue became sore. On the fourth day the pain became more severe in the area of the socket. The tissue behind the socket was swollen and tender. My throat is tender under the jaw on the right side. I went back to the dentist and she diagnosed dry socket. She packed the socket with something that smells like cloves. She thinks the lymph nodes in the throat are inflammed and prescribed Amoxicillin 3 x 500 mg daily to treat that. I have been on the Amoxicillin for 24 hours without any improvement yet. I am returning to her office daily to have the socket repacked.\n\nThe pain around the socket eases following the treatment with the clove pack. But the throat and tongue pain remains intense, particularly the throat. It is difficult to swallow and talk. When I speak it feels like the back of my tongue is swollen. I'm almost constantly salivating. I am taking 600 mg of Advil every 4-6 hours. Once the Advil wears off the pain intensifies and I become very uncomfortable.\n\nToday when I saw the dentist for the 2nd repacking the Advil was wearing off. During her inspection she put finger pressure on the back of my tongue and the pain was so intense that I held my breath and the back of my calves perspired leaving droplets of sweat on the plastic covering the dental exam chair. The dentist prescribed Tylenol 3 to help with pain management.\n\nI need to speak on my job and I can't so I've had to take the past couple of days off.\n\nI'm wondering what others think might be going on here. Is the treatment regiment appropriate? Is it normal to have this level of pain for almost one week? Are these symptoms to be expected? When can I expect to recover?\n\nI'm concerned. advil_lover: A follow up on this, it so happens that I developed an infection as well as dry socket. I am on two antibiotics and after five days they finally started to have an effect. Pain is reduced enough now that I can swallow without the searing pain I had a few days ago. The infection affected my tongue, causing painful bumps or sores on its surface at the far back. Last night I reached way back with my index finger and felt them. I'll remain on the antibiotics until they are finished. Also I am referred to an oral surgeon for a second opinion. \n\nI read on wikipedia that dry socket can be caused by a difficult extraction and this is surely what happened to me because the dentist worked on the tooth for almost an hour. Zuri Barniv: Yes, that could be, but sometimes dry sockets happens for no reason at all. No one really knows what causes them, but they do occur more after difficult extractions. I know you are not a women, but they also tend to occur more in females and those on birth control pills especially (double the risk) due to higher estrogen levels. This is why women should probably wait to have teeth extracted till around the end of their menstrual cycle when estrogen levels are lowest." }, { "id": 708, "title": "Food stuck in fresh socket", "dialogue": "Julie97: Hello!\n\nI got four teeth extractions (for my braces, they are not my wisdom teeth) this morning and I finished approximately at 10am. My dentist informed me that I should drink liquids and eat ice cream. Also, I was informed not to rinse my mouth for today.\n\nAt around 11:50 I was hungry so I decided to eat ice cream even though my mouth was still numb. As I was eating the ice cream I noticed there were tiny pieces of some sort of candy or cake in it, but I did not think it would be a huge problem. (I was eating strawberry shortcake ice cream) \n\nWhen I finished I continued to place the gauze back into my mouth where I noticed that something was in one of my lower gum sockets! Thinking it was just ice cream and it would just melt away, I dabbed it with the gauze causing the piece to be further pushed in and realizing it was one of the tiny pieces found in the ice cream! \n\nI am really scared since the teeth extractions are very new and is still in the beginning process of healing. I have read that you should rinse it out with salt water, but my dentist informed me not to rinse out my mouth for today.\n\nShould I be scared? Will it disturb the healing process of my gums? Will it naturally come out as my gums heal? (The piece is in pretty deep) What should I do? \n\nPlease help. \n\nThanks, \nJulie" }, { "id": 709, "title": "General anesthetic and teeth extraction", "dialogue": "cathypatten: I am in the process of getting dentures and my insurance covers everything but the general anesthetic because they dont see it as medical necessity,I am appealing their decision and my argument is going to be that general anesthetic is a necessity,how else could a oral surgeon remove teeth that are broke off at the gum line?Unless there is something I am missing here,or am I wrong here? Zuri Barniv: It is not medically necessary to get any kind of sedation for oral surgery, but in some cases it can make it a lot nicer for you. With local anesthetics alone (shots in your mouth), you should not feel anything the surgeon is doing except for the sensation of pressure. By the way, you probably don't mean \"general anesthesia\" which is usually done in a hospital by an anesthesiologist and a machine breathes for you. Most likely you are referring to \"IV sedation\" which is done in the dentist's office, you are semi-conscious but mostly asleep and, the big thing, is you breathe on your own without the help of a machine. BIG difference between the two terms. Unless you are getting something exceptional done in your mouth (and it doesn't sound like you are), the insurance is very unlikely to pay for IV sedation if your policy doesn't cover it. cathypatten: Thank you for your reply,and ya think your right,looking at my papers and it says general anesthesia but below it it explains given through a vein and total loss of consciousness.Anyways guess I assumed being put out was absolutely necessary because thats what the surgeon said needed to be done,so is it possible to ask the surgeon to just give me local?(and hopefully it will be covered,or at least a little cheaper if I do have to pay it) Zuri Barniv: Hmmm....well, I just want to emphasize that IV Conscious Sedation is very different than general anesthesia. Your papers should say \"IV Sedation\", \"Conscious sedation\" or something like that. You are technically conscious when you get this, unlike general anesthesia where you are unconscious. There is also a HUGE difference in cost between the two as well. I would clarify exactly what this office is planning to do. And if they were planning to, indeed, do general anesthesia, that would be way overkill for some tooth extractions." }, { "id": 710, "title": "Peculiar Insurance Coverage Situation (Single Tooth Implant and Orthodontics)", "dialogue": "PPGJR: In December 2013 I started the dental implant process on my front tooth and this also coincided with braces for my top front 6 teeth. I have been with my Dentist since 2001 and up to this point I have had zero complaints and we have a great relationship. So when I was told by my dentist that my Delta Dental PPO would not cover the implant and braces, I took his word for it at 100% trust that I was being given accurate information. Overall, I ended up paying close to $6K out of pocket for the implant and braces. Literally today, July 8, 2015, I called Delta Dental and found out that my Delta Dental PPO actually DOES cover a single tooth implant (up to $2500 cumulative lifetime) and orthodontics (up to $1000 cumulative lifetime). I also learned that this coverage was available to me in December 2013 when the procedure was started. Now, the problem with me getting reimbursed is that the procedure was started over 1 year ago and so Delta Dental says I would not be eligible for reimbursement, even if my dentist submits a claim retroactively. \n\nNow, I have some questions for all of you:\n\nis it my responsibility as a Patient to double check the information that my dentist gave me - that the implant and the braces were not covered? Or, was I within reason to take his word for it since I have a great relationship with him?\nAny solutions to the problem of not being reimbursed because the claim is over 1 year old? We literally live paycheck to paycheck and are severely struggling financially so the $3500 that I could have saved if my dentist filed the claims through my insurance would REALLY help me. We wanted to take a small vacation to Disneyland for my children's birthdays in August but we can't afford it right now. The $3500 would allow us to give our children that experience and so much more.\nPlease help me with your expertise, opinion and advice.\n\nThank you very much! Zuri Barniv: 1. Yes, the relationship is between you and the insurance. The dentist is not responsible for your insurance unless they are a DMHO/DMO Delta provider. Assuming they are Delta Premier or Delta PPO, then it's all on you. Keep in mind that even a great dentist with a wonderful and experienced staff can make mistakes. When dealing with this much money, you should always double check everything.\n2. Yes, try writing Delta an appeal letter. If you state the facts of the case, there is a better than zero chance they will consider making payment or partial payment. I would ask the dentist to write a letter you could attach stating it was no fault of yours and would support your appeal. If that doesn't work, escalate it and keep appealing as much as the law allows. It only costs you a stamp and you have nothing to lose.\n\nOne last thought. Even when I know for sure a procedure is not covered by Delta, I still submit the claim just in case. I have had many situations when Delta made payment even when the claims representative said it would not be covered. This is why most all dentists submit a claim for expensive treatment even when it seems pointless. One question to your dentist is: \"don't you always submit a claim for everything you do and especially for very expensive treatment?\". Had he done this, you would have gotten a pleasant surprise when the check came in.\n\nKeep us updated on what happens. PPGJR: Thank you very much for your reply Zuri. I really appreciate it and it makes a lot of sense.\n\nThis is good to know for future reference and I consider it a lesson learned. I'm sure my dentist will consider it a lesson learned for him and his staff as well.\nI completely intend on writing as many appeal letters as necessary until they tell me to stop. Great advice to have my dentist write a letter to vouch for me as well. I have been loyal to his practice for 14 years so I am hopeful that he would do this for me. \nAnother great piece of advice for my dentist. He is currently working on my case to see what he can do but if it doesn't work out, I will ask him that question as part of the learning process for all of us.\n\nI will keep the forum posted on the outcome and ongoings. Thank you very much once again!" }, { "id": 711, "title": "Waiting list for Extraction of wisdom teeth", "dialogue": "Jessicajones121: Hi all, \n\nI've recently been referred to the Glan Clywd Hosiptal in North Wales to have two wisdom teeth extracted. \n\nThe teeth are impacted but they're causing reoccurring pericoronitis and abscesses in my mouth. \n\nI've been on Metrodiozale for over three weeks and I still have an infection in that area affecting my tooth and gum, causing server pain and I'm having trouble sleeping. \n\nI've spoken to the hospital and the waiting list for the procedure is up to 6 months. I'm not sure what I can do now as this is really affecting my working life as I travel and see clients and at the moment my face is swollen and sore meaning I'm struggling with appointments. \n\nI'd consider going private but my dentistry said this wouldn't help? \n\nAny advice would be appreciated. \n\nThanks. Zuri Barniv: Doesn't going private mean you can get the extractions done at YOUR convenience, not the government's? I fail to see how that wouldn't help?" }, { "id": 712, "title": "Dental Osteomyelitis", "dialogue": "Goran Bertoft: Hello, I am new to this forum (and to forums on Internet...). \n\nMy field is Dental Osteomyelitis and Dental Chronic Osteomyelitis and I am interested in knowing what the status is today in general and if I can be of help to any of you dentists, using my work and findings that has been published (latest 1996). I have released my articles on a website (dotcom with same name as the title above) and hope the information will be of use.\n\nAnybody of you out there that can help with a brief update on where we are today on these isues?\n\nThank you very much in advance.\n\nBest/Goran Bertoft Goran Bertoft: Hello again, my website now contains published articles on Dental Osteomyelitis and Dental Chronic Osteomyelitis and letter correspondence with Dr Eugene Ratner, Facial Pain Clinic, Brooklyn, New York. I am adding more articles on the subject. www.dentalosteomyelitis.com. Thank you. Best/Goran Bertoft" }, { "id": 713, "title": "allergic reaction after Clove oil and mouthwash", "dialogue": "Elaine: I have been treated for a dry socket with clove oil and corsodyl mouthwash. Since then I have got a red swollen right side of the inside of my mouth which apparently is covered in ulcers according to the dentist.. Has anyone had this before and what did you do? I am in so much pain and was just told to go away and come back in 7 days. Thanks Zuri Barniv: Dry sockets require almost daily attention by the dentist for those 7 days. The swelling and pain probably have nothing to do with the clove oil (I cannot know that for sure, but it is unlikely). You need to get more attention to this problem by the dentist. Are you seeing an oral surgeon or a general dentist?\nDr. Barniv Elaine: Thanks for your reply. A general dentist, the dry socket is now resolved. I have been to the doctors today and have been given antibiotics. I did find something on another forum from people who have experienced the same with clove oil, perhaps too much was used as seems very strong" }, { "id": 714, "title": "synthetic bone substitutes", "dialogue": "Ksenia: The question is about good and bad features of the material Adbone TCP. Have you ever used it? What is the result? What other bone substitute can you recommend?\n\nthank you in advance" }, { "id": 715, "title": "Arnica tablets before implant surgery??", "dialogue": "Rach29: I'm due to have 2 implants in 6 days time, and wondered if arnica tablets would help with reducing any bruising and swelling?" }, { "id": 716, "title": "How Long Does a LeFort 1 (Double Jaw Surgery) Procedure Take?", "dialogue": "pacerboy9: Hi everyone, \n\nSo I am having LeFort 1 double jaw surgery in about 3.5 weeks (on July 22nd), and was wondering how long those kinds of procedures generally take? Also, will I have a foley catheter put in during the surgery? My pre-op appointment is on July 20th. \n\nAny info would be helpful. \n\nThanks!" }, { "id": 717, "title": "\"Badly\" impacted wisdom teeth, but no pain and no eruption through gum. Should they be removed?", "dialogue": "shak_ka: My bottom two Wisdom teeth are impacted, see below image link.\n\nI have already been to two different oral surgeons to enquire about whether they should be removed, and they both recommend it, but they were unable to estimate whether it would cause me problems in the future if I decide against having them removed.\n\nThese impacted teeth have never caused me any pain or discomfort. I heard that the main reason people get them removed (don't quote me on source) is the difficultly of brushing them, however, as my Wisdom teeth are not poking through the gum (and I assume never will?) I guess this wouldn't be a problem for me?\n\nAbout me: 27 years old, somewhat poor history of dental hygeine - i.e. lots of cavities and fillings. Oral surgeon says my removal would be \"difficult\" due to the close proximity to nerves.\n\nLooking for opinions. Thank you! Only reason I'm asking is that I don't want to spend the thousands of dollars on extraction if it's really unnecessary.\n\nxray image\n\nP.S. This article states: \"Little evidence exists to support removing impacted wisdom teeth that are not causing pain and swelling, aren’t negatively affecting other teeth, and are disease-free, finds a new review in The Cochrane Library.\" which makes my decision even more confusing. shak_ka: Bump, please, anyone? Zuri Barniv: The reason to remove your wisdom teeth has nothing to do with how easily you can brush them. The problem with your wisdom teeth is that they press up against the second molars in a way that can create a pocket in your gums. Bacteria can enter that pocket and potentially cause an infection. Yes, the key word here is \"potentially\". Also, decay can more easily form on the back side of your second molars when a wisdom tooth is pressed up next to it. The bottom line here is risk. There exists risk in removing your wisdom teeth, but there is also risk in leaving them. No one can tell you precisely what will happen. It comes down to the opinion of the surgeon you talk to, but most surgeons recommend what they do best...surgery. Keep in mind that as you get older (especially over age 35) removing wisdom teeth becomes harder and more risky. It is better to deal with them early if possible. Looking at your x-ray, I think your risk is moderate for a problem over your lifetime. I would recommend a cone beam x-ray (3D x-ray) to better evaluate the situation and the proximity of an important nerve they seem to contact. If you find a highly skilled oral surgeon who takes the time to review such an x-ray and who takes the time to explain things to you, that is a good start. It sounds like the surgeons you saw didn't have the time to educate you and that's not a great sign, in my opinion. I would remove them if it was me, but only with a conscientious and careful surgeon who has weighed all the risks, benefits and alternatives with me. If nothing else, you don't need to rush into it and you can take your time to figure it out. Hope that helps.\nDr. Barniv shak_ka: Thank you so much for the detailed reply! I went to get the opinions of two oral surgeons, and only one of them suggested that I get a CT Scan done, so I will likely go with him has he seems more careful. shak_ka: I've attached a few snippets from my CT Scan that my surgeon had requested. http://i.imgur.com/OmpUlL4.jpg (Topogram) http://i.imgur.com/GTFSlXV.jpg (Mandible Axial) http://i.imgur.com/w2T0rg3.jpg (Mandible Axial) Sorry, I'm certainly no radiologist or oral expert, so I'm not sure if these shots are actually helpful.\n\nAfter any opinions. Thank you very much! Zuri Barniv: Unfortunately, these are not useful slices. You would want to show images that display what it would look like if someone was facing you and they peeled back the jaw bone in the area around the wisdom tooth. Either way, it is a moot point because the oral surgeon that ordered it is the best qualified to interpret the results and convey the info to you.\nDr. Barniv" }, { "id": 718, "title": "What are my options?", "dialogue": "victoria: Hi, \n\nI have my wisdom tooth extracted and the dentist said the tooth next to it also needs to be extracted. Even after 3 weeks there is pain, swelling and infection on lymph node. Still taking Antibiotics.\n\n\n\nI just want to know from the experts/specialists if there are other options to keep my tooth." }, { "id": 719, "title": "Are these acceptable dental implants", "dialogue": "kev313: Dear all,\n\nMy mother (75) has recently had 7 implants done on her upper jaw. The dentist did this without any surgical guide and had perform minimum invasive operation on her (no cut open of the gum to reveal the bone). 4 implants (molar) came loose and had to be removed, 3 stayed. I had my mother go to another clinic to get an CT Scan. The enclosed are capture of two implants that I think are problematic. The implants punch thru the bone in the upper jaw instead of completely surrounded by the bone. I want to go back to the dentist to have my money back, do i have sufficient ground? Dentgr: Wow........not acceptable at all!\nAs for your question....super-sufficient ground. kev313: Dentgr said:\n\n\n\n\t\t\tWow........not acceptable at all!\nAs for your question....super-sufficient ground.\n\t\t\nClick to expand...\n\n\nI would think the same but the dentist told us that this is very common for mini implant. He said the implant are holding tight. However, my mother start to have redness and swelling right above the gum on top of one of the implants now. He gave her antibiotic and anti-inflamation medication for a week today. I am not so sure about this as this only suppresses the problem for now, Will it happen again sometime later. Another dentist suggest us to remove those two, saying that it may eventually come loose when pressure applies... But he gave ambiguous comment whether this is a passable or acceptable implant or not.....eventually he refuse to admit my mother's case. it is a small community and the dentists want to protect each other..... My mother has been in pain for the last couple of months..... what a nightmare!! Dentgr: kev313 said:\n\n\n\n\t\t\tI would think the same but the dentist told us that this is very common for mini implant. He said the implant are holding tight. However, my mother start to have redness and swelling right above the gum on top of one of the implants now. He gave her antibiotic and anti-inflamation medication for a week today. I am not so sure about this as this only suppresses the problem for now, Will it happen again sometime later. Another dentist suggest us to remove those two, saying that it may eventually come loose when pressure applies... But he gave ambiguous comment whether this is a passable or acceptable implant or not.....eventually he refuse to admit my mother's case. it is a small community and the dentists want to protect each other..... My mother has been in pain for the last couple of months..... what a nightmare!!\n\t\t\nClick to expand...\n\nSorry to hear so. I agree you SHOULD have them removed as soon as possible. \nThis case is not a candidate for flapless surgery especially when there's not a surgical guide fabricated.\nThese implants don't look mini to me." }, { "id": 720, "title": "Pain - how long after extraction?", "dialogue": "Eric2005: I had a molar extracted by an oral surgeon around 11 AM Wednesday. Dentist also did prep for future implant. It's 2 AM Friday and I just woke up with pain. I have been taking pain killers ever since the extraction. This is the first time an extraction has resulted in ongoing pain. Is this normal? I am concerned. Nimita: One can expect some degree of pain after tooth extraction. It usually lasts for a week and the region still remains tender for few more days. The reason that you still had pain maybe because it must have developed a dry socket. Swelling peaks after the second day but starts decreasing thereafter. Persistent swelling suggests an infection. After extraction of the wisdom tooth or complicated extractions, slight bleeding may occur after three days. Continue warm saline rinsing and avoid smoking to prevent delayed healing." }, { "id": 721, "title": "Dental Implant - Brands", "dialogue": "Sujoy: Hi,\n\nI am not sure if this question has been asked multiples times but here it goes:\n\nMy dentist has given me two options for dental implant - Nobel Biocare and Biohorions. Which one should I go for? It is more lower jaw molar teeth.\n\nAnd also is Zirconium crown the best option? \n\nPlease let me know.\n\nThanks\nSujoy Zuri Barniv: Both implants are excellent, flip a coin. But Nobel implants are more widely known and those are the kind I place myself. Zirconia crowns are fine. The more important piece is called an \"abutment\" which is what goes between the implant and the crown, They can also be made of zirconia but I recommend having it made from titanium. kev313: My understanding is that there are different dentistry tools for different brand and of course different accessories.... it would be easier for you to switch to a different dentist in the future..... I learnt this the hardway in this part of the world (not USA) I currently live." }, { "id": 722, "title": "Having all four wisdoms extracted. General/local anesthesia? Very scared", "dialogue": "yo0123yo: I am 27 years old , about one year ago I was made aware by my then dentist that it would be in my best interest to have all four of my wisdom teeth extracted. They are not impacted and have come up but not completely, so this leaves a little flaps of skin that sometimes will bleed if I bite down too hard or even from brushing my wisdoms, since they are only like 75% erupted. Last week I had another dentist appointment and had two cavities filled and she also suggested that it would probably be better while I'm still \"young\" and under 30 and she gave me a referral to an oral surgeon which I am sitting in the waiting room at now. I am pretty scared. I definitely don't want to be awake for it. Can anyone describe the process and how your experience was? Do they usually extract all four in one visit? Also I am worried about pain even though I heard they give hydrocodone after, the reason why I am worried is because I take opiates recreationally so should I let the doctor know this and therefore ask for oxycodone? Don't really want to be looked at as a drug seeker when I will be needing them for pain. This is going to be my first surgery I'm so nervous. yo0123yo: Just left the office and the xray ended up showing four partially erupted wisdom teeth and then there is one that is impacted (or a tooth like mass), it is small and right next to my top left wisdom tooth. The dentist recommended general anesthesia and to be done in 2-4 weeks. Will attach the xrays when I get home. yo0123yo: In this Xray of my mouth you can see the mass I am talking about in the upper right hand corner right next to the wisdom tooth. It's not even causing me pain, should I still have it done? So scared lol yo0123yo: I just thought of this... that tooth is just barely barely popping out of my gums(top right in the photo). I notice on the xray that the right side of the xray has a bigger \"mass\"? Is that tissue or is that my jawbone?? The worst news I could here would be that my jaw needs to be drilled in to. lol oh wow. Sorry guys I'm just so nervous its my first time ever getting any kind of surgery and of course drilling/cutting a tooth out of my jawbone would be my first surgery. AnnMarie: You should be fine seeing they are so close to the surface. I had three pulled when they started to abscess and caused ear and throat pain. Not all at once but a few years apart The worst was the bottom left and that was mainly because the dentist didn't put a stitch in and I lost the clot and got dry socket. It was HORRIBLE! I still have one in my upper cheek that they refuse to remove. They were all in deep in my head. Trust, you'll be good." }, { "id": 723, "title": "Upcoming Front Implant Surgery", "dialogue": "Rob: Hi, I am having implants put in my two front missing teeth soon. I lost my two front teeth due to failure of crowns & also just bad genetics. I'm having the procedure with IV sedation (because I don't tolerate nitrous oxide). Just wondering if anyone else here has had this done, & what should I expect? I've had my wisdom teeth removed, with IV sedation, & that was a fairly easy process to recover from. The dentist told me the initial procedure that places the implants will require a healing period of about 2-3 months, during which time I will still be able to wear my flipper/bridge to conceal the gap in my front. I'm actually looking forward to this because the flipper is VERY uncomfortable to wear for more than a few minutes at a time, & I can't eat with it in at all. Basically it just lets me get through day to day until my procedure. So what can I expect from the procedure pain-wise, & are they usually pretty successful? The dentist told me he had never had one fail yet (knock on wood). It's my understanding that the surgery will involved placing screws in my bone, that will then have to heal & meld to the bone, & after that's completed, then they can just screw in the crowns into those. Is that right?" }, { "id": 724, "title": "Wisdom teeth surgery", "dialogue": "Firas: First Hello to every one and thank you for this nice forum.\n\nI have a big problem, my wisdom teeth is in a horizontal orientation, it was ok till a part of my teeth was broken and now it became not comfortable, hard to clean and smelling bad, so I thought if it is possible to remove it without a risk I'm just ready to do that \nabout tow months a go I visited a doctor, after checking my X-ray film he said to me that there is a risk to damage the nerve and that will make me losing the sensation with the right part of my downer lip and may be that will stay forever ,\n\nI felt so scared of course and I left the hospital till I realized that I have to try more \n\nI visited a different hospital tow days a go \nand he said totally different thing, \nhe said to me that my surgery will be in 1/7/2015 and when I asked him is it possible to damage the nerve he said to me no don't worry. that made me feeling happy a bit but at the same time I started feeling nervous, should I trust him and believe what he said ?\nthat is why I thought to ask doctors and specialist in this forum to tell me the chance of the nerve damage in my situation \nplease dear specialists and doctors check my X-ray and tell me is the position of the nerve and the teeth really can damage the nerve during the surgery ?\n\nSincerely \nFiras from Turkey Zuri Barniv: Unfortunately, the risk of nerve injury on the lower right tooth is very real as the tooth intersects the nerve in the x-ray. That does not mean it intersects it in reality. What I mean is that you are looking at a 3D object in 2D. The nerve may be very close and your risk is very high or the nerve is farther away and you will probably be fine. There is no way to tell with this x-ray. In the United States, the standard of care dictates that you get a 3D x-ray (cone beam x-ray) in order to see what is really going on there. Without that, all any dentist can tell you is the risk exists and that the risk is real (not theoretical). I would insist on a 3D x-ray and I would only see a surgeon who has experience with these issues and agrees a 3D x-ray is needed here. I would not go to a surgeon just because he tells you it will be OK. Firas: thank you very much dear Barniv for the clear answer,\nso you think that I really need 3D X ray I hop they can do it in Turkey I will visit the dentist again and asking for a 3D X Ray \nplease don't hesitate to tell me in case of nerve damage will I stay for the rest of my life without feeling in the right down part of my lip ?\n\nwhat if they will tell me that they don't use 3D X ray in Turkey ? what I have to do ?\nthere is no chance to know the real risk from just this panoramic picture ? Zuri Barniv: Yes, I really think you need a 3D (cone beam) x-ray. Nerve damage could cause you to lose all sensation in your lip and chin on the lower right side, but it could also cause pain to occur there, which is actually worse than being numb. The risk is there. You cannot know the risk from just a 2D panoramic x-ray. There is a good chance your dentist will tell you they don't do 3D x-rays even though I know for sure they have the machines in Turkey. If you are in Istanbul, Ankara or other big city, I would be surprised if you can't find a surgeon who has experience with this and access to such a machine. In the USA, it costs about $300 to take this x-ray. \n\nRead this for more information on cone beams x-rays in Turkey: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528136/ Firas: thank you very much for your Answer dear,\nnow I'm worrying more then any time before, \nI can't imagine the horrible causes that can happen to me in case of a bad surgery \nI'm living in Eskisehir but I will go to a big city to save my self \n\nactually the doctor did a different film for me, but when I went back home I checked the file I found he filmed the wrong place \nI will share the picture with you \n\nI will find a way to get a 3D Xray before the surgery or I will cancel the meeting with that doctor\nreally I appreciate every advice \nthank you very much \nas soon I will get the 3D X ray I will share it with you Zuri Barniv: By the way, you do have a very deep cavity on your lower left molar 3rd tooth from the back and a moderate cavity on the tooth behind that one. You will probably need a root canal done on the deepest one to fix it. Firas: thank you very much dear Barniv yes the Cavity already hurting me and I got a meeting to repair it, any way I dot a 3d Xray and it is in a CD I made Iso file and I will upload it and send you the link \nthank you very much dear for your help I really appreciate it Firas: the link of the ISO file of the CD is\n\nhttp://ovh.to/T8q5Thc\n\nand this is a short Video that I did to show you the position of the nerve \nI think I'm ok what do you think ???? Zuri Barniv: The video is not helpful. Can you show me pictures where you see the tooth and the nerve in cross sections - like what you would see if you were looking through the jaw bone. That program you have should be able to do that. If you want, upload the files and I will run it on my program. The files should be in a DICOM format and there may be a few hundred of them in the folder. Firas: Thank you for the answer dear,\nI uploaded an iso file, I mean virtual cd image\nIf you have \nPower iso, deomon tools or magic iso you can see the cd,\nOr if you have CD burning software you can burn the iso file in a cd, \nI prefer that you use the cd and see well because I'm not specialist in reading tomography, and in the cd there is many settings like adjusting image setting, display soft tissue, changing lighting, \nPlease, help me to know the real situation of my nerve because when I will go to a doctor I want to be ready and know every thing to be sure that he is doing every thing right \nNow I'm using my phone when I will go back home I will try to check the DICOM files\nBut the cd that the doctor gave to me run automatically with luncher Firas: I found DCM file in a folder called Images may be this file you need it\nI shared some pictures that I think they are useful \n\nand this is the link for the DCM file\n\nhttp://ovh.to/Y7eqak9\n\ndo you thing that I will be OK ?\nthank you really for every thing Firas: I found an easy way to send to you my 3d Xray \n1) download the file \"tomography.zip\" from this link -click here to download-\n2) unzip the file \n3) you will find a file called \"Romexis_Viewer.exe\" double click on it \n4) \n\n\nthen you will find a window like that \n\n\n \n\nselect the english languge then click start viewer from the cd and finally you will be able to see the 3d x ray and control it like you want Zuri Barniv: Mohamed, it is hard for me to see clearly without the DICOM files and I don't want to install anything on my computer. The bottom line is the 3D x-ray needs to be used and interpreted by the surgeon doing the work. The nerve is very close to the tooth. An unskilled and inexperienced surgeon will cause damage there even if they have a 3D x-ray. The best advice I can give you is to see a surgeon that is familiar with 3D x-rays, takes the risk here seriously and explains to you their experience in this matter. If you are satisfied with their response, I would go forward. Obviously, any surgeon who has this 3D x-ray has a big advantage because they know the best way to remove the tooth and minimize your risk. Firas: thank you for the clear answer doctor sorry for the inconvenient, I think DICOM files are special for your software and I'm sure I have no DICOM file, but I looked for a tutorial how to use my software and I found this picture is it more useful ? Zuri Barniv: Yes, these views are much more useful, but my original advice from my last post remains unchanged. You need to work with an experienced and skilled surgeon to minimize your risk and they need to use this 3D x-ray when planning your extraction." }, { "id": 725, "title": "Surgical Extraction gone awry", "dialogue": "ExposedJawBone: I am new here and sooooooooo scared!\n\nI had left a broken filling which took a piece of my tooth with it too long due to fears of going to dentist and when I finally went 2 weeks ago the dentist told me it had to be extracted. During the extraction (it was one of my upper molars) the tooth broke apart and the dentist told me he had to extract the 3 roots separately. One of them wasn't frozen and had to be frozen 3 times. I was soooo happy when it was finally over.... \n\nI went home and immediately when the freezing came out I could feel a lump in my upper gum where it attaches to the side of my face.. the lump is painful and has not moved or lessened in 2 weeks. The lump is above the last tooth in my upper jaw NEXT to the extraction site. I went back to the dentist but the check up was done by a different dentist and when I asked him what's jabbing into my cheek he said \"bone\"..... to which I asked \"bone??\" but received no explanation and was sent home with some clindamycin (antibiotics).\n\nYesterday I was brave and put my finger in to feel around and the thing jabbing into the side of my face ISexposed jawbone!!! No one told me this happened - How does this happen?? - It's not even near the extraction but over the other tooth next to it! -- I am SICK that neither of the dentists told me about it or why I've been in such pain = Will the skin grow back over the jawbone??? How can they have done this and not even told me about it? I've been crying for 2 days and the pain has been unrelenting for 2 weeks and I cannot smile at all! Since the dentist never told me about what happened during the surgical extraction, will he do anything to help me? -- Will it heal????\n\nPLEASE HELP! - I haven't gone back to the dentist again b/c I'm scared. Zuri Barniv: Don't let this get you so upset, you will be fine. It is probably not as bad as it feels. When we do difficult extractions, sometimes a piece of the jaw bone can break off. Sometimes we see it and clean it out and sometimes we don't and it is noticed later. Exposed bone in your mouth is not a big deal in the short term, but you do need to get it looked at and treated. The treatment is usually to numb the area and clean the area where it happened. I understand you are scared, but you need to get it looked at. The office you are going to may not be a good match for you as they don't sound like very good communicators. Go to Yelp or the phone book and find a well-regarded ORAL SURGEON (not a general dentist) and pay whatever it costs to get it evaluated and treated properly. In most cases, everything heals up fine and there will be no long-term problems. \nI hope that helps. ExposedJawBone: Zuri Barniv said:\n\n\n\n\t\t\tDon't let this get you so upset, you will be fine. It is probably not as bad as it feels. When we do difficult extractions, sometimes a piece of the jaw bone can break off. Sometimes we see it and clean it out and sometimes we don't and it is noticed later. Exposed bone in your mouth is not a big deal in the short term, but you do need to get it looked at and treated. The treatment is usually to numb the area and clean the area where it happened. I understand you are scared, but you need to get it looked at. The office you are going to may not be a good match for you as they don't sound like very good communicators. Go to Yelp or the phone book and find a well-regarded ORAL SURGEON (not a general dentist) and pay whatever it costs to get it evaluated and treated properly. In most cases, everything heals up fine and there will be no long-term problems.\nI hope that helps.\n\t\t\nClick to expand...\n\nThanks for your reply but you did not understand what I initially wrote. \nI went back today. The owner of the dental institute saw me and told me that my upper jaw bone IS exposed, and it is not where the tooth was extracted. She explained that the dentist had to create a 'flap' over the extraction site, but I don't know how that has anything to do with the part of my jaw bone which is exposed since the exposed bone is above the tooth behind the extraction and above it.\n\nShe also told me that if the skin doesn't grow back they will need to shave down the bone. She says that usually they put people in my predicament on hydro morphine. I barely take the Ty3's they gave me because I don't like narcotics and they make me ill. \n\nAdditionally, she acknowledged that her 2 male dentists did not educate me as to what was going on and wants me to call her in a week to check in with her. I've noticed that men do not seem to know how to provide information the way women do. I will never go to a male dentist again." }, { "id": 726, "title": "Treatment for a Patient with Oral Sub-mucous Fibrosis in usa", "dialogue": "khanz: hey every one here is the question\nI'm looking for Treatment for a Patient with Oral Sub-mucous Fibrosis in usa i can't open my mouth at all the the opening is 17mm can you guys help me with it thanks in advance" }, { "id": 727, "title": "Upper Jaw Pain and Facial Numbness", "dialogue": "Leona Wyatt: I had a lower molar extracted on the left side about 30 days ago .. about 2 weeks ago I started having numbness on the whole left side of my face and EXTREME upper jaw pain, it hurts to chew and even yawn. I have never had a tooth extracted so I am not sure if this is part of the normal healing process. My dentist did tell me that the roots were extremely long and he had to do ALOT of pulling to get both roots all the way out. Zuri Barniv: Is the numbness just on your lower left chin and lip or on your upper lip and cheek as well? Overall, your symptoms do not sound normal for 30 days post treatment. I would wonder if you have contacted your dentist yet?\nDr. Barniv Leona Wyatt: No .. It is my upper jaw almost right at the joint where the upper and lower jaw meet and the numbness is my whole left cheek almost to my ear but not my chin at all Zuri Barniv: Leona, this sounds like something associated with your jaw joint which is near your ear. It is unusual to feel numbness after a difficult extraction but it can happen. If the doctor presses very hard against your jaw during the extraction, it can cause aggravate the joint and cause problems.It's impossible to diagnose you in a forum. You need to make an appointment to have the doctor evaluate you. If this doctor was not an oral surgeon, then I would definitely consult one." }, { "id": 728, "title": "Zirconia tooth implant question", "dialogue": "BLS: I had an upper molar (#14) extracted 4 months ago and am considering an implant. However, I am concerned about the safety of titanium implants after reading some academic journal articles about the risks associated with titanium corrosion (immune reactions, titanium debris making their way to other parts of the body and lymph nodes).\n\nhttp://www.sciencedirect.com/science/article/pii/0300571294902003\nhttp://www.actaodontologicalat.com/archivo/v22n1/fulltext/articulo1.pdf\nhttp://goo.gl/Gul1C9\nhttp://goo.gl/TKDsvb\nhttp://www.ncbi.nlm.nih.gov/pubmed/18561292\n\nIs zirconia a good alternative to titanium? I know there hasn't been a lot of long-term studies on zirconia dental implants, but I'd like to find out if anything conclusively negative has been found about the safety of efficacy of zirconia implants.\n\nHave zirconia implants been approved by the American Dental Association and other regulating agencies?\n\nThanks in advance. BLS: Forgot to ask what the ADA and other dental organizations think about these studies on corrosion and titanium. In light of these findings is titanium still a safer bet than zirconia?\n\nWhich would you choose if it's for yourself and your family and why? BLS: Bumping up and hoping someone might be able to answer my question. Zuri Barniv: The articles you cite are not all relevant as some discuss the interaction with an implant and the pieces that fit on top of it to make a crown. Others discuss theoretical problems with implant corrosion or under what conditions corrosion can occur. I did not have time to review them in detail but am not sure the one or two there actually discussing the health implications are from reputable peer-reviewed journals. All of them fail to cite ANY real health problems but only discuss the potential for them. Zirconia is not without issues, but the main one is the lack of studies over a long period of time. Zirconia implants are FDA approved and I don't know that the ADA has a specific position on anything like that. But keep in mind that just because the FDA approves something, it doesn't mean they have done long-term studies on every possible scenario or that they guarantee it is perfectly healthy. \n\nSuffice it to say that Grade-1 titanium (the kind implants are made from) remains one of the most biocompatible materials available and I have placed them in my friends and family without hesitation. I discuss materials more in my blog, if interested. \nwww.straightupdoc.com" }, { "id": 729, "title": "Implant pain", "dialogue": "droopdog7: So I started my implant process nearly a year ago and it hopefully will come to a successful conclusion soon. Anyway, I replaced a tooth on the lower jaw that had a root canal over 25 years ago. A crown was never placed on it (no dinero) so over time is basically rotted. When I finally made the decision to get an implant, I found out that an abscess had infected a large part of the bone below the tooth (requiring a significant grafting procedure). Waiting the six to seven months, the graft was successful and an implant was inserted (with no abutment). \n\nAfter four additional months post implant, I was finally deemed ready for the abutment and eventually the crown. What I find curious is that when I had my 1 month and what became three month post implant visits, the dentist was somewhat surprised by the level of discomfort I had in the area when he applied pressure with that evil steel hook thingy. I was surprised by his surprisement because I could not envision it not hurting?\n\nAnyway, having waited an additional month post implant because of the sensitivity in the area, I went into to get the abutment (which turned out to be removing the first screw and inserting the new one with abutment. That was nearly a week ago and boy, was it not fun. The dentist originally intended to remove the first implant and place the new one sans any numbing agent. Terrified, I said okay.\n\nThe removal of the first screw was terrifying but fairly painless. The placing of the new one though was not that way. I mean, he was able to begin placing it but once it started to get tight, the pain shot down to my toes! Again, the dentist was a bit surprised by my reaction. And again, I cannot envision a scenario where that particular action would not be painful. \n\nThey then when to a topical numbing agent (which did nothing) to the shot. And even with the shot of novocaine, that final tightening reached the high pain category. Okay, now after all this, here is my first semi-question. The dentist seemed to infer that the pain was due to contact with the gum (or something like that?). He would ask where it hurt, and frankly, it hurt everywhere. The pain was difficult to locate and I was busy suffering, but it did not feel like just a gum issue. Seemed to me to be the same as before (when he poked and prodded and one and three months). What if, the pain was in the bone? You know, the place that the screw was being tightened? Is that significant in any way?\n\nSecond, I am a week post second implant screw (with abutment). I am scheduled to go in next Monday for the crown but I have a hard time believing it won't be extremely painful because the area feels sensitive still. It is supposed to heel in the next four days? As a side note, when the second implant was placed, the dentist was about to take it out because he could not tighten much, even with novocaine, on account of me screaming in pain. He was about to remove it he determined it was already a tight fit. Maybe that is why I was screaming? Anyway, I assume if I am still sensitive come next Monday, I need to tell him something, as I don't believe that crowns are generally placed using a numbing agent. adisa: hi;\nWell first of all ı have to say that I had the same problem around 3 years ago. Obviously I needed to get 8 implants (4 on the top and 4 on the bottom) and full mouth crown. What can I say I am young but my dad also lost his tooth really young. Anyway just because I was so afraid I decded to have only 1 for the beginning. The dentist sad the same think my bond was not enough strong to carry the implant so they put graft (new bond) and ı waited around 6 months. everything was ok. after 6 months ı got my implant but the think I didn t check for details. around 2 months later I got really huge pain. I went to dentist may be everyday to stop the pain but painkillers didin t work. I got the same oparaion as you had. they took of the implant and sad that I need a new one. I did not convinced about the reason why I had that crazy pain and why they ned to put a new one. Thats why I didn t accept to have another implant in the same place. \n\nAfter all I did big research about implantolojy let s say implants are different with the quality and size. Your dentist should check about all alerjic situations off you and find the true implant to put. While I was searching I found out one clinic in Turkey (surprisely so cheap) I called them and asked for all details. I checked for forum of clinic and talked to other pations. Finally I decided to go anyway I wanted to go for holiday too. They offered free transfer from airport and free accomndation. The hygiene surprised me and smiley faces. There were around 8 dentists but the surgeon was around 35-40 years old a kind man and really has fast hands. I waited for first 2 days before treatment and watched for pations who are coming mostly from England. Everything seemed ok to me. After 2 days I start with my treatment wıth 4 implant in a day and 4 for next day. The name was Qimplant made by German. \n(350£ for 1 implant)!!! \n\nAfter a week my implant operation done. I have to say that I am so happy now. I was gonna have porselen crowns in Spain but now I have zirconium jus because of the prices in Turkey I paid around 100£ for one zirconium. \n\nEnd of the story, you never know what is the problem when you get pain. Do research and don t decide quick." }, { "id": 730, "title": "Problem with extraction, please anyone and everyone help/give advice", "dialogue": "OxyMade: I'm 16, and as a very young child I got abused by my dentist and.. long story short I'm very hesitant with dental work. I The issue happened at around 6 or 7.. and I refused to go to a dentist.. April 2014 I finally got tired of all the tooth pain and decided to go and get everything fixed. I got a fantastic dentist and I have no problems letting him do anything. he's done a lot of deep fillings and a root canal. I don't care about it.. it doesn't make me nervous, I have no problem with getting injected with lidocaine because I'm so used to it. However when I first went in April 2014 my dentist and I made a sheet of everything that needed to be fixed and both of my second molars needed to be extracted. #18 is worse than the other one.\nIn fall 2015 I went to an oral surgeon to get them both extracted and the lidocaine alone wasn't enough for me when he attempted to pull them it felt like no lidocaine was there. I was told I could be knocked out.(I'm now realizing that it doesn't mean totally knocked out.. apparently it only makes you groggy and you don't remember anything) so I go back to the same oral surgeon and he puts the IV in me and that's all I remember until waking up and being sat up and he was done. I didn't know much that was going on when I \"awoke\", but the first thing I did was feel only #31(left side second molar) was out and I said why did you only take one out and he told me that he had to stop because I started flipping out and grabbed his arm while he was doing it and kicked one of the assistants and put her on workmen's comp. I was very confused because I didn't remember any of this. After recovery of the extraction I attempted to setup another appointment to extract #18 and he told me because of what happened he couldn't put me out because he could get sued so I tried again with just lidocaine and I couldn't do it. The oral surgeon then verbally abused me because I was having a hard time with the tooth and he was rushing on the last time he attempted to extract it and he was getting frustrated so I tried a new oral surgeon to see if they could put an IV in me, but that oral surgeon told the next one the situation so it didn't matter what oral surgeon I went to they could only use local. This next oral surgeon was very nice and so very patient with me I was so surprised, yet again I couldn't do it.. he said he couldn't inject anymore lidocaine into me yet as soon as he pulled on the tooth just the slightest it was just the absolute worst pain it felt like there was no lidocaine injected at all. A week after he tried last time I was in constant pain, they prescribed me tylenol 3.. after another week I stopped taking it and it was a horrible pain so I was always taking it and always having them prescribe it to me whenever it ran out. This was in December or January 2014/2015. A few weeks ago in April 2015 I just had a few more fillings done and while there my dentist asked me if he could take out the decay out of #18 to make it not hurt all the time and possibly easier to extract and I was very numb and not feeling any of the fillings.. usually I would say no in fear that I would feel pain, but I said go ahead. As he went I felt nothing. He also, took a lot of the tooth down because the sharp edges were cutting my tongue and cheek and when I left it didn't touch my cheek or my tongue so I was happy. A couple days after this appointment I realized what he did by taking all the decay out was make the tooth completely hollow exposing the nerve. Since then food gets in there every single time I eat something food gets stuck and I use a small pick with bristles as the end to get it out, I always stab my nerve. It's always a very bad constant ache. The tylenol 3 I mentioned earlier wasn't doing enough so they prescribed me vicodin and whenever I don't take it it just hurts constantly.. on friday I ran low and my dentist was on vacation so I had to wait until today Monday to get more and then he told me that he's prescribed me so much that he can't prescribe anymore.. now I have to just sit through constant pain and am trying to get the tooth extracted but, what should I do? I can't be given IV and it's so much pain getting it pulled with just lidocaine, never mind how hesitant i am to even try with just lidocaine because I already know it's going to hurt?\nAny advice will be appreciated. Dentgr: Have they tried an intra-pdl syringe? OxyMade: I'm not sure what that is." }, { "id": 731, "title": "sinus pain 18 days after upper molar extraction", "dialogue": "Lampetarian: Hi\n\n18 days ago I had to have my upper left 1st molar extracted after a failed root canal which was causing significant pain for several weeks, in the end I had to request it be extracted due to the pain. Since extraction I've continued to have several problems, firstly it got infected needing a couple of courses of antibiotics to resolve. Now it seems to be healing well if more slowly than I'd like, however I've been left with quite a lot of pain in my sinuses which doesn't seem to be easing. The pain is mostly a pressure mostly within my nose, but which also can move across from my jaw above the extracted tooth, and up into the bridge of my nose and across my forehead towards my temples. At times it feels like I've been punched in the face! The neighbouring teeth are also pretty sensitive.\n\nthe dentist said there was no sinus communication during the extraction nor have I had any leakage of fluid between sinuses and mouth. The tooth was a 'beast' to remove (dentists words not mine) and took a lot of pulling to extract. I have also had to have a lot of work on my upper left jaw in the last few months (fillings, a wisdom tooth extraction and the failed RCT) so I suspect this may be contributing to the pain as my mouth is metaphorically saying it's had enough. \n\nIs this likely to just be due to trauma/bruising/inflammation to the surrounding tissues in my mouth/sinus floor after the extraction or something more serious? If just bruising, I guess it just needs time, but how long could I expect it to continue?\n\nthanks for any help anyone can give about this. Any advice greatly appreciated" }, { "id": 732, "title": "Inflammation on side of tongue please help", "dialogue": "JasonMiller1: Hello- Im Jason. Back in late January i was eating some salty chips and it caused some inflammation on the side of my tongue. it took several weeks to get better (and certain foods kept irritating it) but then it came back. when i looked at the side of my tongue i saw what appeared to be a small sore/hole and a white halo surrounding it. I went to an oral surgeon and he said that the area was coming into contact with a sharp edge of my tooth and that i should get it smoothed out by my dentist. He also said he could biopsy it for me which kinda scared me. ANyway i wanted to see if anyone can offer some feedback on this. \n\nAlso just a brief history...my mother has erosive oral lichen planus and in the past i had two outbreaks of something similar to what i have now only it was on the inside of my cheek and on the inside of my lower lip. both areas healed and dont bother me anymore but much like what i have now, there was a small sore that seemed to cause this white patch to form around it. i attached a current pic with an arrow pointing to the site of the sore \n\nThanks so much! James Michael David: This is a painful procedure but it will helps it heal quickly and effectively, rub a salt on top surface of the sore under your tongue and gargle with water, after then wait for 2-3days of healing." }, { "id": 733, "title": "extreme pain 10 days post extraction", "dialogue": "spoon: i had a back tooth pulled. ive had other teeth pulled so i knew what to expect, slight pain and soreness. That is perfectly fine but, at about 9 days after the extraction, it became very intense and getting worse.The pain literally kept me up all night. Now I am on day 10. i went and saw my dentist this morning and he checked it out and said everything looked perfectly fine, no dry socket. He gave me some antibiotics and Tylenol 3's saying it could be an infection on the bottom. Today is Still day 10 and im still in extreme pain. meds not helping at all. keep calling them and they keep saying to just take ibuprofen and call in the morning if it still hurts. i feel like I am not being taken seriously of the amount of pain I am in. It is a shooting pain from the base of my jaw all the way up to my head causing headaches and my ear to hurt. As ive said i have had 3 other extractions and not one of them has hurt like this. Is there anything else it could be? Anything i can do? \n\nside note : i was not given anything post extraction, not antibiotics or anything for pain which was also different from my other extractions.\n\nThank you in advance for any help ! Bill A: I had a similar problem with an extraction, intense persistent pain after a tooth had been removed. In my case it was because a fragment of the extracted tooth was still lodged in the gum and needed to be removed. spoon: Would the dentist not be able to tell if there was still a piece in there? did your dentist notice it right away or did you have to keep going back? Its now day 11 now and still in ongoing pain. haven't called the dentist yet in case it is just an infection and trying to give antibiotics time to work. Not proud of it, but i had to get some other pain medicine as the dentist keeps putting off giving me anything to help (not sure why he would). At this point im just ready for it just to be over. Bill A: I had to go back to have the tooth splinter removed. The dentist did not notice it right away. The pain was so severe that I thought that another tooth needed to be extracted, which was not the case.\nYou might wish to check out this informative presentation:\nhttp://www.animated-teeth.com/tooth_extractions/a-tooth-fragment-sequestra.htm spoon: your explanation fits almost exactly... i started checking out my other teeth earlier today to see if i need another one pulled. top and bottom beacuse i cant pinpoint where the pain is as its the whole side of my face. going back again first thing tomorrow James Michael David: Your dentist should do an x-ray to make sure that their are no fragments left in the gums that one thing causes the pain and 10 days is a hell of a pain." }, { "id": 734, "title": "Think I'm in trouble - could use info", "dialogue": "Larry: Hi,\n\nThis situation is so tough on me it's even tough to type out. I'll try and simplify.\n\nMy trouble started 20 years ago. I developed hyper sensitivity allergies to things and became scared to do the things needed for my health. Shortly after a bottom molar cracked in half. I've literally lived with it for almost 20 years, never seeing the dentist and chewing on one side. I almost had it worked on, but didn't. Terrible decision. \n\nAbout 2 years ago my top wisdom tooth on the other side broke in half. I lived with that as it didn't cause much pain. About 4 months ago while eating the majority of the wisdom tooth fell out. I can feel just a tip of the outer part of the tooth in a few spots. At first it was a bit hole and how I can feel skin in the middle of the hole (not sure if it's a swollen nerve or what. It didn't hurt for the first month, but I've had some pain recently. \n\nTo make things much worse, I have a heart valve issue and overall am not in great shape. \n\nAt this point I've got myself into a position that I don't know how to get out of. I always sort of thought I could have the tooth(s) extracted if needed, but with the wisdom tooth now below the gum I'm guessing it's now major surgery. \nI'm in such bad mental shape it literally feels like I can either struggle along as is until a complication kills me or risk my life by dealing with the dentist/surgery. \n\nOverall thoughts/worries:\n\nSo much wrong with my mouth, where would they start?\nFear I couldn't survive going completely under anesthesia instead of a local, but pretty sure they'll need to put me under for the wisdom tooth issue\nNo idea how they'll get my cracked wisdom tooth out\nCan't imagine dealing with my heart issue though surgery (if that's needed) before handling my teeth, BUT I can't imagine doing he reverse either\nSorry for the long post. I know there's not an easy answer, but would appreciate some input. \n\nAnd if nothing else this might be a great lesson for those putting stuff off. If only I had gone years ago.\n\nOh boy... drmins: It appears to be that, you are very much frightened about your dental visits and this delay in consulting your dentist has resulted in things getting worse.\n\nYou dentist would examine you and make an over all assessment of your oral health.Based on the history given, you will probably need an extraction for your top wisdom tooth that is broken.It can usually be done under LA (local anesthesia) and need not be much worried about it.\n\nHOWEVER, ENSURE TO TAKE THE NECESSARY ANTIBIOTIC PROPHYLAXIS AND YOUR CARDIOLOGISTS CONSENT BEFORE UNDERGOING YOUR DENTAL SURGERIES." }, { "id": 735, "title": "Wisdom Teeth Extraction did not go well - question now", "dialogue": "skcup: I had my wisdom teeth removed a few weeks before Xmas. I should make it clear that I am no longer seeing my dentist; the process was terrible. She extracted them under a local and was distracted the whole time and stabbed me repeatedly while stitching up the sockets because she was having another conversation. She also left in the middle of the procedure to go see another patient, leaving me alone with my mouth jacked open and blood in my mouth. One of the lower teeth was a lot more complicated than she'd implied and curved around my jaw. I suspect she should have referred me to an oral surgeon for that one but didn't want to lose out on the $$$ doing it herself. Horrible experience and I'm not really a baby about this kind of stuff in general.\n\nWhen I left, she gave me really vague instructions about after care and sent me home. I did my best but still developed dry socket and an infection a few days later in the lower (complicated) extraction site. I returned to the office and they grudgingly saw me (made me wait forever too) and she gave me a clove packing and an antibiotics prescription (nothing for pain) and told me to take the clove pack out in 9 days. Well, it fell out in the 3 so I went back to get it repacked. Once again, they grudgingly saw me. Went home, that night the pain got worse to the point where I couldn't sleep or think. I called the next day and asked for something for pain and she said she'd call a prescription in right away to my local pharmacy. Went to the pharmacy and was upset because they seemed to have lost the prescription. They looked for a few hours while I ran errands. When I went back, the told me she'd JUST called in the prescription then (almost four hours since she said she'd do it right away). \n\nAnyway, I know all of this detail is not relevant to the medical situation but the short version is: this woman is horrible, her office is horrible, they are disorganized, unprofessional and unconcerned with follow up. \n\nIt's now been about a month and I've recently developed what feels like a swollen flap of skin at the complicated lower extraction site. It seems to be getting bigger but I am having trouble telling. I am worried that there is something in there from before the dry socket healed up and that it's abscessing. Is that likely? Will it burst on its own if I wait? There's almost no pain except when I poke at it. \n\nI really don't want to go back there but I'm not sure if any dentist will deal with me since she did the surgery and should be doing the follow up. I'm in Canada and insured if that makes any difference.\n\nAny advice is appreciated. And for the record, I've documented everything that happened with the procedure and am sending a letter to her to explain why I'm leaving the practice. I haven't send it yet because I wanted to be 100% sure I was in the clear from complications before burning any bridges. DIG IT: Hey skcup,\n\nSomething similar happened to me at around the exact same time as it happened to you. I had an abscess form at the back of my throat after wisdom teeth removal, which blocked my airway within 4 days (had to have an immediate surgery).\nI hope that you have seen a medical professional about it, because sometimes rarities do happen. If it was infected, I hope you took some Antibiotics for it & that you're all good now.\n\nI know it's a bit late, but if you see this I'd like a reply to see how you went with it. skcup: thanks for the reply - in the end, it turned out to be bits of tooth fragment working loose. I got about 3 of them that came to the surface and it ended up being okay. I spoke to several other dentists at the time who advised me what risks to watch out for so I would have sought medical help if necessary DIG IT: Oh that's pretty lucky all the fragments surfaced without the need of surgery or anything. Glad you're all okay!" }, { "id": 736, "title": "Possible infection surrounding extraction zone", "dialogue": "ryan f: (PHOTO) I had a wisdom tooth extraction performed one week ago. I went to get it checked out yesterday morning and the dentist said it was fine but I'm skeptical as it was not a very thorough check.\n I have only now noticed a significant wound on the inside of my cheek and discoloration around the inside of my mouth with a noticeable amount of discomfort. any help and opinions would be greatly appreciated DIG IT: That looks infected; I hope that by now you have seen a Doctor about Antibiotics and that you are okay." }, { "id": 737, "title": "a couple of questions about periodontitis from worried patient", "dialogue": "kenny siu: hi, I am having serious periodontitis, and possibly the advanced type because I have loose teeth, suffering both physically and mentally.\n\nI don't want to bore you guys by going through all my thinking, but I have a lot of confusions and questions about periodontitis treatment and surgery\n\n1. Does the success of periodontitis treatment depend very much (or very little) on individual dentists or periodontist? or does it usually depend on the severity of the patient? Since in my country (non-US), the treatment and surgery charge for periodontitis could vary for thousands of US dollars because of different clinics and doctors.\n\n2. What are the main types of treatment and surgery for all levels of periodontitis? And what are the reasonable ranges of fee for periodontitis-related treatment and surgery? I don't even know the 'order' of fee (hundreds? one thousands? five thousands? ten thousands?? I don't know!! ) for periodontitis treatment / surgery\n\nI am not looking for the best bargains when something bad is already happening, but I might not afford to spend thousands more for the same thing because of different doctors and clinic, unless they will give different results.\n\n\n\nthank you so much for all advice and comments drmins: Hi, periodontal care can range between a simple scaling and a complex flap surgery with bone grafts.So does the charges.\nSo at first,we need to conclude on your periodontal condition and chose on the level of treatment needed.\n\nFor a given procedure, prices can vary SLIGHTLY between the doctors in the same region and its much related to many operational factors.\n\nHowever, ensure that you get the treatment at its earliest. Coz, periodontitis is a degenerative disease and prevention of further loss is of much importance in this treatment.\n\nKeep smiling..\ndr.mins kenny siu: drmins said:\n\n\n\n\t\t\tHi, periodontal care can range between a simple scaling and a complex flap surgery with bone grafts.So does the charges.\nSo at first,we need to conclude on your periodontal condition and chose on the level of treatment needed.\n\nFor a given procedure, prices can vary SLIGHTLY between the doctors in the same region and its much related to many operational factors.\n\nHowever, ensure that you get the treatment at its earliest. Coz, periodontitis is a degenerative disease and prevention of further loss is of much importance in this treatment.\n\nKeep smiling..\ndr.mins\n\t\t\nClick to expand...\n\n\nHi Doctor, I am not in India or the US. I am in Hong Kong, I have consulted different clinics and their prices could vary up to US 2,000 for the same treatment. I guess there are only two kinds of treatment possible for all kinds of periodontitis (non-surgery and surgery one)\n\nAs I said, I am not looking for the best bargain and it is not possible to go to every clinics, but I am worried if I can't afford further treatment and care if the money is used incorrectly.\n\nDo you think different doctors will vary very greatly for periodontitis treatment and surgery??\n\nThank you again. drmins: 1. At a given locality, there will not be a huge change in the rates as you said. \n2. Periodontal treatments can be a simple scaling, a root planing, a closed curettage,a flap surgery, a flap surgery with bone grafting etc.So, to comment about the type of treatment needed for your periodontal condition,we need to assess it first.If you have an intra-oral pic or and OPG x-ray image,kindly post the same. Once we assess it and conclude on the approximate treatment that may be needed,i can guide you regarding its rates.\n\nkeep smiling..\ndr.mins kenny siu: drmins said:\n\n\n\n\t\t\t1. At a given locality, there will not be a huge change in the rates as you said.\n2. Periodontal treatments can be a simple scaling, a root planing, a closed curettage,a flap surgery, a flap surgery with bone grafting etc.So, to comment about the type of treatment needed for your periodontal condition,we need to assess it first.If you have an intra-oral pic or and OPG x-ray image,kindly post the same. Once we assess it and conclude on the approximate treatment that may be needed,i can guide you regarding its rates.\n\nkeep smiling..\ndr.mins\n\t\t\nClick to expand...\n\n\n\nHello,\n\nThe deep cleaning fee quoted by my periodontist is equivalent to USD 5300 something totally, that include 4 times deep cleaning.\n\n(Do they mean deep cleaning for full mouth repeatedly for four times or full mouth repeatedly for 1 time, but to divided the process into 4 times? (each time finishing one quadrant of the mouth?) Which one sounds more likely????\n\nThank you again" }, { "id": 738, "title": "best treatment advice bad teeth", "dialogue": "nicholas myers: Hey everybody \n\nFirst time posting; just after a little guidance if anybody has any time!\n\nMy teeth are pretty bad due to lack of confidence and issues growing up and a lot of fighting with older brothers and just plain simple lack of dental care I am looking for a quick fix I don't think I could bare bracers for as long as they take and the head aches they give just got good job so can't be in pain or annoyed by bracers I'm looking for a month of bullshit max.\n\nI thought veneers but they are pretty bad anybody or any expert advice or any ideas are appreciate attached are some basic photos of my mouth no extremes to avoid bracers are out of the question Dentgr: As it seems you are young at age. So I would strongly advice you to do the right thing that you won't regret in the future. BRACES! you got nice teeth. I don't think that your orthodontic treatment will take sooo long. DONT do anything else because there's not a way to have a nice cosmetic outcome. drmins: Agree with Dentgr. The treatment of choice in this case is orthodontic treatment alone. This is not a good case for veneers. \nGo for the right thing." }, { "id": 739, "title": "EATING AFTER IMPLANT NO ABUTMENT YET", "dialogue": "seashellbeach: Had an implant done 2 weeks ago with a healing cap....meaning...implant WITHOUT gum covering over top. I see a healing cap visible and no gum is covering anything.\n\nMy question is, can I eat on this side and this area at this point?? (this is an upper left first-pre-molar, tooth #12)\n\nI read conflicting things online where they say, no eating on affected side for 4 to 6 months if you have an implant and visible healing cap visible.\n\nOnline says the \"eat mostly everything\" after 3 weeks is only applicable to those with the implant and gum covering surgery.\n\nPlease clarify when I can eat and what I can eat and after what time frame. My dentist office is closed for March Break and on day of surgery they only told me about care in the first 48 hours...not sure or maybe I didn't hear what they said about the upcoming months....\n\nIt is tedious having to chew only on 1 side of the mouth and I cannot imagine doing so for 4 months while I wait for the crown. thank you. Dentgr: I would suggest avoiding eating on that side for at least 1 month. After that period just be carefull not to bite hard on that side." }, { "id": 740, "title": "Full Teeth Extractions", "dialogue": "Toby: Hi I have had dental clearance to go in hospital for all my teeth being removed under general anaesthesia.\nHowever an X-ray shows that there are wisdom teeth still down inside the lower jaw !\nAs I will be having dentures made will the oral surgeon remove the wisdom teeth form the lower gums while extracting all the other teeth under general anaesthesia ?\n\nAnyone know I'd be keen to know the answer !" }, { "id": 741, "title": "Crowns past sell by date", "dialogue": "Bignige: Hi,\n\nI am new. I am terrified of dental treatment following a bad experience with a dentist when I was a child. I am now 53 years of age and when I was 18 I had 4 crowns fitted following root canal treatment.\n\nOne of the crowns has fallen out several times and the dentist has 'glued' it back in. Last time I went he told me that the tooth to which it is attached is in such a bad state that if it comes out again I will have to have the tooth out.\n\nAbout 2 months ago it came out and I have not dared go to the dentist as I am really scared of having the tooth out - not only that but today the crown next to it has come out too.\n\nI am scared because I assume that as the teeth are in the gum that the dentist will have to cut my gum open to get the teeth out - and when I was a child I had a tooth out and the bleeding did not stop for hours - I ended up in hospital and had to have my mouth stitched. It was so traumatic that I had to stay off school for 2 weeks!\n\nCan anyone tell me what will happen if I have the teeth removed?\n\nAlso, what will happen about the large gap in my mouth - they are the teeth to the left of the centre tooth - looks really bad as I am myself a professional person and the gap is obvious when I open my mouth!\n\nWhat may happen if I don't have the teeth removed - I believe that the nerves have been removed so there should be no pain - but is there a risk of infection etc?\n\nLastly, if I have the teeth taken out - what can be done to fill the gap (bridge?).\n\nI can't afford to spend lots of money on having implants etc.\n\nAny help much appreciated.\n\nNigel" }, { "id": 742, "title": "Need help- wisdom teeth extraction 4 weeks ago now pressure and hard area along jawline. No pain.", "dialogue": "Elaine S: My son had his wisdom teeth removed 4 weeks ago. About two weeks ago he said he had pressure along the jaw and into his ear. No pain. He feels like he needs to pop his ear but it won't pop. We just noticed when he clinches his teeth there is a hard area on the jawline compared to the other side of his face." }, { "id": 743, "title": "White squishy bump in extraction site.", "dialogue": "Jgloede710: Can you please tell me if this is normal? Large white squishy bump in extraction site... Looks almost like it was packed with something and never taken out. Tooth was extracted 2 days ago. Pain is tolerable with ibuprofen but is sore. I can't get back in to see my Dr until tuesday, which is 4 days away! Is this something I need to remove from extraction site???? Dr. E: Jgloede710 said:\n\n\n\n\t\t\tCan you please tell me if this is normal? Large white squishy bump in extraction site... Looks almost like it was packed with something and never taken out. Tooth was extracted 2 days ago. Pain is tolerable with ibuprofen but is sore. I can't get back in to see my Dr until tuesday, which is 4 days away! Is this something I need to remove from extraction site????\n\t\t\nClick to expand...\n\nusually this is just fibers of blood clot but in mouth the red gets washed out. I normally pick them out and let fresh blood into the site. don't worry" }, { "id": 744, "title": "Wisdom teeth holes please help!", "dialogue": "Nick5741: So I got my wisdom teeth pulled today (all 4) and one side looks stitched up but the other is completely open I can not even see stitching.. Is this normal? drmins: Its a much delayed reply from me. Its broken suture or stitch.I hope you have got it corrected" }, { "id": 745, "title": "help please", "dialogue": "Darkel: I am extremely poor and have next to no money. My wisdom teeth are really bothering me and I need to get them out. Could someone please give me instructions on how to remove them myself, cost-free? Thanks.\n\n-Dar kel drmins: Dear friend, \nIts not practical to get a wisdom teeth extracted by the patient himself. What is the issue you experience with your tooth now? Is it just a gum swelling around your teeth or the pain is due to a decayed tooth? Kindly post a pic.\nThe least cheap care you can give is warm saline gargle for a very temporary relief.\n\n(Don't be depressed about the finance. Ups and downs are a part of life.May God bless)" }, { "id": 746, "title": "Affordible and quality implants?", "dialogue": "Kateharp: 3 years ago I got a short implant that went bad. Fluid gathered in my jaw and a blister in my mouth (dentist said he'd never seen that before). It was removed and I lost $2,000 and was worse off than when I began because my jaw hurt all the time.\n\nRecently I went to the UCSF dental school (chair professor) and he recommended I do 2 implants (I have 2 missing teeth next to each other) because they don't do anything under 10MM and a longer implant will not be stable by itself. The cost would be $15,000 for 2 implants, bone graft and sinus life. I went to a different private dentist who said they were wrong and he did the successful implant for $4500 with no lift or graft.\n\nThis seems ridiculous that 2 people can have such opposite views in the dental industry! It's like the wild west.\n\nMy question is: Since there are so many implant manufacturers, how do I know which is the best and most affordable? A new dentist I visited recommended Hoissen. Do you any of you have an opinion? Everyone seems to have one brand they push, but I'm paying the money and I'd rather decide my own brand and go to someone who uses it." }, { "id": 747, "title": "Baby molar tooth and another painful cavity", "dialogue": "ieatglitter: So, my first molar on the bottom is a baby tooth that unfortunately has such a massive cavity that it needs to be removed. It causes me serious pain every other day or every few days. I will be getting it pulled within the next few weeks (I am in Paris for three months and the wait times here are horrible. The dentist wants the opinion of a specialist because he stated that it could be a difficult tooth to extract...\nBut, I have another concern. I have a few very small cavities...and he did an x-ray of all my teeth, but said none of them were big (except the one) Well there is an upper molar (second from the back) that is causing me some pain...like, it hurts but I can deal with the throbbing ache. He said the cavity was small but there is definitely a little hole in the side of the tooth. Can a little cavity really cause pain like this? It's kind of worrying me a bit. This is the second dentist I saw here in France and both of them say the cavity is small in this tooth and there is no infection. I will be getting it filled...but I would like a second opinion from people online who have dealt with small cavities and the pain. \n\nAny insight would be great, thanks!" }, { "id": 748, "title": "somebody help!", "dialogue": "trent: I'm new to this forum. I'm desperate. I had a wisdom tooth and a molar removed 5 days ago and I'm having horrible pain. I'm pretty sure it's dry socket. My dentist is closed for Christmas. Actually, all the dentists are closed in the small town I live in. Should I go to the ER? Do they have what's necessary to treat this problem? And... to further complicate things, I take suboxone(buprenorphine/naloxone) which s an opiate antagonist, so traditional pain meds won't work. Please help!!!!! DRAVG: go to the ER. you wouldn't know if they do have whats necessary unless you go. doesn't seem like you have many options." }, { "id": 749, "title": "What Kind of Anesthesia Do You Receive for Lefort Jaw Surgery?", "dialogue": "pacerboy9: Hi,\n\nI am having Lefort jaw surgery this Spring to correct an open bite and I was wondering what type of anesthesia you would normally receive? \n\nIn the past (for other surgeries) I have asked for (and been given) anesthesia through a mask (see pictures). I would much prefer this method as I HATE, and have a FEAR, of needles. \n\n\n\n\n\n\nIf there are any videos or experiences of the anesthesia experience for jaw surgery, please share them with me. I am very NERVOUS! \n\nThanks, \n\n- pacerboy9" }, { "id": 750, "title": "Bone graft not healing well", "dialogue": "Kinia: 11/14/2014 - I had tooth #19 extracted and gtr-nonresorable barrier as well as a bone graft put in. I was in pain prior to the procedure and was told hat a leaking root canal was causing the discomfort. During the surgery, I was told that there was an infection by one of the roots and that the doctor \"scraped it off\" completely off the bone. I was told that the entire procedure went perfect and according to plan.\nI diligently followed all post-op instructions. As soon as the next day, I noted stuff \"falling out\" of the treated area. They looked like tiny white/off-white stones. I called the office and informed the doctor but was told that it was normal.\n11/24/2014 - I had my 1 week post-op. I was told everything looked great. I complained about things falling out of the area but was told that it was only an insignificant fraction of what was put in. I complained that there was a lot falling out but was assured that I should not worry.\n12/16/2014 - I had my 1 month check up today and was told that the area did not heal as it should have and that it healed with a \"big indent\" and there was no specific reason for it. I asked if it was because I noted all those things falling out and the Dr. said no. He said that everything might have \"sunk in\" due to the infection that was there prior to the procedure. I was told to come back in 2 months after everything heals completely. He said he would do an x-ray and If the bone was not good for an implant, he would go in and re-do the graft.\n\nQuestions:\n1. What could cause a graft not to heal properly?\n2. Is it true that a pre-existing infection that he said he scraped-off could have caused the walls around the tooth to collapse?\n3. Is it a common procedure to re-do a graft after just 3 months of the initial grafting?\n\nI feel a bit uneasy about the situation and would appreciate your expertise and advise.\n\nThank you. Dentgr: grafting particles \"fall out\" when there is a gap. This gap allows micro organisms to enter the site and contaminate the grafting material. If graft is contaminated I would suggest removing it , let the area heal re-enter and regraft." }, { "id": 751, "title": "Clear 'jelly-like' substance in mouth after Wisdom's extraction", "dialogue": "DIG IT: Hi guys,\n\nI really want to know why I'm getting a clear sticky substance in my mouth. I had my bottom wisdom teeth removed almost 4 days ago & 2 days ago developed dry socket on the right side. I got an emergency dentist to fill the hole with some special stuff 1 day ago (some weird brown stuff), and soon after then I've noticed a thick, sticky, stringy, clear substance that is jelly-like and sticks to the back of my mouth.\n\nWhen I do salt gargles I can loosen it up and pull some of it out, but it keeps developing on its own again. I've been taking codeine (8 tablets per day since last night) & amoxycillin (3 tablets per day) in the way of tablets (as well as metronidazole twice a day).\n\nIf you have any idea why this is happening / how I can get rid of it, please comment below. This clear substance is also making it very hard for me to swallow.\n\nThanks for your time;\n\n\nDIG IT." }, { "id": 752, "title": "Upper Wisdom Teeth", "dialogue": "Akira: Hi, in the past year my wisdom tooth has been growing out slowly and once in a while causing some pain to my jaw as it is growing out and affecting the areas around it. However recently I decided to take a squizz though my mouth and feel around the area of the growing wisdom tooth.\n\nI had felt a small bump close to the tendon/tissue/gum part of my jaw. Took a look and it looked like this http://i.imgur.com/M9glUWN.jpg\n\nTook a close look and seems like the wisdom tooth has been rubbing against my inner jaw. However there is now pain in the area at the moment, there was a bit of pain about a month or two ago.\n\nIs this a type of infection? Pericoronitis? Please help!\n\nhttp://i.imgur.com/LQ3gEKQ.jpg" }, { "id": 753, "title": "Dry socket or normal healing process??", "dialogue": "Salpal: Hello! I had my two lower impacted wisdom teeth removed 3 days ago (11/25, today is 11/28) and they were stitched up and seemed to be healing beautifully, I couldn't see any blood clot but I also couldn't see any hole that would indicate dry socket. Before my surgery and for the past few days I was extremely paranoid about getting dry socket so I have tried to be extremely careful. Earlier today both sites still looked good, now on the right side there is a hole that I can clearly see into! It doesn't hurt but from what I understand if it is dry socket then it wouldn't hurt until tomorrow since the hole appeared at some point today, right? I called my surgeon and he told me that it was to be expected but I don't think that he realized how deep the hole is. It's hard to find any clear information about if a gaping hole 3-4 days after surgery is normal or not, please help?! I took a picture if that helps. Thanks!! Dentgr: Don't panic. That's not a dry socket. Seems like the stitches came off. Healing progress will continue..." }, { "id": 754, "title": "Prolonging a bone graft after extraction.", "dialogue": "corona0822: I have 2 separate issues with my teeth that I need worked on and only have enough money (right now) to get 1 situation done at a time. My 1st issue is a periodontal issue. I have serious bone loss behind my front bottom teeth and need a bone graft to build it up to prevent my teeth from falling out. This, considering its my front teeth is the highest priority. The other issue I have is regarding tooth #30. I had a root canal many yrs ago that \"failed\". I have 2 roots that seem to have an absess or infection below (wont know exactly until they go in there- theres no pain what so ever) and is very close to the jaw nerve (1 is large, the other isn't as big). My oral surgeon told me that in order for me to eventually have an implant I need to have a bone graft done at the time of extraction (note- apicoectomy is not an option since its too close to the jaw nerve). My question is would it be possible to have the extraction, clean out the socket and leave it as is for a year or 2 (after my front teeth are fixed) and then have the bone graft? Would the fact that I have bone loss already from the infection cause further damage and less chance for an implant later? Would the shifting from pulling the tooth out affect the grafting for the front teeth?" }, { "id": 755, "title": "Advice and Suggestions For Retained Baby Teeth", "dialogue": "carriej: Hi there,\n\nI am a 25 year old female, and I have 2 retained baby teeth. I believe they are called pre-molars on the bottom jaw, the exact same spot on each side. They are the teeth right before my two molars.\n\nThey have started becoming extremely sensitive and bothering me all the time. They have each been repaired multiple times, and regardless of my excellent oral hygiene I guess it's time for them to come out. They look fine and seem solid in there, but since they are bugging me he said its the best idea.\n\nHowever I have a problem. I have a disease called Wegener's Granulomatosis, so I don't have any insurance. I am extremely immune compromised (another reason he wants to take them out) I can afford to have the teeth removed, but the replacement options are crazily priced. I am sure it is worth it, but the price I was quoted on for implants was about $9000. I simply can't justify it. \n\nI know I will not wear a denture, so it's not even an option.\n\nWill there be any major concerns of just pulling them out and having a space? I am very upset to do that.. But I really don't see how there is any other option that will work for me.\n\nI am hoping someone can come on and tell me a magical solution... But I know that that's unlikely. Dr. Garrett Fiorenza: Pulling them and leaving a space has pros and cons. The pro is you get these teeth out that are starting to give you some fits. The con is you will have a gap in the position where the teeth used to be. This gap will allow the teeth behind these teeth to drift forward. \n\nIn my opinion, if you can't afford implants, get the teeth out and see how you do with having a gap. You will either not even notice the gap, or you will be annoyed by the space and look into saving up for the more expensive implants. Either way I think it is best to remove these teeth since they are becoming sensitive to you. Hope this helps,\n\nGarrett Fiorenza, DDS\nwww.fiorenzadentalgroup.com\nGreenwood, IN carriej: Thank you for the response!\n\nI guess I will just have them pulled. Funnily enough, they have been bearable so I am less likely to part with them until after the holidays.\n\nWill there be a soft spot there that will be jarred when eating hard food (nuts, crackers, etc), or will it be fine?\n\nMy dentist led me to believe that the implants must be placed on tooth removal, and that I would not be able to get them down the road if I decided to. \n\nI guess we will see what happens. Dr. Garrett Fiorenza: The area will be soft at first, but the gum will harden and you won't hurt it by eating. Without seeing xrays it's hard for me to comment, but you should be able to get implants down the road. As long as your bone looks fine now and you aren't waiting 30 years to get the implants.\n\nGarrett Fiorenza, DDS\nwww.fiorenzadentalgroup.com" }, { "id": 756, "title": "Cracked dead molar extraction", "dialogue": "Nill: Hi, I had a cracked dead bottom molar that was the most vile pain imaginable. My dentist pulled it and the wisdom tooth behind it. After the extraction The same one on the other side broke in half exposing the root and I'm in the exact same predicament. After asking my dentist to pull this side he instead gives me a referral to an oral surgeon to get other 3 wisdom teeth and the other cracked molar extracted. My problem is this I don't wanna go under but the surgeon refuses to operate unless I do. He will not do two separate appointments and it is very costly for anesthesia. I have already missed the appt and set up again to have this done. I have been on rotating trips to the Er and dentist only to keep getting reffered to this surgeons office where I cannot afford surgery. I'm in godawful pain and been on antibiotics for this on and off for two years. I'm constantly stressed out about dying from infection and even more about dying from anesthesia . getting all these teeth pulled is the main priority but I can't afford it and I feel my life is on the line. My surgery date is two weeks away but I am afraid I won't have the money and will be turned away again. What should I do please help. What if I was allergic to anesthesia what would the surgeon do Then? The staff at his office are annoyed by me and is almost impossible to speak to him in person. I'm gonna go there today in person to get ask them to send a release form to my insurance to pay for anesthesia.They refused to send this authorization form when I asked them over the phone. Sorry this is so long" }, { "id": 757, "title": "seven months after wisdom teeth extraction constant feeling of swollen gums and burning in gums", "dialogue": "tlcha: I had wisdom teeth extracted on left side upper and lower 7 months ago but because I had 2 fillings on the molars next to the wisdom teeth extrated then a root canal on one of those fillings right after. All this done in the past 7 months. Ever since I had the fillings done then root canaled it caused my gums to feel swollen, pressure, and burning in gums on that left side.\nI want to ask if this has happened to anyone else? after wisdom teeth surgery???? Must have been to much dental work for my body to handle on that side.Does anybody know why this might have happened?? If it is nerve pain will it ever get better? Dealing with this everyday makes it rough. I want to feel good again." }, { "id": 758, "title": "Do I need Frenectomy?", "dialogue": "ELA: I had my braces removed in May 2014 and a lingual retainer was placed. On Sept 8, 2014, I noticed that there was a small gap between my two front teeth, then on Sept 11, 2014, the gap became bigger. My 2nd upper premolar is also missing. According to my Dentist I need a Frenectomy. Before I had my braces, my two front teeth was kinda overlapping (since it came out as a permanent teeth.) So I don't understand why all of a sudden I need a Frenectomy. I went to 2 other Dentists and they didn't recommend the same. I attached some photos for your reference. Sorry for the not so clear photos. But I still hope you can help me. ELA: Note: All the other IMG-titled photos are current. Dentgr: I believe that the retainer is no longer bonded on your right central incisor. Should also check periodontal condition.\nIf you pull your upper lip upwards does the tissue in between the two incisors go white?\nIf yes you may need frenectomy. movemen: looks like frenectomy might needed to relieve the pulling of gums and eventually separating the two central incisors" }, { "id": 759, "title": "Knife edge ridge jawbone", "dialogue": "Anotherdavid: Hi all\n\nCan you Help my mum who I fear can't take much more. She has knife edge ridge on her upper jaw, possibly due to osteoporosis. The bone is so worn down in places filing down to flatten it is not an option. What are her options? With low bone density I'm not sure she could have implants and the mouth is so sore she can't wear dentures, therefore can't work or eat in public. So sad to see her like this. Please help. Dentgr: One option is having her denture relined with a soft tissue reliner.\nThis is kind of elastic material that won't press her mucosa against her knife edge ridge that's causing soreness.\nShe will though have to periodically repeat the procedure because these reliners harden after some months." }, { "id": 760, "title": "Infected Root Canal - Implant needed?", "dialogue": "happygirl0612: Hello,\nI am so confused about what to do with my tooth. \nLast year in April 2013 i had a root canal done on tooth # 30. I waited a little over a year to get a crown. In august 2014 i did a crown and ever since have been having issues with that tooth. First it started with sensitivity to heat and then after the dentist performed a bite adjustment, i started having sensitivity to cold which still continues to date. \nI went back and saw Endodontist there who told me that x-ray shows a possible infection on the bottom of the root canal and the only 2 options that i have are apicoectomy or implant. \n\nI read a lot about it and dont think apicoectomy will be good for me in a long run. I dont want to leave a dead tooth inside that is prone to the infection. I am young (29) and dont want to come to the same issue years later. So at this point i am considering an implant. \nI read a lot about implants and currently there are 2 that are on the market, titanium and zirconium. \nI would prefer a zirconium (metal free) implant and based on what i have seen so far, it seems to be a safer more natural choice. \n\nIs that possible that infection developed AFTER the crown was placed? Why is that? The x-rays taken before the crown dont show anything. \nWhat do i do now? Dr. Garrett Fiorenza: As far as the root canal is concerned, it is hard to say by just looking at these 2 xrays what has been going on with this tooth in the long term. It is unlikely that the infection happened after the crown was placed. If you waited over a year to get the crown chances are the infection was there and you just didn't have any symptoms.\n\nI would get a consultation with an oral surgeon to talk about the costs involved in getting this tooth taken out and replaced with an implant. Then compare that with the cost of an apicoectomy. You will find that apicoectomies are expensive, but not as expensive as an implant. The thing to realize is even if you get the apicoectomy then 10 years from now you could still need an implant. On the other hand, if you get an implant (which have a 96% success rate) chances are you'll have it for the rest of your life.\n\nNow, titanium implants are the standard right now. They have the longest track record and are very successful. I would go with titanium. Hope this helps,\n\nGarrett Fiorenza, DDS\nwww.fiorenzadentalgroup.com\nGreenwood, IN happygirl0612: Thank you so much for your reply! I know the cost is high for both, but my main goal is to find the BEST solution for my overall health and i am willing to spend the money needed for whatever procedure. \n\nIs it true that apicoectomy does not guarantee that the root canal will stay infection free for all my life and that is just the matter of time until it gets infected?\n\nAlso, even though titanium implants have been longer on the market, i read many positive things about zirconium implants. Why are they NOT more used by dentists? Are there anything i should be concerned about when it comes to them? Dr. Garrett Fiorenza: Apicoectomies can last your whole life. However, since you've already gotten an infection in that tooth after the root canal it lowers the long term prognosis. So in your case I would be willing to bet that at some point down the line that tooth will get an infection or other complication after you do the apicoectomy.\n\nDentists use titanium more because of it's track record. These implants have been studied and have long term success rates of over 90%, even going out 20-30 years. With the zirconium implants dentists don't know for sure how they will last long term. Just personally, if I were looking for the best option for long term success I would go with titanium since it has that long term success rate that's been confirmed over and over again. Hope this help,\n\nGarrett Fiorenza, DDS\nwww.fiorenzadentalgroup.com\nGreenwood, IN happygirl0612: Thank you so much for your reply! \nI do understand that titanium has a proven record for lasting a long time. However, aren't dentists concerned with what impact it may have on the patient's overall health? What about titanium corroding in the mouth or affecting your immune system and creating autoimmune issues?\n Its not just the matter of being durable and lasting, it is also so important to consider other long term effect on health and such. I want to have a tooth that not only lasts but also doesn't harm my health! To me that is probably even more important. \nI have read so many scary things online when people complained how titanium implants have affected their health negatively! \n\nBesides the durability, lasting and lack of research , do you have any other major concerns for ceramic implants? \n\nAlso, is there any test that can be done to prove that i am not allergic to the titanium metal, etc? \n\nI am guessing outside of just implant & apicoectomy, i have no other viable options, correct?\nthank you!! Dr. Garrett Fiorenza: No there's no negative effect the zirconium would have besides for a lack of track record. Remember though that titanium is inert and is perfectly safe, that's why doctors use it on hip and knee replacements. But if that is a worry for you then zirconium is a viable alternative.\n\nI'm sure you could contact a specialist to see if you are allergic to titanium, although titanium allergies are incredibly rare.\n\nYou could also have a dental bridge placed. This is a slightly older technology for replacing teeth. They would put crowns on the teeth on either side of the missing tooth, and put a fake tooth (just the top part, no root) in the space. They are a good option for replacing a missing tooth, but implants are far better.\n\nGarrett Fiorenza, DDS\nwww.fiorenzadentalgroup.com happygirl0612: Thanks so much for the info! \n\nI definitely dont want a bridge since it may negatively affect other teeth in the long run since they get affected. So i guess the only viable option for me is to have an implant. \n\nThe reason why i was concerned about getting a zirconia implant (outside of its short track record) was that i read they may have isotopes in them! That is really scary to me! Do you know anything about that? \n\nAlso, what can happen in the worst case scenario with zirconia implant, it breaks and it has to be replaced? Is that all that can happen? I read that they are just as durable if not more as titanium.\n\nthank you. Dr. Garrett Fiorenza: I'm not familiar with isotopes in zirconia implants. You're right the worst case is that it breaks and you have to get it removed and replaced. Dentgr: I believe there's a second distal root that is not treated.(i can see 2 lamina dura at the distal root). Check it with an endodontist before you proceed with other options. happygirl0612: Dentgr said:\n\n\n\n\t\t\tI believe there's a second distal root that is not treated.(i can see 2 lamina dura at the distal root). Check it with an endodontist before you proceed with other options.\n\t\t\nClick to expand...\n\n\nThank you for your reply! I happened to see an oral surgeon today who told me that implant may not be necessary and he also suggested to check with experienced Endodontist. He suggested to do a 3D scan that should show more the condition of the tooth. My symptoms are sporadic and mild and upon his exam today, i showed NO signs of discomfort. from time to time i feel sensitivity to cold. \nWhat success rate would a repeat root canal have?\nIs it same thing as epicoectomy or something else?\n\nthanks! Dentgr: happygirl0612 said:\n\n\n\n\t\t\tThank you for your reply! I happened to see an oral surgeon today who told me that implant may not be necessary and he also suggested to check with experienced Endodontist. He suggested to do a 3D scan that should show more the condition of the tooth. My symptoms are sporadic and mild and upon his exam today, i showed NO signs of discomfort. from time to time i feel sensitivity to cold.\nWhat success rate would a repeat root canal have?\nIs it same thing as epicoectomy or something else?\n\nthanks!\n\t\t\nClick to expand...\n\nRoot canal retreatment success rate varies. In your case ,if there's a missed canal, it's very high(about 95%). He will though remove the crown and post buildup to access the extra canal. In my opinion it's worth to give it a try. There's nothing like our own teeth!\nMolars like this usually have 3 canals. Under the microscope I've found up to 5!(in bibliography I've seen even 6 of them!)\nSo give it a chance.\nApicoectomy is a different procedure. Retreatment procedure is like the treatment you had in the first place.\n...apologies for my English but I'm not from an English speaking country...." }, { "id": 761, "title": "Impacted wisdom tooth, rotting seventh", "dialogue": "Krzysiek: Hello.\nI have a big tooth problem and I count on your help and counselling, Also it's really an urgent case. I'm not from an English speaking country, so I may not be able to use specilistic terminology while describing my case, but I think you can see everything in the pictures attached. \n\nI was directed to the facial surgery department to have my wisdom tooth removed. But after a quick glance at the x-ray which I'm also posting here, the doctor declared that she isn't going to remove my eighth tooth, although it's growing almost vertically, because the seventh tooth is rotten so badly, that it needs to be extracted first. She said that when the wisdom tooth fully gets out of the gum it will be able to compense for the lost seventh in its place. Do you think it's really possible? Can the croocked eighth tooth play any role in my mouth?\n\nMy situation isn't good, because my sixth tooth on the side is dead and it will soon fall apart if the whole work of chewing food is handed over to it \n\nWhat is your opinion? Do you really think there's no hope for my seventh tooth? And what if the surgeon only removed the part of the gum that still covers the seventh (making it impossible to bore in) and tried to treat the seventh tooth, leaving the eighth tooth still impacted. Do you think that can be a solution? Krzysiek: Is there really no advice for me? I forgot to mention I'm 20 years and I don't feel like losing all my molars on the right side yet Dentgr: I don't think there is a chance of wisdom tooth to move in the 7 position.\nI would suggest treating the 7 and 6 and maybe extract the 8.\nCheck the 5 as well. Seems like having a decay under the filling but it might be a panoramic artifact." }, { "id": 762, "title": "Full dental implants", "dialogue": "thetiggler: There are lots of different dental implants nowadays. When getting a full set of dental implants (both upper and lower jaw) which is considered the best? I am talking about things like all on four, all on six, etc. I am just talking in general as I realise everybody is different an not all patients will be suitable. LADentalclinic: When you say a full set of dental implants do you mean one implant to replace each permanent tooth (28 implants) with a crown restoration or are you talking about getting a denture that snaps onto implants? Nicolas: Yes, there are full set of dental implants. There are All on four, all on six and all on 8 dental implants. The best dental implant would be all on six because it is safer and a restoration can be placed even if one of the implants fails. All on four dental implants can cause jaw line fracture and there failure risks are high. movemen: four or six implants is all depends on bones available, arch configuration (oval, wide, long) and quality of bone. Also depends on what kind of prosthesis you are planning to get. The fixed type that secure in the mouth will require more implants" }, { "id": 763, "title": "Question about underbite jaw surgery?", "dialogue": "JasonXCV: I'm getting my braces taken off next week and while my braces have managed to straighten most of my teeth I still have an underbite at the front. I'm currently 19 and have lost eligibility for the surgery now and the only option I have left is paying for it out of pocket or letting insurance cover it. Can I still get corrective jaw surgery even if it might be years after I have my braces off? drmins: Dear Jason,do you have a pic for this case? JasonXCV: Unfortunately I don't have any pictures or x ray copies. I got my braces taken off today and the the only major thing still there is that under bite. Since I have my braces off now is there a possibility for me to get orthodontic treatment again to get prepared for the surgery?" }, { "id": 764, "title": "had a tooth pulled today have questions", "dialogue": "kaitlin4599: hello i had a molar in the bottom left side of my mouth pulled out today. they said it was a tooth plus a root tip it was the second to last tooth in the lower left side they also gave me stiches in my mouth i had tooth pulled yesterday around 4pm my question is this im using the gauze they gave me and after 8 hours my mouth is still bloody i am changing the gauze out every 45mins like my dentist said should i still have as much blood as i do never had stiches before at least not after having a tooth pulled when can i expect the blood to subside?\n\ni also took 4 ibuprofen today after my dental appt as i wasnt able to get to the pharmacy before the numbness wore off could this be causing the extra blood?\n\nupdate its now 2am and im bleeding more then i thought the blood also looks like its cawagulating or something the last slimy gooey blood i gently let fall into the sink with out spitting was the size of a quarter kaitlin4599: there lots of goopy chunks of blood in my mouth i cant really explain it" }, { "id": 765, "title": "$1500 out of pocket with medical insurance. Is this right? (wisdom teeth extraction)", "dialogue": "Marie D: Hi, my name is Marie. I need to have my two lower wisdom teeth removed. The oral surgeon that I visited me quoted me at $1500 out of pocket after my Delta Dental insurance pays. The practice is in network.\n\nI called the insurance and a representative told me that Delta covers up to $1250 for the procedure. I asked the doctor's office to break down the cost of the procedure for me:\n\n$650 first wisdom tooth\n$650 second wisdom tooth\n$750 anesthesia\n$700 for a biopsy on a little bit of excess skin that they're removing from my gums (according to them they're legally required to send it in for a biopsy).\nAnd the rest in administrative costs.\n\nDoes this seem correct or am I getting swindled? Marie D: Any comments will be greatly appreciated! Mina Pain: Marie D said:\n\n\n\n\t\t\tAny comments will be greatly appreciated!\n\t\t\nClick to expand...\n\nI am just a patient, but I have paid more than that to have teeth removed, so it is being done (especially by an oral surgeon or prosthodontist, cause specialists cost more) - than I would say \"fair price\" nycsongs: Hi, I had a molar removed in February. It cost me $308. I have Delta Dental.\nCheck your anesthesia options. Are you getting a general (sleep) which costs more? If you have a local (awake) anesthesia option that would save you some money.\nI've never heard of that biopsy add-on.\nRegards-\nJim jennifer sevin: my son had 4 impacted teeth removed by an oral surgeon and it cost $2152 before dental and medical insurance kicked in. The dental paid $1872 leaving me with a balance of $250, but they billed my medical insurance for the exact same amounts and said I owed $745 also. What I don't understand is how they can charge the mdeical insurance for the whole amount they charged the detnal if my dental paid 90% of the bill?" }, { "id": 766, "title": "Wisdom Teeth", "dialogue": "Callum: Hi,\n\nMy dentist recently recommended me having my wisdom teeth out, I am 21 years old and I have good hygiene.\n\nI was thinking I would try getting some other opinions before I go ahead with it.\n\nThere is absolutely no discomfort or pain,\nthere already half erupted but apparently there impacting into the jaw bone so they wont come through anymore.\n\nWhat are your thoughts?\nPictures are attached LADentalclinic: Wisdom teeth can be very difficult to keep clean and can be very susceptible to decay. Did your Dentist note any decay on your wisdom teeth? If you choose to keep your wisdom teeth for a while longer make sure you continue to get regular checkups. If you are unable to keep the area clean between your wisdom teeth and your adjacent 2nd molars, decay can occur which would jeopardize the 2nd molars. You definitely don't want to lose those teeth. Dr.Michael A.Blum.: Wisdom teeth is not to remove when they are healthy,grown in completely , positioned correctly and able to clean daily. There are difference opinion of different dentist regarding wisdom teeth extraction. jhonypeter: Usually, wisdom teeth get taken out when they are pushing on any surrounding teeth or are not coming straight up. This may happen when one's mouth is too small and doesn't have enough room for the wisdom teeth. (I think this is called impaction). Nicolas: There is no need to remove wisdom tooth if they are healthy and positioned correctly. Sometimes dentists suggest for extraction of wisdom tooth of they are not fully grown or erupted near the lower jaw. Since you are younger, its removal may not cause you much pain after surgery. Many dentists believe it's better to remove wisdom teeth before the roots are fully formed. jennifer sevin: DOn't know if I'm posting to the right category, but I have an issue with dental and medical insurance billing. My son had to have 4 impacted wisdom teeth removed this year. The dentist billed the surgery through my dental which paid 90% of the bill, leving me with a $250.00 balance. Then they billed the medical insurance for the exact same amounts, but medical only paid $990 of the procedure leaving me with a balance of $745. Is it legal for them to bill both insurances for the exact same amounts when the dental insurance paid almost the entire bill?" }, { "id": 767, "title": "Condylar fracture treatment", "dialogue": "Srinivas: Hi\nMy dear son had a condylar fracture on left side when fell down on his chin. \n\nWe had a CT Scan which showed a fracture, so we have consulted a snr.doctor who recommended not to go for any surgery but will heal with in 2-3 weeks by itself and recommended not move the jaw and stay on liquid diet.\n\nWe are fully not happy as this may result in future problems to my dear son. Please find below URL for images of CT scan as I was unable to upload the images. Please advice if we require to undergo any surgery or braces and let us know how SERIOUS IS THIS FRACTURE.\n\nhttp://tinypic.com/view.php?pic=2qa8itj&s=8#.U_bGZfmSzgU\nhttp://i61.tinypic.com/vzk10k.jpg\nhttp://i61.tinypic.com/2u9lgtg.jpg\nhttp://i61.tinypic.com/20qjede.jpg\n\nYour advice will be much appreciated.\n\nThanks\nSrinivas" }, { "id": 768, "title": "Need three implants! Can only afford one. Which one?", "dialogue": "nycsongs: I have 3 missing molars-\n#4 (upper right)\n#31 (lower right)\n#14 (upper left)\n\n-which I've put off replacing because of the $$$. I've decided to get one implant for now.\n\nBut which one?\nI'm thinking either the top or the bottom on the right side because that side is missing two, whereas the left side is only missing one. But which one? Top or bottom? Which usually lasts longer?\n\nOr should I go with the single missing molar on the left, and have at least one \"complete\" side for chewing?\nI just can't afford two, never mind three implants. Any advice would be appreciated. Thanks!\n\n-Jim DDSSAW: First: Replace #14-you do 80% of your chewing with your first molars and it will get you the most benefit for your money.\n\nSecond: Replace #4-This is from an esthetic standpoint. Patients can often see second premolars when they smile, so this would be my second option.\n\nThird-I WOULD NOT get and implant in #31 position. Second molars are rarely used and I don't recommend having them replaced with an implant. You may eventually lose #2 due to surpraeruption of your maxillary second molar, but that is not a big deal and you will never miss it. \n\nHope this helps!\n\nDr. Steve" }, { "id": 769, "title": "Extraction Site & Tissue Pain", "dialogue": "Mina Pain: I have had a lot of tooth extractions and dry sockets, so I am familiar with that pain. Exactly 1 week ago, I had a lower 2nd bicuspid and the adjacent 1st molar pulled. It was a difficult extraction and the root had to be split, removed and no stitches were put into the gums. Within 3 days I started experiencing pain that hasn’t stopped since. Sharp stabbing pain in the upper gum on the same side as the tooth extractions (I have no maxillary teeth) and sharp pain in the extraction site that feels like dry sockets. Due to the July 4th holiday, I went to the ER and they prescribed antibiotics, in which I am taking. On Monday, July 7th I returned to the dentist and told him of the intense pain, in addition to asking about the jaw bone that is still exposed. He told me that things were healing, I don’t have dry sockets and to use ambisol on my gums for the pain. Nothing is taking care of the pain! \n\nThrough much experience with extractions, I have never had this type of pain, but the dentist insisted this healing process is normal.\n\nSo I am hopeful to get some help here with understanding what is going on and these are my questions:\n\n1) Will tissue eventually heal over the exposed lower jaw bone?\n\n2) What is causing my maxillary gum tissue to have sharp intense pain?\n\n3) How long should I wait to see if the gum heals or at what point should I return to the dentist since there is no more follow up?\n\nThank you in advance for your time and attention." }, { "id": 770, "title": "Dry socket", "dialogue": "gthedentist: Hello to everyone. Recently i met a couple of dry sockets after wisdom tooth extractions and was worried if there is any relation to the immediate application of ice pack after the surgery. I have searched about the causes and this is not included so an experts opinion would be very helpful. Thank you in advance. LADentalclinic: Dry sockets are caused when you lose the blood clot that forms after an extraction. This is the first step in the healing process. A dry socket is exposed bone. Ways to prevent dry sockets are: For the first 36 hours after the extraction do not rinse and spit, smoke, drink through a straw, drink anything carbonated, or do any heavy lifting. Sometimes even if these instructions are followed you can still get a dry socket, particularly if you had very difficult surgical extractions." }, { "id": 771, "title": "Tumor in upper gums. Help!", "dialogue": "Krystle: I've come to find out that my mom has a tumor in her upper gums. When she had her wisdom teeth pulled she developed this bump. It's not painful and looks like if one side of her gums are largely Inflamed. She's actually had this lump for about 20 years now and she never thought anything of it. Over the years it has grown slightly bigger. She is finally seeing the oral surgeon and waiting on test results. Just wondering of anyone has heard of this or knows what it can be. Oral surgeon says it could be bone build up? Anyone waiting for test results knows that it can the longest and most stressful time :/ please help" }, { "id": 772, "title": "Chronic Gum Pain & Discomfort Following Frenectomy/Gum Graft from 2.5 Years Ago", "dialogue": "mymouthhurts: Hi there,\n\nI've experienced chronic gum pain where a frenectomy/gum graft was performed on my lower front gums for the past 2.5 years. I've seen lots of different dentists and doctors but none have been able to solve the problem.\n\nI was recently referred to the Academy of Laser Dentistry by the dentist who performed the frenectomy/gum graft. He recommended that I look into doing laser therapy. I am currently searching for a dentist who is knowledgable in this area in San Diego. I've contacted some ALD certified dentists in the area but they don't do laser therapy for gum pain.\n\nIf you feel as though you may be able to help me or send me in the right direction for this unique problem please let me know and I would be extremely grateful.\n\n History and potential factors for my chronic mouth pain:\n\n• I'm a healthy 24 year old male residing in San Diego, CA.\n\n• On Dec. 28th, 2011 I had gum graft surgery & frenectomy to correct receding gum line in Colorado.\n\n• On June 8th, 2012 (about 6 months after the gum graft/frenectomy surgery) I put a small (capsule sized) amount of MDA (similar to MDMA) in my mouth at a concert which made direct contact with the graft area. The chemical temporarily gave my mouth an unpleasant chemical burning sensation but went away after about 30 minutes. This may or may not be related to the pain I experience.\n\n• I've seen many different professionals regarding this issue with no luck in finding a solution or any real direction on how to solve it:\n\n• Endodontist: Concluded there was nothing wrong with the roots of my teeth in that area by conducting a cold test\n\n• Periodontist: Several Periodontists have looked at the area and said it looks normal and are not sure what the issue is\n\n• Neurologist: I saw Neurologists at UCSD who were not sure what the issue is or how to solve it\n\n\nSymptoms detailed description:\n\nI experience frequent mouth pain where his frenectomy was (lower front gums). The pain and discomfort feels like some type of nerve damage and is always changing, and can be intense, throbbing, tingling pain for more than 24 hours, or I can be free of most symptoms for up to 24 hours at a time. Most of the time, there is a dull, aching discomfort. It feels like a pinching sensation on the inside of the lower front gums where the frenectomy was, and sometimes feels numbingly painful, similar to being very cold without the temperature sensation. The area is sensitive to cold and hot water, and seems to go away during and immediately following chewing on food. Over the past 2.5 years the overall sensation has not increased or decreased in intensity outside of its consistent pain spectrum (although it fluctuates in intensity on a daily basis within the pain spectrum).\n\nHere's an image outlining where I feel the pain/discomfort.\n\n\n\n\n\n\nAgain, if you feel as though you may be able to help me or send me in the right direction for this unique problem please let me know and I would be extremely grateful." }, { "id": 773, "title": "Tourette's & OCD compulsion to grind & push on teeth", "dialogue": "apw623: Hi Everyone,\n\nDoes anyone know if there is a solution to my dilemma? I suffer with Tourette’s & OCD and have an intense compulsion to grind and push on my teeth. A few years ago I actually snapped my incisor tooth due to this and haven’t been able to replace it as I have been afraid of doing the same again. My dentist has suggested a bridge but I’m afraid that won’t be strong enough if I start pushing on it again. He says an implant may be risky as I could cause damage to the jaw bone if I pushed on it too much. I’m at a loss. Is there such a thing as a flexible implant? Or, is there some sort of material the tooth can be made out of so that if I push on it, the actual tooth will break instead of the implanted rod? Or any other options? Any advice would be greatly appreciated.\n\nKind Regards,\nApw623 LADentalclinic: You might consider wearing an occlusal or bite guard (sometimes called night guard) to prevent you from clinching or grinding which would protect your teeth. If you don't find a way to control your habit you will continue to damage your teeth and any restoration that you get to replace the broken tooth is likely to fail. apw623: LADentalclinic said:\n\n\n\n\t\t\tYou might consider wearing an occlusal or bite guard (sometimes called night guard) to prevent you from clinching or grinding which would protect your teeth. If you don't find a way to control your habit you will continue to damage your teeth and any restoration that you get to replace the broken tooth is likely to fail.\n\t\t\nClick to expand...\n\nHi LADentalclinic,\nThank you very much for your reply. Yes, I have thought about a bite guard, but I would be worried if I had the compulsion whilst I was out of my home and wouldn't be able to wear it. I've googled them after your suggestion though and see that you can get clear translucent ones which I didn't know about. I think I may get one before I have the implant to see how I get on with it. With an implant, is it possible to also attach some sort of extra support to the teeth either side?\nMany thanks,\nApw623 LADentalclinic: Not really, but implants are made out of titanium. It is an extremely hard and strong material that is also used for artificial joint replacements. Once it has fully integrated with your bone it should be rock solid." }, { "id": 774, "title": "How can you tell if your surgical exposure chain is broken? Please help!", "dialogue": "Larissa Salgado: I can't tell whether or not my chain is broken because i see where they attached it to my wire, and I see it through the little hole in my gum, but I don't see the chain across from point A to point B. Is it possible for the gum to heal over the chain, and make it not visible in some areas? Please help!" }, { "id": 775, "title": "Considering a Frenectomy", "dialogue": "Rohkey: Hey all,\n\nI'm 24 and I'm partially tongue-tied. It doesn't really affect me much and I never seriously considered having surgery on it, but with my last visit to the dentist I was warned that my frenulum may be starting to pull my gums down, risking exposure of the roots of my bottom teeth and other issues. I looked into getting a frenectomy and soon learned my insurance would not cover it as it is considered cosmetic, and as a graduate student I cannot afford to pay out-of-pocket. My dentist back in Michigan said he would be willing to perform it on me and write it up as a filling...but I have some reservations. I've been going to this dentist all my life but he's admitted to me he has only done this procedure once and never on an adult. Also he would be doing it with a scalpel and not a laser. Does anyone have any advice on if I should go ahead with it or perhaps suck it up and find a more qualified oral surgeon to handle it? I've read a couple horror stories where a simple frenectomy has caused permanent pain in the tongue/gums and also cases where the healing process goes awry and the frenulum comes back more restrictive than before. Any/all feedback would be greatly appreciated. LADentalclinic: This is a very simple procedure that takes 10 minutes or less, but i'm not sure that i'd want someone operating on me who has only done it once. You may want to wait until you can afford a more qualified dentist or oral surgeon. You may be able to appeal the insurance companies decision as well. This may require a letter from your surgeon. An electrosurgery unit is good for this procedure. It cuts and cauterizes the area at the same time which results in minimal to no bleeding. Rohkey: Thank you. As my dental insurance is only in Michigan (I live in Atlanta now) and I'm only in MI for two-three weeks out of the year, I'm going to ask my dentist if he thinks I can wait a year to have the surgery. If so, I'll see what I can do about the insurance and finding a more qualified physician. LADentalclinic: Waiting another year won't make a difference. Just remember that the actual procedure wont be as bad as it seems, so you don't have to be overly nervous. Best of luck to you." }, { "id": 776, "title": "Given the wrong dentures!!! Help", "dialogue": "Gnome92: I went to go and be sedated and have 12 top teeth out today and a immediate denture put in. I got in the chair ready to go needle at the ready when the dentist noticed the denture didn't look right to what I was having done. I was having 2 teeth saved. One either side. The denture only had 1 gap. The dentist said it wouldn't fit my mouth. 1 of 3 things has happened:\n1)the man that made them used my impressions but some one else's notes meaning the wrong teeth made\n2)the man that made them jus completely messed up spectacularly \n3)my original dentist have give me the wrong teeth to take to the clinic to have it done \n\nMy question is: I am heart broke I have never cried so much in my life it took a 5 month waiting list, me booking a wasted week of work, my mum losing a days pay from her work to look after me, sorting out child care for my \ntoddler and A LOT of distress on my part as I said before I'm heart broke. \n\nPlease help what would people suggest I do. Do I have any grounds to sue them? Or take any legal action at all. I'm so upset that I should have new teeth now but I'm sat here crying with my bad teeth still LADentalclinic: Wow. That's too bad. I'm glad they discovered that it was the wrong denture before they removed all of your teeth. That would be even worse. How long did they say it would take to make the correction? I would think that you would at least be given a discount on the price of the denture." }, { "id": 777, "title": "Implants", "dialogue": "Guest: I have a three tooth bridge that came off because of decay. Upper left side,molar already missing. Now I have 4 upper side teeth missing. On one side of the gap is a bad wisdom tooth and on other side is a tooth with a crown. Can 2 implants support a Bridge? Can mini implants be used on upper jaw? LADentalclinic: Can two implants support a bridge? Yes, but whether implants are an option for you will depend on several factors, including the amount and quality of bone in the area. To really learn your options you will need to schedule an appointment for a consultation with a Dentist who does implants. Oral Surgeons and Periodontists specialize in implant placement." }, { "id": 778, "title": "Implants or Bridges ?", "dialogue": "dentalguy: I have my four front teeth broken , two central incisor , one left lateral incisor and one left canine ........now I am confused whether I should opt for an implant or go for a bridge. Please help. The doc says that if you opt for bridge then the bridge would be given a support of 2 or 4 natural teeth which would be filed to smaller size. And for implant , three implants would be done and 4 crowns would then be placed on those implants. What would be better for me? I am really really confused and messed up. RajatSethi: I think you have to go for implants.With the help of a good dentist you can implants your teeth.Also a good dentist help you in this case.So it will be better for you to consult to a good dentist..." }, { "id": 779, "title": "Dental implants in Mexico???", "dialogue": "NaomiMacLean: Can anyone recommend a good dentist in Mexico for a dental implants?\nI know there's a number of horror stories online; so yes, there's a lot of dentists to avoid. But I've also heard some great stories of dental treatments in Mexico. Can anyone share they're experiences? Jennifer Shaw: Hello Naomi, there are a lot of good dentist in Mexico that can give you great quality dental implants for a cost-effective price. Border cities are targets for dentists who are looking for different kind of customers, most of them Americans.\n\nI had extensive dental work done in Los Algodones with a help of a medical tourism called PlacidWay. I had 5 teeth extracted and 3 implants that included bone grafting. I was able to saved money and was really happy with my implants, which is 3 years old right now and still looking great. If you are concerned with the qualifications of the dentist, or having troubled finding one, then a dental tourism provider must be a smart choice, specially for first timers. If you want to have a list of trusted dental clinics and dentist in Mexico, you can contact the provider that I used: info@placidway. com. Good luck to you!" }, { "id": 780, "title": "No wisdom in extraction", "dialogue": "Joshua: On April 3 I had my two wisdom teeth pulled out on my right side. The top extraction has no complications and is in the appropriate healing stage. As for the bottom tooth, this on was slanted in my mouth and was sawed out. The tooth came out in pieces. \nWhen I got home I looked at the extraction site and noticed a white pointy object below the bottom wisdom tooth's pervious location. I assumed it was just a stitch at first. \n The next day I looked at it again because I was feeling some sharp rubbing my tongue. I inspected the pointy piece and assumed It was a piece of the tooth that was left behind. I finally got to get back to the dentist today and he told me that it was bone that had fractured and poked through the gum. The doc cut the bone and now I'm feeling relief from the pointy object but I'm wandering how will the second hole on the side of my gum about as big as a pencil eraser is going to heal. There is a stitch over the bone but the bone is slanted and a blood clot is on the side of my gum. Will the heal back to normal? LADentalclinic: The human body is an amazing thing. It is not unusual to have bone chips after an extraction, but most people heal with no complications. Having a suture over the extraction will help. If you do notice anything that seems unusual you can schedule a follow up appointment." }, { "id": 781, "title": "Secondary wound closure/healing", "dialogue": "Jerry: 5 weeks ago i had a small growth removed from my hard palate by a local periodontist. It was sent away for biopsy and came back as a benign epithelial hyperplasia. It was removed by excisional biopsy and allowed to heal by secondary closure. After 5 weeks I now have a larger and firmer \"knot\" where the biopsy was taken. This has me slightly concerned. Is this likely the scar/healing process or should i go in for a second look? How long should I wait for healing/swelling to subside. Thanks for any info." }, { "id": 782, "title": "Extraction of Root End Filling Material", "dialogue": "Divya: I had a root canal on the upper front incissor and after that an apicoectomy was done and MTA was filled at the root end. But after this tooth is really paining. If I extract the tooth will MTA also come out. I want to get rid of MTA." }, { "id": 783, "title": "Extractions after TMJ meniscectomy", "dialogue": "Maddison: I had a meniscectomy 13 years ago on my left TMJ. I have had no problems with it so far and am still pain free. I have a tooth (36) that is crowned but now has decay under the crown and it needs to be extracted. I have one dentist who is happy to do it and one that will not touch me and has referred me to an oral surgeon. Do you think a GP dentist should remove it or an oral surgeon?" }, { "id": 784, "title": "Desperately searching for Steri_oss 3.25mm External Hex Attachment", "dialogue": "DMABR: I am a former dental implant patient who is DESPERATELY searching for a replacement piece, as I am having several autoimmune problems, as well as other health problems due the piece that I have currently. My dentist cannot locate this piece and has been searching for months, so I am trying here on my own. This is what he wrote on the paper that he gave to me: Nobel Biocare, 18-year-old Steri_oss implant, 3.25 mm diameter External Hex Attachment. If anyone here can help me, steer me in the right directions, give advice or point out a forum that would reach a wider range of dentists, I would appreciate it more than you can ever know. Thank you." }, { "id": 785, "title": "Had a crowned tooth snap below the gum line.", "dialogue": "MrMan99: Hey guys,\n\nI have an emergency root canal done in Iraq around 2006ish. When I finally got home to the states they crowned the tooth. About 2010 the whole side of my face blew up, it looked like I got beat really bad. I even had a black eye. I immediately went to the dentist. The dentist said he couldn't find anything wrong with my teeth and that he would prescribe antibiotics, but most likely it was a bad sinus infection. The antibiotics worked, and the pain stopped. Fastforward to yesterday. I was chewing some food and my whole tooth just slid out of my gum . I didn't feel any pain, it still doesn't hurt.\n\nHere is a picture. Do you think there is anyway to save this or do I just need an implant?\n\nP.S. Dark spot on the tooth seems to be metal, not rot. I actually can understand why it fell out? I have some Macro lenses if you need and extreme closeup of the tooth. Libra: crowns may fall off due to lack of cement, imoroper fit or very small amount oof tooth strusture remaining to hold the crown.\nu cn temporarily save it by applyng adhesive materials on crown or ur dentist may re-cement it if it is still in proper condition.. otherwise go for a new crown or an implant BilboSwaggins: Take it to your doc. Like Libra said you may be able to save it, but honestly if you want to just take care of it the right way and never worry about it get get some dental implants. I'm sure it'd save you any future headaches... After you recover from the surgery of course. Dental Implants Honolulu" }, { "id": 786, "title": "Tongue Stitches?", "dialogue": "JJ7: Hi,\n\nAbout a year ago, I burned my tongue (Literally from smoking a tobacco pipe one time, and it was the first time I ever smoked! And has been the only time since) somehow a piece of the burning tobacco fell onto the tip of my tongue and burned it. Ever since then I noticed the tip of my tongue actually had a tear/ slight piece missing, I can't believe this could happen, I thought for sure it would heal by now, but it has not and there is a slight rip in the tip of it and I cant stand seeing it. Is it possible to have an oral surgeon or dentist stitch this to mend it? I know this isn't an ordinary situation, at least not that I'm aware of. I really just want to have my tongue without this nuisance. I don't think this was there before the incident, or that I just noticed it when burning my tongue, does anyone else have slight tear/gap in the very tip of tongue to the bottom part of the tip? It is mostly noticeable when I move my tongue, I can see it. Insight is greatly appreciated.\n\nThank You." }, { "id": 787, "title": "Opinions on my lower left Wisdom tooth.. extraction booked for Friday morning! :(", "dialogue": "MrBear5587: Hey guys and gals,\n\nJust wanted some thoughts really on my lower left wisdom tooth, which is due for extraction on Friday.\nTo cut a long story short, I'm 26 - hadn't been to the dentist for about 12 years to him retiring, and my own stupidity in not getting a new dentist. Had known I needed to go and get my teeth sorted for around 8 years.. yet I procrastinated.\nDidn't finally go until September last year for my initial appointment/checkup. Needed 2 extractions and 7 fillings. (Prior to this, had only 1 filling from many years ago). Over the last few months, I've been a couple of times and had everything done except the final extraction (lower left wisdom tooth). I've been putting it off because I'm terrified.\n\nI can't put it off any longer, the appointment is the coming Friday...\n\nPictures aren't majorly clear, but the inner side of the tooth, which can't really be seen is actually slightly below the gum-line. I'm slightly worried that the dentist won't be able to grip the tooth. I had a lower molar pulled about 3 months ago (not a wisdom tooth), took around 6 weeks to heal, I'm guessing this will take longer - will I need stitches?\n\nDoes this look like it will be a trouble-free extraction? Plan is for it do be done only under Local Anesthetic.\n\nCouple of pictures below. Thoughts would be appreciated.\n\n\n\n \n\n \n\nThank you. MrBear5587: Well didn't go to plan, although the Dentist is excellent my tooth isn't numbing or budging very far..\n\nDentist couldn't remove the tooth. Had absolutely loads (at least 12 shots) of anaesthetic, tooth wouldn't numb. Shooting pain throughout my jaw as soon as she started to rock it side to side.\nTried for a good 30 minutes. Practically no movement in the back roots apparantely and the tooth is infected.\n\nI've got to see an Oral Surgeon, in March unless I go to hospital (which I'm not), to have it removed.\nApparently they will cut down the side of the gum around the tooth and possibly end up removing some bone.. sounds fun.\n\nI've been given some antibiotics to clear up the infection.. Metronidazole 200mg & Amoxicillin 250mg (5 day course). Not entirely clear whether I take them now, or wait until March, so I've just finished the course before I see the Surgeon. Will probably speak to the dentist later to clarify.\n\nAlso, now because my tooth is loose, it feels higher when I close my mouth (so it now actually touches the top tooth). Whilst I'm still numb, I'm hoping that it will settle down, as any pressure on the tooth causes immense pain else I won't be able to bite.\nNumbness wore off about 1:30PM, first shots were around 11AM. Can't close my mouth properly and jaw is pretty sore, but it's manageable.\nAbove all, I'm just really annoyed with myself. I've not been able to use this Wisdom tooth for atleast the last 10 years. Why didn't' I get it sorted?\nThe other lower wisdom tooth ended up having a very large filling - no problem, I can use it now. If I'd have gone sooner, that would have been a small filling, then the left one that was attempted to be removed today could have been saved.\n\nI knew I needed to go, but kept putting it off.\nHindsight is a wonderful thing, eh?!" }, { "id": 788, "title": "possible mandibular torus??", "dialogue": "clayc84: hello everyone new here just a question i have. forgive me if its been answered somewhere else. I have had a bony growth under my tongue near the salivary gland for some time now. from what ive researched it seems to be a mandibular torus or something of that sort. i have an appt at the dentist in 2 weeks. just trying to get some insight on it before i go. any info would be greatly appreciated! ive attached a pic of the area in question." }, { "id": 789, "title": "pregnant patient with unilateral condylar fracture", "dialogue": "abih: A 40-year-old female patient is in second trimester of pregnancy presented with RTA complaining of pain and limited mouth opening, on examination occlusion is disturbed, radiograph reveals intracapsular condylar fracture on left side ,\n\nA, what would be your management plan for this patient? Libra: As the patient is pregnant, we should try to go for a non-surgical treatment. But i think sugrery will not going to cause any harm but we should be aware also.\nso start with painkillers and anti-inflammatory drugs.\nfor limited mouth opening, do jaw exercises.\nbut these procedures will only treat the symptoms.\nso if possible, wait for the pregnancy to concede.\nthen go for condylar surgery." }, { "id": 790, "title": "had tooth extracted today, question", "dialogue": "jayC: Had an oral surgeon extract what would be labeled tooth #4 today as it was broke off at the gum line. Initially I went in Wednesday and he had a hard time getting the root out saying it was \"really in there\" and then saying I would need to be put to sleep to get it extracted because my bone density was so strong that more pressure would be needed. Since no one was with me I was scheduled to come back today. They put me to sleep and did it, seemingly everything went ok, upon waking up I asked about it and they told me it was still difficult to get out.\n\nI've noticed though that the tooth next to the one extracted is pretty sore and swollen around the top and it looks like it has been pushed back a little bit. It has me a little concerned. Is this out of the ordinary? I hope that it's normal and everything will be normal once it heals.\n\n\nThanks." }, { "id": 791, "title": "Soft Tissue Pain", "dialogue": "OldRanchHand: I had my back molar removed in early August and developed a dry socket. Everything finally healed by the end of the month. However, just last week, I had a piece of hard candy in my mouth and without thinking bit down to break it right on the spot where the molar was removed. It didn't break the skin, but now the soft tissue and gum surrounding the old extraction site is tender and sore. There is no swelling that I can discern. Is this anything that warrants a return trip to the dentist, or is it normal for an extraction site to still be a bit tender when biting something hard several months after the tooth was removed. There is no pain unless something presses the soft tissue where the tooth used to be. Apologies for the long post. Hope I explained myself OK." }, { "id": 792, "title": "Is implant really necessary?", "dialogue": "jassie628: Hi, \n\nI just had my lower left end molar removed. My dentist advised me to do an implant in order to prevent the upper molar from overgrowth and eventual loss. I am in two minds as I am worried about the risks of surgery and would like to know if it is really necessary to do the implant. Thanks for any advice. danielhermann: hi jassie628\nImplant is necessary to prevent overgrowth.Dental implants improves a quality of life that is much more comfortable and secure than the lifestyle endured by those with fixed bridges or removable dentures .Dental implants eliminate the day-to-day frustrations and discomfort of ill-fitting dentures. They allow people to enjoy a healthy and varied diet without the restrictions many denture wearers face. With a sense of renewed self-confidence & the chance to speak clearly and comfortably kellogg9: I'd recommend it. A family member has it and it has changed their life tremendously. David Smith: Advances in technology and techniques have significantly improved the patient’s dental implant experience.Most patients are comfortable with this procedure and they experience confidence in smiling and eating!" }, { "id": 793, "title": "2nd Last Lower Left Molar Extraction - Benumbed,Stiff,Hard Tissuses!!", "dialogue": "Hani Hijaz: Hello to all forum mates!\n\nI am facing a problem after the extraction of the above mentioned molar.The problem is that the skin inside area right infront of the molar extraction place has become benumbed,very stiff,little swollen and as tissues and nerves are so stretching and pulling till the ending on the top of the lower lip right starting form the beneath.\n\nI am so upset to think whether this will be cured or not as it is more than 25 days and this\nsituation not arised after trhe extraction but just after a day when i undergone a hard and\nsevere pain in the said molar.\n\nThe detist has been saying that this will go with the passage of time and thus no medication is needed as this happens mostly as the nerve out there is compressed or need growing thus to take just vitamins for its quick healing.\n\nPlease advice and how to get rid off this stiffing and benumbed of the nerves or tissues.\n\nLove to all forum mates and God Blessings!\n\nHani Hijaz\nNewbie to Dentistry Forum" }, { "id": 794, "title": "Hydrogen Peroxide", "dialogue": "MartyD: What do you rinse the socket with so that you can visualize it better? I have been using saline but have a colleague who uses Hydrogen peroxide and swears by it. Is that acceptable? marrkarnell: Hydrogen peroxide might be too acidic that may cause a itchy or stingy feeling. That's quite harsh. You think? kellogg9: You can try Hy. Peroxide but i will bet good money after a few rinses your gums will be sore and it will keep getting worse. Seems like you should only use peroxide maybe once every 3 days or at least then water it down from the 3% level u get from local stores" }, { "id": 795, "title": "recovery time GA vs local", "dialogue": "dcPress: So, which type leads to less pain and a quicker recovery. \n\nIn other words, is allowing the Dr. to put his foot on my chest and pull beneficial or is it better if he takes his time since I'm awake?\n\nThanks,\n\nJim" }, { "id": 796, "title": "2 tooth extractions, tons of pain, please help", "dialogue": "coco_madam: Early today I went to a new dentist for the first time since I moved to PA from NJ. I have a really bad cavity, and was in a ton of pain. I ended up getting my TWO back molars extracted, and then after they were done I asked I realized the dentist hadn't given me anything for the pain. I asked one of the the nurses, and she said no, so then I tried to asked her if there was anything I could do at home, to help with the pain, (such as heat or cold, or what OTC would be best) and she cut me off and start barking \"NO NO NO! just take what you would if you had a headache. NO NO NO!\". I traveled about an hour and a half there, so when I got home and the Novocain wore off, I was in severe pain. I tried taking two aleve, no help what so ever. My Fiance called the dentist back (because i was literally hysterical with pain) but the nurse said the doctor left already, and that I would have to go to my primary (by this time it was 4PM, and there was no way I could get in) or go to the ER (which I'm not doing because I have a genuine fear of hospitals, and I dont feel like having to sob infront of everyone in a crowded ER). \n\nI keep trying to nap it off but I keep waking up every 10 min. from the pain, and It's still bleeding like crazy, & I'm not sure if thats normal.\n\nIs there anything that may help with the pain at home?\n\n& is there anyway I can make a compliant against this office. The paper work I signed before the extractions indicated that I would receive meds. for the pain. & they even asked me for my pharmacy information before hand. They were incredibly misleading. & in no way, shape, or form would I have gotten BOTH teeth pulled side by side, if I knew I would have to sit here and suffer." }, { "id": 797, "title": "Extraction of crowned/bridged teeth?", "dialogue": "ouchie mowchie: I am in declining health, and can no longer keep my upper dental work clean enough to be comfortable.\n\nI have about 4 to 6 adult teeth in my upper mouth (I never had the seeds for most of my adult teeth) and I have one big piece of bridgework that covers the top of my mouth with of course the adult teeth as the anchors.\n\nI have read that crowned teeth are extracted with tooth and all at one time. However this is not possible in my case.\n\nTo remove these teeth that have been filed down for the bridge work, would it be more complicated and expensive to remove them as a regular tooth? or not?\n\nThanks for your replies." }, { "id": 798, "title": "Wisdom teeth and light headedness", "dialogue": "rocksolid: So I have been lightheaded for over a yr. I have been to every doctor and everything is normal. I found a website where people felt the same way I do and when they had their wisdom teeth removed they felt better. I have 3 wisdom teeth, 2 on the bottom and one on top. They do not hurt me but the one on top is going into my nasal cavity. Could this be causing my light headedness? Should I have them all removed?" }, { "id": 799, "title": "Titanium dental implant and bone healing", "dialogue": "MayaT: I'm a 24 years old girl.\n\nI about a month ago I had 4 molar teeth removed in my lower jaw as they were completly rotten. I would like to have fixed Dental Implants put in their place.\n\nFor now there is only empty place were these 4 teeth were and I did not put any bridges or dentures in their place.\n\nI would like to know how long it would take after the removel of the \nteeth before the bone structure starts to shrink and how long I \ncan wait before I must get the fixed Dental Implants?\n\nEconomically I can't afford implants right now \n\nI spoke with a local dentist and he said that it usally takes a year before the healing begins and becouse I'm that young there is no need for me to be in a hurry.\n\nIs that true or should I be in a hurry???\n\nI can the send x-ray image to whomever wants to see it" }, { "id": 800, "title": "Fistula?", "dialogue": "Wafflesown: Hello, I had my wisdom teeth removed quite a few months ago, and I was wondering if I could possibly have some sort of oromaxillary (oral maxillary, or whatever) fistula that's not visible, as I've been suffering from a bit of jaw tightness, pain, aches in my teeth as well, and a bad sinus infection? Like, could it be just past the gum line? I went to the dentist's for an exam the other day, and I asked her to check the extraction sites, which she said looked fine, so I neglected to ask her about the fistula possibility. Anyway, I dunno if anyone has any experience with fistulas, or if they'd be able to help me, but I'd love it if you could. \n\nPlease, I need help; don't ignore me if you can help it. danielhermann: Hi,wafflesown \noromaxillary fistula may develop as a complication of removing a tooth, or from infection or trauma.Sometimes the roots of a tooth are so close to the bone under a maxillary sinus that the bone is damaged when the tooth is removed. This can open a passage between the mouth and sinus.Before surgery, you may have an imaging test, such as a computed tomography (CT) scan to help the doctor plan your surgery.A surgeon may choose one of several techniques to close the fistula.Sometimes a surgeon will place a piece of medical-grade foil over the opening and then stitch the skin flap over the foil.You probably will have general anesthesia, which means you will be unconscious during the operation.doctor will prescribe antibiotics to prevent infection and a decongestant to keep the sinuses clear. You probably will take these medicines for a week to 10 days.given a list of precautions to follow to avoid smoke, blow your nose, or suck on items such as straws, hard candy, or ice. A fistula can cause chronic inflammation or infection of the sinus.In some cases, a very small fistula may be treated without surgery. A dentist or oral surgeon may apply gauze or another product over a blood clot that forms in the hole left by the extracted tooth. The gauze stays in place for a few days to help the wound heal." }, { "id": 801, "title": "Natal teeth?", "dialogue": "Ewood1985: Two weeks ago I had a lovely baby boy! As they were cleaning him up I heard the nurse exclaim he has TEETH! Yep my baby boy was born with natal teeth. It's his two front lower teeth, at birth they were not fully emerged from the gum. They were loose under his gums and I was informed they may need to be pulled as they can be a choking hazard. They had not erupted when we left the hospital nor at his check up, so the pedi decided we did not need a referral to a pediatric dentist. They have since erupted and are still semi loose but not so loose that I worry about them coming out just yet. \n\nI have found very little info on natal teeth and my pedi doesn't have a whole lot to say about it. I want to avoid having them pulled if we can, and so far they don't seem to hinder his ability to nurse ( not entirely pleasant for me though). \n\nI'm wondering if I should just go ahead and try and find a dentist who will see him. I just want some info I turned to dr google (not a fan of using google in place of real medical/dental advice) and cannot find anything useful. Would x rays show how well the root is developed and give an idea if they need to come out? Also can they become more sturdy in the mouth as he gets older? He doesn't seem in any pain and eats very well. \n\nI had no dental care as a child and now suffer because of it I don't want my children to have my oral problems I'm just not sure what to do not do I want to subject my 2 week old to having teeth extracted if its not truly needed. MartyD: You should take him to see a Pediatric Dentist. They are well trained to deal with natal teeth and by starting the baby in his new dental home you can avoid all the problems you had as a child. The pediatric dentist will take an occlusal to determine the root length.The Xray and the mobility will determine if the tooth needs to be extracted. It is possible that the there is enough root development to allow the teeth to become more anchored. No extraction should be performed on a child less than 10 days due to Vit K issues but since your child is older you should be safe. Also there is a risk of residual tooth formation and a need for a second procedure. At any rate, I would not avoid going to the dentist. At this stage the baby has no memory and the procedure will be more difficult for you than for him! marrkarnell: The pediatric dentist might do some xray before he performs such extractions. It's quite a hard job, i guess, because the gums of your baby is still soft that the dentist might be careful in performing." }, { "id": 802, "title": "What is the difference between a simple extraction and a surgical extraction?", "dialogue": "b11_: What is the difference between a simple extraction and a surgical extraction? danielhermann: Simple extractions are ones where the tooth is grabbed by forceps and the tooth is extracted with no complications.\nA surgical extraction is when drilling is necessary to remove the tooth or tooth is removed with complications like extensive decay , curved root etc. marrkarnell: Simple extractions are performed on teeth that are visible in the mouth, usually under local anesthetics, and require only the use of instruments to elevate and/or grasp the visible portion of the tooth. Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line or because they have not erupted fully." }, { "id": 803, "title": "Detached gum after wisdom teeth removal?", "dialogue": "amedina: I had all 4 of my wisdom teeth extracted about 8 days ago and in the bottom left of my mouth, the gum near the second to last molar all the way to the back of my mouth isn't attached via stitch or anything to my teeth at all, unlike normal gum tissue. Meanwhile in the same exact spot on the right side, the flap of gum tissue is attached to my teeth and rest of gum ( was via a stitch until stitch fell off) and isn't as loose at all. The gum tissue is very sensitive and not attached. Any and all info or tips are very appreciated thank you.\n\nI will be going back to the dental office in a little less than 1 week from today, but i don't wanna wait that long to ask my dentist(he told me to just keep the spot clean and that's it -_-) thanks\n\n\nalso, when i wear my retainers at night a part of the retainer touches the unattached and sensitive part of the gum tissue." }, { "id": 804, "title": "Partially impacted wisdom teeth damaged teeth in front. What to do?", "dialogue": "Ascendant: The wisdom teeth in my lower jaw are partially impacted and have both pushed into the teeth in front of them. When I consulted a dentist last week about them, she said I had two options:\n\n1. Get the wisdom teeth pulled (she couldn't, I would need an oral surgeon), then see what needed to be done on the teeth in front of them. She said with how far the wisdom teeth went into those teeth and with how close to the gums that I would most likely need a root canal and some kind of crown with an extension (I think that's what she said, but not 100% positive). She didn't rule out the possibility of getting them filled, but said that I would probably need a root canal and the other work and that it would be very costly.\n\n2. Since the wisdom teeth themselves are fine, pull the teeth in front of them that are damaged, then have work done to try to pull the wisdom teeth up to the other ones. Though she said this would be cheaper, until I could get the wisdom teeth pulled up to fill that gap, I would have a large gap in the back that would affect my chewing.\n\nAlthough #1 is the more expensive choice, I am hoping that maybe they can just fill it or at least try to before doing a root canal. I really don't know what to do. I don't like #2 because I know that pulling the wisdom teeth forward will be a long process, and I don't know how well they would be able to get the wisdom teeth lined up with the other teeth if I were to choose option #2.\n\nI know it's hard to give advice without seeing the actual x-rays, but I am really not sure what to do, and I don't have the money to get 2nd and 3rd opinions. I want to try to do the most affordable option, but I don't want to not be able to chew my food properly because of pulling the teeth that I need to eat with. Any advice would be greatly appreciated." }, { "id": 805, "title": "Dental implants - Y/N?", "dialogue": "Sooted: Should I get dental implants if I remove both my bottom 2nd molars?\n\nBoth bottom 2nd molars (#18 and #31) will be gone soon due to cavity buildup.\n\nWhat will happen immediately if i DON'T get dental implants? Will my jawline shift considerably? What will happen to the top 2nd molars? Most importantly, what can i expect in the long run without implants?\n\nThanks!!!" }, { "id": 806, "title": "five extractions left bubble or blister.", "dialogue": "ecogenie: Had five teeth extracted. Three came out fairly easy but the last two had problems with coming out. The dentist had to keep pumping novacaine into the area. Then into the side of the cheek. She had to file down the bone after the teeth were out. Said she had to put more novacaine around the bone and this is where the blister is just behind where the five front bottom teeth were. Does anyone know about this and what will happen? Thanks" }, { "id": 807, "title": "Wisdom extraction numbing, what do you think?", "dialogue": "Lycy: I had my wisdom teeth removed on the top last week, and the bottoms were checked but not ready to be extracted. I have healed nicely, no other issues with that got my stitches removed today and talked about the issue of numbing. But now my dentist is confused, and so am I.\nI have been experiencing numbness on half of my tongue and the gumming below it. It is only on the bottom and since I did not have my bottom wisdom's extracted but checked with a incision. It does not really make sense.\nHe took a pokey tool, almost like a needle to my tongue today and poked certain parts of it to test the feeling. I experienced no feeling on the right and felt it on the left.\n\nWhat do you think it is?\nI go back for a check up on this in 2-3 weeks. Nothing has improved at all." }, { "id": 808, "title": "About mucocutaneous diseases...", "dialogue": "youngdds: During our dental education we have oral medicine,oral pathology lessons and we learn (not sure about it) the diagnosis and treatment of mucocutaneous diseases (like pemphigus,lichen..) theoricaly.But in practise, we always consult the patient to a dermatologist for its diagnosis and treatment.Have you ever treated them? Or would you take the responsibility of treatment?" }, { "id": 809, "title": "Is this a blod clot?", "dialogue": "JimmyAlderson: Hello all. I had all four of my wisdom teeth extracted last Thursday, 12/6. Recovery seems to be going well, no considerable pain. The holes are filled with what I have up until now just assumed to be the blood clot. Though it just now hit me...I would expect a blood clot to be dark red/black, not the light green color that I have in my extraction site. Is this built of food, or is this the blood clot, or another stage of healing? Here's a picture...it's not the best and doesn't show the true color, but hopefully it will give enough evidence to determine whether it's normal, or a problem. Thank you!\n\nLink to the picture: tinypic.com/1sgmpw.jpg" }, { "id": 810, "title": "Extreme pain possibly caused by implant", "dialogue": "brandy: My dentist referred me to an oral surgeon to have tooth #13 replaced with an implant. Although a crown was possible, he suggested the implant because \"I would never have problems with it again.\" Six months after the implant was placed, I was referred back to my dentist for the abutment/crown. I expressed my concern that the crown was too small to my dentist, but he assured me it \"looked great.\" The next week, a large filling fell out of the tooth located behind the implant. Since then, I have experienced phases of extreme pain that last for about an hour and can only be relieved with ibuprofen and pain medicine. The pain is intense and includes the entire left side of my face. When the pain dies down, my jaw and ear are sore to touch. It could be weeks before I have another episode. I have an appointment this week to see the same dentist, but I am considering seeing a new dentist. I have never been officially diagnosed with TMJ, but I do grind my teeth at night and clinch during the day. What is causing this pain? The implant or the crown? If it is the filling that fell out, do you think this was caused by the implant? Thank you." }, { "id": 811, "title": "Amazing experience in Trophy Club", "dialogue": "210ashley: I just move to the Trophy Club area and need 3 wisdom teeth removed. I was very nervous and in pain and needed the teeth out asap . I found a Oral Surgeron very close to my home in Trophy Club and he was able to see me that day! He removed the teeth and i had absoulty no pain the staff was so nice and he clearly is great at what he does. If you need a oral surgon go to Dr. Andrew Sohn at North Texas Center for Oral & Maxillofacial Surgery. Best part is he was on my insurance plan!!!" }, { "id": 812, "title": "Need advice on 4 tooth bridge options", "dialogue": "DevDWK: Hello\n\nDuring my youth I had a serious injury to my front teeth.\n\nOn a slide accident, my front teeth were pushed into my nasal cavity. \n\nCurrently I have a front bridge that encompasses, a root canal and post in #10 tooth, a root canal and post in #9 tooth, # 8 tooth root removed, and a root canal and post in #7 tooth.\n\nI have had ongoing issues throughout the years, around 7 years ago #9 tooth went abscess with considerable pain and swelling. \n\nOnce puss broke loose and it healed, the whole post system was replace, due to the infection I lost some bone tissue. \n\nCurrently I have a conic infection in the gum in front of #9 tooth. I am periodically on penicillin to keep it in check. \n\nAdditionally, #7 tooth has become prone to chronic infection due to the fact a larger than necessary post was used and it has compromised the tooth root wall. \n\nI have visited a pedodontist, with 3d scans being done. \n\nI have been advised to remove the root of #9 tooth and #7. \n\nDue to bone loss they want to use cadaver bone, to rebuild the tissue and once healed, use implants for the bases of a 4 tooth bridge. \n\nWhile I travel a lot to the USA, I currently live in Canada, and am having trouble getting action taken on my issue. \n\nMy question’s are;\n\n1: are their alternative dental practices that would allow for removal of the bridge, keeping the roots, and let the tissue heal, and replace the bridge and post system?\n\n2) In regards if an implant is imminent; Is it safe to use cadaver bone replacement, why wouldn't they use my own tissue? \n\n3) I’ve see news articles and research that using pigs bladder powder would assist in tissue regeneration; would this assist my situation and do you have any information on this? \n\nYour advice is greatly appreciated." }, { "id": 813, "title": "Gum is detached from first molar", "dialogue": "bsilver: Hello,\n\nI had 4 wisdom teeth extracted last week. The bottom ones were impacted. Now that I am able to eat normally again, I've noticed that the gum between the bottom right molar has become detached. Whenever I eat, the gum gets pushed down and food gets stuck inside it. Will this attach itself again over some time, or do I need to go back to get this taken care of? Appreciate any feedback on this. Thanks!" }, { "id": 814, "title": "Possible implant issue due to clenching?", "dialogue": "khurley23: Hoping for some info and hope. I had an implant put in my lower jaw about 3 years ago. In the last 7-10 days, I have suddenly become \"aware\" of it. It's not pain exactly but more like a slight pressure as if I had recently had dental work and had some slight soreness as a result. I googled possible issues and saw a lot of things related to smoking and clenching or grinding of teeth. I have never smoked but I have developed a clenching problem within the last 6 months or so. I wear disposable bite guards (Plackers) at night but I admit that prior to this issue with the implant, I was only wearing them about 60% of the time. When looking in the mirror while I clench my teeth, I can not see any place where the implant tooth is touching my top teeth. I do not believe I am guilty of clenching during the day but I do notice that throughout the day, I have a lot of tension in my jaw. The cherry on top is that I switched jobs about 5 months ago and today looked at my dental insurance only to find that no procedures related to my implant are covered. I'm freaking out. Does it sound like I could be losing the implant or have to have extensive work done? Or could some stress relief possibly make this all go away? Any advice or suggestions are welcome. Thank you!" }, { "id": 815, "title": "Dentists and Dental Hygienists in Midwestern States - Dentistry Survey", "dialogue": "VetTech2020: My name is Theresa Gabel, CVT. I am currently a student in the Veterinary Technology Bachelor’s Degree Program offered through St. Petersburg College in Florida. Upon graduation I must complete a research project on a topic of my choice/interest.\n\nI am conducting a survey for dentists and dental hygienists who reside in the Midwestern states. A response from a dentist and dental hygienist from your facility (if applicable) would be greatly appreciated.\n\nThank you for your participation!\n\n- Theresa Gabel \n\nLink to the Survey: https://www.surveymonkey.com/s/JJJM7KB" }, { "id": 816, "title": "About Wisdom Tooth Extraction", "dialogue": "wisedental: Hi everyone,\n\nI was recently told that I need to have the 2 wisdom teeth in my lower jaw removed. These teeth are impacted and partially erupted: the one in the lower left of the jaw is impacted horizontally, and the one in the lower right of the jaw is impacted at an angle pointing forward (mesial impaction). The prospect of having to undergo surgery to remove the wisdom teeth has been causing quite a bit of distress in me because it seems that the recovery post-surgery is rather long and troublesome. \n\nOne of my main concerns is that I’ll end up with large open holes that fail to heal and refill with gum tissue, and I’m also worried that the gums on the teeth near the extraction sites will suffer irreparable damage from the surgical procedure (for example, the gums on the second molars next to the extraction sites may become detached or recede). And to add to the possible complications, I’m 33 years old, which is a little old and makes recovery from surgical extraction of wisdom teeth more difficult. Are my concerns warranted?\n\nAdvice and answers to my concerns would be greatly appreciated. Thanks in advance!" }, { "id": 817, "title": "Retained canines and gap in front", "dialogue": "molle6: Hi I am 23 years orld and still have baby canines due to retained canines and I also have gap in front that I want to fix. What can be done?\n\nMy dentist found this out when I was around 15 but after seeing my 6 year older brother having the same thing going to the dentist every month for 4-5 years with chains in his mouth I told my dentist, \"hell no\" \n\nSo now I want to know if there is any way I can get a good looking smile with oral surgery?" }, { "id": 818, "title": "Immediate implant & Wisdom tooth removal", "dialogue": "ewelinka: Hello,\n\nI am going in to get, hopefully, an immediate implant. Its on my canine tooth so hopefully it wont need bone grafting even though i have had an infection in that tooth for almost 4 years despite 2 apicols. My wisdom tooth started growing out and i have one impacted wisdom tooth and they are starting to bother me. I was hoping i could go get my wisdom teeth (2) removed the day after my canine tooth extraction/implant surgery. Will this affect the healing of my new implant/possibly bone graft or it there no risk if i go ahead and get my wisdom teeth removed the following day.\n\nI am trying to get pregnant so i want to do as much possible in the least amount of time but i don not want to risk a failed implant." }, { "id": 819, "title": "Dental Implants", "dialogue": "makoto06: Hello! I need two dental implants for teeth I was never born with (I am 28.) They are the top lateral incisors. I had a consultation with an oral surgeon, and he noted I do not have adequate bone (and ridgy bone?) and would need to do a graft before the implants. With the graft and the implants (not including abutment and crown) it is running $16,000. Does this sound about right? I think it is very steep. Right now I am wearing a retainer with the fake teeth but must take it out to eat or drink anything but water, which is hard to do in a social setting. Does anyone have any recommendations for alternatives that would allow me to eat and drink in public without removing my teeth? dentimplants: Have you had the treatment? This sounds very expensive. Shop around. If you would consider travelling, you have this treatment carried out for approx $3,000 in Hungary, in some very good clinics that specialise in this area. Did he use a CT scan? This gives the best indication of the bone quality. See my website if you want more info." }, { "id": 820, "title": "i want dentures.. at 23.", "dialogue": "smallgums: Hi all \n I'm looking into gettin my teeth removed and having dentures. I have massive over crowding and small gums for my mouth (thus the name smallgums) I've been told that I will need 6-8 teeth removed my gums worked on and then a spacer and then braces to get my teeth perfect.. in all being out of wrk for at least a month if not longer.. \n\nI'm completely comfortable in getting rid of my teeth.. Id like to enjoy the rest of my 20s with a great set of teeth not be brace face for god knows how long. \n\nIs this a possible idea.. I'm willing to pay out of pocket for this to be done.\n\nThanks! Chris. dentimplants: It doesn't sound like a good idea to have teeth removed at a young age. One of the aesthetic functions of teeth is that the roots act as an anchor for the bone in your gums. Without them this bone will degenerate potentially giving your face a sunken appearance. You could consider implants also although these are more expensive." }, { "id": 821, "title": "which surgeon you recommend who specialises in aesthetics jaw surgery", "dialogue": "hankypanky: i've seen with a consultant before and they say my jaw bones and my bite are fine. the problem is i have a jutting lower jaw (chin too far forward) and this made my jaw improperly aligned.....it's killing me socially and i have anxiety and depression , and i point my finger to this problem so i need to fix it..\n\ni have 3 consultants in mind and would like your opinions on surgeons who you think will give me the best results.. thanks\n\n\nMr Mark Ho-Asjoe\nMr Nigel Carver \nMr Jagdeep Chana hankypanky: i need help picking a surgeon... because most of patients who have good results with them are female dentimplants: I have a friend who has had this done. It is a pretty major surgery so should only be carried out if definitely needed. Sorry can't help with surgeons but good luck with your search." }, { "id": 822, "title": "Online Educational Program about Dental Implants?", "dialogue": "Bob: Hi everyone. \n\nI recently finished my dental surgery degree and during school, I realized dental implants are my area of interest. However, I feel I haven't acquired enough skills to perform well my first dental implant surgery by myself. I'm really interested in keeping up with the day to day techniques regarding dental implant procedures. So, I would like to find an online educational program where I can improve my knowledge and skills to perform any dental surgery. I would appreciate a lot if you could tell me where I can find it. Caroline: There is an online continuing education program called DDS Mentoring which I have been using some time ago. It is owned by Dr. Gary O'brien, a well-known dentist in Glendale, CA with many years of dental implant expertise. In fact, he is the Director of Advanced Implant Training World Wide Implant Direct LLC. So, he is training doctors in Advanced Implant Surgery and Prosthetics. In DDS Mentoring, he gives lectures and advices to all the dentists who are members of the site with subjects like dental implants and others. Dr. O'brien discusses the dental implant cases that we give him and he will guide us on how to solve them. Also, many dentists members have the chance to discuss and share information in forums regarding implants and other dental issues. I really enjoy this wonderful opportunity because it is very helpful.\n\nI truly suggest you to join the DDS Mentoring. It provides you easy information to learn and a clear guide to place a dental implant. You will learn a lot and you will gain more confidence when you're doing a dental implant surgery.\n\nHere is the website: ddsmentoring.com dentimplants: Would you not be better to learn from working with a dental implant specialist?" }, { "id": 823, "title": "Buying implants?", "dialogue": "Alien: Could you please clarify if I can buy implants not from my dentist? I'm not sure his price is good.\n\nI made a research and found out that best are Nobel and Straumann. Where can I buy it and should I?\n\nThanks Alien: Anybody? Any help appreciated. dentimplants: Hi Alien, my company has conducted market research on the market in the UK. I'm not sure where you are based but in the UK there is a massive range of prices for the same treatment. I would recommend shopping around. Nobel and Straumann are the two most respected implant manufacturers and also the most expensive. There are other companies which produce very good implants also at lower prices. The most expensive element will be the dentists time anyway.... Get in touch if you would like further information." }, { "id": 824, "title": "Have something poking out on my gum beside my tongue?", "dialogue": "Erik81: I had all four of my wisdom teeth taken out 2 months ago,as if that wasn't painful enough i ended up with dry socket in both lowers. About 2 weeks into it i notices a sore spot rite below the extraction, didn't think a lot about it till today i felt it to see it it was still there and i felt it had poked through a bit. Its a bone or a piece of tooth for sure just because it feels very solid on my fingernail.Has anyone ever had this or has any info on the subject? Thanks bubbiebee: I had that also when I had tooth 30 extracted. the bone had shifted and a sharp piece was hitting my cheek. Went back to the oral surgeon and he gave me a choice to either leave it and it would heal or he Novocaine me and snapped it off and then just stitched it back up. Very fast and it helped." }, { "id": 825, "title": "Wisdom teeth extractions-Nervous Teen", "dialogue": "Tori.: Hello,\ni'm looking for some advice/reassurance \nTuesday i'm due to get my wisdom teeth taken out i'm going to be awake during the procedure- not my preference but my wisdom teeth have been giving me a lot of discomfort and i need them out as fast as possible and it was either wait 2-4 month or 2 weeks so i took the 2 weeks.\nBut here's where it gets confusing for me.\nI am NOT good with pain the discomfort my teeth have been causing me lately makes me have to take 2-4 ibuprofen already as it is, now I'm extremelyconcerned with the after pain of this procedure.\nHow can I talk to my Dentist about my concerns without him thinking i'm trying to get pain pills to get high?\nBecause i tried talking to my mom and she just tells me how they are just going to give me \"tic tacs\" Aka prescribed ibuprofen and if i asked about othe pain relivers they would think i was a junkie?, it makes me nervous and uneasy and basically like i don't want to get this done and deal with my discomfort because im taking ibuprofen as it is now. i have a very low tolerance for pain and now i am stressed and have extreme anxiety over this. Can someone tell me and appropriate way to relay my uneasiness to the dentist. westiegal: They'll be only too happy to prescribe strong painkillers in my experience. I'm studying dentistry and they want you to be as comfortable as possible - Vicodin all the way! AlDental: Listen...Just got mine out friday, and it was cake. I was just like you and very squeamish when it comes to stuff like that. But, I was put under and don't remember a thing. But I can tell you what they're going to give you will numb your jaw more then you can believe. Stinks you can't wait for the anesthetic, but ya gotta do what ya gotta do.\n\nHere's how it went for me. Came home from surgery, ate something those pain pills pumping. One thing that I recommend is having something ready to eat as soon as you leave the dentist. Have some jello or something waiting in the car, because as I was eating all the numbness was going away. And it was very painful, and I'd skip it if I could. Not cool at all...But, it was only for about an hour and then hydrocodone finally took effect. Kept popping them as advised throughout the whole day and it kept me pretty pain free.\n\nNow the next day was kinda ehhh. I woke up w/ no pain but some swelling occurred over night. I actually didn't have to take the vic's since the day of, I've been in good shape pain wise. But I did develop some sort of throat infection. Very mild, just scratchy throat, and a cough. But I heard this is normal and can occur because, some of the bacteria that the tooth had within gets expelled into the mouth, and can get you sick. So I kinda had that head cold feeling all day which wasn't all that fun, but I'll take that over pain any day. Today, I've been doing my thing like normal. Still kinda tough to eat really fast, and kinda tender, but no pain what so ever. If you've been suffering from tooth pain already you'll get through it just fine.\nSeriously, don't sweat it.\n\nThings to remember:\n-Have something to eat and drink as soon as you get out of the surgeons! The pain WILL come and it WILL hurt, so if you can avoid it do so. The faster you get the pain pill in you the better.\n-Be super careful if you smoke. I've been smoking very lightly, and not sucking on the cig hard at all. Make sure to leave a crack in your lips so you suck in air as you take the smoke in. That way you're not creating any kind of built up pressure in your mouth. The smoke doesn't cause dry socket, but the sucking does. Smoking will delay healing, but I've been fine doing what I'm doing. Also, straws are fine too. Just don't suck on them like you normally would. Be very gentle, and you'll be good.\n-Take it easy your first and second day because those to me were the uncomfortable ones. But seriously nothing to be scared of!!\n-GUM!!! The taste of healing is not a good one...Got me some double mint and fixed that. Gross taste.\n\nGood luck with your extractions!! AlDental: Wow...I just realized how old that post was..." }, { "id": 826, "title": "After an extraction/bone graft: grit?", "dialogue": "Joshocom: A couple of weeks ago, I had a tooth extracted and a graft put in place. \n\nAlthough most of the stitches have dissolved by now, the membrane appears to be in place. Nevertheless, I've been having a small amount of tiny, crumbly grit (not as hard as sand) on a daily basis.\n\nIs this normal?" }, { "id": 827, "title": "Do I NEED to get my wisdom teeth removed?", "dialogue": "aissela: I feel like dentists make it a huge deal to get your wisdom teeth removed, even if it's not necessary. I want some opinions as to whether or not I should have the procedure done...\n\nI'm 22, female. For years now my dentist has told me I should get my wisdom teeth removed. However, for years I've never had pain, and the alignment of my teeth are fine, so I haven't gone through with the procedure. However... One of my lower wisdom teeth is now coming out, but I have no pain. Apparently, it's a bit slanted/not straight, and so my dentist says I should have them removed. But again, I have no pain. \n\nI would really, really prefer to avoid the surgery. I have a very sensitive mouth... even though I floss and take care of my teeth well, getting a normal oral cleaning or exam at the dentist is painful and leaves me sore for at least a whole day afterwards. So I'm worried about the pain and recovery that I would have to deal with after the procedure. Also, I know how much the procedure costs... and I've read that a lot of dentists make the most money doing it, even when the procedure is unnecessary. \n\nLastly, I'm not comfortable with being under anesthetic. I've watched the videos of people who are high after the procedure. Most people find it funny- I'm horrified. I would hate to be in that position. \n\nSo is removing the tooth REALLY necessary? Do they have to remove ALL of them? What are the alternatives? I'm \n\nThanks in advance! aissela: Why does this have 40 views and no replies? Someone please help me!" }, { "id": 828, "title": "Wisdom Teeth Removal to Prevent Crowding?", "dialogue": "steve321: Hi everyone! \n\nI am concerned that my top wisdom teeth coming in are crowding my front teeth. There is only a very slight overlap at the moment but am afraid this may get worse with time.\n\nI have attached two images; the first are x-rays taken from 2008 and the second from a couple days ago in 2012. \n\nMy wisdom teeth are giving me ZERO pain and this is just a concern for crowding. Could someone give some insight, from the x-rays, as to whether or not my top teeth are crowding together?\n\nAnd finally, if I were to wait until the top wisdom teeth were to fully grow in what would be the consequences as far as crowding and what actions could I take in the future to correct this?\n\nThank you so much for your time.\n\nSteve pahd: Do you mind me asking how old you are?\n\n----------------------------------------------------------------------------------------\nEvery tooth in a man’s head is more valuable than a diamond. \n~Miguel de Cervantes, Don Quixote, 1605" }, { "id": 829, "title": "wisdom tooth numbness", "dialogue": "csjones86: I had a wisdom tooth (just the one) extracted two weeks ago today. It was a nasty extraction, but my recovery has been textbook normal and healthy until last night. I started experiencing numbness in the extraction area and along the gum line, as well as that side of my tongue (it's the upper left side, if it matters). It has not REMAINED numb throughout the recovery; it just started last night. I have made an appt. to have the dentist look at it on Monday, but I don't want to spend the whole weekend making up nightmare scenarios in my head! Could someone tell me what this could be?\nItems of note: I do smoke an e-cig, but surprised myself by easily waiting the recommended four days, and then started very slowly when I picked it back up. I have only been smoking \"normally\" for a few days now. I had a couple of moments when I forgot to not use a straw, but quickly remedied the situation when I realized my mistake. I had very minimal soreness and have had no pain for a week now; I have been very good about my salt rinse. \nI guess in the end my question is WHAT DID I DO WRONG?????" }, { "id": 830, "title": "My Lower Wisdom Teeth", "dialogue": "crankit: I've had an x-ray done on my wisdom teeth and today my two upper wisdom teeth were removed with out any issues. I'm told that my lower wisdom teeth can be removed with an operation but there is a risk of injuring a nerve. \n\nI'm unsure whether or not to go through with the surgery and I'm trying to way up my options. \nI'm 27 years old and my teeth are in relatively good condition except for an overbite and overcrowding, see pics.\n\nI'm considering braces in the future to fix my bite and I'm not sure if lower wisdom teeth will have an effect on this. \n\nJust wondering what some of the people on here think." }, { "id": 831, "title": "hospital neglect??", "dialogue": "baxb: Hi im 38 female live in uk. For last few years Ive had a reoccuring lump on my palete. 6 month ago i went to my GP and he referred me to Maxillo Oral Surgeon who after taking x ray, he said i had 2 other cysts in my gums and would need them all removed along with 16 teeth. A date was set and my dentist made me a set of Dentures in advance as i was worried about losin so many teeth.\nSo on the day of the surgery, i was met by a new surgeon who i had never met. The op went ahead and i woke up with my dentures full of blood but not fitted. The surgeon checked his work and told me wait few days before inserting dentures. \nFor the next 2weeks i tried n tried but could not insert them. \nSo i went to my dentst who was shocked that the hospital did not fit them in during surgery. Anyway the dentist also realised that the surgeon left a back tooth in which rendered my dentures useless. And now i have to wait few months for my gums to heal before he can take next moulds for permanent Dentures. \nEven though the surgeon had my dentures during the op, why would he leave a back tooth in knowing i wont fit be able to fit dentures in? They knew i was worried about losing my teeth. This was done on nhs. Is this hospital neglect? hankypanky: hi , if i was u i would try being referred again, but i would choose the hospital rather than ur gp or whoever choose for u. u are allowed to choose where u want to be treated , its ur right, dont let anyone tell u different, ur gp may say that they cant refer u, but thats not true, they say that to save costs, anyways i would go to different hospital, u should look at nhs choice website.. crankit: If there was some kind of authority I'd be reporting. I seem to hear alot of stories like this these days." }, { "id": 832, "title": "In conflict in extracting tooth as recommended", "dialogue": "Trudijane: Hi,\n\nA few months ago, one of my upper back gums swelled up and was accompanied by some pain. I decided to go directly to my periodontist first since it related to my gums. I guess he injected an antibiotic and the swelling/pain just went away. I have had no problems with that particular area for a few months.\n\nHe took a lot of X-rays and shared them with my dentist in order to consult with him as to what I should do. My dentist told me that there has been bone loss above that tooth he felt that root canal would be a waste of money and suggested I have that tooth extracted and then decide if I want an implant or not - later.\n\nI'm very much in conflict in making that appointment to extract this tooth because it has felt normal for the past 2 months. My dentist assured me the infection would come back and I should have it extracted so it doesn't affect the adjacent teeth. I keep putting it off because that tooth feels fine and if I did get it extracted, I would opt for an implant which is very expensive.\n\nWhat shall I do? Can I wait awhile? \nThanks,\nTrudijane gels: I would bring copies of your radiographs and get a second opinion from another Dentist. It's never good to wait when making these kind of decisions because it could get worse even though it feels fine at the moment. crankit: I agree with the last reply. A second opinion sounds wise." }, { "id": 833, "title": "Curious if removal is healing well (16 hour mark)", "dialogue": "Tewan: Yesterday around 11:30am CST I went in to get the top back right tooth pulled. Come 2:00pm or so I was leaving the office heading home. Since then I've slept probably 14 hours at least and have had only three pudding cups and about a bottle of water to drink during this time. While sleeping, I kept my head propped up on three/four pillows laying on my back with an ice pack on the side of my face (right) that the extraction was on. I've been taking the antibiotics and hydrocodone that were prescribed along with 12 hour sudafed to prevent any sinus issues.\n\nI've also been keeping two gauze pads folded into a 1cm x 2cm x 2cm area in the extraction area as to soak up any bleeding and prevent me from sucking when my mouth is closed. I've tried keeping this out but as soon as I take it out my sub-conscious takes over and starts trying to suck in air through my closed mouth. The gauze is changed rather regularly (First due to bleeding, but now to keep it clean and drier as most bleeding has stopped).\n\nWhen I remove the gauze pad and do the short sucking (because once I notice myself doing it I immediately stop) it feels that there's air coming through the extraction site. Is this normal?\n\nIn addition to the aforementioned food / drinks, I just had two more pudding cups as well as a half-bottle of water to take another dose of medicine. Eating and drinking this round was quite a bit easier.\n\nThe main concern I have though is if the extraction site is healing well so I took a picture at the 16 hour mark with my cameraphone in hopes to someone here may be able to help out.\n\nUnfortunately I am unable to post images or links until I get 5 posts, so hopefully the moderators don't mind if I go around this rule... \n\nhttp://tewan.info/images/.hidden/extraction.jpg" }, { "id": 834, "title": "coronectomy question", "dialogue": "sensameliablue: I have an impacted lower wisdom tooth which x-rays show has roots on the nerve.....my dentist says there is a 1% chance of permanent nerve damage if I have it extracted. Here is my issue......coronectomy has been suggested but the dentist has said I will be in \"agony\" afterwards.......this has panicked me...is it not pain which is controllable with strong painkillers? How long does the pain last and how painful is it in comparison to full extraction? What causes the pain> Is it the retained root or the fact that bone and gum has been cut into? Will I have stitches? Need more info / some advice, thank-you." }, { "id": 835, "title": "2nd opinion on my daughter's teeth", "dialogue": "Coppermtn99: I was hoping to get a second opinion for my daughters teeth. I have x-rays. My daughter is 12. Her ortho wants to pull teeth C and H. I understand C needs to be pulled and an implant put in. My concern is that he wants to pull H (which might actually be 11) because he is not sure if it is a big tooth or little tooth and wants to add an implant. I am hestitant to extract this tooth. He says that I am not thinking of her overall looks, but I am just not that comfortable pulling a good tooth because he is not clear if it's a big tooth or baby tooth. He says if does fall in 10 years she will have to get braces all over again - that seems crazy to me. \n\nI was born with missing teeth as well and had two bridges and then on one side I did get implants a year an a half ago. They will have to come out because I got an infection and it's not taking. I have spent $100,000's on my teeth and they have been a nightmare. I just want to make sure that I am doing the best thing for her. She does grind her teeth, the implants would be going where there is missing teeth, our family has a history of autoimmune disease (i have never had her checked) so the implants are not a sure thing as everyone keeps telling me. \n\nI am not against what he is recommending I just would like some thought as to pulling a perfectly good tooth and doing an implant. \nI really appreciate you looking at this." }, { "id": 836, "title": "Kenneth Reed Mandibular Block", "dialogue": "upman: Hello! I am a dentistry student that is writing his thesis and would like to know if anyone here on the forums has come across the Kenneth Reed mandibular block technique. If you know about this technique or have used it, please share your experiences with it. Thank you" }, { "id": 837, "title": "Sutres Left in Mouth", "dialogue": "glowy: What happens if nonresorbable sutres get left in an extraction site? My fiance got two teeth removed, and when we went back in to get the black silk sutres removed, they could only find one. They put in two on each side. What is going to happen? How high is the risk of infection?" }, { "id": 838, "title": "cyst removal", "dialogue": "amyius: My daughter is 16, she had a lump come up on her lower right jaw. I took her to the dentist and they took an x ray. They found a lesion on her jaw under teeth numbers 28-30, which we found out to be a very large cyst per the oral surgeon. It became infected so the oral surgeon did a I&d the next day, we are having a CT scan next week to see how big it really is. Then go from there to have it removed. I was just wondering if anyone has had to have one removed, and what to expect. Apparently this cyst was on an x ray she had done in 2010 and her dentist missed!! Now she has lost at least two teeth maybe three. How long is recovery??" }, { "id": 839, "title": "Concerned about dry socket", "dialogue": "Macguy59: Had a molar surgically extracted (due to one stubborn root) approximately 4 hours ago. The instructions that were handed to me didn't say anything about not spitting or using a straw. I have spit twice (though trying to be careful) and used a straw to drink a small amount of water. Both are apparent no-no's from what I'm reading online. I've already got myself worked up about dry socket now. How quickly does the plug form and if I have dislodged it or loosen it will it reform ? I don't really see much of any bleeding now. Do I need to get back to the dentist tomorrow to have them check it ? Thanks" }, { "id": 840, "title": "Dental Cyst Surgical Removal", "dialogue": "samv: Hi,\n\nI was affected with dental cyst in the mandible(lower jaw) with around 2.5 cm in dimension.\nIt was associated with a non erupted wisdom tooth .\n\nSo i consulted a Oral Surgeon and as per his advice i did three tooth (wisdom teeth ,upper wisdom teeth and a teeth in lower jaw in side of the wisdom teeth(as cyst is in the root of that teeth also ) removed with cyst in a general anesthetic mode.\n\n\nAfter the removal it was around a week,but i am having the following problems:\n\n1. Pain in the left portion with a small swelling.\n\n2.Numbness in the half lip and small portion in cheek.\n\n\nI like to know how much time it will take the pain and swelling/numbness to go in normally ?\n\n\nThanks in Advance\n\nSam" }, { "id": 841, "title": "Dry Socket Terrible Pain", "dialogue": "Amanda: I had my wisdom tooth bottom left, pulled last thur Jan 12, felt great for about a day, then started hurting worse and worse. Since then i've been on pain killers constantly which do nothing for the pain and have had my extraction hole packed with medicated gauze and clove stuff twice so far. My dentist is closed Fri, Sat and Sun, and i'm fearing the worst. When will the pain go away, I can hardly eat, or sleep, its constant agony, i've never been in this much pain before and its terrible...is relief coming soon? I did smoke but i've stopped since my tooth was pulled and it didnt even make a difference \nAm I alone? Please help!!" }, { "id": 842, "title": "What is this type of bone graft?", "dialogue": "LACSTS: I have been trying to research a specific type of bone graft. Its not the kind you would get when you have an extraction done.\n\nSay, you had back teeth pulled years ago and now the ridge is not big enough to support an implant. What is the bone graft called where they cut your gums open and do a bone graft?\n\n\nTo be more specific I had all of my back teeth on the lower left side pulled about 5 years ago. Recently I have been getting all of my dental work done. My dentist said that I would need a bone graft done in order to get implants done on those back teeth.\n\nHe wants me to go have a CT scan done at a radiologist. I have been trying to research thjis type of bone graft but I do not know what it is called.\n\n\nAny help is appreciated." }, { "id": 843, "title": "Teeth Extractions", "dialogue": "princess4ever: Hi, \n I'm going to have 2 teeth removed next week. One wisdom and a molar. I'm going to be awake during the extractions. I have never even had a cavity so I have no idea what to expect from getting teeth pulled. I'm really nervous about the whole thing. What should I expect? Do the shots hurt? Will it hurt at all when they remove the teeth? Any help would be much appreciated. Thank you dustinn: princess4ever said:\n\n\n\n\t\t\tHi, \n I'm going to have 2 teeth removed next week. One wisdom and a molar. I'm going to be awake during the extractions. I have never even had a cavity so I have no idea what to expect from getting teeth pulled. I'm really nervous about the whole thing. What should I expect? Do the shots hurt? Will it hurt at all when they remove the teeth? Any help would be much appreciated. Thank you\n\t\t\nClick to expand...\n\n\nYou may some minor discomfort, because extractions require more shots than other procedures, but after you are numb, you shouldn't feel anything. jessica: Pain during Tooth extraction\n\nThere will be no pain during tooth extraction. You will just feel pressure but no pain. the procedure is done under local anesthesia. You will just feel a prick during local anesthetic shock.For pain after tooth extraction, pain meds are given by the dentist. sqwerl: Laughing gas or nitrous oxide also helps if it's available but it may cost you extra money even if you have an insurance plan. sunny: princess4ever said:\n\n\n\n\t\t\tHi, \n I'm going to have 2 teeth removed next week. One wisdom and a molar. I'm going to be awake during the extractions. I have never even had a cavity so I have no idea what to expect from getting teeth pulled. I'm really nervous about the whole thing. What should I expect? Do the shots hurt? Will it hurt at all when they remove the teeth? Any help would be much appreciated. Thank you\n\t\t\nClick to expand...\n\n\nmyself never had tooth extraction but i have seen my sister and mother they didn't had any pain you just relax." }, { "id": 844, "title": "Flapless vs Conventional Flap for Implant Procedure?", "dialogue": "Kenny: Looking into doing an implant @ #30. It was extracted about\n30 years ago. 29 & 31 are present and healthy. Good stimulation\nhas provided excellent bone structure @ #30 (so they tell me).\nWhat are the pros and cons, benefits and disadvantages of the\nfull flap incision versus the \"flapless\" procedure.\nThanks" }, { "id": 845, "title": "Wisdom Teeth Removed - Strange Sensation in Ear and Jaw", "dialogue": "Superchief: I had my upper two Wisdom Teeth extracted exactly 1 week ago. Seemed to go very smoothly and as far as I cna tell everything is healing properly. I don't have any major pain that is of concern; one of the sites is still a bit tender and prone to stimulating headaches; no big deal.\n\nMy concern however is this extremely bizarre sensation that I am feeling in my jaw and both ears. It is the strangest radiating, and constant feeling I think I've ever experienced.\n\nI'm not sure how to explain it, but my ears feel as though they have been opening and closing as they can during a plane flight.\n\nMy jaw feel tired as though I was shredding several pieces of gum during the same flight. \n\nI don't know how else to describe it. Is this normal? Is this part of the healing process?\n\nIf anyone is familair with this and can provide any feedback it would be greatly appreciated." }, { "id": 846, "title": "wisdom teeth removal - severe pain in 1 area", "dialogue": "cu2012: i got my wisdom teeth out on wednesday (8/3). all are healing well and not giving me trouble except for my lower right one, which i was told would be the worst to deal with. i have throbbing along right under my ear and down to the extraction site. is this normal and what can i do about it? also, i can't feel part of my tongue (numb). \n\nwhat should be done about these? will my tongue feel normal soon?" }, { "id": 847, "title": "sinus perforation after tooth extraction", "dialogue": "ybmssun1: had a tooth extraction upper (next to wisdom) 16 days ago here by a local dentist. He told me it is a sinus perforation with 2mm hole. He use plug and stitch and put me on 10 days antibiotic after the extraction.\nAfter 14 day, the dentist open the stitch; then the day after the stitch removed, when I rinse my mouth there is a little water coming out my nose. I planned to visit an oral surgern but she and my dentist said there is a good change to close up naturally and asked me to wait for a week. At this moment, do I need to take antibiotics again to prevent sinus infection?\nwhat kind of oral surgern can you recommend?\n\nI am sort of worried, heard sinus infection cannot be taken easliy. You advice was highly appreciated.\nJeffery" }, { "id": 848, "title": "Drill piece left in gum near sinus after root canal", "dialogue": "betzadeleon: I had a root canal done on Tuesday Jul 19th (pulp inflammation old filling was previously there, suspicion of micro fracture, took 2 weeks to diagnose). \n\nThere was following complication:\n\nThe endodontist broke off the tip of the drilling iinstrument while working on a root. She was trying to extract that small bit of drill (this is invisible in the attached pictures as it's in the root canal somewhere). \nIn trying to extract that tip of drill, a second drill broke off and was somehow inserted deeper into the gum. This piece is titanium nickel and is 6mm long. That's the one that is visible.\n\nToday the endodontist did a gum surgery to try to remove that piece but she did not reach it, as it's farther up than she can safely extract or risk looking for.\n\nSo now she has referred me to an oral surgeon, whom I have an appointment with end of August His initial assessment (after looking at the x-rays) was to let the tissue around the drill piece heal (4 weeks), and get more firm before attempting anything. He will also run a CBCT scan to pinpoint the exact location. I inquired about the risk of having such a piece around or in the sinus, but he indicated that the bit is in the soft tissue, and does not pose a risk. \n\nI am still very worried though, as my endodontist seems so insecure and there is such a long time to wait for the oral surgeon. \nI would value your opinion on these x-rays, what are the risks, what do you see, is the drill in the sinus and should I push for an immediate consultation? I am desperate. \nThank you." }, { "id": 849, "title": "Can't bite down with stiches (Wisdom teeth removal)?", "dialogue": "Ace: I just got my wisdom teeth out today, and although my right side is fine, I can't bite down due to the left side of my cheek being stiched too far over my gums.\n\nWhenever I bite down, I keep biting my cheek, I want to know what the heck is going on here. I know it's normal for the stiches to be attached to the cheek, but are they supposed to be that far over, and if I leave them be will I be able to bite normally after a period of time, and how long exactly?\n\nIt's been frustrating, and I've only been having this issue for the last 10 hours or so." }, { "id": 850, "title": "I need HELP I had a Extraction", "dialogue": "MAstudent11: I have looked and gotten some answers on the internet but its not good enough..I also posted in yahoo..and noone responded anyway heres my story..\nTHIS IS THE TOOTH ON THE LEFT SIDE ON THE TOP NEXT TO MY VERY FRONT TOOTH.\n\nI had a bad tooth that cracked all the way where you could see the pulp of the tooth.this was 2 years ago...I let it go because I did not have insurance that would cover getting it fixed or the money and I was not in pain. Well gradually I got pain and it became Abscessed..anyway I went to the closest place that accepted my insurance and it was a dentures place that did extractions but since I put on the form that I had tachycardia the dentist or whatever he was would not pull the tooth. So I was sent to a oral surgeon and he wanted to put me under for one tooth?? Anyway he gave me antibiotics for 10 days and I was suppose to go back and have it pulled but my insurance would not approve being put to sleep for this. So I didn't go back and I just let it go. Well it had pain on and off sometimes, but not until this year about 2 weeks ago it got abscessed again, or im not even sure if the infection was just there for all this time. I went to the ER and they didn't do a x-ray or anything they just gave me pain meds and a antibiotic for penicillin 4x a day for 10 days. About 5 days later I went and seen a dentist and he took a x-ray of the tooth and said it STILL had alot of infection in it and gave me, I hope I spell it right, Clindomycin to combine with the penicillinm, I also told him it was very sore in my nasal and i was having sinus problems and he said it was infection. So I took it as prescribed and then about 3 days later I went and had the extraction. I felt it, even though he gave me shots...I just had that done on this past tuesday..Well he told me that 2 days after the procedure I could stop the antibiotic, and I did. Well I am having alot of sinus problems now, I feel stuffed up, and I also feel like theres ALOT of pressure in the gum where he took the tooth out. So could there still be infection??? I just don't understand I was on 2 antibiotics and the first one I was taking a week and the infection was still there. What should I do at this point? Go back to the dentist, or is this common after extractions? I heard of sinus holes but im confused because most say in the back top molars you get those. Please just offer information..\nThanks" } ]