Asking questions...why not?

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I was at my dentists the other day as I have an abscess above one of my molars and a broken molar next to it. The teeth I am told, need to be extracted, as even if they get rid of the infection I am told it will come back.

Um....At this point, mostly out of a desire to see if I actually can save the tooth instead of losing it, I posed the question "why...why will the infection come back".

I was given a blank look by the dentist before they replied with "the infection will come back"

Yes we have established this belief (I won't call it a fact as you cannot predict the future with certainty like that...a more accurate statement would be to say there is a high probability of the infection coming back) I thought to myself so asked again "yes but why will the infection come back, what is the science behind it?"

Granted I could probably have phrased the question more effectively but I was becoming frustrated by now and was losing the ability to articulate my words and think clearly. What I meant was what factors can contribute to the infection returning and how can I reduce this possibility? (Ie are there dietary changes that could be made, any other dental procedures I can have, will exercise help by boosting immunity, is there a better toothpaste I can use, do genetics play a roll, does ethnicity play a role and so on...)

All the same I was met with a blank look and once again told "the infection will come back".

I try one last time..."why will it comes back" when the lady smiles at me, hands me some paper and says "write your thoughts and feelings down on this and send it back into the surgery"

Huh?

They can't tell me why my infection will come back and if there is anything I can do to reduce the possibility of it recurring? And why did she look at me like I was backwards for asking or as though I was the one who was not getting the point. She was the one who couldn't answer the question!

I think my question is a reasonable one, especially given my interest in such things as the paleo diet. Given that our hunter gatherer ancestors had very little tooth decay and actually had very good teeth (despite media representations of them having dirty, rotten or broken teeth...this was not the case at all) and given that humans started to develop significant dental problems and rates of tooth decay not found in paleolithic human societies since the dawn of agriculture, perhaps our ancestors dentistry has something to teach us!

No one at the dental practice has heard of the paleo diet.

I live in the dark ages of science over here...seriously!

As for the teeth, if they do remove them, then it needs to be done at hospital as they too close to my sinus cavity for the dentist there to do it. Oh joy. I will ask the hospital surgeon the same question then....maybe they can save it, at least the one that is not broken beyond repair and has a root canal. I am fond of that fella it has served me well what with putting up with my eating habits!

Your mouth is warm and wet and you keep on putting non-sterile stuff in it called food, this represents an ideal environment for any microbes to thrive and so tooth infections are always a problem. I only know of two solutions, sterile food and drink (something which is difficult if not impossible) or regular use of a strong mouthwash after every meal.

if this were the reason than everyone would be having all their teeth removed

if it is possible at all get a second opinion - if I can't get a reason to do something I don't do it, ESPECIALLY something irreversible and damaging. Every time I see a dentist they want to take out the only wisdom tooth I have and can't explain it - it has never had a cavity or any problem, it fits my mouth fine - I am certain the reason they want to remove it is so they have something to do - nothing with my health or well being.

and the hospital surgeon will NOT be equipped to save the tooth - his entire reason for being there is cutting it out and he won't consider it.

In my opinion, its sounds more like how your asked the question rather the question itself. If you would have started the exchange with - I don't understand this, can you explain it to me? By my circumstances, I have to be very frugal with my fiances; is there any thing I can do to prevent the infection from coming back?

doctor's value their time and want to spend their time doing things which make them money. They will inform you of problems they can fix or pose a health risk but if you ask them to give you med school in a nutshell they probably won't consider doing that over finishing your consultation and moving on to the next billable client.

Also, they probably have no f*****g idea why the infection will come back. A lot of science is observational so all they know is that the events are correlated but no one has ever spent the millions of research dollars to investigate that particular question.

If I were to speculate, however: Removing teeth disrupts the immune system in that area and creates vulnerability to infection. If you already have an infection your body has little way to fight it. Your body will generally prioritize structural repairs like filling in the gums over fighting an infection as it has finite resources to spend and limited pathways to transport them. Generally after any major operation you are more susceptible to infections. Also, if a 'bad' tooth is removed that has an infection the process of removing the tooth is rather messy so the infection will be spread to anywhere that fluids from that tooth goes.

If they have to do tooth extraction, that means the tooth (or teeth) are so badly damaged that nothing can be done to prevent the bacteria inherent in the mouth and in food from re-infecting them and spreading through the jaw.

http://www.webmd.com/oral-health/tooth- ... um-disease

Prevention measures (such as you describe) work with healthy teeth but they can't protect such badly damaged teeth. And you really can't make your mouth a sterile area (as Eccles noted by joking about sterile food and mouthwash). Undamaged tooth enamel provides its own protection (which is why people don't routinely have to have all their teeth removed despite germy food and mouth) and mildly damaged enamel can be patched over (fillings, root canal) but your teeth (or at least 2 of them) have apparently gone way beyond that point.

As to why they didn't just say what I did (or what Eccles did), I don't know. Maybe Buffinator is right and they thought you were asking for a mini-med school explanation which they didn't have time for given that such an explanation requires time which is not billable. Maybe they are so used to giving scripted answers that going off script just didn't happen. Maybe they thought you were trying to talk them out of recommending tooth extraction.

But in any case it's because your teeth are too far gone to save and immune boosting measures (via exercise, diet etc.) will be insufficient to save the adjoining parts of your jaw.

As somebody who also reads a lot about (and practices) the Paleo diet, I can appreciate how you point out that our ancestors had superior teeth with that diet. But it's preventive, not curative. Once your typical diet has done the dental damage, a Paleo diet can't reverse it. However, it could be protective for the remaining teeth.

Last edited by Janissy on 11 Mar 2014, 8:20 am, edited 2 times in total.

That was an interesting question, Bumble. This kind of explains it.

(It's like there's a home for bacteria once the tooth gets messed up, so they keep coming back to it.)

http://www.medicalnewstoday.com/articles/170136.php

I have had infections come back after dentists made me wait an extra two weeks from "running out of antibiotics" to "making it to my appointment." At that point I am incapable of caring if the infection's caused by tiny hobbits spraying my teeth with pure sugar bombs, I just want to make sure it never comes back to vex me again.

The broken tooth is beyond saving as it is nothing more than a root left in the gum, the rest of the tooth disintegrated. For reasons unknown I have issues with the molars near my maxillary sinus breaking apart, but not my bottom molars or front teeth. The abscess was originally above the broken tooth, which I asked the dentist to extract months ago and they said there was no need to remove it if the abscess had gone. It's a nuisance though as food keeps getting stuck in the hole where the root is. It busted in such a way that part of the root came away with the rest of the tooth but part of the root got left in there.

The abscess then turned up over the tooth next door, which has a root canal. The dentist said the root canal is good, but there is pus around the tooth that is seeping out into my mouth and a small amount of bone missing from around the socket of the tooth (i think). It does not hurt much as there is no nerve left in said tooth...both teeth are dead sensation wise most of the time (bit of a mild ache if I feel anything). I feel slightly unwell though, like I have mild flu.

As the root canal is good I did not know if the tooth next to it was removed (the root that is left behind) if the root canal tooth will calm down as I think the root from the broken tooth might be the cause of the abscess and not the root canal.

I don't have many molars left due to my teeth breaking apart (from before I went paleo) and my abscess was quiet (had gone) until I attempted to reintroduce wheat to my diet 4 months or so ago. Ergo I thought if I kept the wheat out of my diet completely and had the root out the root canal tooth might recover. It;s not wobbly or anything and she said the root canal was good.....

I had an infection at my wisdom teeth, and after the second time it was infected, they removed it as well.

The reason is, that normally a tooth is "closed" by the surrounding flesh. So at an normal teeth that is tightly surrounded by tooth-flesh, bacteria or viruses, causing an infection, cannot reach the internal tooth area.

If you have an infection, then whyever, something is not alright and allows bacteria/viruses to enter the area of your tooth beyond the flesh. If you cut yourself accidently, and so created a way for the bacteria, then that can heal and afterwards the tooth will be secured again by healthy flesh. But if you whyever, dont have any recent physical cause that can heal, but have instead a permanent problem, that causes bacteria and viruses to enter, then they will do so. And because of you being unable to clean the tootharea below the flesh, with your brush, they will spread once they are in.

Had that kind of s**t, because my wisdom teeth having not enough space and so only being 50% outside, with the rest of the upper tooth still being loosely cloaked by flesh. Through that opening bacteria came in, caused an infection and 6 months afterward, I got the same infection again, because of the problem with the loosely cloaked flesh still existing.

Because of my second infection being directly before my already payed wedding holidays, they could not extract the teeth immediately, but instead cut all the infected area open, removed the infected mud, and I really was forced to desinfect my mouth the first week of my holidays, to prevent the infection coming back again while I am on vacation. That mouth desinfecting might be ok for a short time, but for longer times it would be too anoying, so you can only eat two times a day, and need to relie on clear water/filtered tea, the rest of the day, as well that after desinfecing, you should as well not drink anything for about 2-3 hours, so that you dont wash the desinfection away immediately, because you are as well not allowed to desinfect the mouth to often, because of traces of that stuff getting in your stomach and irritating it, if you overdo it.

If your tooth is already that much damaged, that there is no tight flesh anymore around an healthy tooth stump, then bacteria will enter again, simply because they can and have already proven to do so.

I would get a second opinion if possible. I had an infection, abcess, and dying tooth, and the initial dentist I consulted told me it would have to be removed.

I consulted another dentist -- she saved my tooth, and told me the first dentist was an idiot, in not so many words.

I had an infected root and they didn't have to remove my tooth, they gave me a root canal and no infection ever returned -- I say this just to illustrate that it doesn't necessarily become infected again, depending on what the situation is.

I originally had a trauma to the root of my front tooth when I was young, following fainting onto a stone floor. They saved the tooth and the root was intact for the next twenty years -- until another milder trauma caused the root to start dying and to develop and abcess., ie infection. The infection actually went away spontaneously, but the dead tooth needed a root canal in order to save it. They performed that, cleaning out the debris, the tooth was saved, an no infection has recurred in fifteen years.

Now, your situation may be different, with something different going on in your tooth that is not the same as what was happening in mine. But if they can't explain to you WHY an infection may reoccur -- which is a simple and legitimate question to ask, you have the right to see a different dentist.

I walked out of the first dentist and got an entirely different opinion, prognosis and result from another dentist, so it's worthwhile for you to try the same.

I can explain about the infection coming back. Had the same situation once.

The tooth is dying or has died. Blood is no longer flowing in and out of where the infection is.

Even anti-biotics that end the infection in the rest of your mouth can't reach the core of the infection. No blood is getting in there.

The infection is hiding in there, beyond the reach of the anti-biotic (if they put you on any), laughing and waiting until things are safe (the medicine is out of your system) so it can come out again.

Then, the whole problem starts up all over again. The only solution is to do a root canal (remove the stuff the infection can live in) and crown, or to just plain pull the tooth.

The root canal and crown can be horribly expensive, so those of limited means who are in this situation end up having to just have the tooth pulled.

This is why you were told what you were. The infection will come back because it never really left, and is just waiting to emerge from the tooth again.

Agree with you. 3-4 years ago they asked me to take my 3 wisdom teeth out because they were impacted and I never did it, they never mentioned anything again after that as if they didn't notice I never went to take them out! I'm glad I didn't take them out, hopefully I remain glad I didn't. 2 years ago I got my first cavities and I had zero clue they were there, and they said "wow, they're really bad", and they drilled far down into my tooth, well, after that, I now have sensitivity in those 2 teeth I got the fillings in even though I never had a problem before, it really pisses me off. After that experience, I have been avoiding the dentist because they lost my trust.

OP, I say go to another dentist for a second opinion.

No idea if this would be the case here, but I usually assume when someone responds in that sort of way to that sort of question, that they don't know the answer.

I am going to assume they do not. They did not know other things as well such as the potential side effects of certain antibiotics they give out or about how diet affects dental health.

This is worrying. I will search for a more knowledgeable dentist.

Even if I can't save this tooth information on how to prevent recurrent infection would be helpful to know so as to prevent such problems as I am experiencing now in the future.