Chances of Gum Disease: I wanted to take a minute to share with you some information on failed root canal treatments, chronic infections in the mouth and what that means to you.
Frequently Asked Questions:
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What are the symptoms of mouth infection
Can your tongue cause gum recession
Can gum disease affect your tongue
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What are the two early signs of gum disease
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Chronic infections are really important to understand, because if you have one of them in your mouth you might not know. One of the symptoms of a chronic infection, if the nerve has already been treated by a root canal treatment, is that it normally doesn’t have very much pain.
Not always, but normally it doesn’t have any pain. But one common symptom that you can jot down that is often found with a tooth that has a chronic infection is that when patients bite down on this tooth, it feels a bit different.
So keep that in the memory bank, and we’ll go through some clinical cases now to show you exactly what is happening in these teeth. In this case here, there’s a back lower molar and the molar in front of it that don’t have some great fillings on them.
You can see these are open margins, not very well finished. Little bit of decay here. Things aren’t going great in this person’s mouth. But to top it all off, these are incomplete root canal treatments, and this tooth has had the nerve drilled into, there’s decay in the tooth and there’s been no treatment done at all.
So, in this case, we would definitely suspect for this tooth that it would have a chronic infection if this had happened some time ago. And again, I repeat, there was no pain for this patient at all. All that was experienced is that when they chewed down things felt a little bit different.
So what’s happening? Underneath this tooth, bone loss, from bacteria inside the root of the tooth creating toxins, inflammatory toxins that then come out and cause reabsorbtion of the bone by the immune system underneath the tooth.
Now there’s a granular cyst there and this patient is in some serious need of treatment. This tooth in front, it’s had an incomplete root canal treatment. It may even be a little bit of a file left there in this tooth.
If you can see that little curvy white line there. But regardless, this root canal treatment was not successful. We can see darkened area here on this x-ray. There’s scarring indicating bone loss underneath this tooth for the exact same reasons as before.
So you’ve gotta really make sure that you’re observing the x-rays that your dentist takes after they’ve finished the root canal treatment to make sure that the job’s been done to a high level of satisfaction.
But even then, and we’ll show you this next clinical case, sometimes that isn’t even enough. This tooth had, what would be by all accounts, if there was no bone loss underneath it, a very successful root canal treatment.
The root canal treatment is this part here, and it goes all the way to nearly the tip of the root. And the same in the front roots of the tooth, but still bone loss underneath it. So what’s happened? After this root canal treatment, bacteria have propagated into the tubules.
There’s lots and lots of micro-tubules that exist inside the roots of the teeth. And that propagating bacteria has caused a biofilm that’s produced inflammatory toxins. Those inflammatory toxins have come out of the end of the tooth root and they’ve caused a bunch of bone loss.
There’s again, granular cystic tissue there instead of bone. The immune system is trying it’s hardest to overcome this, but it’s just not able to do it. So if you’ve ever experienced again I’ve gotta tell you guys, if you’ve ever experienced a tooth that didn’t feel right to chew on.
You knew something just wasn’t quite right, get this checked out so that you know in advance. Now there’s another case that I’d like to share with you all. It’s this 3D case from a patient who actually had bone loss as well, underneath her non-root canal treated tooth.
And it’s critical that we understand that not every tooth with a chronic infection, or bone loss, or problems has to have had root canal treatment, okay. A lot of the failures that we see in teeth with root canal treatment happen with teeth that have had trauma, old fillings, history of complex dentistry, cracks, that sort of thing.
We won’t go into that now, but let’s just look at this case together to see. We took a scan for this patient because we couldn’t clarify with the normal two-dimensional x-ray and they gave us all of this 3D data, okay.
We can change the density of the images if we need to. We can get a lot of clarity around what’s happening in this person’s mouth. We’re gonna skip through to this image though ’cause it’s the most helpful for this video.
So we can see underneath this tooth here, as we cycle through the films from the panoramic image, that unfortunately there’s a lot of bone loss up around the tips of these roots. And what does that mean? It means that unfortunately this patient is suffering from a chronic infection from a tooth which had the nerve die.
Bacteria again, bred in that instance inside where the nerve used to be and that’s unfortunately causing bone loss and cystic granular tissue to be there. Poor immune system is doing the best it can, that’s why these lesions are circular, and they haven’t spread all the way throughout this whole region in the mouth.
But it’s not a good situation nonetheless. So again, another great case for you guys to see and understand what is happening in some other people’s mouths. And hopefully this can give you some context and some great information for your own oral health journey.
Getting the right diagnosis is critical, especially in instances where the immune system is being affected by a chronic infection. The body is related to the teeth and the teeth are totally related to what happens in the rest of the body.
I hope this has been helpful. If you have any questions make sure you get in touch. Leave a comment below. Make sure you look after your teeth, look after your health and I’ll catch you on the next video.
Bye for now.