Have a fistula on gum of tooth#3 which was root canaled twice

[USA2Elsewhere]

i

I noticed swelling on my gum above this tooth. Dentist says I need the tooth extracted. Not sure I'm going to use this office because I was not offered LA before a test was done on the tooth and fistula (gutta percha test) and it was painful. Mom has used this dentist and has not had LA and had pain here also. How long do I have to choose a dentist before the infection gets too bad. Very nervous older lady here.

Went to the oral surgeon yesterday for my consult for tooth #3. First thing done after assistant went over med history was to take my BP. Don't remember if I mentioned I'm on Lotrel generic for BP. Dosage was for years 10/20 but due to swelling in back of ankles my primary care (mind you he left in December) put me on "intermittent" lasix for the swelling and changed to lotrel 5/10. So I stopped the lasix under my new nurse practitioner and stayed on the 5/10. So now I'm on half the bp med I was on before I ever took lasix. This is okay for now. Readings are not the optimal I had on the 10/20 but for now I'm okay with 135/80 or so. I was shocked my bp reading was 160/75 at the oral surgeon's because I have terrible white coat hypertension also. I expect it will go up when I'm there for the extraction, scheduled for Mar. 26. I asked the oral surgeon what happens if my bp is too high for the extraction. He said he would send me to my primary care to get the bp down first. That was a relief. Another relief was that he will not use IV sedation on me or GA because of things like my pulmicort med for asthma. When I asked if he will use any epi, he did not have to think about it and said no, another relief.. Maybe the collagen plug he said he will use will sub for the epi. He said to not stop the 81mg aspirin but then said to talk to my primary care about it. I'm afraid of bleeding so I'm going to push for at least reducing the aspirin. He's not at all concerned with bleeding. He said he will put in bone grafting because the infection caused bone loss. Also I asked him about the possibility of arteriovenous malformation and to check for bruits and he sort of laughed and said I'd know already if I had that. He did look around my mouth and pushed gently on tooth #3. I asked him about tests for other bleeding problems and he laughed again -- same reason and said he would lose his license to rx any of these PT or clotting factor tests as theyre considered medically unnecessary. He said go ahead and get them without him if I want. I would still like to pursue the possibility of screening for any rare disorder which could affect the outcome with this tooth. I have a list of the 13 factors as well as BT and PT/PTT/INS. Primary care (a nurse practitioner, for now) said CBC is normal including platelets. What if any test could be done to be as sure as possible that I don't have a hidden problem that could affect this issue all the way through the implant, which would be done about 3 months after the extraction? (He doesn't do the implant prep same visit as the extraction, which I feel would be too much for me with the anxiety.) Anyway, I'm relieved until I go in for the extraction. So please I'd especially like to hear if there are any other screenings or test advice, incuding but not limited to bleeding/clotting possibilities.

 

[geos]

The CBCT is a Cone-beam computed tomography. It gives a 3d image in comparison to the traditional 2d radiography.

 

[comfortdentist]

cone beam cat scan which is typically used in dentistry

 

[USA2Elsewhere]

The CBCT is a Cone-beam computed tomography. It gives a 3d image in comparison to the traditional 2d radiography.

The CBCT is a Cone-beam computed tomography. It gives a 3d image in comparison to the traditional 2d radiography.

The oral surgeon told me the xray he has that the endodontist gave him would show if i had any arteriovenous malformation of the maxilla.

 

[USA2Elsewhere]

cone beam cat scan which is typically used in dentistry

comfortdentist, is there a reason the oral surgeon is sure this 3D imaging isn't necessary? If it's used in dentistry, he surely won't use it.

 

[USA2Elsewhere]

Oh, and I'm also going to my nurse practitioner this week to talk to her about this. She probably won't know the dental questions but may know about the clotting disorders.

 

[USA2Elsewhere]

I just looked up the cone beam xray and I did have a full panoramic xray about 17 years ago. Would that have shown any congenital arteriovenous malformation of the maxilla?