Quick question regarding sepsis/infection.

[Gilbo]

Hello, it's me again, sorry. As previously mentioned, I have Prostate Cancer and following my recent first molar extraction (3rd March), had dry socket and antibiotics to treat that on 11th March (five day course of Metronidazole), which finished on 16th. March. The next day, the 17th, I had a bone scan for my cancer, which thankfully came back as 'all clear' today. While this is very good news, they also found on the scan that I have a 'dental sepsis', which I think means the socket is still infected? In fact, having looked it up, it does seem to be rather dangerous to have such a thing! I do still have pain around the socket area, though it does seem to be calming down and healing. I just wanted to ask any dentist, if you think I should mention this to the local emergency dentist (the only one available to me now!), or, as it's almost impossible to see anyone now, should I just let it go? Having read up a bit more, I do not (at this moment) have any of the other symptoms of sepsis mentioned, I do also have type 2 diabetes, as I see this is mentioned as a risk factor for it as well.

Many thanks.

 

[Niall Neeson]

Hi Gilbo,

Firstly, congratulations on the great news with the scan, that’s fantastic.

Can I ask, do you have any swelling or redness other than directly around the area where the tooth was removed? Does the face look different on that side compared to the other side? I presume your breathing has not been affected in any way?

You’re absolutely right that true dental sepsis is a serious diagnosis. It is usually accompanied by some pretty serious symptoms too i.e. you’d know about it!

I get the impression that this term may have been used incorrectly to describe the healing or infected socket. It’s good news that you feel that it’s healing and improving. Some lingering discomfort is not uncommon, especially with accompanying underlying health conditions.

If there was any sign of spreading infection or increased swelling I would call the emergency dentists ASAP but considering it’s 2 weeks since that previous assessment it sounds like things are settling ok. Considering the current situation and your underlying conditions, it’s probably best to avoid a trip out unless it’s essential.

Would you mind posting a photo or two? It would be helpful to see the area, also the area around the face. If you’re happy to of course. You could also PM me with it if you prefer.

It sounds like it’s fine, I just don’t want to be sure!

Niall

 

[Gilbo]

Thank you Niall! I tried the photo thing, but didn't get a good enough picture to post yet. I think it looks just like it should do, but I will try again tomorrow!

I don't seem to have any other swelling anywhere, nor does my face look any different. Today (Wednesday), I tried ringing the emergency dentist I mentioned, only I couldn't get to speak to anyone as the phone just cut me off after waiting for about 15 minutes to be connected!

I then rang 111, who said I should try to ring my new dentist, I told them I already tried that, but they said, as I haven't had a first appointment there yet, that I still do not class as one of their patients. The 111 clinician told me that I should then try ringing my old dentist, which I didn't think would work, only I was surprised that it actually did! So hopefully, I should be going there at about nine in the morning to get a course of antibiotics, which should clear up any pain in the socket.

The strange thing is, the opposite first molar, which this same dentist also root-canalled, has now started stinging and feels very sore whenever it is touched! (I am in the wars!) This is probably caused by my only eating on the right side at the moment. So I hope this new course of tablets (if I do actually manage to get some), will kill two birds with one stone! Or rather, two dental problems with one course of pills, to be more accurate. I will let you know how it went.

Many thanks again.

 

[Niall Neeson]

Thank you Niall! I tried the photo thing, but didn't get a good enough picture to post yet. I think it looks just like it should do, but I will try again tomorrow!

I don't seem to have any other swelling anywhere, nor does my face look any different. Today (Wednesday), I tried ringing the emergency dentist I mentioned, only I couldn't get to speak to anyone as the phone just cut me off after waiting for about 15 minutes to be connected!

I then rang 111, who said I should try to ring my new dentist, I told them I already tried that, but they said, as I haven't had a first appointment there yet, that I still do not class as one of their patients. The 111 clinician told me that I should then try ringing my old dentist, which I didn't think would work, only I was surprised that it actually did! So hopefully, I should be going there at about nine in the morning to get a course of antibiotics, which should clear up any pain in the socket.

The strange thing is, the opposite first molar, which this same dentist also root-canalled, has now started stinging and feels very sore whenever it is touched! (I am in the wars!) This is probably caused by my only eating on the right side at the moment. So I hope this new course of tablets (if I do actually manage to get some), will kill two birds with one stone! Or rather, two dental problems with one course of pills, to be more accurate. I will let you know how it went.

Many thanks again.

Hi Gilbo,

Glad to hear you eventually got in touch with a dentist. It’ll be good for your peace of mind to get an opinion.

The discomfort on the opposite side may indeed be related to the additional work. It’s also not uncommon to clench or grind the teeth at night during a time like this, even if people are unaware of doing it. Either way, it’s likely to be temporary and will hopefully settle down fine.

Yes, please let us know how it all goes.
All the best,
Niall

 

[Gilbo]

Well Niall (and anyone else watching), I got the antibiotics that I hoped for! My old dentist was as friendly as could be today! I just hope that they do the job on the toothache, as he said the next and only remaining step for this tooth, is to have that one out as well! That would be the last thing I want!!! So hope it doesn't need to happen. Or if it does, then hopefully this first extraction site will be fully healed up and not causing me any grief at all, as I'm sure I would be in Hell to lose that one too! He also said that, having the first tooth crowned instead of extracted wouldn't have worked and that he can't see why that option was even offered to me! Though I personally think I should have gone for it!

It's funny to think that my old dentist turned out to be the only one in the whole country who would not only see me, but would help me too! Maybe he felt a bit guilty, as he did both root canals, which both later failed! Though I suppose it can happen to anyone and I can't really hold him responsible! Maybe I should go back to them d'you think? As my 'supposed' new dentist is running scared and has so far refused to see me at every turn! Although they get the best reviews of any local ones. As I recall.

 

[Gilbo]

I also got some anti-depressants today, for the first time in years. I'm gonna pop the first one in tonight and hope it works (in about four weeks time!) But if this all goes according to plan, I shouldn't be on them for very long at all, I hope!

 

[Niall Neeson]

Hi Gilbo,

I’m glad you’re happy with the outcome and I hope the discomfort all settles effectively.

In relation to choice of dentist, I think that’s one where you’ve got to follow your instinct.

The root canals working out long term is likely more to do with your immune system/ healing due to the medical conditions rather than your dentists technique so I wouldn’t necessarily hold that against them. At the same time, I don’t know the reasons why you started looking for a new dentist in front first place so there may be more to it than that.

That’s your call and there are many factors to consider.

Either way, I wish you all the best with both your dental and medical care moving forward.

All the best,
Niall

 

[Gilbo]

Thanks again Niall. Just to finish, my dentist had arranged a 15 week wait (until 13th. May), with their dental surgeon to extract my tooth! The tooth actually split apart many weeks before that, back in February. I think because she hardly ever goes in to work anymore, they had done that to try to get rid of me! The dentist himself had always done any work needed himself. But I think I may have been a little hasty in judgement. I couldn't see any other reason for such a delay, but now I've brought it on myself, that I will probably be waiting for at least six months!

Many thanks for your help and good wishes. Best regards, Gilbert.