Expert: Mark Bornfeld DDS - 3/23/2009

Question
Hi Dr. Bornfeld...I wrote you a couple of weeks back about strange bilateral
tooth and face pain I've been having for 8 months.

I wanted to let you know I had some more xrays done, and I have what is
believed to be condensing osteitis between the two lower molars which have
been causing me pain. I'm getting a CT scan tomorrow to make sure it is not
something more serious.

I am aware osteitis usually comes from infection/inflammation. It is possible
this infection or inflammation could have spread to the other side of my jaw
and face?  

I'm going for treatment in a couple of days. I just wanted to share this new
information with you and get your counsel. Many thanks.  

Answer
Dear Kristin,

No-- condensing osteitis does not spread, much less jump to the other side of the jaw. If a lesion resembling condensing osteitis is present on both sides of the jaw, the two lesions are either independent and unrelated to each other, or they represent some pathological entity OTHER than condensing osteitis-- perhaps one of the fibro-osseous disorders such as osseous dysplasia.

Condensing osteitis is usually easily identified by its close association with a contiguous infected tooth, or with the socket of a recently extracted infected tooth. Unfortunately, some dentists use the term "condensing osteitis" as a catchbasin term to describe anything that resembles it on x-ray, regardless of whether the other diagnostic parameters fit.

If your dentist is unclear as to the true diagnosis, it would be preferable for you to request a referral to an oral pathologist for more formal exploration.

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY