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Dentistry/Dental Implant Question

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Question
Dear Dr. Teig,

In July of 2013, I had a tooth extracted and all the infection cleaned out, in order to begin the implant procedure. On that same visit, he packed in cadaver bone. I then went back for x-rays with this specialist in November of 2013. He said everything looked good, other than I lost a little of the cadaver bone on one side, but he said it would be just fine. In December of 2013, I started experiencing jaw pain near the bone graft and immediately went in to have this checked out and they said everything was fine. Do you know what could cause this pain? Thanks for your input.

Answer
Tammy - What you have experienced is a situation I find that is not uncommon when a bone graft the same day an infected tooth is removed and even if the socket is scraped to remove any inflamed tissue.  The problem is that the bacteria in the infected tissue actually extends into the surrounding bone.  This extension allows bacteria to grow in the surrounding bone and cause future problems if a premature placement of a dental implant is done at the time an infected tooth is removed.  

With the loss of some bone in November and now the episode of pain near the graft, in my experience, it usually means that the remaining bacteria is still alive and beginning to grow and eat away at the bone.  In my experience, I have seen that the bone is often needed to be cleaned out now, antibiotics given, along with warm salt water rinses and allowing the bone to completely heal.  It is for the experience that you are now undergoing, I have always felt that bone grafting in an infected socket is wrong and the socket should be allowed to heal. Look, I cannot be sure that that is what going on, but from your symptoms and the history of what went on, I thin a low grade or active infection is active.  

I, of course, cannot be sure without examining you, but from what you have endured, it seems to be what is occurring.  You need to be examined by a board certified oral and maxillofacial surgeon.  I wish you well and hope it all heals or is taken care of soon.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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