AboutJoel S. Teig, DMD, FABOMS 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
DMD
Awards and Honors National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude
Question My A1c levels are usually 5.9 or below, and my daily blood sugar levels run between 100 and 120. I am Type II, and also take meds for hypertension (dyazide and avapro). Is there anything else that could be causing this? I now have some swelling of the gland under that side of my jaw. Thank you.
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Followup To
Question -
After having a cracked filling replaced (tooth #31), two weeks later I had a small bone chip protrude through my gum on the lingual side where the wisdom tooth next to #31 would be. (I had my wisdom teeth extracted in 1978). My dentist took x-rays and removed the bone chip, said it was not related to the recent filling, and was probably left over from the wisdom tooth extraction. In the last 4 weeks, I have had two more bone chips come through at the same spot, and another one is starting to emerge now. My dentist says don't worry about it.
I am very concerned. I am 55 years old, mild diabetic, but not on any medication that would cause this, according to my dentist. What is your opinion?
Answer -
Jeffrey - It is possible, though rather remote that residual loose bone from an extraction of 28 years ago would now all of a sudden come to the surface. There must be some other factor causing the residual bone fragments to emerge.
I'm assuming from your statement that you are a Type II diabetic. If you are not totally in control with your blood sugars, the body can have areas that are blocked from normal blood flow. This significant reduction in blood flow can produce fragments of bone to be produced which then emerge.
My suggestion is to first be examined by a doctor a little better versed in bone chip occurances. This doctor is a board certified oral and maxillofacial surgeon. He can better define the cause of the bone fragments. Also if you are not already taking your blood sugar levels a few times per day, it might not be a bad idea to do so before significant medical problems develop.
If you have any further questions feel free to contact me again.
Answer Jeffrey - Obviously your blood sugar levels and A1C show that you are a well controlled diabetic. The submandibular glandular swelling you describe is indicative of an inflammatory process. Having had an extraction 28 years ago would very unlikely create an inflammatory process. Having your dentist obviously dismiss the recurrent episodes of bone loss is a perspective that may allow some active process in the area to proliferate. I am not saying, without directly examining you, that there is something there, but you need to be examined by a doctor who has a better perspective and knowledge of the type of situation you describe.
My suggestion to you is to seek a second opinion from a local board certified oral and maxillofacial surgeon. This type of doctor is well versed in the many varied causes of the what you are describing.
If again have another question do not hesitate to contact me again.
