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Oral Surgery/tooth infections

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QUESTION: Hello,

The last few years my mouth has been deteriorating rapidly with many infected teeth which required 5 root canals, and crowns, and two emergency extractions of severly infected teeth that were making me ill in my body. Ive been on several rounds of Amoxicillin. I have very low self esteem and trouble with self care and have neglected my teeth. That combined with my father's bad teeth genetics, luck of the draw. Please don't judge me. I need help.
I am currently ill with chills, nausea and
overall sick feeling consistent w previous infections. I'm way overdue for at least three more root canals (which I've put off because of money concerns) and believe I may have infections seeping into the sinus cavity and or jawbone.
I feel systemically ill with chills, nausea and at times a flushed face.
I'm scared. I cancelled a new endo appt today in the state where I'm in because I'm so sick and scared of this situation and unclear what to do. Sounds dumb I know but I couldnt get out of bed. I also suffer from depression and severe PTSD. It seems to me I've read that clearing the infection with a round of antibiotics before procedures is wise.
What is the best antibiotic and what strength for a case like this?
Who do I turn to to properly assess this situation? I am in MA.

If I walk into the ER what can they do for me?

Which antibiotics can be effective if it's gone systemic/sepsis? How do they detect where it might be in my system? On a recent blood panel a few mos ago, my white blood count was 10,000. High normal.
I was hospitalized twice this past year with AFIB and have not been well although my heartbeat is normal managed by blockers. I am of course concerned about my heart.
I am an ultrasensitive person. This feels a living hell.

My old dentist is in another state. I'm embarassed to call him because I owe him $20k.

Any advice you can give me would be greatly appreciated. I'm in trouble here, feeling ill and terrified.
Thank you.

ANSWER: Emily - I am so sorry to hear that you seem to be suffering from infections from the mouth and an overall effect throughout.  My suggestion is quite simple and is necessary to not only determine the causes, but arrive at a solution to regain your health, while allowing your teeth to also be healthy.

In Massachusetts, there are a number of dental schools, dental residency programs in hospitals and Massachusetts state programs.  My main interest is to not only regain your dental health, but also return your overall health to a much better state. For that reason, I think it might be best for you to be evaluated at a dental residency program associated with a hospital.  If you could get back to me and tell me where in Massachusetts you live, I can refer you to an appropriate facility near you.

So please get back to me, tell me where in Mass you live and I will try to find and appropriate place to help you.   

---------- FOLLOW-UP ----------

QUESTION: Hello Dr Teig,

Thank you for very swift, kind and thoughtful reply.
To answer your question, I am on the Cape, in Hyannis. We have Cape Cod Hospital here. I do have MASS HEALTH/Neighborhood Health Plan.

I know Tufts is supposed to have a good dental clinic and maybe others in Boston?
Any and all ideas you might have would be enormously welcomed.

I really need to do something as I am feeling quite unwell.

Thank you for your empathic response. Not everyone is that nice.

I should tell you I come from a very good upbringing and have been accustomed to top drawer dentlstry. I'm not the public health clinic type if you know what I mean. If there were a way to get a First Rate Professional Diagnosis and the appropriate care without outlandish costs that would be my choice.

My dentist in NY is old school. I feel I need and want state of the art leading edge dentistry..most likely to be found at a first rate dental school clinic where there have all the new knowledge and  equipment. For instance the panoramic CT scan machine of the head jaw and neck. At least 1/2 my teeth have been root canaled. I just don't know if I can handle anymore. He wants me to have three more. That's $3-4000 dollars. But losing more teeth and the prospect of implants or worse(!) is also so daunting to me.



Anyway, Thanks again and I'll wait to hear from you. What state are you in? Just curious.

Too bad you're retired ;-)

Emily

Answer
Emily -  I am in New York, but I have found a facility in Massachusetts south of Boston.
  
    Northwoods Medical Center (Tanuton)
    2007 Bay St. Suite B110
    Taunton, MA  02780  508-823-7323

This facility is a Tufts facility and has dental residents along with practicing dentists.  They handle all aspects of dentistry, but they also have physicians at the facility.  You need to make an appointment for your dental situation and during the examination be sure to tell them of the effect of the dental problems has caused on your overall health.  

I hope this facility works for you.  They are associated with Tufts and Massachusetts so they should have the ability to address your problems and guide you to appropriate treatment to reverse the problems you have been enduring.

If for some reason they can not help, you can get back to me and I will try another way.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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