Healthy Smile: You Have A Large Infection

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

Once I informed the patient of what I found through a clinical and x-ray examination, he had a question for me. He asked me, “Was this around last year”? The basis for his question requires that I tell you a little history of this case. Over a year ago, he called me in extreme pain on his lower right side. Based on his description of the constant pain and inability to close his mouth, I felt that we were dealing with, at best, an acutely inflamed tooth. The worst-case scenario would have been a significant infection. Since it is impossible to practice dentistry over the phone, I encouraged him to come in. He was in such agony that he needed very little convincing to set up this appointment.

When he came in, he was not sure as to the source of the pain. I then proceeded to ask a series of questions that would help me localize the area and hopefully provide him with some relief. Frequently, severe pain in the mouth area can come from other causes then teeth. My first step was to eliminate non-dental issues. Once I felt we were dealing with teeth, I needed to do a series of tests to determine which tooth. As is often the case, when he came to me, the pain had gone away. Did he imagine all of the discomfort? It was possible, but not likely. I have treated him and his family for years and knew him well.

I’m sure that many of you are screaming in the background, “take an x-ray.” Taking an x-ray was part of my diagnostic process. Many times in situations like this, an x-ray is inconclusive. Today I probably would add a 3D image to my visual armamentarium to help me reach a conclusion. I needed to put on my Sherlock Holmes hat and make a diagnosis based on deductive reasoning. After spending a considerable amount of time with the patient, I determined the source of the pain. We discussed several treatments and together decided to treat the tooth with a root canal procedure. He was leaving on a mission to South America in a few days, and we had to act quickly.

Immediately, after the procedure, he experienced marked improvement and felt great. Off to the airport and he went on his trip. After a few weeks, upon his return, he called me and said that he was 98% better, but still had some lingering issues. I advised him to give it some more time to quiet down totally and that was the last I heard of the problem.

Fast forward a year, and I receive a call with the complaint of a broken tooth. This tooth was the second tooth to break in as many days, and could not eat. The second tooth fractured so severely that only half of it was left. At the ensuing visit, I took an x-ray and discovered an infection. Apparently, the source of the lingering pain from last year was a hairline fracture in the tooth. That fracture led to the death of the tooth, which resulted in a bone infection.

Due to space limitations, I will end this column now and explore this a little more in the next article. In the meantime, we are open to answer questions and help you treat your emergencies and pain. Don’t hesitate to call Joyce at 440-892-1810 I wish all of you strength and health for the days ahead.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com