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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
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Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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Is it possible to have bone spicules migrate to the surface

Resolved Question:

Is it possible to have bone spicules migrate to the surface of the gum on the lingual side of the mouth and behind the back teeth 30 years after extraction? I have had an incident in the past where a bone spicule migrated out of the roof of my mouth. The dentist looked at it and said it could take 4-8 weeks for the area which it did. But why so many years later? I had my wisdom teeth extracted 30 years and while they were not impacted, they were crowding the other teeth. They were removed by a general dentist using what looked like a phillips head screwdriver and a mallet. Any thoughts would be greatly appreciated.
Submitted: 4 years ago.
Category: Dental
Expert:  Mark Bornfeld, DDS replied 4 years ago.
Dear ,

It is possible for bone spicules to work their way out of the gum at any time. However, it is unlikely that a piece of bone, or "sequestrum", would be causally related to an extraction that took place so long ago.

Sequestrae occur after extraction as a result of a separation of a piece of bone from its moorings, which eliminates its blood supply. Just as any other part of the body that is deprived of its blood supply, the piece of bone dies. The body recognizes the presence of the dead bone as a foreign body, which initiates an inflammatory reaction that eventually expels the sequestrum. However, it is implausible for a devitalized sequestrum to be retained by the body for 30 years; if it was caused at the time of the extraction, it would have surfaced within one or two months, not 30 years.

That does not mean that sequestrae don't occur for reasons other than extractions-- they can occur as a result of anything that may kill bone. That may include bone
infection (osteomyelitis), certain medications (bisphosphonates, which are used to treat cancers and osteoporosis), and can even occur do to unintended bone injury during surgery (for example, a dentist performing electrosurgery at the neck of a tooth).

Keep in mind that what you interpreted as a bone spicule could have been something else-- for example, an impacted fragment of food or even animal bone in food can produce an inflammatory foreign body reaction, and the fragment can be mistaken for your own bone. Rarely, fragments of teeth that were inadvertently allowed to remain in the jaw after extraction can surface years later-- especially if a denture prosthesis is worn over it.

Hope this helps...
Customer: replied 4 years ago.
So whatever this spot is, how should I treat it? I am currently using warm water and salt rinses along with peroxyl. I am taking tylenol for pain. How long should I give this process before seeing my dentist?
Customer: replied 4 years ago.
So what are the potential possibilities if it really is a piece of my jawbone breaking off? What can be done then? Since this has happened before about five years ago, I figured things would be ok after several weeks of treatment. What should I worry about if small pieces of my mandible are breaking off on the lingual side?

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