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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 3488
Experience:  Dentist and Anesthesiologist for 37 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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I have diagnosed with a bone spicule after the extraction of

Customer Question

Hi, I have diagnosed with a bone spicule after the extraction of a molar on the upper right side. Is it normal for this to be achy and pressured and for how long? Feels like something is "pushing out". It was a very large molar and the dentist did not alter the bone after the extraction because there may be an implant there and he wanted to save as much bone as possible. Does this make sense? Also, what is the best pain remedy? It is almost as bad as a migraine. In fact I think it may be triggering a migraine...Thanks for your input.
Submitted: 2 years ago.
Category: Dental
Expert:  Dr. Katz replied 2 years ago.
Welcome .I will do my best to answer your question.I am not a great typist,be patient and feel free to ask if anything is unclear.Bone spicules are fairly common after extractions but any sharp edges should have been trimmed off at the time of the extraction.Do you have any swelling? How long ago was the extraction done? Is there any sinus stuffiness? Were you placed on an antibiotic?
Expert:  Dr. Katz replied 2 years ago.
I see that you are offline.I will be on the road for a couple of hours but I will check back for your response in a bit.
Customer: replied 2 years ago.
Hi Doctor- Here is the sequence of events, maybe TMI, but I sent this info to my GP today so she knows what is going on. Thought this would work for you....Let me know what you think particularly about next steps....6/10. Met with Dr. I, Dr. M partner regarding Mercury Amalgam removal at your recommendation. Also discussed symptoms I had been having on the upper right, (heaviness, dizziness, pressure, shooting pain at times). He took x-rays and noted inflammation around the root of upper molar right side, next to implant. Recommended root canal, per the tooths involvment in a bridge, as an attempt to save this tooth. Recommended Endodonist and I made an appointment. Decided to put off removal of cavities until insurance renewed in Jan.6/23 Consult and root canal performed same day. . Dr. C said there was evidence of calcificaton of the nerve, which would explain symptoms but saw no sign of infection. felt procedure had gone well. Tooth and area felt better for about 2 weeks and then symptoms started again. (Cost out of pocket - 700.00)7/25 woke early in the AM with sharp increase in pain. Called Dr. C on Monday and saw him on 7/28. STARTED ON PENICILLIN (4 TIMES A DAY) He recommended another surgery, this time going in from the top (Cost would be 1200.00 to me. Said it was 50/50 I would ultimately loose the tooth because if was cracked) Scheduled surgery on 7/7.7/4 - Saw Dr. M for consult regarding treatment plan. (Dr I not available) He recommended extraction explaining root canals are generally not good for the body and I would likely lose the tooth any way. Recommended removal of the tooth and replacement of the bridge with two implants, though also said a bridge across two implants would work. Said Dr. Iwas trained to all of this work. Said "this is his thing"8/6 - After much discussion settled on plan of one additional implant and a bridge to the exisitng implant, and in order to decrease the number of surgeries Dr I removed the tooth and set the adjacent implant at the same time. Later stated Dr. M agreed with this treatment plan. This was difficult. Tooth was very large and had to be broken to be removed. Lots of pressure on the jaw. Didn't think there was any damage to the jaw.8/7 Stopped pennicilin. Pain was resolving, clot formed well. Taking Aleve and Vicodin at night and some in the day time.8/9 Pain began to get worse. (pain level 4-6) Emailed Dr. I.8/10 Saw Dr. I, thought healing was going well, but there may be infection related to food trapped in extraction sight. RXED AGMENTIN AND ANTIBIOTIC RINSE. Said take for 3 days.8/11 - Pain got better, less pressure, energy better. Pain level 2-38/14-15 - Pain increased again, more pressure as well. (Pain level back to 4-6)8/17 - Saw Dr I again, Dxed bone spicule's. (Bone spurs proturding from the gum) These are a part of my jaw. I think there are a total of three emerging. He saw no sign of infection and took x ray to confirm. Explained he had not removed any bone at the extraction site from the jaw because there was a possible need for bone graph if we decided to do a second implant after all. Said this could take weeks if not months to resolve, but would remove them in a few months if there was still significant pain. Wants other wounds to completely heal. Have continued with Augmentin for a few more days. Using clove oil, salt water washes. Still need pain meds to function, though Vicodin only when it is really bad. Cost to me: 2000.00. The implant crowns, and bridge work will begin in January. That cost will be between 2000.00 and 4000.00. I may get some coverage with insurance.I have been taking Aleve for 6 weeks. Twice a day.8/18. Up at 3 am with significant pain and pressure. NO SIGNIFICANT SWELLING. I will see Dr. I a week from Thursday (9/1)for follow up. Just trying to control pain and discomfort.I am glad there is no infections and I am afraid to stop the anti-biotics but will. My guess things could get worse before better as bone finishes poking through gum. Major symptom is pressure/throbbing. I am really beginning to feel the fatigue now.Dr. I has been very responsive and his follow -up after the surgery has been included in the price (so far). He is a gentle soul and I think has done the best he can with my concerns. I am frustrated with my progress. He probably should have shave down the bone around the extraction sight. It was his call and stated they do what they can to preserve bone. I really don't know what the right thing was.AGAIN, ANY IMPUT WOULD BE WELCOMED.
Expert:  Dr. Katz replied 2 years ago.
There is alot of information here plus alot of misinformation. Amalgam fillings do not cause systemic illness and neither do root canals .The research on these two areas is extensive and your doctor has avoided reading the research in favor of his own treatment plan.Pushing implants is a money making scheme in many cases.There are numerous options besides implants that are much more predictable ,safer,cheaper and longer lasting.My impression is that you may have a sinus infection.Bone spicules do would cause pain just at the gum at the site of the spicule protruding and would not cause the symptoms that you are describing.Your dentist may be nice but he is misinformed.If you could upload xrays of your mouth,I could give you a better idea of what is going on.
Customer: replied 2 years ago.
Thank you for the input. I do not have access to the x-rays. I will see about getting it. In the mean time, I will try to find someone to look at the treatment plan. At this point, the implant is in place and the tooth is gone...I have to live with that and go from here. I will continue with the antibiotics and see if we have more improvement. Thank you again.
Expert:  Dr. Katz replied 2 years ago.
I would be more than happy to discuss possible treatment plans with you but I really need to see the xrays.Immediate loading of implants is a recipe for failure.If you can avoid that it may help.The antibiotic of choice in your case is Amoxicillin 500 mg every 8 hours for ten days.