Since this is primarily a medical blog, I would like to stray, for a moment, into the world of dentistry. Four years ago I contracted some kind of infection in my left lower jaw. The three molars felt like someone was drilling into them constantly - especially #18. They were raised up a millimeter or two, which only made things worse. I tried to chew exclusively on the right side. It felt like the mumps; yet I have had MMR. Well - sometimes a vaccinated person gets the mumps anyways. I didn't know - my doctor didn't know - my dentist didn't know. Thinking it was viral, I didn't take antibiotics. I didn't even take antiinflamatories (my mistake), until the infection spread up the ear canal and into the upper jaw. Eventually the infection went away, but three months later I noticed a swelling near the root of #18. Soon thereafter the entire tooth cracked, and had to be removed. I consulted two dentists, and they both agreed that I must have bit down on #18 hard, and fractured the root, and that caused the jaw infection and (eventually) the loss of the tooth. They even convinced me to get a mouth guard, which isn't a bad idea by the way, but after some thought I had trouble accepting tooth grinding or tooth trauma as a plausible explanation for the loss of #18. I don't remember biting down on that tooth, and it is actually lower than the others, so it would be the last one to be affected by tooth grinding. Remember that the infection seemed to come first, and then it went away. Why would it go away if it were caused by a tooth fracture? Did the fracture heal itself, and then reopen three months later? No - I believe some kind of infection took hold first, and then the tooth fractured because it was 2 millimeters too high, and crashed into #15 whenever I chewed. Or the acids from the infection ate a tiny hole through the calcium and into the root. In any case, I am convinced, four years later, that the infection came first.
Last May it happened again, on the right side. The infection was centered beneath #30, but it spread through all three molars below and started to climb the ear canal. I delayed, yes delayed, for a week or so. Why? Because my wife had gone through tmj a few months earlier, and that was the most recent thing in my head. I wasn't thinking four years earlier. So I babied that side of my mouth, like it was tmj, but it didn't get any better. Finally I stood up and said, "I need an antibiotic!" I went to the dentist, and she took an xray, and saw nothing. I'll say it again; she saw nothing, just like four years ago. Based solely on my descriptions and symptomology, she agreed that an antibiotic was a reasonable course of action, especially since I do not overuse them. My last course was 36 years ago. So I started an antibiotic, and in 4 days I could eat again. I was no longer in agony, and all the teeth were back in place accept for #30, which was still a millimeter high and a bit loose and spongy to the touch. I finished the ten days, and things felt much better, but not completely well. A month later #30 started to ache again, so we took another xray, and this time she saw a tiny infection between the two roots. Another course of antibiotics cleared this up, and I felt pretty good for several months.
In December, #30 was really aching again, so I decided to try one more course. After ten days, now into January, #30 felt better than it had in a year. I could chew steak with it; no problem. I went in for another xray and the infection was massive. It had moved down to the base of the roots, rather than up between the roots. Sure enough, if I pushed on it from the side, I could feel the infection. It didn't really hurt, it just felt swollen and soft. Two dentists and an entodontist said a root canal was my only hope, and even that was 50/50. Being unemployed, I couldn't come up with a thousand dollars for a 50/50 outcome, so I had the tooth out. And it looked perfect! No cracks, no fractures, rock solid. "There's probably a crack at the microscopic level." explained my dentist. Perhaps - or perhaps she's trying to justify what we just did.
In December, when #30 was flaring up for the last time, my wife got some kind of jaw infection. She described it to me. "It's mostly one tooth, but the teeth around it ache too. They are raised up, out of place, and they feel a bit loose, or soft. They also hurt like hell, especially if I put any pressure on them." I stood up and gave her my own advice. "You need an antibiotic!" But this time we didn't dawdle. This time we weren't too late. These soft tissue infections are very deep, and one course did not irradicate the bacteria completely. (A patch placed directly on the gum would probably work better.) She took a second course, and that did the trick. Her teeth are back to normal, and she didn't lose any, the way I did. She has learned from my mistakes.
The timing is interesting, isn't it? She's never had anything like this in her 48 year history, and now she contracts a jaw infection just as mine is raging. Obviously I have passed it over to her. Not surprising, since we are intimate; but even with all this contact, it isn't easily transmitted. She didn't catch it four years ago, when I had the infection on the left side, and it took her 7 months to catch it this time around. I have no idea how it is transmitted, or how I got it in the first place. But once you get it, you're likely to get it again on the other side. I did, and Wendy did too, as you will see below.
None of the doctors or dentists I have talked to are familiar with these "infections". They all think I am grinding my teeth, then the fracture, then the infection; because that is the scenario they know. But I know the infection comes first, and in the case of my second tooth, there was no fracture. Obviously Wendy's tooth was not fractured either, since 20 days on an antibiotic set things right. So there is some kind of jaw infection going around, and it could explain at least some of the <25 million root canals> performed annually; along with an untold number of extractions for those who do not want the ordeal or the expense of a root canal. Even if these jaw infections are extremely rare, they could still account for millions of needless extractions and root canals every year. A doctor or dentist somewhere needs to take me seriously!
It is now the end of February, and Wendy has a new jaw infection on the other side. The symptoms are the same, just in a new location. It is concentrated beneath one of her molars, but it's affecting the others as well. Did she fracture that molar too? Of course not. "You need an antibiotic!" I declare. A few days later her tooth is better. That's another tooth she would have lost if we did not take prompt action.
If you have symptoms similar to these, run to your dentist, get xrays taken, and listen to what she has to say. But you might also run to your doctor, and explain the situation to him. If you don't have to do anything immediately, try an antibiotic. But be aware; you have to start treatment right away, or the infection will triumph, and you'll lose the tooth eventually, probably within a year. also give warning to your partner, since it can be transmitted through close contact.
Wendy and I can't be the only two people on the planet with these recurring infections. Somehow we need to get the word out, and develop a new mode of treatment.