Infected Tooth. Best Path Forward?

[Needforname]

Hello. After years of dentists and doctors dismissing my suspicions of a possible tooth infection, as usual my gut feeling was proven correct. Just today, it was confirmed by an endodontis that a root canal I had done many years ago is definitely infected. Which naturally leads me to wonder if this infection is somehow linked to my rheumatoid arthritis and 15 years of chronic pain, and could possibly explain why none of the meds I've taken fail to work.

Of course the endodontist who verified this infection completely dismissed any possibility of the infected tooth causing RA. He claimed the infection is a localized trapped bacteria and that there is no science or study to back up claims of people experiencing remission from a tooth extraction.

I'm now left with the option to surgically remove the infection, or have them drill out the infection, or just extract the tooth. I'm opting for option 3 (extraction) so that I can rule out the RA link. But I'm not sure what type of doctor I should have perform the extraction. The endodontist said he wouldn't be doing it, and that I'd have to have my dentist or a surgeon perform the extraction.

I was hoping to hear other's thoughts on this. What kind of practitioner would be able to perform an extraction in the safest way possible? A dental surgeon, a holistic dentist?Also, should I skip my Enbrel and Methotrexate and start on antibiotics before getting the tooth pulled? My RA doctor told me it's fine if I decide to take antibiotics while on the RA drugs, yet sources online say that kidney damage can happen. I'm weary about stopping the RA drugs because I don't want to screw up any possibly progress (even though they aren't helping yet).

Any input would be appreciated. It would be nice if I could trust the judgement of my doctors, but they have failed me for 15 years. I was told the "professionals" that my tooth in question was fine for the longest time. They were wrong. I was told all of these drugs would work. They haven't. I'm being told that a dental infection is not linked to RA, yet I've read a few accounts in these forums from folks who claim otherwise.

If this extraction somehow miraculously heals me, I'll make certain to let the world know. Thanks.

[Cherub198889]

Gwaad.... you are telling me my story. I was carried onto the dental chair by my husband as I was in so much "RA" pain....Guess what? I jumped off the dental chair and was able to walk after the extraction. I actually felt the "RA" symptoms leaving my body as I laid shivering on the dental chair after the extraction. I can not explain the feeling of the "RA symptoms leaving my body" .... but I would love to hear your story.

I fell "arse backwards" into being RA free & now drug free once my 2 root canals were delt with. It's not about "discovering the cause of RA" or "Debating what causes RA".....that's best left for the scientists of the world to discover...For me, and maybe you, it's about incompetent dentists doing surgeries that they have no business doing. Their incompetence can give you symptoms that mimic RA.....the toxins leak into your bloodstream and slowly & painfully start shutting down your organs.....then the next step is death. So while the rheumatologist try & figure out how to help you...they can't....your "RA" keeps snowballing because truth be told, you don't have RA in the first place.

It has been 10 months since my 10 year old root canal (Canadian molar # 37) was extracted. It is also 10 months since an endodontist retreated another 10 yr old root canal (Canadian molar #26) . The endodontist pulled out a 10year old gangrene root that my dentist missed....my ankle reattached to my leg the moment the 10yr old gangrene root was pulled out of the old root canal.

So, since my dentist didn't do the 2 root canals properly, and now they have been fixed, my RA+ diagnosis changed. I have reactive arthritis,,,,and I am left very angry that my dentist tried to, and almost succeeded in killing me.

I do not believe incompetent dentists causes RA....but an incompetent dentist leaving in infected root in your root canal can....and DOES cause RA-like symptoms.

Please make an appointment with an Oral & Maxillofacial surgeon in your area. My surgeon & my endodontist saved my life. Please keep me informed.

All the best to you

Sue

[Needforname in reply to Cherub198889]

Hey Sue. You are actually the inspiration behind me getting my tooth checked. After reading your story and others like it, it verified my concerns, which ultimately pushed me to get an x-ray and referral to the endodontist. The sad thing is that numerous doctors and dentists dismissed my prior concerns with this tooth. Basically I've probably had an infected tooth for nearly 15 years now.

I was going to message you personally and ask your recommendation about what kind of dentist / surgeon I should visit. Thank you for mentioning the oral & maxillofacial surgeon. I'm not sure if I need a referral or not, but I'm going to call my dentist tomorrow and see if he can recommend someone for me. I just googled "maxillofacial surgeon" and it seems they have 8 years of schooling and are much more educated than a regular dentist. That sounds good to me... especially since this tooth is very close to my sinus cavity.

The endodontist thinks I'm nuts for getting the tooth pulled rather than just cutting out the infection, but part of me will always wonder if they got all of the infection if I chose the removal method and it didn't stop the RA symptoms. He laughed when I told your story and said "that's not possible... the infection is localized... must have been something else or placebo". I said, first of all, if it was placebo, wouldn't you think the placebo effect would have worked when she took the meds rather than a dental procedure where she didn't even suspect it would help?". Of course he was not interested in learning more about this. They are so stuck in their ways and afraid to have their profession and knowledge questioned.

I'll let you know how it goes. Thank you very much!

[sylvi]

Darling first off the general advice is not to take drugs while on antibiotics,but in your case everything is turned up on its head. I would certainly take some antibiotics to start getting rid of the infection. Then it might be a good idea to get it removed in a hospital as there are more facilities there should anything change and hopefully there will be no problems when they remove your tooth.xxxxx

[Needforname in reply to sylvi]

Hey Sylvi. Thank for the reply. Where I'm torn is the conflicting info. For example, it says on WebMD and other websites to not take antibiotics while on the meds I'm on. It can cause kidney damage... especially since I'm on pain meds and 2 RA drugs. And the endodontist says antibiotics will not reach the infection anyway, because it leaks from inside the tooth. Though I would like to get the antibiotics in my system before I get the tooth extracted. I need to find a good surgeon because the tooth is very close to my sinus cavity, but am low on funds and need to be fiscal. Anyway... thanks. I'll look more into the antibiotics. I appreciate your time.

[sylvi in reply to Needforname]

I think for this problem it will harm you its not like your going to be on antibiotics longterm. That is just my opinion,but you need to speak to the surgeon who will be doing the surgery to see what they feel you need to do beforehand.xxxx

[Needforname in reply to sylvi]

Thanks. I saw a new RA doctor today. He is now saying that I might not even have RA since none of the meds have worked and because I don't have visible swelling. He says I may just have to deal with the pain. So confused right now. I'm only 37. No way in hell I'm living another 15 years like these last 15 years of chronic pain. This isn't living.

And when I try to get antibiotics none of my doctors or dentists will prescribe them. They all say to ask someone else for a script. I'd like to rule out possible infection by trying the antibiotics prior to trying infusion therapy.

Anyway... I have an appointment set up for Jan 2nd to get the tooth removed with a maxillofacial surgeon. Since no one will prescribe me antibiotics, I guess I'll just have to hope that the extraction will offer some relief. Thanks for your help.

[sylvi in reply to Needforname]

Ask to see the pain clinic and see what they can do to help you darling i am under them and next month they are going to get me an infusion for the pain. ALso they are going to get me into the tens clinic. Now to your problem there is certainly something wrong with you or you wouldn't be in pain(god only knows i know about pain) You could still have ra,but it can come in different forms and sometimes they don't always show up in your bloods darling. Ask for a second opinion and start again from scratch. It could be you might have fibromyalgia just for an example so there could be something amiss with you darling. I know being in pain 24/7 is a nightmare and i know how it gets you down. Know there is a answer out there somewhere darling so keep plugging at the medics to get an answer. Hugs to you darling.xxxx

[Needforname in reply to sylvi]

Thanks Sylvi. It seems we both know pain too well unfortunately. In response to your reply... I'm already seeing a pain mgmt doctor and have been on oxi's and percoset for a few months. They bring the 9/10 pain down to a 7/10. Tried everything else under the sun and nothing works.

Been tested for lupus, lyme, and lots of stuff. Some doctors think I may have Fibro, but Lyrica didn't help. Prednisone didn't help. LDN didn't help. Neither did MTX or Enbrel. Now I'm being told by this new rheumi that he questions if I even have RA and not something else since I have no apparent swelling. Though my anti-ccp levels are 2,600. A positive anti-ccp is highly indicative of RA. But the fact that prednisone didn't even help is very odd to me and the doctors.

I have an apt to get the tooth removed on Jan 2nd. Hoping that may fix something. I've always wondered about some other tick born illnesses since I was bitten years ago and had a rash. The doctors dismissed it of course so no treatment was ever given. Always in the back of my mind. Lyme tests show negative, but I need more conclusive testing from a lyme literate doctor when I can afford to.

Have you been able to get your pain under control by way of meds? I see you mentioned a tens clinic. I bought a tens unit on Amazon a few years ago. Have since purchased many for family who are also in pain. They're like $30 and work just as good as the ones at the chiropractor offices I think. Something to consider.

Thanks.

[sylvi in reply to Needforname]

I have one,but struggle with using it hence going to the clinic and she said they could loan me one as well,but the problem is when the pain never stays the same from day to day. We can't win can we.

Keep plugging at the medics for an answer darling.xxxx

[Cherub198889 in reply to Needforname]

I was given antibiotics before I left the oral surgeons office. I was told that I was "lucky' that the 10yr old infection didn't go to my brain. I was also given the impression that it could still go to my brain if I didn't take the antibiotics.

So, not meaning to give you medical advice,...... I felt I was damned if I take the antibiotics while on RA drugs and I was damned if I didn't take the antibiotics.

[Needforname in reply to Cherub198889]

I hear ya. It's confusing. I saw a new RA doctor for a second opinion today. He's saying that I might not even have RA since none of the meds have worked and because I don't have visible swelling. He says I may just have to deal with the pain. So confused right now. I'm only 37. No way in hell I'm living another 15 years like these last 15 years of chronic pain. This isn't living.

And when I try to get antibiotics none of my doctors or dentists will prescribe them. They all say to ask someone else for a script. I'd like to rule out possible infection by trying the antibiotics prior to trying infusion therapy.

Anyway... I have an appointment set up for Jan 2nd to get the tooth removed with a maxillofacial surgeon. Since no one will prescribe me antibiotics, I guess I'll just have to hope that the extraction will offer some relief. The doctors say that antibiotics aren't necessary because a tooth infection is localized and the antibiotics won't reach the infection anyway. These doctors cause more confusion than clarity.

Enough of my whining. I'll let you know how the extraction goes. Thank you very much.

[Cherub198889 in reply to Needforname]

Yeah I hear you. I found it so frustrating over the last 10 months that no one would give me antibiotics. About 3 months after my extraction my right knee doubled in size causing my rheumatologist to inject steroids into my knee. The steroids did nothing and my knee continued to swell.I couldn't fit my knee in any of my jeans or pants. I had to wear skirts.

Anyways, I gained an extra 9 pounds as my GP & rheumie thought my synovial fluid burst into my tissues. Xrays were then taken and only minimum OA was discovered. My synovial fluid was normal and not swollen.

I asked "why is my knee so swollen?" and the only answer I got back was, "maybe your knee has always been this big"

I was left upset and angry. By August my knee started to go down on it's own, but my left ankle started to swell. I had camel humps surrounding my ankle. Again test were done and the answer I got back from my rheumy was,

"has your ankle always been this big?"

It wasn't until September that my diagnosis changed to Reactive Arthritis.

Apparently my body has been left to sort itself out. My blood work looks normal now. No more inflammation & I do not have a positive RF anymore.

I guess what I am trying to say is, if you feel your symptoms leave your body within 12 hours after the extraction, it may take a year or so to completely clear. I wish I would have known this, maybe I wouldn't have spent this past year so angry.

All the best to you

Sue

[Needforname in reply to Cherub198889]

Wow Sue. It's making me angry that they had the nerve to say to you "Maybe it's always been that big". What a load of crap. It's like when they say "It might just all be in your head". It's a cop-out.

So did you ever take antibiotics then? Sorry if you mentioned this already. I get confused after reading through so many comments. I have a script of Penecilin from a few months ago I never used. I'm thinking about taking it.

Just got a call from the infusion people telling me I can finally start that. But she said we have to put things on hold after I mentioned I'll probably be starting antibiotics and I have a tooth infection. I also mentioned that the second RA doctor said I may not even have RA because there the only swelling seems to be caused by the RA drugs, and I have no RF factor. Though I do have very high anti-ccp (2,600), ligament and bone damage. So confused. One rheumi says I should try infusions, and another says he wouldn't take anything and to just deal with the pain.

I guess my only hope at this point is that getting the tooth removed will help. The doctors keep telling me that it won't because any dental infection is localized. I guess time will tell. Thanks. Hope your pain keeps fading.

[Cherub198889 in reply to Needforname]

Who knows? I think you should get that tooth extracted and see what happens. It's not about what causes RA....that's best left to the scientists.... Please feel free to PM me after the extraction and we can exchange our real names & personal emails.

My fingers are crossed for you my American friend

Sue xxoo

[Neonkittie17 in reply to sylvi]

Agree .. I had all my wisdom teeth removed thirty years ago pre RA in hospital with a two day stay but they were bonkers teeth with roots like trees growing sideways, but you definitely need a dental surgeon who has many years of practice behind them. If it is deemed a difficult extraction they may want you in the (dental) hospital as a day patient and keep a close eye on you and then let you home later in the day.

[Kai--]

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Supplemental/ related info, Needforname: healthunlocked.com/nras/pos...

Best wishes. 🙏 🍀 🌺 🌞

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🎄 🔖 🎁 🎅 ❄️ ☃️ 🌨

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[wishbone]

Could be your infection hasn't cleared because of the effect enbrel and methotrexate are having on your immune system.

[Needforname in reply to wishbone]

Hey there. I don't believe the tooth has ever cleared up. The tooth has been infected for at nearly 2 decades apparently. I know this because it use to swell up and cause pain. Doctors and dentists of course dismissed my many concerns. It wasn't until this week though, that a trip to the endodontist and x-rays proved my concerns were right all this time. He said the root canal was botched from the beginning and that the infection has been trapped there since the botched root canal was performed.

Also, before I started on the MTX and Enbrel, the pain was still extreme without the weakened immune system. I'd like to try antibiotics, but my doctors and dentists won't prescribe them. I visited a new RA doctor today and he's saying he wonders if maybe I don't even have RA because I have no visible swelling and numerous meds haven't worked. He said I may just have to live with the pain.

More confused than ever. One RA doctor wants me to try infusions, and the other says I may not have RA and to stop all drugs. And none of them will prescribe antibiotics. I guess I'll just have to wait till Jan 2nd and hope the tooth extraction helps with my healing. It's hard to think anything will work though, after 15 years of this nonsense.

Thanks for your time Wishbone. I appreciate it.

[wishbone in reply to Needforname]

I didn't realise you'd had the infection so long before starting any RA meds. That said, if you do eventually start antibiotics then I would see what your specialist has to say about stopping enbrel and methotrexate, not only for the possible organ damage you mention, but also because they, especially enbrel, are strong immune suppressors and certainly won't help any in shifting that infection. I believe enbrel losses much of its effect in a couple of weeks, methotrexate takes longer, not sure how much though. As you say, the meds don't seem to be helping you anyway, so might be a good idea to have another talk with your specialist. In any case you can always go back on meds at a later date if you want. Enbrel starts working very quickly in most people, after just 24 hours I started to feel its effect...was like a new man in a few days...well almost!

[Needforname in reply to wishbone]

Wow... that's amazing you felt relief after just 1 day on Enbrel! Yeah, my RA doctors are on vacation for a few days, so I'm voluntarily stopping my meds so that I can get this dang tooth yanked. And like you said, they aren't working anyway. Thanks man. Glad the drugs are working for you.

[wishbone in reply to Needforname]

Might be best to hold on and discuss it with your docs first.

That enbrel episode was over 2 years ago. I've since had to stop taking it along with every other immune suppressing med because of serious infections.

[Needforname in reply to wishbone]

Sorry to hear you had to stop the meds. Hope you have some relief. My doc is now questioning wether I have RA or something else. Always more questions than answers.

[wishbone in reply to Needforname]

Thanks, hope you get sorted soon.

[Neonkittie17 in reply to Needforname]

OMG the original dentist should have xrayed your tooth/jaw when you had the symptoms of an infection. I'm sorry you've had this for so long. Glad you're putting it right. Good luck.

[Cherub198889 in reply to Neonkittie17]

I had numerous dental xrays over the past 11 years & nothing was shown....maybe my dentist pretended everything was OK?....who knows?.... Anyways, this is not about root canals causing RA...this is about dentistst taking your money to preform a root canal and causing RA symptoms....everyone should know or learn to understand that dentists have NO knowledge or schooling to preform such surgeries. ONLY ENDODONTISTS should preform root canals.

[Nik8210]

I have just had teeth pulled by the dentist and the guidance in Scotland is that antibiotics are discretionary and that you carry on with your RA medication as normal I am on benapli methotrexate hydroxy.

I debated the issues with myself and missed two weeks of RA meds healing slowly but so far so good. I figured that if the RA meds suppress parts of the immune system I might dodge the infection and dodge the need for any antibiotics.

So far healing slowly but no infection had a few slightly worse than average days.

The above changes were my idea and I did tell the dentist and RA team

[Needforname in reply to Nik8210]

Interesting. My confusion comes from reading on popular health websites like WebMD that kidney damage can result from takin RA drugs alongside antibiotics. One doctor says it can't hurt and another says I shouldn't. Since I'm on pain meds too, I don't want to risk it. The RA drugs aren't working anyway, so I'm just going to stop them and take antibiotics in a few days if I can get some. Thanks and best of luck with your own healing. Hope your new year includes less pain.

[dbestdeb]

My rheumatologist told me to never take my Enbrel if I have any kind of infection or feel like I’m getting sick, as it suppressing the immune system will keep you from healing. I’d skip it for sure.

[Needforname in reply to dbestdeb]

Thanks for that. I was just told the same. Got a call from the infusion people to get started on that. I told them I am in limbo with my infected tooth and trying to get a script for antibiotics yet all of my doctors are on vacation. And I mentioned that the second RA doctor is now questioning whether I even have RA since none of the drugs have worked and I have no visible signs of inflammation. Though I do have bone holes and ligament damage. The other rheumatologist thinks I just haven't tried enough drugs. Not sure what to think any more.

The infusion lady said we can't do the infusion if there is any possible infection. I have an old script for penecilin that I'm thinking about taking soon. My last Enbrel shot was on Tuesday. Last Methotrexate was Saturday. Apparently it's recommend to wait 1-2 weeks after taking auto-immune suppressants before taking antibiotics, but I'm getting my infected tooth extracted on Tuesday. Might take the Penecilin on Monday. So little answers from doctors, so many questions. I'm sure everyone in these has felt the same at some point. Thanks again for your input.

[dbestdeb in reply to Needforname]

I don’t think I’d take any drugs like antibiotics that the surgeon doesn’t know about. You never know about interactions with something he might give you. I’m sorry you have such a time with doctors. I’m in the USA and our system is different for sure. If I don’t like one of my doctors, I switch to one I do like. I have recently chosen a team of young women doctors that I am very grateful for. I hope you get some answers soon.

[Needforname in reply to dbestdeb]

Thanks for the reply. You make a good point. Maybe I'll call the oral surgeon Monday and ask if I can take the antibiotics. I too am in the USA and have good insurance, though because they're all about money I have to take the drugs they recommend. For example, I was denied the infusion my RA doctor and I wanted to try, but instead have to settle with a newer / less-tested infusion drug option. If the crappy drugs don't work, only then can I try the better ones.

In regards to doctors, there are only 2 RA doctors around where I live, and I see them both. One is a young woman and the other is an older man. Both contradict each other so it's very confusing. All I know is that no treatments have worked and I've been in pain for 15 years. I've lost all trust in the medical industry. Their only answer is more drugs that cause more problems.

I'm glad to hear stories like yours, where you've found a solution that works for you. It gives me some hope.

[dbestdeb in reply to Needforname]

My ins company also denied the Enbrel but my doc was able to change their minds somehow. The jury is still out on if it will make me functional again or not. I do like my docs though. I recently moved to a larger city and that is the reason I have a decent group of doctors. The small town doc I used to go to just threw steroids at the problem most of the time. My new one hates using steroids. Yes, I think we all know what you mean about not having faith in doctors. It’s a rough road we’re all on I’m afraid.

[Damaged]

Wow, what a journey you have had. I recently had a root canal turn to abscess/cyst. The X-ray still shows a large dark area where the bone deteriorated. I have also been prompted by posts to have dental issues looked into. In my case however, CPP remains 300. My RA is still very active. In reading the article I read that there is no good root canal. The body does not tolerate dead tissue. The dentists know this but money is always the determinate factor. They make all their money doing root canals. They do not seem to care that they are poisoning people.

Even if it does not reverse RA for you it may dramatically improve how you feel. I hope your recovery continues.

[Needforname in reply to Damaged]

Hey there... I'm beginning to think that there is no good root canal either. I've read that there is only an 85% chance of a root canal being successful. That's not very good. Not to mention the number is probably higher since often times problems aren't even reported. Plus, like you said, having a dead item in our body doesn't make much sense. I think the inventor of the root canal even turned out to be an advocate against them later on. It is a money racket. I know this because all dentists and endodontists fail to even acknowledge the possibility of root canals being linked to auto-immunity issues. They want to stick their head in the sand and not accept the fact that what they are doing may be hurting people. It's a shame.

Thanks and best of luck with your own issues. I would definitely verify if you can, whether your tooth is infected or not, and remedy it asap. Apparently there are 3 options to consider for an infected root canal... 1) cut out infection through the gums, 2) extraction, and 3) a 2 part process of drilling out infection and filling it in with disinfectant and then re-filling after infection has been extracted. This third option isn't 100% effective though.

[Damaged]

I did have dental surgery in November. My Rheumie retested for Sjogren's and CCP (Cyclic Cittrulinated Peptide) was still at 300 a month after surgery. It is what it is. I literally have a mouth full of root canals. The Endodontic specialist wanted to do two more but I refused. So happy I did as they are not causing a problem.

[Needforname in reply to Damaged]

Glad you opted against more root canals. They definitely serve a purpose, but they scare the hell out of me after reading some of these things. Best of luck.