Barbara Tritz, RDH and holistic dental hygienist at Systemic Dentist. Barbara authored this post in her Queen of Dental Hygiene blog, sharing what she learned at the International Academy of Oral Medicine and Toxicology meeting she attended in September. We are sharing excerpts from her blog post, reprinted with her permission.
Today’s blog is about taking teeth out (or as we call it “extraction”) and the why and how of doing it correctly. Yes, there is a right way and a wrong way of taking teeth out. The wrong way introduces bacteria into the bone, causing a silent infection in your jawbone. Do you want to be harboring a focal infection in your jaw that may well be infecting your entire body? If NOT, read on! This is a controversial post for some, but really it shouldn’t be!
Many dental professional will recognize the name Dr. G.V. Black, one of the early pioneers of modern dentistry. Dr. Black, back in 1919 recognized the importance of cleaning out the bone and creating a healthy extraction site when a tooth is removed.
When the bone does not heal correctly, it creates holes in the jawbone that then harbor bacteria and other debris. These holes are called Cavitations, NICOS (Neuralgia-Inducing Cavitational Osteonecrosis), or the more technical term: Osteonecrosis of the bone. They can be a source of bacteria that then infects other parts of your body. Osteonecrosis means bone death, and happens when there is a lack of blood supply to an area of the bone, whether it is in your jaw or other part of your body, say the knee. These areas may or may not hurt, appear red, or have any signs of infection on the surface. However, the bacteria is not silent underneath!
The Bottom Line: if your mouth is not healthy, your body’s not healthy. Read on and learn!
A Short Digression into Bacteria
I’ve been using a phase contrast microscope since 1985 and know there are lots of bad bacteria and other pathogens, like viruses or candida, in the gums. In my line of work as a biological dental hygienist and periodontal therapist, I see their destruction of the gum tissues and bone daily.
What I’d always wondered: what happens when these bad bacteria from the gums travel into the bone after a tooth infection and/or tooth extraction? How does the body deal with them? Can the body kill them once they get into these extraction sites? What happens when the bone heals up around them? These pathogens are looming inside the tooth itself- they are the cause of the tooth death and consequential removal. Lots of bad stuff going on there invading the tooth down to and through the root tip and thus into the bone. The million dollar question: What the heck happens to these bad bugs?
I’ve heard dentists talk about extracting teeth and immediately placing an implant into the socket- yikes- that area is full, full, full of bacteria!
I’d once asked a former employer/dentist about that and she said she “really didn’t know” but since the specialist said it was okay, she was okay with that. Well, heck no! I’m not okay with that, I have to admit. I’d never recommend that for a family member, so I don’t recommend it for you either! I had a patient who’d had an implant placed in her lower front tooth area and it failed twice, and she lost a lot of bone there. The initial problem was a root canal that had failed – another controversial topic for a different day. I suspect, now, that the bone was never properly cleaned and disinfected from the initial root canal and associated infecting pathogens. Just my guess, but I do know no one ever did a pathology test on her bone health in that area. She lost lots of bone and ended up with a bridge. Wish I’d known then what I know now.
Here’s what that x-ray really looks like with a CT scan – Note infection into the sinus cavity
So! Back to my question- what happens to those bugs in the bones and tissues? According to my research the answer is if they are not properly removed they stay there and live, happily. The bone heals over and around them. These areas become hidey-holes for bacteria, literal holes or cavitations in the jawbone.
Bet you had a dry socket when you had your wisdom tooth removed?! Lack of blood flow due to the bacteria causes a dry socket. These areas are called osteonecrosis of the jawbone or hidden osteomyelitis. The medical community recognizes this can occur within the bones of the body yet the dental community ignores this. It says it is not a concern. This lack of blood flow causes jaw bone death. Most people have no pain or discomfort from them although some folks do have what’s termed “neuralgia-inducing cavitational osteonecrosis” or NICOs. NICOs can refer pain and bacteria to other areas of the body. Yes, you read that correctly! These pathogens can and do travel to other areas of the body setting up shop, and infecting you far from the initial site thus the focal infection I mentioned in the first paragraph. These extraction sites can also cause facial pain and neuralgia.
In addition to doing dental hygiene, I have had the welcome opportunity to assist in dental surgeries with the incredible dental surgeon, Dr. Panahpour. He’s taken the time to show me what these holes in the bone look like. Once he removes the thin outer layer of healed-over bone, the area inside the jawbone is exposed. It is quite literally a hole filled with mushy bone that resembles ice crystals. It may also have oily dark blood that looks rather like an oily cyst. He scrapes and curettages it clean, and sends all the contents to a lab for culturing. It is bone chilling (sorry!) to see these pathology reports, knowing the jawbone is filled with bacteria like E. Coli as well as:
Fusobacterium nucleatum ss vincentii
Plus many, many more.
I am familiar with some of these pathogens, as they are connected to gum disease. I’ve given you a quick review of the research literature to show you the oral-systemic connections. Could all these oral pathogens, as well as many more, be the source of our chronic illnesses? As you may have seen from clicking on some of the links above, there are some serious systemic health complications from these oral bacteria. Food for thought!
When the bone is all cleaned out, Dr. Panahpour then starts the healing process. His skills as a master surgeon are confirmed by the follow up CT scan a year or so later when that scan confirms there is indeed bone regeneration! Might be time for that dental revolution!
Infection in the bone around two impacted teeth! OUCH!
A Wiser Way to Extract Wisdom Teeth
Wisdom teeth are the most popular teeth to extract- for many there is just no room in the jawbone for them to erupt properly. The fact our jawbones can no longer accommodate all 32 of our permanent teeth is a whole other post we’ll get to soon. Stand by for that, more controversy!
My youngest daughter had two wisdom teeth removed this summer so I got a front seat look at the entire procedure. As I’ve written in previous articles, I now work for biological dentists and am seeing “things” differently. I’ve assisted in other tooth extractions during my career. For the most part, teeth are really not hard to remove, though I’ll spare you the details. My older daughter had all four out and was home within an hour. Teeth out, bite down on gauze, coupla stitches, and boom, she was home. Not so for younger daughter. Instead, teeth out, bone cleaned out, the periodontal ligament and other pathology surrounding the root were then removed (sort of like the after -birth, it needs to be properly removed), flushed the sockets with ozone water, then platelet rich fibrin (PRF) is placed within the socket to enhance bone healing. Then sutures and home.
Have you heard of Kim Kardashian’s so-called “vampire facial”? This is the same idea, but a little less “glam” and a little more real-world important. PRF deserves its own post, really, but meanwhile, click the link to learn more! Dr. Panahpour takes the patient’s blood, centrifuges it and places the plasma that’s rich with protein and fibrin back in the patient’s body. It enhances healing. Over two hours for these two teeth. Yes, it takes longer but so worth it… Tami will not have cavitations in her jaw bones!
Here’s the incredible part! Little to no swelling, no dry socket and Tami was back up and at it the very next day. Here’s the photo proof!
Tami right after surgery to remove two wisdom teeth.
Tami, the day after surgery
Tami, day three slightly swollen
Tami, flying high four days after surgery to remove two wisdom teeth
Little to no swelling, no pain, and no need for heavy-duty pain medications. Now, just to be clear, I’m not promising your extractions will be as effortless as Tami’s were, but it can be done.
Can you say that after your wisdom teeth came out? I certainly can’t. I had a dry socket, and significant pain for several weeks. I looked like I’d had the mumps, with swollen cheeks for several days. I have seen my CT scan and I know I have holes in my jawbones due to those improper extractions so as I address them, I’ll take you along for my ride!
I love a happy ending to Tami’s wisdom teeth saga.
Dentistry may be slow to change, but the research is there to show these holes harbor toxins and these toxins affect other parts of our body. Until I started working with a biological dentist, I’d never even heard of these focal infections. However, after seeing what pathogens are nesting in the jaw, and the holes they create, I am, more than ever, convinced that it is the source of many of our systemic infections. I had always thought dentists were indeed removing all they needed to, and were cleaning everything out. That’s why we go to specialists?! Right!? Not so much. I see all manner of holes in the jaw on radiographic x-rays and CT scans, now that I know to look. If you need your wisdom teeth or for that matter, any teeth removed, look for a “biological” dentist, check out the IAOMT website. Do it the right way, not the cheap way, otherwise it may cost you in the long run.
Please help me start a dental health-total body health revolution! Questions, Comments?! I love hearing from you.
Meanwhile, keep smiling!
Biological Dental Hygienist
Specialist in Orofacial Myofunctional Therapy