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Avatar universal

osteomylitis?

Hi, I posted a few weeks ago.  I'm 35 yrs old, 4 years ago I had my upper right first molar re-filled after the filling broke,  and ever since then  (on and off) I've had severe pain issues spreading to my right maxillary sinus and jaw, and sometimes down the front of my neck.    Right now the area just above and behind the tooth in question is very painful to the touch, and I have pain spreading.   I plan to go to a university emergency clinic as soon as I can.  i am very worried that i may have osteomylitis or something bad going on.  If I'm not having a fever, just the pain,  does this seem likely?    Also I was wondering,  will the routine x-rays they willl do for me ever miss osteomylitis or something similar?   I have wondered also if I"m getting an abscess, but I can't see any major swelling in my gum.
15 Responses
540545 tn?1377626518
MEDICAL PROFESSIONAL
Have you seen an endodontist (root canal specialist)?  They may be able to determine if the tooth is the source of the problem.  Again, I'm assuming its a tooth issue only because of the timing of your discomfort.  

Yes, routine x-rays may miss an osteomyelitis. Unfortunately x-rays are 2-D images of a 3-D object (your mouth).  It can't see from all angles.  

Avatar universal
By the way, I do not have a sinus infection.  I had an ENT look in my sinuses with an endoscope.
Avatar universal
I appreciate your replies.  I think that since I don't have dental insurance I'm probably going to have to go to a dental school emergency clinic with pain as my complaint.

This leads me to another question that I was wondering if you might have some insight to...a logistical question, if you will.  I am actually disabled with original Medicare, and I know medicare doesn't generally cover Dental (which I find baffling considering the cost of treating cardiac disease)... A extraction or something routine isn't a big deal, but I am petrified at the prospect of facing something big.  At what point would Medicare step in and cover your treatment for issues of a dental origin?  Would they do it if it's medically necessary?
Avatar universal
Actually, what are the odds the bone would be infected if the plain xrays are normal and I haven't had a fever recently?
540545 tn?1377626518
MEDICAL PROFESSIONAL
Kind of hard to say about the osteomyelitis and x-rays.  I think its a thorough diagnosis that's made with x-rays, discussion with you and the clinical findings as well as what they may learn about previous treatment and their tests they run.

Yes, medicare does stink in that regard.  They don't actually cover any dental procedures at this point.  Its mostly on a state by state basis but most states do cover kids I believe but not adults.  Not 100% sure though.  May want to discuss with your medicare provider but that's my understanding.  If its a medical emergency they may cover some of it.  Dental insurance and medical insurance are billed differently with different codes, etc.  

If its something significant and cost is an issue, extraction may be the only option.  You can ask the dental school if they know of any free clinics that may provide care.  You can also contact your local dental society.

Avatar universal
Hey again, thanks for the additional reply.
I went to UAB dental school and they pulled it out for me  (quite an ordeal...it seemed much worse than my wisdom teeth 10 years ago).  I was given a LOT of lidocane and then some other kind of injection as well, since I will still feeling pain.

Anyway , the student dentist told me there was an infection, but not quite an abscess.   At this point , there is massive swelling in my gum and my lymph nodes under my jaw are swollen are sore.  

The one thing that surprised me is that I wasn't prescribed any antiobiotics,  I even asked to be sure and they said I didn't need them.   Is this normal even when I have an infection?  

  I do have some amoxicillin (500 x 3 times per day) here that was given to me by my Doctor a couple months ago and I'm awfully tempted to take it just to be sure.  Will it hurt anything if I do?
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