Good day,

I've searched and searched on this subject to no avail - I'll try to
keep this short.

A few weeks ago, I woke up with a sore gum and tongue - right beside my
last molar (I've never had wisdom teeth). The next day, my molar
started to hurt when I bit down on something, and the gum was quite
sensitive. The following day, I couldn't bite down on anything without
pain, and my lymph nodes were swelling a bit (no gum swelling though).
That night I went to a medical clinic, and the physician gave me
Erythromycin and asked me to see a dentist. Two days later, the pain
was gone, but I noticed that my second last molar was 'higher' than the
other teeth. That molar has a filing, but I've never had a root canal
or anything like that. I also noticed some 'crowding' on my front
lower teeth.

A week later, I saw the dentist. He took x-rays and poked around and
said that everything appeared to be normal. He indicated that the
physician probably mis-diagnosed the problem, as the flu was going
around (which explains the swollen nodes), and I probably just bit down
on something hard and 'strained' the ligaments of my molar. He noted
that there was no gum swelling, no gum boils, no bad taste, and no sign
of root infection, etc. He placed some cold material on my molars and
indicated that the nerves were indeed alive and well.

A week later, I noticed a 'dent' on my gum (about 3-4 mm below the
gumline) right beside a small bony 'bump' that I've had for years. A
day later, I was poking around my gums with a cleaning pick, and I was
able to put the pick right inside a small hole in my gum. I could feel
something hard with the pick, so I picked some more, and out popped
what I can only describe as a small piece of 'sea coral'! If I pick
inside the hole now, I can still feel something hard, but it seems more
firmly attached (I think it's the bony bump). I don't know if it's far
enough down the gumline to be a tooth root, but it certainly is bone or
tooth-like. Throughout all of this, I've felt no additional pain, but
my nodes are still a bit sore (though less than before). My front
teeth are still 'crowded', though it seems no worse than before.

So, my question to the dental community is: What is happening to my
tooth and gum? I'm not sure if I trust the dentist I saw, but I figure
I'll probably have to see someone at some point. Could an original
infection have caused the tooth to raise slightly, breaking off a piece
of rough tooth material from the side of my tooth? Could I really have
an infection that is rotting the roots and breaking off chunks that
migrate to the surface? Why would my x-ray look so normal, and why
wouldn't my gums be swollen or sore at all. Could I have bitten
something hard that caused a piece of broken root to migrate through
the gumline? The dentist who I saw indicated that I should come back
if I start experiencing pain again, and that if it was an infection,
he'd expect me back in about a month. Should I just wait to see if the
broken piece of tooth was causing all of this?

Any and all comments are greatly appreciated.

Thanks,
Andrew.

wrote:

> Good day,
>
> I've searched and searched on this subject to no avail - I'll try to
> keep this short.
>
> A few weeks ago, I woke up with a sore gum and tongue - right beside my
> last molar (I've never had wisdom teeth). The next day, my molar
> started to hurt when I bit down on something, and the gum was quite
> sensitive. The following day, I couldn't bite down on anything without
> pain, and my lymph nodes were swelling a bit (no gum swelling though).
> That night I went to a medical clinic, and the physician gave me
> Erythromycin and asked me to see a dentist. Two days later, the pain
> was gone, but I noticed that my second last molar was 'higher' than the
> other teeth. That molar has a filing, but I've never had a root canal
> or anything like that. I also noticed some 'crowding' on my front
> lower teeth.
>
> A week later, I saw the dentist. He took x-rays and poked around and
> said that everything appeared to be normal. He indicated that the
> physician probably mis-diagnosed the problem, as the flu was going
> around (which explains the swollen nodes), and I probably just bit down
> on something hard and 'strained' the ligaments of my molar. He noted
> that there was no gum swelling, no gum boils, no bad taste, and no sign
> of root infection, etc. He placed some cold material on my molars and
> indicated that the nerves were indeed alive and well.
>
> A week later, I noticed a 'dent' on my gum (about 3-4 mm below the
> gumline) right beside a small bony 'bump' that I've had for years. A
> day later, I was poking around my gums with a cleaning pick, and I was
> able to put the pick right inside a small hole in my gum. I could feel
> something hard with the pick, so I picked some more, and out popped
> what I can only describe as a small piece of 'sea coral'! If I pick
> inside the hole now, I can still feel something hard, but it seems more
> firmly attached (I think it's the bony bump). I don't know if it's far
> enough down the gumline to be a tooth root, but it certainly is bone or
> tooth-like. Throughout all of this, I've felt no additional pain, but
> my nodes are still a bit sore (though less than before). My front
> teeth are still 'crowded', though it seems no worse than before.
>
> So, my question to the dental community is: What is happening to my
> tooth and gum? I'm not sure if I trust the dentist I saw, but I figure
> I'll probably have to see someone at some point. Could an original
> infection have caused the tooth to raise slightly, breaking off a piece
> of rough tooth material from the side of my tooth? Could I really have
> an infection that is rotting the roots and breaking off chunks that
> migrate to the surface? Why would my x-ray look so normal, and why
> wouldn't my gums be swollen or sore at all. Could I have bitten
> something hard that caused a piece of broken root to migrate through
> the gumline? The dentist who I saw indicated that I should come back
> if I start experiencing pain again, and that if it was an infection,
> he'd expect me back in about a month. Should I just wait to see if the
> broken piece of tooth was causing all of this?
>
> Any and all comments are greatly appreciated.
>
> Thanks,
> Andrew.
>

Could be foreign body, or tartar, or...almost anything.
This sounds like something that should be immediately obvious to a
competent dentist, but only speculation if I or another guess.
BTW, don't go picking around your gums with a "pick".

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Thanks for the reply Steve. Believe me, I wish it was just a popcorn
shell or something simple like that. When I poked around, it really
felt like whatever was in there was part of my tooth. I don't have a
good idea what tooth roots look like below the surface of the gumline -
can they resemble coral-like structures? Could this be bone material?
Have you seen anything like what I describe before?

- Andrew.

wrote:

> Thanks for the reply Steve. Believe me, I wish it was just a popcorn
> shell or something simple like that. When I poked around, it really
> felt like whatever was in there was part of my tooth. I don't have a
> good idea what tooth roots look like below the surface of the gumline -
> can they resemble coral-like structures? Could this be bone material?
> Have you seen anything like what I describe before?
>
> - Andrew.
>

OK, I'll guess. You may have fractured a cusp on a molar, and it may
either be hanging on to the gum, or else you may have dislodged a large
lump of tartar.
Understand that this is a wild guess; if there is any way for you to
post a photo somewhere it would help. But it's unlikely this is a big
mystery.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Update: there's definetly a larger piece making its way through! My
theory is that when I bit something hard, a piece of my tooth broke off
and became infected. The antibiotics cleared up the infection, but the
broken root is making its way through my gum. It's not painful or
bleeding, but I'm wondering what to do with the hole it leaves behind!
Does any of this make sense to the dental professionals out there?

- Andrew

Sorry Steve,

I must have been typing while you were posting. I think you hit the
nail on the head with the fractured cusp. Now, what do you normally do
in these situations? Does the tooth have to be extracted, or can it
recover from a chunk being broken off?

Thanks for the accurate guess! I'll post a picture on Flikr if I have
a chance...
- Andrew.

wrote:

> Sorry Steve,
>
> I must have been typing while you were posting. I think you hit the
> nail on the head with the fractured cusp. Now, what do you normally do
> in these situations? Does the tooth have to be extracted, or can it
> recover from a chunk being broken off?
>
> Thanks for the accurate guess! I'll post a picture on Flikr if I have
> a chance...
> - Andrew.
>

If you put your finger on the fractured segment and can see it
wiggling, there is a good chance it hasn't broken off TOO far under the
gumline.
Typically this happens in a tooth with a large filling. The cusp
fractures down and away from the chewing surface of the tooth.
While sometimes it fractures way down under the bone and needs to be
extracted, there's a better chance it can be pulled out. The tooth will
likely then need a crown.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Yes, it's wiggling - but (and this is the important part) it's wiggling
through a hole in my gum! My gum seems to be rapidly pushing it out,
and soon, it's going to make its way through the gum! The tooth does
indeed have a large filling. The fracture is completely under the
gumline, as the tooth above the gumline is intact. The dentist already
indicated that the tooth had two large cracks and would probably need a
crown. Maybe he didn;t realize just how cracked the tooth was.

Any recommendation as to how I should treat the residual hole left in
my gum when the broken part comes out?

Thanks again,
Andrew.

Hi Steve,

Here's a couple of images of the gum with piece sticking through:

http://www.flickr.com/photos/amonti/

Not much progress tonight - I think that the piece has 'settled' a bit.
Any commentary on the images is appreciated.

- Andrew

Steven Bornfeld wrote:

> Shouldn't be necessary to treat. When the fragment is removed, the gum
> will heal. Then you can concentrate on fixing the tooth.
>
> Steve
>

OK that looks like a lingual sequestra to me.

These things sometimes develop spontaneously.
If I am correct, treatment would be removal with anesthesia,
or let nature take it's course.

I doubt very much that this is tooth structure.

JMHO

On 15 Dec 2005 23:00:37 -0800, wrote:

>Hi Steve,
>
>Here's a couple of images of the gum with piece sticking through:
>
>http://www.flickr.com/photos/amonti/
>
>Not much progress tonight - I think that the piece has 'settled' a bit.
> Any commentary on the images is appreciated.
>
>- Andrew
>
>Steven Bornfeld wrote:

--

Whamatus
Take out the G'RBAGE