Discussions By Condition: I cannot get a diagnosis.

lower jaw pain, loose teeth

Posted In: I cannot get a diagnosis. 12 Replies
  • Posted By: lucy's mom
  • April 28, 2007
  • 11:31 PM

Nuclear bone scan shows positive for activity on both sides of lower jaw.Tests are needed for clear diagnosis as to whether it is dental disease or osteonecrosis.:eek: I had tooth extracted 3-4 mths. ago and took Fosomax for 3 yrs. or so. I am schuduled for cat scan but last week's teeth xrays show bone loss. Also sch. for perio exam but was wondering if anyone had any info=gums don't bleed but the bottom front gums are recessed a bit. I am 61 and took oral Fosomax since 04 or so. Thank you!

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12 Replies:

  • Has infection been entirely ruled out? Is your blood Calcium level elevated?
    Anonymous 42789 Replies Flag this Response
  • First, thanks so much for replying. no infection found in dental xrays but primary doctor prescribed and I just finished the z pack. I don't know about calcium level-blood tests weren't ordered. Pain in lower left front is sporatic-kind of bad today. I am sch. for perio on Tuesday and was thinking about postponing cat scan untill after the periodonist sees me (financial considerations).
    lucy's mom 15 Replies Flag this Response
  • I was extremely interested when I read your post as I have similar symptoms. If your interested, you can do a search either using my name "Jean Marie", or thread title "Face/Neck/Chest pain for over 3 years following dental procedure".Lucy's mom;41045]Nuclear bone scan shows positive for activity on both sides of lower jaw.Tests are needed for clear diagnosis as to whether it is dental disease or osteonecrosis.:eek: I had tooth extracted 3-4 mths. ago and took Fosomax for 3 yrs. or so. My nuclear scan showed "hot spots" along the lower left jaw - which is where I have had two teeth removed & when this whole mess started. I'm wondering if "hot spots" aren't the same as "activity"? I was told these hot spots were normal given the trauma to my jaw (one of the teeth removed was abscessed and had gone undetected for over 2 years...the reason for a lot of my incredible jaw pain - but apparently not all as I'm still having problems). An oral pathologist told me that bone takes at LEAST 6 months to completely heal. But your scan showed activity on both sides - just not the side of your extraction?I am schuduled for cat scan but last week's teeth xrays show bone loss. I was told that a nuclear scan was THE test to determine osteocronosis. So I'm wondering why your doctor is scheduling a CT scan? Did he explain what a CT scan might show that the nuclear scan didn't? I could of misunderstood, but I thought a nuclear scan was much more sophisticated than a CT scan (Ive had both).Also sch. for perio exam but was wondering if anyone had any info=gums don't bleed but the bottom front gums are recessed a bit. I am 61 and took oral Fosomax since 04 or so. Thank youDid you get a referral to a perio, or make the appointment yourself? That is one specialist I haven't been to. I've considered it, but didn't know if it would be appropriate. I think it possible I could still have infection in the soft tissue below the gum where my teeth were removed - or possibly osteocronosis, which I understand is often hard to diagnose. If you find the periodontist helpful in ANY way, would you PLEASE post back?? Also, I've been told my gums are receding somewhat...I just thought it was age. :) I'm 53.Good Luck,Jean
    Jean Marie 38 Replies Flag this Response
  • Nuclear bone scan shows positive for activity on both sides of lower jaw.Tests are needed for clear diagnosis as to whether it is dental disease or osteonecrosis.:eek: I had tooth extracted 3-4 mths. ago and took Fosomax for 3 yrs. or so. I am schuduled for cat scan but last week's teeth xrays show bone loss. Also sch. for perio exam but was wondering if anyone had any info=gums don't bleed but the bottom front gums are recessed a bit. I am 61 and took oral Fosomax since 04 or so. Thank you!I've replied to this, but it hasn't shown up yet.:confused: I'm going through something somewhat similar. Will post again tomorrow if original post doesn't show up!Jean
    Jean Marie 38 Replies Flag this Response
  • Hi Jean-I canc. CAT scan-research says won't show and dental xrays don't show-bone scan 3 way are sensative but aren't specific as to diagnosis. MRI is the best for both being sensative to problem and correctly diagnosing problem. I go to perio tomorrow-I really feel it must be dental disease and not osteocrosis of the jaw and 1st gen. dent. just missed seeing it. OSJ from oral fosomax type drugs is just sooo rare. Thanks for taking time :)
    lucy's mom 15 Replies Flag this Response
  • Hi Jean-I canc. CAT scan-research says won't show and dental xrays don't show-bone scan 3 way are sensative but aren't specific as to diagnosis. MRI is the best for both being sensative to problem and correctly diagnosing problem. I go to perio tomorrow-I really feel it must be dental disease and not osteocrosis of the jaw and 1st gen. dent. just missed seeing it. OSJ from oral fosomax type drugs is just sooo rare. Thanks for taking time :)Ohhh, an MRI - I thought you were going for a CT scan. I've had an MRI done quite some time ago, too. Please keep me informed as to whether the Periodontist was helpful. I am especially wondering if they can identify osteocronosis (or rule it out) and/or other oral infections. Thanks & good luck!
    Jean Marie 38 Replies Flag this Response
  • Primary sch. CAT scan but it's not correct test for osteonecrosis of the jaw-for this disease a bone scan 3 way will show bone activity but is not specific as to diagnosis. The OSJ site says MRI is correct test-I'm talking about osteonecrosis-not soft tissue or lymph nodes swelling (what you have).
    lucy's mom 15 Replies Flag this Response
  • Primary sch. CAT scan but it's not correct test for osteonecrosis of the jaw-for this disease a bone scan 3 way will show bone activity but is not specific as to diagnosis. The OSJ site says MRI is correct test-I'm talking about osteonecrosis-not soft tissue or lymph nodes swelling (what you have).Yes, I understand what you are saying - but I'm wondering if osteocronosis could be causing my soft tissue problems. I at least want to rule it out. It's a tough diagnosis to make (even with sophisticated tests) from what I read. And I had an infected tooth in my mouth for almost 3 years! It seems possible that infection from osteocronosis could spread to the soft tissue. Or maybe I could just have infection in the soft tissue...or a cyst, or tumor, or.....I don't know. An oral surgeon I saw thought it possible I have an antibiotic resistant infection. However, my Internal Medicine doc refuses to even consider it. All I know is that when I talk for over 10 minutes, the soft tissue becomes incredibly painful - then I get hoarse. No one can figure it out! HA! We are now posting on about 4 threads to one another.:) Had my dying tooth not gone on so long without detection (could osteocronosis have caused this?), I do not believe I would be having these continuing problems. That's why I have hope for you...that you will get to the bottom of your problem soon and feel good again.Jean
    Jean Marie 38 Replies Flag this Response
  • Hi Jean, I would suggest a perio-they are the experts for gum disease.If you google "dental disease" the FDA site will explain gum disease(periodontal disease). Osteonecrosis is bone disease where jaw bone dies-very rare and only recently began occurring in patients on either 1v fosomax or oral fosoman type drugs.-not anything for you to even consider
    lucy's mom 15 Replies Flag this Response
  • no osteonecrosis can't be your problem, thank goodness!! I'll post after perio appt. tomorrow
    lucy's mom 15 Replies Flag this Response
  • no osteonecrosis can't be your problem, thank goodness!! I'll post after perio appt. tomorrowJust wondering how your appointment went. Are you ok??Jean
    Jean Marie 38 Replies Flag this Response
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  • Hi Jean, I cancelled yesterdays appt. as not under my insurance and have appt. Friday AM. Are you familiar w/ Dr. Oogle website? It has patient feedback on different types of dent. all over usa. Also I found lots of info on Wikipedia-accurate and footnoted. To rule out Osteonecrosis a qual ultrasound is required. This very scientific article explains why cat, mri, regular xrays don't work. It says needs to be coupled w/ panaramic xray and explains why. You might get a referral , at least , for the "QUS" from your primary doctor. If your dental ins. is like mine, its so limited.Remember, your synptoms don't match osteonecrosis-just read it to explain what different tests can and cannot disgnosis. I'll post back after Fridsy's appt.
    lucy's mom 15 Replies Flag this Response
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