Rich dentists - Important Treatment Procedures - additions

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Wallace, I forgot two very important elements to this process. First should be testing for coagulation disorders, and serious blood thinners should be used if indicated and the INR monitored during treatment. Most people with osteomyelitis of the jaw have blood coagulation issues, either as a cause or an effect of the infection. Good blood flow is essential to healing this infection. Those who have coagulation disorders need to have their INR checked regularly during treatment to be sure it's at the right levels to promote healing. (This INR will usually need to be maintained at a higher number than people who do not have coagulation disorders). Second. Sinuses must also be scanned because there can be infection feeding back and forth between the two regions. Especially if you're infected with bugs like actinomyces. Fixing one without addressing the other will result in failure. All infected areas

need to be cleaned up. Fortunately, if any of the infection in the sinuses is due to structural problems, the new baloon sinuplasty can treat that with much less invasive/destructive correctional surgery. But at a minimum, any old infectious pockets should be removed, if we hope for the jaw to also clear. So, a good ENT should also be on the team and ideally be in attendance during the jaw surgery in case there's any breaking through to the sinuses, which is very possible. So here's the ammended process: Correct Process for removal and treatment of an infected tooth/jaw. CT scans by a highly skilled radiologist who can correctly identify the problem areas in the jaw AND sinuses. Blood coagulation tests should be ordered and INR monitored

during treatment to promote healthy blood flow to surgical sites. Rotation of the tooth for extraction (i.e. the Ogram Technique - no drilling, no epinephrine, no wedging against another tooth for leverage). Light scraping of the bone to clean up necrosis (only until blood flow is achieved). Bone samples immediately sent to the lab for culturing. d by hand for actinomyces. Multiple therapy I.V. antibiotics, immediately adjusted when culture results come in. Hyperbaric Oxygen possibily prescribed to speed healing. (it's usually prescribed with osteomyelitis surgery). Continuous follow up care to ensure the infection is gone.