Dear mag. Tomaž Rotar,
while reading your answers to questions, I came across your opinion that every non-vital tooth can be a chronic inflammatory focus that may cause chronic pathological changes elsewhere in the body (hair loss, iridocyclitis…). I am 35 years old and for quite some time (since the beginning of the year) I have had increased hair loss. Thyroid O.K.; I have no other health problems. The lower second premolar (a non-vital tooth) has a filling. The area around the tooth is painful. I often feel a dull ache in this part of the jaw. Only in this area do I also feel discomfort when flossing. When I first mentioned this to my dentist, he said that the gum was simply sensitive and the tooth was O.K. No X-ray or anything else was done.
I would like your opinion on whether a panoramic X-ray is the right examination to show whether there is really something wrong with this tooth or to reveal an inflammatory focus. Or should I undergo some other examination?
I have already had problems with similar prolonged hair loss in the past (6 years ago), precisely because of a similar situation (a purulent focus and a cyst under another tooth). At that time the problem was discovered by mag. Franek in Ljubljana, who also confirmed that this had contributed to my difficulties at the time.
I sincerely ask for your valued opinion because I am already desperate.
I look forward to your reply.
Kind regards, ana (mobile 041 88 11 88)
Dentist Tomaž Rotar answers:
Dear Sir/Madam!
Non-vital teeth are chronic inflammatory foci. An X-ray (panoramic radiograph) is certainly the first examination when looking for periapical changes in the bone around the root tips of non-vital teeth. Unfortunately, no examination gives us the answer to the key question: whether the focus (the non-vital tooth) really also causes disease at a distant site (hair loss). In these and similar problems we can only speak of probabilities that a connection exists. We decide whether to remove such a tooth according to the magnitude of the potential risk the focus might cause: heart-valve surgery (we remove the tooth because it may pose a risk of a fatal complication after surgery), hair loss (removal carries the risk that the hair will continue to fall out nevertheless).
Have a nice day!