I have high CRP levels. Can a dental bone infection cause this?

Question

Hello doctor,

I currently have a very high CRP (C-reactive protein), and the doctors suspect it may be coming from my teeth or a dental bone infection. I have attached the following: X-ray (attached as a picture). CAT (computed axial tomography) scan report. Could you please provide advice on the following:

Do you see evidence of any infected teeth?
What is your opinion on the polyps mentioned in the CT scan report?
What is causing this? And is it an infection?
Do you see any evidence of bone infection or bone loss, or osteomyelitis?
I had the upper right third molar extracted (before having the high CRP). Does the bone socket here look infected?
Does the upper right implant look infected or show bone loss?
Does the sinus cavity look infected?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have seen all the information provided, and I will answer all the queries one by one. Based on radiological reports (attachment removed to protect the patient's identity), there is not much evidence of tooth infection, apart from the presence of polyps, which must be evaluated. Polyps could be caused due to a wide variety of reasons.

For suppose, the apex (tip) of the implant present in the sinus wall may be responsible. The presence of any residual infected tissue during tooth removal may be responsible.

There is no evidence suggestive of osteomyelitis of the bone (as of now). The implant does not show any radiological signs of bone loss and infection. There is an infected sinus present. And medication is required for the same.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

The scan (attachment removed to protect the patient's identity) does not show any infected tissue. The dentist correlates the symptoms with the scan and concludes. The implant breach to the sinus wall does not cause any issues. If it is present within the sinus antrum (cavity of the sinus), then there is only a chance of infection (not always present).

The CRP (C-reactive protein) values are not solely dependent on dental infections. Any infection present in the body causes a rise in CRP values. Sinusitis could also be one of the factors. Cold and cough also cause a rise in CRP values. We need to make sure the cause of the rise is diagnosed properly and treated. The upper molar draining into the maxillary sinus cannot be confirmed by radiological reports.

As I told you previously, it has to be evaluated based on both clinical symptoms and radiological assessment together to come to a conclusion. Is the molar tender to touch also? After knowing the clinical situation only, we can come to a conclusion.

The scan shows that a canal is missed with the treatment, and there is a radiolucency around that root, which could probably suggest that infection is present. The success of retreatment can again be evaluated by the reduction of symptoms and signs of infection clinically (if any) and by radiological assessment.

If the retreatment does not produce a satisfactory result, then we can think of the removal of the tooth. There is an infection on the tooth in front of the implant, and the radiolucency on the tooth present distally suggests that.

NICO (neuralgia-inducing cavitational osteonecrosis) is again based on clinical evaluation and the signs and symptoms experienced. I was able to access the scans with absolutely no issues.

I wish you a speedy recovery and smiles again.

I hope this helps.

Thank you.