to  have this diagnosed?  Does the patient know something >is wrong, or
is it discovered as an incidental finding?

To answer this question I am drawing on my own expriences as
well as others I have talked to. But I am not an expert.

Basically as I understand there are three types of possible
infections osteonecrotic/cavitational, osteomyletic, and perhaps
some types of infection with a lot of bacterial/fungal growth
in the bone, probably included in some terminology as cavitational.

osteomyletic infection is usually acute or chronic. Acute infection
does show clearly on radiographs and I think is fast moving so soon
produces evidence infection as leg and arms.

People with chronic osteomyletic infection are usually aware
that something is wrong (especially if it damages the nerves and
believe me sometimes it does) and go to the doctor where they
usually initially misdiagnose it. Eventually tests may be done
such as a thin sliced CT which show some erosion of the bone
or an MRI which hows possible problems in the nerve, or sinus problems
may develop from the jaw infection visible on the CT
as polyps on the bottom of the sinus, mucosal thickening and or
fluid level or sinus tracts, but usually the extent of the infection in
the jawbone is severely underestimated by the scan. Once surgery is
done findings may include, mushy bone, inflammation, bacterial/fungal
infestation, sinusitus, holes
in the floor of the sinus etc and even with treatment the infection has
a strong tendency to recur, i.e. as is the case with leg and arm
chronic om, it is difficult to eradicate even with
abx.

I think in some cases, like my case the amalgam seems to leak,
even depositing copper on the nerve pulp in one case I know of.  This
damages the surrounding jawbone which allows these infections to defeat
the regular jawbone defenses and really set in.

In other cases these infections are traced to poorly done root
canals, use of fosomax or even cracks in the tooth.

 I am assuming there is pain,

No, I could tell something is wrong. No pain, which for seem
reason seems more common for men with OM and less for women.
i could tell something was wrong because the jaw felt funny.
Eventually I went to a local OS to have an extraction, but
he didn't clean the bone above the root apparently, as I expected and
just commented that some of my jawbone was unusully soft when
he (burred down?) a jagged area, "like an 80 year old". Six months
later the infection spread and I really got sick. Then had a CT which
confirmed problems and decided to have surgery done by someone who
would really get all the infection out since the infection extended
over three/four teeth (and I still have infection in the left maxilla)
. The only biopsy I had was after surgery.

(The UMD was very reluctant to read the CT scans even after I was
referred by another local OS becasue of the soft bone and wanted to do
high power panorex ,but I refused, because the surgeon seemed
very unknowledgeable uncomfortable with the surgery and I thought
that I should get an opinion based on the CT before doing anything
else or getting any more radiation.)

I actually have the scans of the infected jaw area and a 3D scan of the
area on CD which I can email you , plus the radiological report and
the email response from UMD about the CT, but I'll save that for
another day because I'm getting a little tired.

REPLY

Many first find out when they read
Jan Drew on SMD where she conmtinues
to continue to warn people.

*IF* anyone has HEALTH!!!!! problems or
BREAK DANCE!!! problems they gots it.

Joel

Any dentist in this world is aware of spongiform bone, cortical bone, etc.

The unaware patient believes its more like a solid block of Formica.

A little time with a microscope could sure help out ClintonZ.

PS- To ClintonZ. Make sure your eye
is at the right end or the images like very tiny.

Joel