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Whom should we consult for oral bone tuberculosis?

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General & Family Physician
Practicing since : 2007
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I am writing on behalf of my mother who has been diagnosed with oral bone TB. She is 61 years old and is a patient of diabetes, high blood pressure, thyroid disorders and chronic arthritis- spread to whole body. During the course of the treatment on oral TB she went through following stages:
i. intake of antibiotics with not much relief
ii. Oral surgery for removal of dead bone which could not control the problem and as per the doctor who has been treating my mother, necrotic bones are likely to form every time it is removed surgically.
iii. A CT scan was done after which it was diagnosed as Bone TB and anti-TB medication AKT-4 was started. This worked initially but problem, pain and irritation in the jaw appeared again
iv. Now the doctor advises her to go out of Patna, where we live, and consult Dr. XXXXXXX XXXXXXX in Bengalore. This however, may not be convenient for us.

Finally, we are extremely confused on where and who should be consulted for the treatment. I am quite nervous for what if we follow a wrong diagnosis or treatment!!
Could you please suggest us the right solution/step to be followed in this case? This will be very helpful for us.

Thank you for your time!
Neetu Choudhary
Posted Tue, 8 May 2012 in Dental Health
Answered by Dr. Mohammed Tauseef 1 hour later
Hi Neetu, Welcome to XXXXXXX Forum.

Thanks for the Query.

I am sorry for what your mother is going through, but with Proper Diagnosis, Treatment and Follow up care, she will definitely lead a Happy and Healthy life.

I Would like to know few more things here, so that I can suggest you better"

1.) What exactly are her symptoms?
2.) When was the Oral TB diagnosed?
3.) Has she lost weight recently?
4.) Is she having cough or Evening rise of temperature?

You should be getting her Examined by a Orthopedist and a Dentist. I don't know about the medical and surgical facility at Patna, but if your treating Doctor has suggested you to visit Bangalore for further treatment, you should seriously consider this as he will be knowing better and can visit Dr. XXXXXXX XXXXXXX Consultant Orthopedist and Dr. Mir Shujath XXXXXXX Consultant Dental Medicine, at Manipal Hospitals, Bangalore, so that they examine her and rule out the exact cause for her Symptoms.
You should be doing this at the earliest considering her age for early recovery. The earlier the Diagnosis, better the Prognosis.

They shall examine her and Suggest:
1.) Blood Work up
2.) Tuberculin Test
3.) CT Scan
4.) MRI Scan ( If necessary)

To rule out if it is,
1.) Bone Tuberculosis
2.) Paget's Disease

The treatment will depend upon the cause. Kindly don't worry and have patience as TB takes some time for complete cure. See to it she completes the full course of Medications if Tuberculosis is confirmed, sticks to her treatment plan and goes for regular follow up.

I Would suggest few lifestyle changes for her:

1.) Let her eat healthy nutritious balanced diet which should include fresh fruits and XXXXXXX leafy vegetables
2.) Exercise regularly and Go for regular brisk walks and maintain a healthy weight.
3.) Schedule for regular follow up and stick to her treatment plan.

Hope I have answered your Query, I will be available to answer your follow up queries.

I Wish her Good Health.

Take Care.
Above answer was peer-reviewed by
Follow-up: Whom should we consult for oral bone tuberculosis? 1 hour later
Dear Dr. Mohammaed Tauseef,

Thank you so much for replying!!
My mother's symptoms, as of now are as follows:
i. she was operated on 21st April and for few days she was okay. After that she started getting some painful irritation, apparently due to the growth in dead bone in her Jaw.
ii. Then CT scan was done and the doctor was not sure but started a trial & error treatment for Bone TB almost 20 days ago. This suited her initially and she was relieved. However, after around 10 days, she again started having the pricking painful discomfort. Then we again met the doctor who suggested us to take her to Bengalore. She is not able to eat, swallow and speak properly and is under immense pain.

Looking forward to your continued advises:

Neetu Choudhary
Answered by Dr. Mohammed Tauseef 2 hours later
Hello Neetu,

Thank you for writing back.

Your Follow up answer suggests, Tuberculosis has not been confirmed, but it could be once of the cause and it has to be ruled out.

As I told you earlier, you should be taking her to a Orthopedician and a Dentist and also get a Opinion from a ENT Specialist so that they can examine her and give their valuable Opinion.

Follow the advises which I had suggested you earlier, it seems to be a completely different case and your Mother needs immediate Medical Attention.

Kindly do not delay and reconsider your Decision of taking her outside Patna, You can also consider taking her to Indraprastha Apollo Hospitals at Delhi, I hope this will be feasible to you if not Bangalore as there are Highly Qualified specialists available there.

I Wish you Mother Very Good Health.

Take Care.
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