Hi nyuszisue,

Many dental problems have little to no obvious symptoms until the problem is severe. Frequently an infected tooth (root canaled or not) that has been draining through a deep pocket will tend to have vague symptoms (as you stated) until the inflammation reduces the opening of the pocket which can then cause obvious swelling or pain. This is commonly seen in aged root canaled teeth. The bacteria that resides inside of root canaled teeth is mainly inside the tiny accessory canals which cannot be picked up on most dental xrays until it has greatly proliferated beyond these canals. So that is why many dentists will tell the patient the tooth looks good and not diagnose the brewing infection until more symptoms or pathology develop.

It is very typical to have some complications after an infected tooth is extracted. Whether or not it had been root canaled does not diminish the fact that the tooth was diseased and in your case your tooth was unhealthy for at least entire 17 years. So you can imagine how sick that tooth was and how inflamed the bone and tissue in that area had become over all that time.

The intensity of the post op complications often depend on how progressive the bacteria had become. Dental xrays and even CT scans do not always show the extent of the problem... sometimes the problem is still in a microscopic phase and cannot be picked up by radiation ..... other times the dentist feels the site looks "typical" and prescribes antibiotics and takes a wait and see approach.

Sometimes an extraction site is no longer diseased but it may be more inflamed and traumatized than it would be if the tooth had not been so ill. In those case the healing will take longer.

The fact that you seemed to get worse on the 11th day post op is indicative of a possibly unresolved bacterial issue. This could mean there is still some bacteria lurking in the bone, the tissue, or the sinus. If it is not detectable (yet) on an xray or scan it will be difficult to diagnose and treat. If this is the case it may progress or it may resolve. It is hard to determine which way it will go. Antibiotics may not help much because the bacteria may not be sensitive to the meds prescribed. The only sure way to know what antibiotic to prescribe would be to culture that extraction site and send to the lab for testing.

A few questions....

Are you getting any drainage from that side of your nose? Does the nasal passage on that side feel inflamed or closed off? Were you prone to any of those things prior to the extraction? Do you feel pressure, pain or an achy feeling in that side of your face beside your nose? Any pressure in or under that eye?

Did the oral surgeon or your dentist say anything to you about the tooth being close to the sinus or a sinus perforation or that your sinuses were low in that area?

Any chance you could post the pre and post op xrays of this tooth???

Are you rinsing with warm salt water? Are you using any mouthwash or peroxide or irrigating the site with anything? What tooth paste are you using to brush your teeth with... and do you floss?