[clair]

My mum has been "unwell" for about 15 years. She was fully investigated at the time by ENT specialists and various Dentists both privately and at the hospital. The last appointment that I attended with her she was advised that there was nothing wrong with her medically and that she was depressed.

She describes headaches, can't get up in the morning, tinnitus, swollen gum, has become very withdrawn and dwells on her own health. She is a heavy smoker. She stopped working at the time and is very lethargic.

She has had lots of extensive dental work including root canal treatment.

The investigations carried out at the time included a sinus endoscope, various scans and xrays. Initially she was told it was a perforated sinus but the ENT/Dental team felt that the shadows on the xray were fatty tissue.

Just recently things have taken her back to the gp. She has had blood tests, eye tests, BP etc and a dental referral by the gp. Everything is ok but the dentist has done an xray and told her again that there is a shadow on the xray and it is possible she has a perforated sinus.

On reading what I can from the internet I would have thought that a perferated sinus would have healed by 15years! Why hasn't there been any infections? Her blood count was fine. Is it possible that it's some kind of fistula that's healed this way? If that's the case would she still have these symptoms.

My gut feeling is that she is depressed and a hypochondriac and I am trying to support her. Whilst I can imagine that some of you feel that I am wicked for saying such things it has been very hard living with her as she is always complaining about something to do with her health. I feel this recent episode is because my dad has become ill and was getting lots of attention. On the other hand of course if it sounds like her problems are genuine I want her to get well.

[Bryanna]

Hi Clair,

It sounds like your mom has several things going on and would benefit from some extensive blood work.... not just the usual CBC type stuff.

Just so you know... it is possible to still have a sinus perforation from an extraction that was done 15 years ago...... especially in someone who smokes. A smoker has a significantly high risk of not healing properly when they have oral surgery. This is in part due to the lack of oxygen in their oral tissue and to the carcinogens in the tobacco. I've seen many hundreds ++ of patients (smokers) whose gum tissue never closed from the extraction. With or without a sinus perf, an open wound any place in the mouth for a long period of time is going to be problem.

It also sounds to me like your mom may have periodontal disease? Do you know if she has that?

Shadows on dental xrays usually indicate some degree of pathology. She may have an infected tooth or if the shadow is in an area that she once had teeth extracted then she could have an osteonecrosis of the jawbone going on. Anytime there is a chronic state of illness in the body, the person is eventually not going to feel well especially if they are under alot of stress.

Routine blood tests can come up normal when something is wrong. Also many doctors think that if a result is somewhat within the so called normal range that it's ok, when often times it's not. Additional bloodwork that looks for specific inflammtory factors and infection may be helpful..... such as C-Reactive Protein, hs-CRP and Erythrocite Sedimentation Rate.

By the way, no one thinks bad of you for feeling the way that you do. It is difficult to take care of an ill parent, never mind 2 of them at one time!

Please keep in touch here and let us know how things are going

Bryanna

Originally Posted by clair

My mum has been "unwell" for about 15 years. She was fully investigated at the time by ENT specialists and various Dentists both privately and at the hospital. The last appointment that I attended with her she was advised that there was nothing wrong with her medically and that she was depressed.

She describes headaches, can't get up in the morning, tinnitus, swollen gum, has become very withdrawn and dwells on her own health. She is a heavy smoker. She stopped working at the time and is very lethargic.

She has had lots of extensive dental work including root canal treatment.

The investigations carried out at the time included a sinus endoscope, various scans and xrays. Initially she was told it was a perforated sinus but the ENT/Dental team felt that the shadows on the xray were fatty tissue.

Just recently things have taken her back to the gp. She has had blood tests, eye tests, BP etc and a dental referral by the gp. Everything is ok but the dentist has done an xray and told her again that there is a shadow on the xray and it is possible she has a perforated sinus.

On reading what I can from the internet I would have thought that a perferated sinus would have healed by 15years! Why hasn't there been any infections? Her blood count was fine. Is it possible that it's some kind of fistula that's healed this way? If that's the case would she still have these symptoms.

My gut feeling is that she is depressed and a hypochondriac and I am trying to support her. Whilst I can imagine that some of you feel that I am wicked for saying such things it has been very hard living with her as she is always complaining about something to do with her health. I feel this recent episode is because my dad has become ill and was getting lots of attention. On the other hand of course if it sounds like her problems are genuine I want her to get well.

[clair]

Originally Posted by clair

My mum has been "unwell" for about 15 years. She was fully investigated at the time by ENT specialists and various Dentists both privately and at the hospital. The last appointment that I attended with her she was advised that there was nothing wrong with her medically and that she was depressed.

She describes headaches, can't get up in the morning, tinnitus, swollen gum, has become very withdrawn and dwells on her own health. She is a heavy smoker. She stopped working at the time and is very lethargic.

She has had lots of extensive dental work including root canal treatment.

The investigations carried out at the time included a sinus endoscope, various scans and xrays. Initially she was told it was a perforated sinus but the ENT/Dental team felt that the shadows on the xray were fatty tissue.

Just recently things have taken her back to the gp. She has had blood tests, eye tests, BP etc and a dental referral by the gp. Everything is ok but the dentist has done an xray and told her again that there is a shadow on the xray and it is possible she has a perforated sinus.

On reading what I can from the internet I would have thought that a perferated sinus would have healed by 15years! Why hasn't there been any infections? Her blood count was fine. Is it possible that it's some kind of fistula that's healed this way? If that's the case would she still have these symptoms.

My gut feeling is that she is depressed and a hypochondriac and I am trying to support her. Whilst I can imagine that some of you feel that I am wicked for saying such things it has been very hard living with her as she is always complaining about something to do with her health. I feel this recent episode is because my dad has become ill and was getting lots of attention. On the other hand of course if it sounds like her problems are genuine I want her to get well.

Thanks for your reply and thanks for confirming that it is possible that this has been going on all this time.

I don't know if my mum has periodontal disease...what is this? I do know that her teeth are in a very poor state with lots of canal treatments, lots of missing teeth and lots of fillings. Unfortunately as her mum lost all of her teeth due to gum disease she never bothered with my mum's teeth as a child and so when my mum first saw at dentist there was lots to be done. The dentist recently found a broken tooth too.

I am aware of the CRP test...I have crohn's and arthritis so very familiar with blood tests which is why when the doc said her white count was in the normal range I assumed nothing to be going on.

Thanks again.

[Bryanna]

Hi Clair,

Your description of your mom's dental history is indicative of periodontal disease. This condition is a progressive bacterial infection of the gums, supporting ligaments and jawbone surrounding the teeth. This condition alone will cause a disruption in the healing of where a tooth was extracted by preventing the bone and gum to heal properly.... sinus perforations are commonly seen in people with this condition who smoke.

Periodontal disease can contribute to other health conditions because the bacteria is continuously moving through the blood to other organs of the body. Extensive research has concluded that the same bacteria that causes periodontal disease contributes to coronary artery disease... ex: clogging of the arteries in the heart, brain and kidneys. So someone who has been living with uncontrolled periodontal disease for a long time will eventually start to feel unwell.

It may be helpful to consult with her physician about her dental issues emphasizing the periodontal disease. This will help him to order the proper blood tests which are generally not ordered on the routine blood workup.

Bryanna

Originally Posted by clair

Thanks for your reply and thanks for confirming that it is possible that this has been going on all this time.

I don't know if my mum has periodontal disease...what is this? I do know that her teeth are in a very poor state with lots of canal treatments, lots of missing teeth and lots of fillings. Unfortunately as her mum lost all of her teeth due to gum disease she never bothered with my mum's teeth as a child and so when my mum first saw at dentist there was lots to be done. The dentist recently found a broken tooth too.

I am aware of the CRP test...I have crohn's and arthritis so very familiar with blood tests which is why when the doc said her white count was in the normal range I assumed nothing to be going on.

Thanks again.