[MAM1]

Hello everyone, I just joined.

I have had problems with the #3 molar and the sinus connected to it for years. Lots of sinus infections over the years. Anyway several years ago it had a root canal but the gum always seemed to be infected and I still felt like something was "in" the tooth. At my last visit i complained of this again and the dentist said I probably needed a new crown since the other crown got drilled through for the root canal. So he took it off and put a temporary crown on but said before I get the new crown go for a consult to the same endontist who did the original root canal. I did and the endontist took X-rays and said it looked like a "halo" around the tooth which he said could either be infection or scar tissue. He tested the tooth for sensitivity (positive) so proceeded to redo the root canal. After he got the cement out he said there was a "flaw" or "crack" in the root letting in infection and so the best thing would be for me to get it extracted rather than try to patch it. He cleaned it out, put disinfectant in, and put the temporary cap back on. So I made an appointment for the extraction for an oral surgeon in a week. Meanwhile he put me on Amoxicillin.

But now (3 days after my failed root canal) my sinus hurts and I feel like I have either a cold or sinus infection. Low-grade fever and getting yellow mucus drainage. Also the tooth or gum feels extremely irritated. My sinus definitely got worse after this failed attempt at a root canal even though I am on 500 mg three times a day Amoxicillin. I am afraid I will have a horrible infection by Oct. 31 when I am supposed to have it pulled. Should I ask for a different antibiotic or just live with this sinus apparent sinus infection until the day I go in for an extraction? What else would help - can I do nasal irrigations until the extraction?

Also, another big fear is I am almost certain this extraction will cause a sinus perforation. How do I know this? Because the first time I had the root canal several years ago on that tooth, after the root canal my nose bled lightly for about 24 hours. I called the endontist's office and they said "sometimes that happens" with no other explanation. Also, whenever I have problems with the tooth, like now, I get a sinus infection.

Will the oral surgeon still take out this infected tooth if I have a sinus infection and if the roots go into the sinus which I think they do? And if I do get a sinus perforation can I still get a dental implant which is what I assume is the next step? Would it be okay not to do anything, no implant no bridge, just leave it the hole there? I have insurance so money isn't an issue but I just don't want any complications. I have a dental phobia as well. This is my first extraction.

Marie,
age 50

[Kitt]

Welcome MAM1.

[Bryanna]

Hi Marie,

Welcome!

I am going to re post some of your thread and comment in bold type.

<<I have had problems with the #3 molar and the sinus connected to it for years. Lots of sinus infections over the years. Anyway several years ago it had a root canal but the gum always seemed to be infected and I still felt like something was "in" the tooth.>>

THE GUM WILL SHOW SIGNS OF "INFECTION" IF THE BACTERIA IN THE TOOTH AND PERHAPS FROM YOUR SINUS HAS BEEN DRAINING THROUGH AN OPENING IN THE GUM. THESE SYMPTOMS INDICATE WHAT IS REFERRED TO AS A PERIO/ENDO INFECTION. SIMPLY MEANS THAT THE BACTERIA INSIDE THE TOOTH HAS SPREAD BEYOND THE TOOTH. THAT SOMETHING THAT YOU FEEL IN YOUR TOOTH CAN BE INFLAMMATION.

<<At my last visit i complained of this again and the dentist said I probably needed a new crown since the other crown got drilled through for the root canal.>>

NOPE. A NEW CROWN WILL NOT SOLVE THE PROBLEM AS IT HAS NOTHING TO DO WITH THE CROWN THAT IS ON THE TOOTH. THE PROBLEM IS THE TOOTH IS OVERWHELMED WITH BACTERIA.

<< So he took it off and put a temporary crown on but said before I get the new crown go for a consult to the same endontist who did the original root canal. I did and the endontist took X-rays and said it looked like a "halo" around the tooth which he said could either be infection or scar tissue.>>

THE HALO IS NOT SCAR TISSUE. THE HALO IS A POOL OF INFECTIOUS BACTERIA. I'M SORRY BUT YOUR ENDODONTIST KNOWS THIS AND UNFORTUNATELY THEY REDO THE RC TO TRY AND RELEASE SOME OF THE BACTERIA. BUT IT WON'T WORK BECAUSE THE BACTERIA THAT'S CAUSING THE "HALO" IS NOT REMOVABLE AS IT IS INSIDE THE TOOTH IN THE MICROSCOPIC CANALS THAT ARE NOT ACCESSIBLE.

<< He tested the tooth for sensitivity (positive) so proceeded to redo the root canal.>>

ROOT CANAL TEETH ARE NON VITAL TEETH AS THE BLOOD SUPPLY HAS BEEN CUT OFF. THE TOOTH TEST POSITIVE FOR SENSITIVITY BECAUSE OF THE INFLAMMATION INSIDE OF THE TOOTH CAUSED BY THE BACTERIA FROM THE NECROTIC TISSUE INSIDE OF THOSE TINY CANALS.

<<After he got the cement out he said there was a "flaw" or "crack" in the root letting in infection and so the best thing would be for me to get it extracted rather than try to patch it.>>

THE FLAW OR CRACK IN THE ROOT MEANS THAT THE TOOTH WAS EITHER FRACTURED TO BEGIN WITH AND/OR THE TOOTH WAS PERFORATED WITH AN INSTRUMENT DURING THE FIRST RC PROCEDURE. THERE IS NO WAY TO "PATCH IT UP".

<< He cleaned it out, put disinfectant in, and put the temporary cap back on. >>

THIS TOOTH IS VERY UNHEALTHY AND THE MEDICAMENTS THAT HE USED TO DISINFECT IT ARE TOXIC. SO IT IS BEST TO HAVE THIS TOOTH REMOVED ASAP.

<<So I made an appointment for the extraction for an oral surgeon in a week. Meanwhile he put me on Amoxicillin.>>

IF YOU ARE COMFORTABLE THEN WAITING A WEEK MAY BE OKAY.

<<But now (3 days after my failed root canal) my sinus hurts and I feel like I have either a cold or sinus infection. Low-grade fever and getting yellow mucus drainage. Also the tooth or gum feels extremely irritated. My sinus definitely got worse after this failed attempt at a root canal even though I am on 500 mg three times a day Amoxicillin. >>

THE ENDODONTIST SHOULD NOT HAVE MESSED WITH THE TOOTH. WHAT HE DID ACTUALLY CAUSED THE BACTERIA TO FLARE UP AND NOW THE ENTIRE AREA IS INFLAMED. I WOULD CALL THE ORAL SURGEON TOMORROW, EXPLAIN YOUR SYMPTOMS IN DETAIL AND SEE WHAT THEY SAY ABOUT COMING IN SOONER.

<< I am afraid I will have a horrible infection by Oct. 31 when I am supposed to have it pulled. Should I ask for a different antibiotic or just live with this sinus apparent sinus infection until the day I go in for an extraction? What else would help - can I do nasal irrigations until the extraction?>>

CALL THE ORAL SURGEON. DO NOT ANY NASAL IRRIGATION UNLESS HE TELLS YOU TO.

<<Also, another big fear is I am almost certain this extraction will cause a sinus perforation. How do I know this? >>

THERE IS A GOOD POSSIBILITY THAT THE SINUS IS ALREADY PERFORATED. TELL THE OS THAT YOU WANT TO KNOW IF IT IS AND HOW LARGE OF A PERF IT IS WHEN HE REMOVES THE TOOTH.

<< Because the first time I had the root canal several years ago on that tooth, after the root canal my nose bled lightly for about 24 hours. I called the endontist's office and they said "sometimes that happens" with no other explanation. Also, whenever I have problems with the tooth, like now, I get a sinus infection.>>

OKAY THIS TELLS THE WHOLE STORY AND YOU NEED TO MAKE SURE THE OS KNOWS ABOUT THIS BEFORE HE EXTRACTS THE TOOTH AS HE WILL MAKE SURE TO LOOK FOR THE SINUS PERF. YOUR DESCRIPTION INDICATES THAT THE ENDODONTIST PERFORATED THE END OF THE ROOT OF THE TOOTH WHEN HE DID THE FIRST ROOT CANAL. THIS HAS ALLOWED BACTERIA TO SEEP INTO YOUR SINUSES ALL OF THESE YEARS. THE ENDODONTIST SHOULD HAVE INFORMED YOU OF THIS.

<<Will the oral surgeon still take out this infected tooth if I have a sinus infection and if the roots go into the sinus which I think they do? >>

THE OS WILL MAKE THAT DECISION. I SUGGEST IF AT ALL POSSIBLE THAT YOU BRING YOUR PRE OP XRAYS OF THE ORIGINAL ROOT CANAL AND ALL OTHERS TAKEN OF THIS TOOTH AFTER THAT. A RADIOGRAPHIC HISTORY OF THIS TOOTH WILL TELL THE WHOLE STORY.

<<And if I do get a sinus perforation can I still get a dental implant which is what I assume is the next step? >>

TO BE HONEST WITH YOU, THIS TOOTH HAS CAUSED A SERIOUS INFECTION AND THERE IS GOING TO BE A MODERATE AMOUNT OF BONE DETERIORATION IN THAT AREA. THE SINUS MAY OR MAY NOT BE AN ADDITIONAL PROBLEM. THE SURGEON WILL LOOK FOR ALL OF THAT WHEN HE REMOVES THE TOOTH. ANYTIME YOU HAVE A RC TOOTH REMOVED IT IS RISKY TO REPLACE IT WITH A DENTAL IMPLANT BECAUSE OF THE POSSIBILITY OF RESIDUAL BACTERIA LIVING IN THE BONE. THIS IS TRUE EVEN MORE SO WHEN THE RC WAS DONE MANY YEARS AGO AND WHEN THE TOOTH HAS BEEN PROBLEMATIC FOR A LONG TIME.

<< Would it be okay not to do anything, no implant no bridge, just leave it the hole there?>>

THE HEALTHIEST OPTION FOR YOU MAY BE NOT TO REPLACE THAT TOOTH. I CERTAINLY WOULD NOT RUSH TO HAVE AN IMPLANT PUT IN THERE IN LESS THAN A YEAR.

<< I have insurance so money isn't an issue but I just don't want any complications.>>

I WOULD BE VERY CONCERNED ABOUT COMPLICATIONS OCCURRING IF AN IMPLANT WAS PLACED IN THAT AREA UNLESS IT WAS POSITIVELY DETERMINED THAT THE BONE WAS HEALTHY AND THE SINUS WAS HEALED COMPLETELY.

<< I have a dental phobia as well. This is my first extraction>>

MARIE, YOUR BODY IS GOING TO THANK YOU FOR GETTING THIS SICK TOOTH OUT OF YOUR HEAD. TALK TO THE OS ABOUT YOUR FEARS AS IT MAY BE BEST TO HAVE A LITTLE IV SEDATION FOR THE REMOVAL OF THE TOOTH. YOU WOULD HAVE TO BE PREPARED FOR THAT AHEAD OF TIME AS YOU WOULD HAVE TO FAST FOR AT LEAST 9-12 HOURS PRIOR TO THE EXTRACTION.

I hope this information is helpful to you. Please try not to worry, you will be okay. Keep us posted...
Bryanna

[MAM1]

Wow, Bryanna, thanks for all that detailed good information! Sure wish I knew before what I know now! I definitely am glad you advised me to wait on the implant because i would have just gone ahead with it. But I've also read that the teeth will start to shift if there is an empty space so what can I do to prevent that? I really don't want a bridge and probably couldn't get one anyway. Also, today my ear started hurting. I only took the ibuprophen for two days because it is hard on the stomach and I wasn't really getting a lot of pain but now I think maybe I should have kept on it to reduce inflammation which I assume is causing the earache. So I took one 200 mg. Motrin this afternoon which didn't do anything. Should I keep upping the dose until the ear ache goes away or try to wait it out until I get my tooth pulled? Friday is the soonest I could get an appointment but the receptionist did say if an emergency develops I should call. I guess I will call tomorrow and see if my ear pain now qualifies for an emergency. The endontist mailed last week's x-rays on Friday to the OS so they won't get them until Tuesday. I guess I now need to run over to my dentist and pick up X-rays of the tooth before the root canal. The endontist is pretty far away and they don't send x-rays digitally but my dentist is close by and the OS is close by so hopefully my dentist will have something.

You know the oddest thing is I have been in and out of the ENT many times over the years with sinus infections and lots of scopes up my nose without seeing anything plus lots of and lots of antibiotics and nasal sprays and antihistamines and not once did the ENT ask me about my teeth. Now I am putting two and two together but I wish the ENT or my dentist had put figured this out. You would think they see this problem a lot. Both my ENT and dentist have been practicing over 30 years so you'd think they'd have a clue.

I didn't know the dentist/OS/endontist can tell if there is a perforation before the tooth is actually extracted. If they know that and didn't tell me that would be highly unprofessional not to mention immoral.

So okay, tomorrow I should try to get in to see my regular dentist to get the x-rays and just tell him what the status is. I may also ask him for a stronger antibiotic (any suggestions?) Then I will try to get an emergency visit to get the tooth pulled but that may not happen. I will report back. Thanks so much for your help!!!!

Marie

Originally Posted by Bryanna

Hi Marie,

Welcome!

I am going to re post some of your thread and comment in bold type.

<<I have had problems with the #3 molar and the sinus connected to it for years. Lots of sinus infections over the years. Anyway several years ago it had a root canal but the gum always seemed to be infected and I still felt like something was "in" the tooth.>>

THE GUM WILL SHOW SIGNS OF "INFECTION" IF THE BACTERIA IN THE TOOTH AND PERHAPS FROM YOUR SINUS HAS BEEN DRAINING THROUGH AN OPENING IN THE GUM. THESE SYMPTOMS INDICATE WHAT IS REFERRED TO AS A PERIO/ENDO INFECTION. SIMPLY MEANS THAT THE BACTERIA INSIDE THE TOOTH HAS SPREAD BEYOND THE TOOTH. THAT SOMETHING THAT YOU FEEL IN YOUR TOOTH CAN BE INFLAMMATION.

<<At my last visit i complained of this again and the dentist said I probably needed a new crown since the other crown got drilled through for the root canal.>>

NOPE. A NEW CROWN WILL NOT SOLVE THE PROBLEM AS IT HAS NOTHING TO DO WITH THE CROWN THAT IS ON THE TOOTH. THE PROBLEM IS THE TOOTH IS OVERWHELMED WITH BACTERIA.

<< So he took it off and put a temporary crown on but said before I get the new crown go for a consult to the same endontist who did the original root canal. I did and the endontist took X-rays and said it looked like a "halo" around the tooth which he said could either be infection or scar tissue.>>

THE HALO IS NOT SCAR TISSUE. THE HALO IS A POOL OF INFECTIOUS BACTERIA. I'M SORRY BUT YOUR ENDODONTIST KNOWS THIS AND UNFORTUNATELY THEY REDO THE RC TO TRY AND RELEASE SOME OF THE BACTERIA. BUT IT WON'T WORK BECAUSE THE BACTERIA THAT'S CAUSING THE "HALO" IS NOT REMOVABLE AS IT IS INSIDE THE TOOTH IN THE MICROSCOPIC CANALS THAT ARE NOT ACCESSIBLE.

<< He tested the tooth for sensitivity (positive) so proceeded to redo the root canal.>>

ROOT CANAL TEETH ARE NON VITAL TEETH AS THE BLOOD SUPPLY HAS BEEN CUT OFF. THE TOOTH TEST POSITIVE FOR SENSITIVITY BECAUSE OF THE INFLAMMATION INSIDE OF THE TOOTH CAUSED BY THE BACTERIA FROM THE NECROTIC TISSUE INSIDE OF THOSE TINY CANALS.

<<After he got the cement out he said there was a "flaw" or "crack" in the root letting in infection and so the best thing would be for me to get it extracted rather than try to patch it.>>

THE FLAW OR CRACK IN THE ROOT MEANS THAT THE TOOTH WAS EITHER FRACTURED TO BEGIN WITH AND/OR THE TOOTH WAS PERFORATED WITH AN INSTRUMENT DURING THE FIRST RC PROCEDURE. THERE IS NO WAY TO "PATCH IT UP".

<< He cleaned it out, put disinfectant in, and put the temporary cap back on. >>

THIS TOOTH IS VERY UNHEALTHY AND THE MEDICAMENTS THAT HE USED TO DISINFECT IT ARE TOXIC. SO IT IS BEST TO HAVE THIS TOOTH REMOVED ASAP.

<<So I made an appointment for the extraction for an oral surgeon in a week. Meanwhile he put me on Amoxicillin.>>

IF YOU ARE COMFORTABLE THEN WAITING A WEEK MAY BE OKAY.

<<But now (3 days after my failed root canal) my sinus hurts and I feel like I have either a cold or sinus infection. Low-grade fever and getting yellow mucus drainage. Also the tooth or gum feels extremely irritated. My sinus definitely got worse after this failed attempt at a root canal even though I am on 500 mg three times a day Amoxicillin. >>

THE ENDODONTIST SHOULD NOT HAVE MESSED WITH THE TOOTH. WHAT HE DID ACTUALLY CAUSED THE BACTERIA TO FLARE UP AND NOW THE ENTIRE AREA IS INFLAMED. I WOULD CALL THE ORAL SURGEON TOMORROW, EXPLAIN YOUR SYMPTOMS IN DETAIL AND SEE WHAT THEY SAY ABOUT COMING IN SOONER.

<< I am afraid I will have a horrible infection by Oct. 31 when I am supposed to have it pulled. Should I ask for a different antibiotic or just live with this sinus apparent sinus infection until the day I go in for an extraction? What else would help - can I do nasal irrigations until the extraction?>>

CALL THE ORAL SURGEON. DO NOT ANY NASAL IRRIGATION UNLESS HE TELLS YOU TO.

<<Also, another big fear is I am almost certain this extraction will cause a sinus perforation. How do I know this? >>

THERE IS A GOOD POSSIBILITY THAT THE SINUS IS ALREADY PERFORATED. TELL THE OS THAT YOU WANT TO KNOW IF IT IS AND HOW LARGE OF A PERF IT IS WHEN HE REMOVES THE TOOTH.

<< Because the first time I had the root canal several years ago on that tooth, after the root canal my nose bled lightly for about 24 hours. I called the endontist's office and they said "sometimes that happens" with no other explanation. Also, whenever I have problems with the tooth, like now, I get a sinus infection.>>

OKAY THIS TELLS THE WHOLE STORY AND YOU NEED TO MAKE SURE THE OS KNOWS ABOUT THIS BEFORE HE EXTRACTS THE TOOTH AS HE WILL MAKE SURE TO LOOK FOR THE SINUS PERF. YOUR DESCRIPTION INDICATES THAT THE ENDODONTIST PERFORATED THE END OF THE ROOT OF THE TOOTH WHEN HE DID THE FIRST ROOT CANAL. THIS HAS ALLOWED BACTERIA TO SEEP INTO YOUR SINUSES ALL OF THESE YEARS. THE ENDODONTIST SHOULD HAVE INFORMED YOU OF THIS.

<<Will the oral surgeon still take out this infected tooth if I have a sinus infection and if the roots go into the sinus which I think they do? >>

THE OS WILL MAKE THAT DECISION. I SUGGEST IF AT ALL POSSIBLE THAT YOU BRING YOUR PRE OP XRAYS OF THE ORIGINAL ROOT CANAL AND ALL OTHERS TAKEN OF THIS TOOTH AFTER THAT. A RADIOGRAPHIC HISTORY OF THIS TOOTH WILL TELL THE WHOLE STORY.

<<And if I do get a sinus perforation can I still get a dental implant which is what I assume is the next step? >>

TO BE HONEST WITH YOU, THIS TOOTH HAS CAUSED A SERIOUS INFECTION AND THERE IS GOING TO BE A MODERATE AMOUNT OF BONE DETERIORATION IN THAT AREA. THE SINUS MAY OR MAY NOT BE AN ADDITIONAL PROBLEM. THE SURGEON WILL LOOK FOR ALL OF THAT WHEN HE REMOVES THE TOOTH. ANYTIME YOU HAVE A RC TOOTH REMOVED IT IS RISKY TO REPLACE IT WITH A DENTAL IMPLANT BECAUSE OF THE POSSIBILITY OF RESIDUAL BACTERIA LIVING IN THE BONE. THIS IS TRUE EVEN MORE SO WHEN THE RC WAS DONE MANY YEARS AGO AND WHEN THE TOOTH HAS BEEN PROBLEMATIC FOR A LONG TIME.

<< Would it be okay not to do anything, no implant no bridge, just leave it the hole there?>>

THE HEALTHIEST OPTION FOR YOU MAY BE NOT TO REPLACE THAT TOOTH. I CERTAINLY WOULD NOT RUSH TO HAVE AN IMPLANT PUT IN THERE IN LESS THAN A YEAR.

<< I have insurance so money isn't an issue but I just don't want any complications.>>

I WOULD BE VERY CONCERNED ABOUT COMPLICATIONS OCCURRING IF AN IMPLANT WAS PLACED IN THAT AREA UNLESS IT WAS POSITIVELY DETERMINED THAT THE BONE WAS HEALTHY AND THE SINUS WAS HEALED COMPLETELY.

<< I have a dental phobia as well. This is my first extraction>>

MARIE, YOUR BODY IS GOING TO THANK YOU FOR GETTING THIS SICK TOOTH OUT OF YOUR HEAD. TALK TO THE OS ABOUT YOUR FEARS AS IT MAY BE BEST TO HAVE A LITTLE IV SEDATION FOR THE REMOVAL OF THE TOOTH. YOU WOULD HAVE TO BE PREPARED FOR THAT AHEAD OF TIME AS YOU WOULD HAVE TO FAST FOR AT LEAST 9-12 HOURS PRIOR TO THE EXTRACTION.

I hope this information is helpful to you. Please try not to worry, you will be okay. Keep us posted...
Bryanna

[Bryanna]

Hi Marie,

Again I will re post some of your thread and reply in bold type.

<< I definitely am glad you advised me to wait on the implant because i would have just gone ahead with it.>>

WAITING IS BEST IN YOUR CASE DUE TO THE LONGEVITY OF THE INFECTION AND THE SINUS PROBLEM. PLEASE DON'T LET ANYONE TALK YOU INTO DOING IT RIGHT AWAY.

<< But I've also read that the teeth will start to shift if there is an empty space so what can I do to prevent that? I really don't want a bridge and probably couldn't get one anyway.>>

TOOTH #3 IS YOUR FIRST UPPER RIGHT MOLAR. THIS TOOTH DOES NOT NECESSARILY HAVE TO BE REPLACED. YOU MAY GET SOME SHIFTING OF TOOTH #2 BUT IT MAY NOT BE SIGNIFICANT. THE MOVEMENT OF THE TOOTH WILL SOMEWHAT DEPEND ON THE POSITION OF THE REST OF YOUR TEETH. YOUR DENTIST NEEDS TO EVALUATE YOUR OCCLUSION, BITE, TO SEE WHICH TEETH BITE AGAINST OTHER TEETH. YOUR LOWER MOLAR BENEATH #3, WHICH IS TOOTH #30, MAY BE OCCLUDING WITH TOOTH #2 AND/OR 4. SO HE NEEDS TO LOOK AT THAT AND GIVE YOU REPLACEMENT OPTIONS ACCORDING TO THE REST OF YOUR MOUTH.

<< Also, today my ear started hurting.>>

CALL THE ORAL SURGEON AND DESCRIBE ALL OF YOUR SYMPTOMS.

<< I only took the ibuprophen for two days because it is hard on the stomach and I wasn't really getting a lot of pain but now I think maybe I should have kept on it to reduce inflammation which I assume is causing the earache. So I took one 200 mg. Motrin this afternoon which didn't do anything. Should I keep upping the dose until the ear ache goes away or try to wait it out until I get my tooth pulled?>>

ALL NSAIDS CAN BE PROBLEMATIC TO THE STOMACH AND TO THE KIDNEYS. SO IT IS NEVER A GOOD IDEA TO TAKE THEM IN HIGH DOSAGES AND FOR LONG PERIODS OF TIME. I DON'T THINK YOUR SYMPTOMS ARE GOING T SUBSIDE MUCH UNTIL THE TOOTH IS REMOVED.

<< Friday is the soonest I could get an appointment but the receptionist did say if an emergency develops I should call. I guess I will call tomorrow and see if my ear pain now qualifies for an emergency. >>

YES, CALL THE OS.

<< The endontist mailed last week's x-rays on Friday to the OS so they won't get them until Tuesday. I guess I now need to run over to my dentist and pick up X-rays of the tooth before the root canal. The endontist is pretty far away and they don't send x-rays digitally but my dentist is close by and the OS is close by so hopefully my dentist will have something.>>

IT IS VERY IMPORTANT TO GATHER ALL OF THE PRE AND POST OP XRAYS OF TOOTH #3 AS A RADIO-GRAPHIC HISTORY OF THIS TOOTH WILL GIVE THE SURGEON A CLEARER PICTURE OF THE PROBLEMS.

<<You know the oddest thing is I have been in and out of the ENT many times over the years with sinus infections and lots of scopes up my nose without seeing anything plus lots of and lots of antibiotics and nasal sprays and antihistamines and not once did the ENT ask me about my teeth.>>

ACTUALLY THIS IS NOT ODD AT ALL. BUT I SUGGEST YOU FIND A NEW ENT AS THE ONE YOU HAVE IS JUST TREATING YOUR SYMPTOMS WITHOUT REALLY LOOKING FOR THE CAUSE. IF HE WERE TO PURPOSELY LOOK FOR THE CAUSE AND DO MORE THAN JUST A NASAL SCOPE, HE MAY HAVE DISCOVERED THE TOOTH CONNECTION A LONG TIME AGO. ALSO IT IS IMPORTANT TO ALWAYS TELL THE ENT THAT YOU HAVE A ROOT CANALED TOOTH AS THAT GIVES THEM A HEADS UP ON TO DO SOME FURTHER EXPLORING.

<<Now I am putting two and two together but I wish the ENT or my dentist had put figured this out. You would think they see this problem a lot. Both my ENT and dentist have been practicing over 30 years so you'd think they'd have a clue.>>

THEY DO HAVE A CLUE AS YOUR SITUATION IS NOT AT ALL UNCOMMON. IN FACT, IT IS VERY COMMON.... IT'S JUST NOT DIAGNOSED PROPERLY. IT'S UNFORTUNATE BUT MANY DOCTORS DO NOT LIKE TO STEP ON ANOTHER DOCTORS TOES. SO THEY TEND TO JUST TREAT THE SYMPTOMS RATHER THAN THE CAUSE WHICH WOULD MEAN THE TWO DOCTORS WOULD HAVE TO AGREE ON THE CORRELATION BETWEEN THE TOOTH AND THE SINUS. MANY DENTISTS ARE NOT OPEN TO THAT CONCEPT FOR SEVERAL REASONS BUT PERHAPS THE MOST SIGNIFICANT ONE IS SIMPLY BECAUSE ROOT CANAL THERAPY IS THE MOST LUCRATIVE FORM OF DENTISTRY.

<<I didn't know the dentist/OS/endontist can tell if there is a perforation before the tooth is actually extracted. If they know that and didn't tell me that would be highly unprofessional not to mention immoral.>>

SOMETIMES YOU CAN SEE OR ASSUME A PERFORATION BY LOOKING AT A RADIO GRAPH BASED ON THE LOCATION OF THE ROOT AND THE FLOOR OF THE SINUS. OTHER TIMES YOU CAN ONLY SEE IT WHEN THE TOOTH IS REMOVED. HOWEVER, IF I HAD PENNEY FOR EVERY TIME A DENTIST NEGLECTED TO INFORM THE PATIENT ABOUT A SINUS PEROFORATION.... I WOULD BE A MILLIONAIRE!

<<So okay, tomorrow I should try to get in to see my regular dentist to get the x-rays and just tell him what the status is.>>

YES.

<< I may also ask him for a stronger antibiotic (any suggestions?) >>

NO. A STRONGER ANTIBIOTIC MAY NOT MAKE ANY DIFFERENCE AS THE TOOTH NEEDS TO COME OUT FOR THE ANTIBIOTIC TO BE MOST EFFECTIVE.

<< Then I will try to get an emergency visit to get the tooth pulled but that may not happen. I will report back.>>

OKAY GOOD. Thanks so much for your help!!!! YOU ARE WELCOME!

[MAM1]

So I went to the dentist who basically just gave me the choice of putting on the permanent crown which had already been ordered and had come in or getting the tooth pulled. I was surprised he was willing to put the crown on when he already spoke to the endodontist who said the tooth had a crack and needed to be pulled. I said, don't you agree that an infected tooth with a crack needs to be pulled and he said, well I know how you are will your fear of dental procedures! So now I have lost all confidence in him. I think he just didn't want to be stuck paying for the new crown or trying to get a refund for it from the insurance. He wrote up a referral with the order to do a bone graft so I can get the implant. He said the whole thing wouldn't take more than 30 minutes with an OS. So I still have my appointment scheduled for Friday. Meanwhile I am still sore from the partial root canal procedure from last Thursday so I am expecting to be in pretty bad shape after the tooth is pulled. I am going to ask the OS whether I can get the bone graft or whatever it is I need for the implant done an a future appointment or whether it has to be done when i get the tooth pulled. I probably will end up going with an implant if the OS thinks it will work but I want everything to settle down and recover in my mouth and sinus before I get anything else done. So I will see what he says. I am totally fearing getting a sinus perforation and having to have surgery to fix that. Meanwhile i started getting horrible diarreah (sp?) from the antibiotic plus I am having my period plus I have this sinus infection so I am in bad shape. i think I will have to stop the Amoxicillan or I will be too weak to recover from the tooth extraction. Will report back after the extraction.

[Bryanna]

Hi Marie,

I feel so badly for you. Not only is your tooth a problem but now you are dealing with other physical issues... not fun :/

I am going to make a suggestion to you and it may seem a bit harsh, but I have extensive experience in the dental field and without question I know this next statement is for your best interest. I strongly suggest that you get a new dentist. The one that you currently have is treating you poorly and I'm afraid he is taking advantage of your fear. What I mean by this is that he knows damn well that tooth is very sick and has no life left in it. He should not have prepared that tooth for a crown in the first place and he should not have ever, ever put that crown on your tooth given the recent history. He did it for the $$$$$ and only the $$$. In my professional opinion, what he has done is unethical, and he assumes you would not question it.

I would suggest that you call your insurance company and tell them that he insisted on doing this crown even though he thought the tooth was very sick and still insisted to do it even after the endodontist said the tooth was not salvageable. The insurance will request your records and if they find him negligent, which he is, they will want him to reimburse them the $$$. You have every right to do this.

Just to let you know the average cost a dentist pays his lab for a crown...... anywhere from $150 (the most inferior materials are used and often imported from China) to $300 (for the highest quality materials). If your dentist has an insurance practice, meaning he participates in most insurances as opposed to private pay patients... or he is part of a clinic type practice, he is most likely using the cheapest lab because his fee per crown is cut by the insurance company and that he way he can keep a high profit margin.

If you would, please give me the cost of the crown and what your insurance paid for it. I am curious what they are.

To be honest with you, you should not fear the extraction as much as you should fear having that dentist do any more dentistry on you. I am sorry that he has taken advantage of you. You may prevent him from doing this to other patients if you called the insurance company and reported what he has done and they make him reimburse the money because he will be shocked that you had the courage to stand up for yourself and he will hesitant to pull this nonsense again on someone else.

Regarding the bone graft... this should only be done if the bone is found to be healthy after the tooth is removed. Otherwise, putting bone graft into infected bone can cause a multitude of health problems. Is the OS associated with this dentist in any way? Is the OS in private practice or is he an insurance practice?

The intestinal problems are due to the antibiotic and stress. It is important that you supplement with a probiotic. This is something you can buy in a drug store or supermarket. The one I would recommend is called Culturelle. But if you cannot get that particular one, then get a different one that does not have any form of sugar or preservatives in it.

When someone develops intestinal problems while taking or after taking an antibiotic it indicates that their intestinal health was not good prior to the medication. The probiotic will help restore the healthy bacteria that is missing and this is necessary to do to avoid getting an intestinal infection. So please do not wait to get the probiotic and take it once in the morning about an hour prior to your antibiotic and then one in the evening just before you go to sleep. Take 2 per day as I explained for at minimum 2 weeks. Then take one per day for at least 3 months, longer would be better yet.
Even if you decide to stop the antibiotic, still take the probiotic as you have depleted your intestines of good bacteria and you have to replace it to avoid getting sick.

Drink water throughout the day, every day to help flush out the toxins and bacteria from your system. Also avoid sugar, soda (including diet), and processed foods. As all of these irritate the immune system and feed the bad bacteria. Eat whole FRESH foods like fruits, vegetables, brown rice, quinoa, grains other than white rice. Eat chicken and fish, not from a can.... the real thing. All of these things will heal your gut and help you feel better.

I'm so sorry you are going through this...... I just want to smack that dentist upside his head for being such a greedy jerk.

Please keep in touch here...
Bryanna

Originally Posted by MAM1

So I went to the dentist who basically just gave me the choice of putting on the permanent crown which had already been ordered and had come in or getting the tooth pulled. I was surprised he was willing to put the crown on when he already spoke to the endodontist who said the tooth had a crack and needed to be pulled. I said, don't you agree that an infected tooth with a crack needs to be pulled and he said, well I know how you are will your fear of dental procedures! So now I have lost all confidence in him. I think he just didn't want to be stuck paying for the new crown or trying to get a refund for it from the insurance. He wrote up a referral with the order to do a bone graft so I can get the implant. He said the whole thing wouldn't take more than 30 minutes with an OS. So I still have my appointment scheduled for Friday. Meanwhile I am still sore from the partial root canal procedure from last Thursday so I am expecting to be in pretty bad shape after the tooth is pulled. I am going to ask the OS whether I can get the bone graft or whatever it is I need for the implant done an a future appointment or whether it has to be done when i get the tooth pulled. I probably will end up going with an implant if the OS thinks it will work but I want everything to settle down and recover in my mouth and sinus before I get anything else done. So I will see what he says. I am totally fearing getting a sinus perforation and having to have surgery to fix that. Meanwhile i started getting horrible diarreah (sp?) from the antibiotic plus I am having my period plus I have this sinus infection so I am in bad shape. i think I will have to stop the Amoxicillan or I will be too weak to recover from the tooth extraction. Will report back after the extraction.

[MAM1]

So I wrote a long response to Bryanna a few days ago but somehow it didn't get posted. Well, rather than doing it again I will just update. I finished the antibiotic Thursday and was supposed to have the extraction Friday but now it's tomorrow (Monday). When the OS say my x-rays he said there was no way to avoid a sinus perforation because the roots of that molar are completely inside the sinus. He said I should get the IV anesthesia and have it done Monday. I am glad he will put me out although now I am worried about the fasting. I can't eat after midnight and the extraction/surgery isn't until noon Monday and then I won't be able to eat because I will be numb and then I won't be able to eat because I will be bleeding. I am thinking I will faint if I have to go 24 hours without eating. I am very scared of how much bleeding and pain will be involved since i know ahead of time this is complicated with risk of complications. I don't think I've ever been this scared in my whole life. So I am asking everyone to pray for me tomorrow that it all goes smoothly. The OS said since I have had the sinus infections we will wait on doing the sinus lift/bone grafts. He doesn't know yet whether I will even be able to get an implant. He said there's only about 1 mm clearance. So before an implant or bridge, how does one chew when the main molar you chew with is missing?

Marie

[Bryanna]

Hi Marie,

I am glad that the oral surgeon has been truthful with you and that he postponed the surgery for tomorrow so you can have the IV sedation.

Regarding the length of the fasting. You should not eat anything after midnight. However, you can have a small cup of water up to 6 hours prior to the surgery.

You may or may not bleed a lot and you may not bleed for very long. Everyone is different. It is important to follow the post op instructions about biting down on the gauze because in doing so the blood will clot faster. You will need to eat within an hour or two after the surgery so you can take pain meds. Something like scrambled eggs, apple sauce, a protein shake, mash potatoes, fruit smoothies, cooked fish, soup broths, things like that. Hopefully you have some of those things in your pantry.

I know this is scary but you will probably do much better than you imagine. Try not to worry about all the little details or the what ifs. Just be prepared with your food before you go, so that you do not have to think about that when the time comes. Plan on eating a soft food diet for the rest of the week. Plan on resting the rest of the day tomorrow.

Sinus perforations occur frequently, so your oral surgeon knows what to do. Tomorrow is about removing that very sick tooth and once that is gone then your body will start to heal. So it's all about taking one step at a time and taking good care of yourself so the next step is easier than the last one.

You will find that you will be able to eat without a problem after that tooth is removed. Again, one step at a time.

Please check in with us when you can. Keeping you in our prayers..... and I'm sure everything is going to be okay.

Bryanna

Originally Posted by MAM1

So I wrote a long response to Bryanna a few days ago but somehow it didn't get posted. Well, rather than doing it again I will just update. I finished the antibiotic Thursday and was supposed to have the extraction Friday but now it's tomorrow (Monday). When the OS say my x-rays he said there was no way to avoid a sinus perforation because the roots of that molar are completely inside the sinus. He said I should get the IV anesthesia and have it done Monday. I am glad he will put me out although now I am worried about the fasting. I can't eat after midnight and the extraction/surgery isn't until noon Monday and then I won't be able to eat because I will be numb and then I won't be able to eat because I will be bleeding. I am thinking I will faint if I have to go 24 hours without eating. I am very scared of how much bleeding and pain will be involved since i know ahead of time this is complicated with risk of complications. I don't think I've ever been this scared in my whole life. So I am asking everyone to pray for me tomorrow that it all goes smoothly. The OS said since I have had the sinus infections we will wait on doing the sinus lift/bone grafts. He doesn't know yet whether I will even be able to get an implant. He said there's only about 1 mm clearance. So before an implant or bridge, how does one chew when the main molar you chew with is missing?

Marie

[MAM1]

Wow, that wasn't nearly as bad as I thought. I lucked out because he said the sinus perforation was small so he didn't do any surgery on that. He said we'll wait and see if it closes up on its own. I sure hope so. I was so certain from what he said before that he would have to do a lot more. I do see stitches over the extraction site. The anesthesia didn't put me out but it seemed like it went super fast. It was only about 25 minutes and it seemed like 15. I was not totally out. I am drinking a liitle water now but still bleeding - it''s only been 3 hours. They said to expect slight bleeding for 24 hours

Novacaine has mostly worn off and I have very little pain. I am tempted to not take the Motrin but I remember it's not just for pain but for swelling/inflammation. He put me on Augmentin which my husband will pick up later today.

I will update tomorrow. Many thanks to Bryanna but stayed tuned because I am sure I will more have questions!

Marie