hi, i had my upper molar tooth extracted last feb18 and sinusitis got worse. i feel drowsiness, facial pain, and bad odor from my left nose.
i just wanted to know if there alternatives aside from surgery to close the hole...

Hi fionzy,

Was there a sinus exposure during the extraction of the tooth? Did you develop sinusitis after the extraction or did you have it before?

Your description of symptoms are indicative of a sinus infection. Have you visited your doctor or dentist?

Bryanna

i hada tooth pulled about a month ago and the rooh wa in my sinus city. whe they pulled it it was absessed and my sinus membrane ruptured. i was wondering if it is normal for them to pull an absessed tooth? also i he had alot of swelling in the area and in cheek, with a burning sensasion all over my face. is that normal as well?

Abcessed teeth should always be extracted. So that is good that you had that done. The sinus membrane was probably perforated from the infection and upon removing the tooth, the perforation became larger. Did your dentist give you specific instructions after he removed the tooth? Things like rinse with warm salt water several times a day for a couple of weeks.... do not blow your nose for several days... do not use any mouthwash until the hole is completely closed...no smoking or drinking alcohol as both of these things will prevent the area from healing closed... no drinking through a straw for several weeks....

Swelling would be normal after the removal of an abcessed tooth. The burning sensation could be unrelated or it could have been a sensitivity to the anesthetic that was used. Is there still swelling and/or burning in your face?

Bryanna

Bryanna
I am a 41 year old male with a bridge over 1 extracted tooth from 2 years ago. The bridge came off about 6 months ago while flossing under it. It was reattached by my dentist. Been experiencing pain in my front support tooth area for several months, about 2 weeks ago the pain got out of hand. Went to my dentist and was referred me to an Endodontic who performed a root canal on my tooth. He spoke in a manner in which I understood what was going to happen and I am very pleased with his professional mannerism along with his staff.

The pain and facial swelling went away and yet I still had some tender issues in my upper gum area. I was prescribed Pen VK as well as an 800mg ibuprofen and 1000mg Tylenol rotating every 3 hours. The last two days is I have noticed some discomfort while biting on my back support tooth. Today while washing my face I noticed some more pain in my sinus area down to the tooth. This is what had led me to find this thread while searching for an answer on sinus/teeth since I have had two sinus surgeries in the past.

Here is what was sent to my dentist:

Today we had the pleasure of meeting and evaluating XXXX for endodontic concerns associated with his upper right bridge in the #3-#5 position. After taking several angled PA’s, a BW, and performing all tests #5 renders of DX of necrotic/SAP. #3 IS tender to percuss and bite on but responds to cold testing within normal. We opted to treat only #5 today.

Under 2 carts of lido w/1:100000epi we opened through a porcelain abutment to discover a two canalled necrotic system. We shaped the P to 18mms w/F3 and the B to 19mms w/F3. The two join as one near the apical 4 mms. We used copious irrigation with endoactivation dried and placed CaOH2 into the system in order to disinfect over the next 30 days.

My question is now that the swelling and tenderness is increasing would the right course be to look at extracting and if so what does that leave for my back support tooth once the bridge is removed. I have spent over $2000 on this one area since my baby tooth extraction. Your response based on what I have laid out for you would be appreciated.

Hi netdude,

According to your post, the root canal is incomplete on tooth #5. The dentist has debrided and widened the visible canals and placed calcium hydroxide inside these spaces. The next visit would be to remove the CaOH2 and melt a rubberized material containing barium into these spaces. This material is called gutta percha ........and just for your information it is highly toxic and has a whole list of other negative issues. I'm giving you that information as a start to help you become better informed when making your decision.

It is not unusual for you to have continued pain in a non vital tooth simply because the bacteria from the tooth has proliferated into the bone which causes a referred pain that can feel like it's coming from the tooth and/or surrounding area... including the sinuses. The fact that the root canal is only partially done, is irrelevant. The bacteria will still be present inside of the tiny canals that are unaccessible and will continue to proliferate into the bone. Again, offering information to help you become better informed.

From your post, it sounds like tooth #3 may be in jeopardy also but it may just be tender from the inflammation from #5. IF the abutment crown on #3 fits well and #3 is healthy radiographically, perhaps the healthiest long term treatment option would be to have the dentist cut the bridge at the junction between tooth #3 and 4, leaving the abutment crown on tooth #3. Extract tooth #5 and allow the site to heal for several months, then re-evaluate the health and fit of the existing crown on tooth #3 at that time. IF #3 is ok, no infection, no swelling, crown fits well... then place an implant in #4 and 5 site
providing there is ample healthy bone and no sinus interference to functionally hold 2 implants. You may also have to put a new crown on #3.... all dependent on the DX at the re evaluation.

If you are missing teeth on the other side of your upper arch... then you may be a candidate for a removable partial denture to replace all of your missing upper teeth.

I know you have spent a lot of money on this area of your mouth. But be aware that you will continue to spend a lot more in trying to retain this tooth because the infection cannot be eradicated by completing the root canal or by taking antibiotics simply because of the bacteria is forever present in the microscopic canals.

Since the root canal was just recently performed... perhaps the endodontist would be willing to reimburse you a portion of his fee if you were to decide to have tooth #5 removed.

Please let us know how things are going......

Bryanna

Bryanna

Thank you for your prompt reply. The Dr. assist called today (third follow up call)to see how I was doing. I had mentioned the increase in tenderness in my sinus cavity down to the tooth as well as the issue with the back supporting tooth. As you had mentioned since the root canal is only partially done they had planned on sealing it on my next appt on July 27th.

After taking my information she called back to say that they will start another round of Pen VK as well as refill # 5 with another medicine. In addition since #3 was suspect they are planning on doing a root canal on it at the same time on my next appt.

In doing some research I found some information on a Apicoectomy procedure but not sure if I am playing arm chair dentist or not. But since I am writing the checks I want to find out all my options. I will ask him his thoughts if this is would be a viable solution to this problem.

If this does not solve the issue based on what you have indicated with the bacteria in the bone I will opt for the extraction and partial denture. According to what the Dr said and what I saw I have great bone support. So extraction will be the final straw. Hoping with combo of meds, refill of 5 and root on 3 solves this.

Again I appreciate your time and insight, will keep you up to date should anything change for the good or bad.

Hi Bryanna,

Just wondering if I can also get some dental advice from you? I had a root canal on my farthest back molar six months ago. All of my molar roots go right into my sinus and I had a chronic sinus throb on that side for the next five months. After multiple dentists, endodontists, x-rays, CT scan and visit to and ENT, nobody could tell me what was wrong and all said there was no infection. Ten days ago I decided to have the tooth extracted and sure enough, it was infected right to the base of the sinus and sinus exposed. I was put on 10 days of antiobiotics (finished now) and have been taking good care of it. The site of extraction itself seems to be healing well but I am still having the throbbing pain around the other molars in the area and into my sinus.

From reading many of these threads, it sounds like maybe there is more infection or perhaps more infected teeth. How do I find this out definitively when nothing is showing up in xrays, CT or blood work? And what are my options if more teeth are involved? I just don't know who to go to any more. The extraction was done by an oral surgeon and he seemed to think it would heal fine. Maybe I;m just rushing it? It has only been 10 days.

Hi Clegs,

I will certainly try to help........

First, your situation is the perfect example of what I have been preaching on this site about root canaled teeth and infection. Not all infections will necessarily show up on xrays or CT scans or even in blood work until they have proliferated and started to compromise the immune system. It really doesn't matter if they show up or not because all root canaled teeth are infected, as you have found out with this tooth.

Ten days of antibiotic may not be enough to eradicate the infection. I would consult with the oral surgeon, have him take an xray and evaluate the area clinically. You may need to see the ENT again also for a sinus scan. I have had patients who had to go on IV antibiotics, some even pic lines, to deal with the oral infection. This is why I keep harping on the systemic risks associated with oral infections primarily from root canaled teeth. It can become very serious.

It is hard to tell if other teeth are involved because an infected sinus will cause pressure and pain in all of the teeth in that area. By any chance.... do you have any other root canaled teeth in that quadrant??

Bryanna

Hi Bryanna,

Thanks so much for your reply. I don't have any other root canals in the area (or in my mouth for that matter) although the tooth directly adjacent to the extraction has a shallow filling. Otherwise, there aren't any fillings on that upper half.

I will happily go back on antibiotics if that might help clear up the infection I guess my worry is just the thought of it spreading to other teeth. But if they are seemingly healthy teeth (as mine are), can an infection spread up through the jaw bone and down into a tooth with no opening (crack, fracture, etc)? And what would be the diagnosis/treatment for this?

The other thing I've read a little about is jaw cavitation, osteonecrosis and the concern over whether the periodontal ligament was removed with the extraction? Can you shed any light on this and whether or not I should be concerned?

Thanks again for your help!