Hi maeri,

The root tip that was left in the bone had died a long time ago. Teeth cannot stay alive if they are not intact. It would be wise to see and oral surgeon and have a panorex xray done to locate the root tip and see if it has developed a cyst around it. That could be contributing to your sinus issues. If he has any concerns about removing it, then it would also be wise to see an ENT doctor to have a scan done to see the extent of the sinus involvement.

I urge you to do this sooner than later because if there is infection associated with this root tip, the health risks of not removing it can be extensive and difficult to treat.

Please keep us posted...
Bryanna




QUOTE=maeri554;833376]Like other posts on this thread, I had teeth removed at 11 years of age for braces. Did not find out until I was in my 20's about the root. At that time I was told it was still live but had now been squeezed between the adjacent teeth and roots. I am now in my 50's and am recovering from the 2nd humongous sinus infection in 30 years. The whole right side of my face was swollen couldn't eat, could hardly talk. Antibiotics seem to be working. Right now it seems the pain is concentrated in my upper jaw in the bone. I am worried about erosion. The ER personel suggested I see and ENT as soon as possible. I am hoping this thread is still active and I can get some advice.[/QUOTE]

Hi Byanna,

Firstly I must remark on how kind it is of you to help and advise people on this forum.

I'm a male and 36 years old with a life-long history of dental problems. I'll give a timeline of events as it should be quicker and more succinct than writing a load of waffle!......

Approx 4 - 5 years ago: Had toothache in upper left 2nd premolar. It was badly decayed and so dentist extracted it. Around the time I would occasionally wake up with an ear ache on the same side but it would always go away after I got up.

Approx 4 years ago: Upper left first molar was hurting. Dentist took x-ray and said it was fine, but she drilled into it as this would apparently relieve the pain(??). It did seem to work.

Approx three years ago: Small pimple like fistula appears on gum where premolar was extracted. It occasionally formed a yellow head and if I pressed around it, I could burst it and release a small amount of pus. The top of the gum (reaching as I high as I can within my mouth) feels a little fibrous and tender to rub above the first molar.

Approx two and half years ago: Saw dentist re fistula. He said it would be infected root tips from extracted premolar. Prescribed amoxycillin. It does nothing.

Two years ago: Caught a standard cold virus. Blew nose on one occasion and mucus was bright yellow (almost fluorescent!). Stopped after cold went.

About 22 months ago: Bent forward whilst putting out trash. A few bright yellow drops came out of my nose. This became an occurence every now and again, around once every few months and would be more likely if I caught a cold.

Aprox 18 months ago: Strange - the molar starts hurting but only in certain situations. I suffered pain every night when I layed down to go to bed, and that would last around one hour and then subside. I also suffered when drinking anything hot and would soothe it by immediately swigging cold water on the tooth. After about a month, the pain went away again.

Approx 15 months ago: Fistula and tender (ish) gum remains. Palate starts to feel strange behind first molar and forms a yellow hanging pocket which seems to be pus. I visited the dentist (a new one, as my usual had left). Was given antibiotics again and told they would not wish to treat until i'd seen an oral hygienist to improve overall gum health.

Following this, my palate remains permanently swollen although there is no pain. It feels hard and raised behind the first molar with a bony formation which seems to be similar shape and structure to the molar. Just above it, the swelling is soft and of pressed, releases pus out of the front of my gum.

As there was no pain (just a horrible taste if I pressed on the palate), the dental practice advised that they didn't consider it an emergency and so scheduled an appointment for months later. I got fed up at this and (stupidly) ignored it.

Two months ago: Molar (which was filled) breaks whilst eating a cookie. The back, palate side of the molar breaks off at the gum line. The filling came out, leaving just the front, gum side in tact. Fed up of the dental service at my old practice (i'm in the UK and they were NHS funded), I arranged an appointment at a private practice to have my mouth looked at.

The dentist observed the palate swelling and unhealthy gum on the other side. She took an x-ray of the area and advised that the root appears to be communicating with the sinus. With this in mind, she's referring me to a specialist oral surgeon at the hospital for further evaluation and probable extraction. She made a couple of further observations though - that there were no premolar root tips remaining and so the source of infection wasn't known with certainty. She mentioned the possibility of cysts etc but if there were, they would be higher up as there was no such thing on the x-ray.

I have a photo of the x-ray which I can send to you? I have a few questions which I don't know if you can help me with?

1. Can the molar be causing all of these symptoms despite it not hurting anymore?

2. If it isn't the molar and there are no root tips from the premolar, what else is likely to be causing tender gum, palate swelling, and pus discharge?

2. Is it normal for infected molar roots (particularly those within the sinus) to cause chronic palatal swelling?

3. The dentist mentioned having the molar extracted and the hole 'packed' to prevent an oronasal fistula. Is this normally done via local or general anaesthetic? I would prefer local, which shocked her as she said that most people would prefer not to be aware of it.

I'm looking forward to getting this treated but am also nervous that it's something more serious like a hidden tumor or something. I'm also really confused as to what causes this type of thing and what to expect from treatment. I just haven't heard of anyone else getting the same thing - especially with the palate!

Any advice would be much appreciated.

Best wishes and happy new year.

PJ

Hi PJ,

Thanks for the kind words.... :-)

Your description is very complete..... sounds to me like you have an infected molar and the infection may have spread to your sinus. Anytime you get a fistula near a tooth, it is indicative of an abscessed tooth. Eventually the swelling doesn't go down and the area becomes quite uncomfortable. Palatal swelling from an infected sinus is not uncommon.

If you could post an xray here or pm me.... I would be happy to look at it.

Bryanna

I saw the oral surgeon ysterday, and the more I think abbout this the angrier I am. My dentist insisted on deep root cleaning. Since I did not resolve the pocket with my great care, he told me to have surgeryon the gum. He didn't want to crown the tooth without this being done. I said no and asked for referal to the oral surgeon. The oral surgeon said the gum surgery would have been for nothing, as the tooth has an abcess, and is not salvageable even with a RC. He of course didn't recommend the RC for the same reasons you stated. so why was this first dentist recommending all this work around this tooths gum line when the tooth was no good anyway?It seems I waisted my money, and now no longer trust this dentist at all! My mate goes to this same dentist, and now neithor of us trust this dentist since he didn't tell me the true condition of the tooth to begin with. the absess was visable on the xray. My room mate was told she has paradontaldisease, and they wanted to do her whole mouth with deep root cleaning. What kind of dentist should she seek to confirm this diaganosis and get opinion from.?As I said I don't believe now, anything I am told by this origional dentist. I am kinda angry now, as there was a waiste of money as I am on medicare/medicaid, and feel like he was not truthful, did work that would not help. Need advise on what kind of dentist for my house mate, and for us to both have a new regular dentist that we can trust to tell the truth. appreciate you Bryanna very much.

Can't IM you. Let's try the x-ray this way. As you'll see, the area around the tooth is dark and is pretty much in the shape as where the swelling and discharge is coming from.

Attached Images

Fig1.jpg (158.4 KB, 299 views)

Hi PJ,

Without any doubt whatsoever, you have a very large infection in this tooth that appears to have proliferated into your sinus. This tooth is severely decayed and broken down. There is no question about the diagnosis of this tooth.... it is very sick and should be removed as soon as possible. I also want to inform you that the second molar, the tooth behind this one, may also be infected and should be evaluated for extraction at the same time as the first molar.

I do not see any evidence of root tips from the extracted pre molar. However, the infection is long standing.... meaning it has been present and proliferating for a long time. That is evident by the size and circumference of the radiolucent areas on this xray.

Please, do not wait or hesitate about removing this (these) teeth.... this is a very large infection and it will travel past your sinuses if left in your mouth.

I urge you to act on this very soon.

Please keep us posted...
Bryanna

Hello!
I went to my dentist for what I thought was a routine extraction of an upper left molar....but he drilled into my sinus, and left a piece of the root (about 5-6mm) in there.
He sutured me up, but they came out two days later and there was water and food going up into my sinus and out of my nose. Cool party trick, right? Not really, it was quite painful. I went in a few days later, and he sutured me up tighter, and it was even more painful. Two days later, sutures are out and everything is coming out of my nose again.
He sent me to the oral surgeon, who had to wait almost a week to do anything because my gums were so inflamed and raw. So I took antibiotics and an oral rinse and had a sinus repair four days ago. I've had loads of swelling and bruising, and I'm still on liquids and some soft foods. The pain is still there, sinus pain, jaw pain, ear pain...since everything is connected.
I have a follow up appointment on Tuesday to see how everything is healing. He had mentioned on my first consult that there may be a subsequent surgery in hospital.
I have a few questions.
1) Why would I need another surgery?
2) Is my dentist who did the initial extraction negligent?
3) How long before the pain subsides? I've missed almost 3 weeks of work due to this wonderful situation. (Christmas is a week away, I'm worried I can't eat turkey!)
4) What now?
5) I have some numbness around my nose and lips, will this go away?

Thanks for any answers you might have!

Squoozyq

Hi Squoozyq,

What a mess!! You poor thing!

The dentist that did the extraction should have had a phone consult or sent you to an oral surgeon as soon as he broke off that root tip because he knew he pushed that root up into the sinus. To just suture this wound closed, was definitely not the best thing to do because the surgery was incomplete and the sinus was obviously open. To make matters worse, he sutured you a second time still aware that the root tip was in there and the sinus was perforated. This is definitely not appropriate dental care.

Did the oral surgeon remove the root tip before he did the sinus repair?? If not, then that may be the surgery he is talking about doing in the hospital. It is not wise to leave a root tip in the sinuses because it can cause a bad infection among other things .... sometimes the surgery to remove it is a bit complicated.

I cannot tell you how long the pain will last.... but until that area is free of infection, you will have chronic sinus issues.

The numbness can be from a number of things. It is best to explain your symptoms in detail to the oral surgeon and see what he says.

I'm sorry you had this happen to you...... please keep us posted.

Bryanna

So glad bryanna posted to you. I feel bad for all your went through. The dentist that left in the root tip did not do the proper thing for you at all!
I hope your whole situation can be resolved very soon, so you can put all this awful stuff behind you. I would be angry enough at the dentist that did this to confont him. There is no excuse for this. So sorry this happened to you. ginnie