[scpike19]

Hi all, I'm new to the forum and have really appreciated all the advice people have given others, so I thought I'd chime in with my problem.

Two weeks ago, I had a filing placed in my #2 molar (upper left in the very back). The cavity was very deep, near the nerve but the dentist thought he could save the tooth until I was financially able to have a root canal and crown. He mentioned it might have to be pulled if the filling had in fact reached the nerve, but thought it could be saved so I would have a year or so to get the root canal and crown. He packed the amalgam in there very tightly, almost to the point that I was very worried he was getting a bit overzealous, but I nonetheless trusted him to do what was best. He's the dentist, after all.

Well, as soon as the 2 shots of anesthetic began to wear off, I was in excruciating pain, shooting down my jaw and bringing me to tears. I called the office and the dentist agreed to write for Norco to control the pain of the deep filling. It took the pain away but made me VERY woozy and out of it. Over the weekend I ended up using Orajel on it frequently, along with the Norco, and it did nothing to stop the shooting pain or migraines I was now experiencing. I figured this meant the filling wasn't going to work and the tooth had to go.

I called and made an appointment for the extraction for the next day. When the dentist looked at the tooth, he said that it did indeed need to go if I couldn't get the root canal done. I couldn't so they gave me a shot to numb me up for the extraction. OH MY GOSH...it was like liquid fire being shot into my gums! I started bawling and couldn't stop until my face was numb about 5 minutes later. The tooth took no time at all to come out, and I luckily didn't feel any pain during or after the shot wore off. I was given a script for pain meds, and the dentist mentioned I had an infection starting. I asked if I should be on antibiotic, but he said no as the tooth was now out and the infection was only inside it. Minimal bleeding, everything else seemed fine.

I waited to rinse with salt water after 24 hours, and kept up with gently brushing. I had some gum soreness the first morning, but chalked it up to the trauma of the extraction. I felt ok, just tired and not quite ready to take on the day. However, as the day progressed, I began feeling intense sinus pain and pressure, dizziness, and generally just unwell, like I'd been sick and my body was fighting something off. Had a low grade fever of about 99.4, nothing I was immediately concerned about. Eating was restricted to soft food and small bites and I was trying to increase my water intake. The second day I saw two red bumps on my gum near the nearby tooth and discharge coming from the extraction site. I thought the healing process was beginning; the clot was there and I had no residual bleeding. On Saturday evening, I felt awful. Horrible head/sinus pressure, swollen gums, and I couldn't open my mouth wide or smile without pain. Smelly and sometimes salty tasting discharge. I called my dentist, who thought this "was the normal healing process" but offered to call in a script for antibiotics anyway. I picked up the script for Clindamycin 300mg 3x/day for 5 days and have been taking them since Sunday around noon. I have 2 days of the medicine left.

My sinuses, especially on the left side (where the extraction was) HURT. I have had issues with them my entire life, but I am now wondering if there was a sinus communication. My eyes feel and look puffy and every time there is a barometric pressure change, I'm in pain and randomly dizzy. My ears are popping as well. I am now finally able to smile and open my mouth without pain after feeling a pop yesterday afternoon. Still feeling like I am fighting something - tired, little appetite (though I am making myself eat, I know I need to so that I can heal) with horrendous postnasal drip and the lovely heartburn/nausea/etc from the clindamycin.

The gum line near the extraction is now quite sharp and bony, for lack of a better term. The swelling has gone down and the hole seems to be closing now as well.

I'm sure the clindamycin will kick a sinus infection if that's the problem, but what if there's a hole in the extraction site?

Any advice you have would be most welcome. I'm terrified of the dentist as it is, and this experience is not helping that anxiety at all!

[Bryanna]

Hi scpike19,

Welcome!

I'm sorry you are feeling unwell and have endured such pain with this tooth.

The first thing to mention here is regarding the amalgam filling. Amalgam fillings are 50%++ mercury which is a highly toxic metal. This type of filling material is seldom used in dentistry anymore compared to the frequency that it use to be used years ago because of the toxicity issues and because there are restorative materials that are much safer to use. So just as a word of caution to you, it would be healthy and safer for you to forgo the amalgam and request alternative composite filling material for any future cavities. If your dentist is opposed to using other materials, then he is not practicing up to current standards in dental care and you may want to consider seeing a different dentist who is up to date.

Did the dentist mention anything to you about the sinus being in close proximity to the root of this tooth? Frequently, the roots of the upper molars are very close to the sinus and sometimes the sinus gets perforated when the tooth is removed. If there is no infection in the sinus or the bone/tissue near the sinus, then a small sinus perforation will generally heal on its own. But if infection has entered the sinus in that area, then it may delay the healing or not close at all.

Very often a general dentist will not know if the sinus is perforated or not because they rarely think to look for that when they remove a tooth. An oral surgeon always checks for a sinus perforation. So it may be best to consult with an oral surgeon for a diagnostic evaluation especially given the progression of the physical symptoms you are experiencing.

Regarding the clyndamicin, the digestive issues that you are having indicate that your intestinal bacteria is in jeopardy meaning the antibiotic is causing an unhealthy imbalance in your gut. It is always a good idea to supplement with a probiotic, healthy bacteria, to replace and replenish the bacteria that is getting destroyed by the medication. The supplement should be taken one to two times per day, one hour prior to the antibiotic or two hours after so as to avoid a contradiction between the two. The sooner you start the probiotic the better because it can reduce the likelihood of further intestinal complications from occurring from the medication. It is also imperative that you stay on the probiotic for several weeks or longer after the antibiotic is done as the healthy bacteria takes weeks to really replenish itself.

Regarding the sharp bony edge... this could be pieces of splintered bone or tooth fragments. Again, an oral surgeon would be able to diagnose that clinically.

I hope this information is helpful to you.

[scpike19]

Bryanna, thanks for getting back with me! I really appreciate the input.

I too questioned the amalgam, but the Dentist said it was necessary to use it because the filling was so large. I will make sure to insist on composite fillings in the future. I don't need that junk in my body!

This dentist did not mention the sinus cavity and tooth roots being proximal, but I have had an oral surgeon tell me that they are. I had my wisdom teeth extracted about 5 years ago and the panoramic films showed that they were VERY close on some places. Luckily, the wisdom teeth were all horizontal so it didn't cause issue then. It's because of that that I feared sinus involvement with this extraction.

I have been taking probiotics and eating yogurt since beginning the Clindamycin on Sunday. I'll be increasing that as well, and will keep up for a while afterward. I don't want to get even sicker and if I can prevent it, I'll do anything I can!

The edge of the gumline near the extraction is not so sharp today, so I'm hoping that the swelling is going down as the site heals and it will resolve itself. If not, I will have to consult with the oral surgeon.

[Bryanna]

Hi scpike,

You are welcome

Regarding the amalgam/mercury filling.... this toxic material NEVER has to be used irrelevant of the circumstances. A dentist that sells a patient on using it "due to the area being filled is large" does not take into consideration the toxicity of the metal and he most likely does not feel skilled enough to use an alternative material. So it really is important to be aware of those issues because it is his ignorance about the toxicity of using it that overrides your health and well being. Just something to keep in mind.

Another "red flag" with this dentist is the fact that he either did not pay attention to the roots of the tooth in proximity to your sinus and/or he just did not bother to inform you. You may want to consider seeking a dentist who is a bit better informed and one who wants you to be too

How are the other symptoms you were having? Are they still present?

The sharp edge .... is that area swollen? If so, then the swelling may be camouflaging the bone. This does not necessarily mean anything bad is going on, it just could be part of the healing process.

Good to hear you are taking probiotics. The most beneficial supplement would be one that is very good quality and high in various bacteria. Here is one that is a personal favorite of mine, I take one every day. So without hesitation I suggest it to others .... check it out and see how it compares to the one you are taking.
http://www.customprobiotics.com/cust...rmula-cp-1.htm

[scpike19]

I certainly will NOT be returning to this dentist! I was previously scheduled to have a cleaning done on June 1, which I questioned after the extraction. The staff assured me I would be just fine 10 days post extraction to have a cleaning. I was wary, especially as this was a molar and would take a while for the gum tissue to heal over the site...I spoke with my sister, who has been a hygienist for over 20 years and said under no uncertain circumstances should I be having a cleaning after the infection and other issues, at least until things were on the mend. I cancelled the appointment and am looking for another dentist.

I actually have been having more problems since this whole fiasco started. First the filling, then extraction, then infection. That was followed by vertigo (believed by my GP to be caused by the horrible vibrating drilling from the filling process), and the sinus pressure was/is horrendous, as well as a creepy/crawly/tingly feeling on the left side of my face, sort of like when your foot falls asleep. Also suspected is a TMJ problem, as evidenced by the inability to smile/popping mentioned in my first post, as well as an "S" curve, clicks and pops upon examination.

I had a set of complete sinus x rays done yesterday, and while I do show some inflammation (likely allergies or a smidge of lingering infection), the doctor did not see a communication near the extraction. So that's lucky! I was terrified I had a tumor or something, the way the xray tech was talking....add that to the already heightened anxiety and BOOM - panic attack! Not so fun.

So the culprit is believed to be, yet again, the dental work. Some sort of nerve damage from the anesthetic injections, or extraction is the best guess for now. I am on a zpak in case there is an infection in the sinuses, and ibuprofen 600mg 3x/day for a week to help with pain and swelling. I'm very impatient and ready for this to be over with, but the doctor says it will take a while for things to heal if they are able.

[scpike19]

Also, the area around the sharp edge has been swollen, but continues to subside. Less pain and irritation each day, so I am chalking it up to healing, as you said.

[Bryanna]

Hi scpike,

I think you made a wise decision not to have your teeth cleaning until after the wound closes up. The last thing you need is bacteria or debris from the cleaning to get caught up in the wound.

Based on your descriptions, there could be sinus communication that was not picked up on the sinus x-rays. Which could account for the vertigo, sinus pressure, and even that creepy feeling in your face. Also any TMJ problems are going to exacerbate your symptoms. The sinus x-rays are most likely 2 dimensional which only gives a limited view. A sinus scan that is done in slices gives a multi dimensional view of the sinuses and oral cavity. This is different than regular x-rays. Did you consult with an ENT dr or just your GP?

An upper infected tooth, which is one that has or had a deep cavity in it, can eventually infect the sinus and surrounding area. In order for the cavity to be deep, it has or had to be present for a very long time. So from the time the cavity started the bacteria has been progressively spreading. Add to that.... drilling into a sick tooth, placing a toxic mercury filling in, root canaling it which causes further trauma, disease, toxicity ... then extracting it .... take all of that into consideration and it is a no wonder you have symptoms of infection and trauma. Does that seem evident to you too?

I assume that your GP is the one who ordered the sinus xrays and has prescribed the z-pak, correct?

[scpike19]

Thanks for the reply, Bryanna!

The sinus series was ordered by my GP, and he prescribed the z-pak. He said that if this persists he will refer me to an ENT.

I agree that it is evident that all the trauma, infection, etc that I'm feeling horrible. I'm just getting frustrated that I had no pain or symptoms of this until the darn tooth initially chipped while I was flossing, which started this whole conundrum!

Hopefully once things settle down and heal, I'll be able to get some relief. It's a hurry up and wait situation now, which is no fun. It's certainly doing my anxiety no good to feel this way.

I have an appointment with my GP at the end of the month, so I guess we will see how it's going then. Fingers are crossed that improvement begins ASAP!

[Bryanna]

Hi scpike,

Based on all that you have shared here, there is still no definitive answer as to what is going on with your sinus. It's important to know even if the surgical site from the extraction heals closed, it does not necessarily mean that the sinus is okay. So just be aware of that fact if you continue to have sinus issues or any physical symptoms of infection after the zpak is done. Your GP really isn't the best source for handling this kind of thing as he has no training in tooth/sinus related infections. So if you do have any issues, please ask for a referral to an ENT and have your dental and sinus xrays sent to him for the consultation. Let's keep our fingers crossed that you have no further complications )

[scpike19]

Yes, no definitive answer is for sure! I will be monitoring things closely and will insist on an ENT consult if issues persist. Knock on wood, swelling and pressure seem to be abating so I'm HOPING things are on the mend for good this time!

Now, to just get this anxiety under control so I can get back to life and planning my wedding! Slowly working my way back to the land of the living - much slower than I want it to be but I have to do what my body can handle so I don't have setbacks.

Thanks again for all your help, and I will keep updating!